John Crown (Independent) | Oireachtas source

In formulating the decision as to whether suicidality will be in the Bill, the five witnesses have the same rights as any five citizens of our country in a popular referendum. The decision has been made by the Supreme Court, which according to Article 34.4.6° of the Constitution states that the decision of the Supreme Court shall in all cases be final and definitive. That can be challenged by the people in popular referendum. That has happened twice. On the first occasion when it was asked clearly and unambiguously it was defeated by a margin of 2:1. There really is no constitutional mechanism for us in this Chamber to decide that we are not going to include suicidality or that we are going to specifically exclude suicidality from a Bill which allows abortion to save the life of the mother.

What we need the witnesses to do, which they are doing very well, is to inform us about some of the relevant practical issues. The reality is psychiatrists do not change the Constitution but they determine psychiatric practice and the psychiatric evidence base. Therefore, when constitutionally mandated psychiatrists at some hypothetical – I believe it may never happen – occasion in the future are confronted with a pregnant woman who is suicidal and are asked to make an adjudication within the rules of the law which we will be asked to pass sometime during 2013, it is their job to formulate the evidence base which best informs the psychiatrists who will be in that position. In truth, what they have told us today is very useful.

I have a few specific questions to ask. One is to my very old and dear friend and colleague, Dr. John Sheehan. If we believe that there will be a net transfer of women who are now going to the UK for abortions to this country - in the event that this new regime occurs - we have to ask why. It will happen for one of two reasons. The first reason is that they are legitimately going to the UK because they are suicidal to seek a legal abortion which they believe might not be freely and legally available in this country. The other alternative is that they are not going to the UK because they are suicidal but will try to game our system. To game our system they will need to do it with the free, voluntary, informed collusion of two psychiatrists.

There is no other way round this and some of our witnesses in January were tying themselves in knots about this, saying floodgates will open but women will not lie. They never explained what the mechanism would be. We will have informed psychiatrists who have the evidence, which tells them a woman is or is not suicidal.

I am a little confused by one thing. In the course of my job I must frequently take histories from people who are very distressed. Sometimes they say they often think of ending it. That is a red flag to me and I must refer them to a psychiatrist who is more skilled than I am in assessing the likelihood that suicide will nor will not occur. I am hearing this morning that psychiatrists cannot do that and I am troubled by that. I feel very vulnerable when I do not send someone to a psychiatrist in case some tragedy happens. As an oncologist who has had a patient commit suicide, I need to know we have the back-up of psychiatrists on this.