Dr. Anne Jeffers:

On the issue of whether somebody who is suicidal can give consent, once again it is about working collaboratively. That is what we do in psychiatry - we work closely with the individual who comes to us with the problem and we ensure that, as regards decisions that are reached, the person is capable of making that decision. It is very clear in the Bill that the person has to, although they have not addressed the issues where the person does not have the capacity. We will certainly be working with the person who has the capacity.

If they do not suffer from a mental illness, this is a difficult area. The whole issue of what we do if somebody comes to us and we think there might be another intervention other than a termination, yet they are very determined that a termination is the only answer. The Mental Health Act would not be applicable in this case. There may be cases but it is hard to describe. I think we would have to try to understand why the person was reluctant to take on any of the treatments we are suggesting. That goes back to their childhood experience and their psychological make-up. There are usually reasons why people cannot avail of treatments that we may be offering. That is what we do in our day-to-day practice, but there may be cases where we have to say to women, "This law doesn't apply to you". They have autonomy and have to make their own decisions. In practice, that is not going to be a decision that is made by one psychiatrist - it is part of the team approach.

The question was raised concerning how one handles a situation where somebody will not accept treatment. The issues of early induction and infanticide were also raised. I will leave these matters to the perinatal psychiatrist.