Dr. John Sheehan:

I will try to deal with a number of the questions. The first was whether the abortion safeguards could be flouted. At face value, the heads appear to be restrictive. Yet the international experience is that what initially appeared to be very restrictive, in practice has turned out to be not restrictive. At face value one could say the heads appear restrictive, but how it might work in practice is a different question. Again it ties into the point I made earlier on the application of the law to women who travel. We do not know the extent of mental health problems in that group or the extent of suicidal ideation. Therefore we cannot say with any accuracy how this will work in practice. On face value it looks restrictive, but the practice is another question.

Senator Mullen asked about contacts with the HSE, the Department or a Minister. I have had no contact from any such people. He also mentioned the college position. I was not party to the college statement, which was devised by the council of college. It has been made available from this morning to college members.

The Senator made a point about good medicine. I have not looked at the issue of conscientious objection - I have been focusing on head 4, which deals with a woman who has suicidal intent and whose life can only be saved by a termination of pregnancy.

As stated, Dr. McCarthy, Dr. Fenton and I, with more than 40 years combined experience, have not seen one case in our work as perinatal psychiatrists. The question about what the Bill, if enacted, might do to the position of psychiatrists was raised. That was one of the points I tried to address earlier. I believe it will cast psychiatrists into a role they have not been in to date. That is a change in role for psychiatrists. It is quite different from, for example, the working of the Mental Health Act, under which there is the option of detention of a person with increasing suicidal risk. This Bill as drafted deals with the woman with increasing suicidal intent whose life can only be saved by a termination of pregnancy, which is an entirely different situation.

On the question of precedent and whether any of us would have to certify an individual, which certification would depend on the rights of another individual, I am not aware of that. Again, as mentioned earlier we would detain a person in his or her own interest, which would not impinge on other rights. On the evidence of termination of pregnancy increasing the risk of mental health problems, there is evidence to show that termination of pregnancy can increase the risk of mental health problems. We see many women who suffer post-natal depression following normal delivery. The answer to whether termination of pregnancy could increase the risk of mental health problems, is "Yes, it could". There are many things that would do that.

The point made by Senator Healy Eames is interesting. It ties into the nature of our society. In my personal opinion, one of the reasons for the dramatic increase in suicide, particularly among young men, is because it is now an option. In other words, it has become "an option". There are a lot of very complex social factors as to why this is so. When one looks at the legislation and the message it sends out, that is a most interesting viewpoint in terms of whether this is potentially normalising suicidal threats. That is a serious aspect of this that probably has not yet been discussed or fleshed out here today. It is a relevant point.