Dr. Anthony McCarthy:

Absolutely, 14 years seems extraordinary, as we know so many women are already doing it here. That is the truth of the matter.

In reply to Senator Colm Burke, we agree with the Medical Council and recognise the role of the GP and the importance of consulting with the GP where possible. Consent for caesarean sections is an obstetric issue and as a psychiatrist, I have no comment to make about consenting to caesarean sections.

Specifically to answer the question about the survey of 113 psychiatrists, I am sure every one of the 864 members of the college got the survey, I certainly got it. When I saw myself misquoted or selectively quoted in it, and a comment that all psychiatrists who attended the last time all agreed, and the complete ignoring of comments that Professor Veronica O'Keane made, I thought it was survey not even worth answering because it just was not a survey that anyone could stand over scientifically.

Senator Crown asked a specific question about capacity. It is a complex issue and we could talk about it for hours. That is why the Legislature has been resting for a very long time trying to get capacity legislation. Capacity is not a simple concept. Someone can be mentally ill and still have capacity. Someone might not be mentally ill but not have capacity. A person could have capacity for some decision making but not others. It could be due to mental disability or brain injury. It is a complex issue but we certainly must think about it when making any of these decisions.

Have I ever certified someone? I have certified a woman into hospital who wanted to kill her baby. She had a delusional voice in her head telling her to do that. Clearly abortion would not have been the treatment of choice. She was very distressed at the time but very relieved afterwards. Equally, I have seen people who have stabbed themselves in the stomach and who have taken multiple overdoses in pregnancy who were not mentally ill, they were profoundly distressed and at serious risk to their own life and the life of the baby. We must dismiss the notion that somehow we can neatly discriminate between mental illness and distress because they interact.

I answered the question on the issue of the 26 weeks and suicidality the last time. I would say to Senator Crown that if there are psychiatrists who will not assess his patients, I will be delighted to see them if necessary and will happily stand over my views.