Alex White (Dublin South, Labour) | Oireachtas source

I am pleased to be here today at the closing session of these public hearings on the general scheme of the protection of life during pregnancy Bill 2013.

First, I wish to commend the Chairman, Deputy Jerry Buttimer, all the members of the committee, those Members of the Oireachtas who participated in these hearings, and all the invited guests for the balanced and respectful approach that we have witnessed over the past three days. Second, I have been following the hearings as closely as I could manage, and have noted that there is a high level of consensus on most of the provisions contained in the General Scheme. There are also, of course, diverging opinions on some of the provisions - both within and between the legal and medical professions represented before the committee.

I assure you Chairman, and the members of the committee, that we will examine these issues from a policy and legal perspective with a view, where possible, to improving the operation of the Bill. I am confident that all of the submissions, and the report that this committee will produce on its deliberations will greatly assist me, the Minister for Health, and officials in examining and refining the issues involved in the drafting of this Bill.

The aim of the Bill is to regulate access to lawful termination of pregnancy in accordance with the Supreme Court judgment in the X case and the A, B and C v. Ireland judgment of the European Court of Human Rights. The purpose of the legislation is to clarify in statute what is currently already lawful as a consequence of the judgement in the X case, and to set out clearly defined and specific circumstances in which this treatment may lawfully be provided.

I would like to address some of the issues that have been raised by contributors during the debate, to allay, if possible, some of the concerns involved. I am aware, for example, that there has been considerable debate about head 4 and the inclusion in the legislation of the risk of loss of life by way of suicide. The Supreme Court in the X case specifically recognised a risk to life arising from suicidal intent, which it referred to as a risk of self-destruction, as a legitimate basis for permitting termination of pregnancy - but only in circumstances where there was a real and substantial risk to the life of the mother, and where this risk could only be averted by the termination of her pregnancy.

Ireland, as a signatory to the European Convention on Human Rights, is under a legal obligation to implement the judgment of the European Court of Human Rights in A, B and C v. Ireland, and must put in place a legislative or regulatory regime providing effective and accessible procedures whereby pregnant women can establish whether or not they are entitled to a lawful abortion in accordance with Article 40.3.3° of the Constitution as interpreted by the Supreme Court in the X case. The Bill has taken account of the fact that assessment of self-destruction is more subjective and, therefore, requires more safeguards to be put in place. It specifies that three doctors are required to form an opinion and jointly certify that a termination of pregnancy may take place if it is necessary to save the woman's life. This provision is made in the Bill in recognition of the clinical challenges associated with accurately assessing suicidal intent, and the absence of objective clinical markers. The legislation specifies that one of the doctors involved must be an obstetrician-gynaecologist and the other two must be psychiatrists. It also allows that it may be appropriate that the pregnant woman's GP is consulted during the process of assessment, where practicable.

I am also aware that the lack of a gestational time limit in the Bill has been raised, and that concerns have been expressed in respect of where a termination of pregnancy is deemed necessary, and the pregnancy has reached a stage of gestation at which the foetus is or may be viable. In such situations, it must be stressed that the wording of Article 40.3.3° and the judgment in the X case make it crystal clear that the life of the unborn must be protected and vindicated where practicable. This means that where a woman has a pregnancy that places her life at risk, and her foetus is or may be viable, she may have a right to have the pregnancy brought to an end but not a right to insist that the life of the foetus be deliberately ended.

In circumstances where the unborn may potentially be viable outside the womb, doctors must make all efforts to sustain its life after delivery in accordance with existing medical practice with early deliveries. In this regard, I note that this aspect was referred to at some length by a number of the obstetrics experts who appeared before the committee.

It should be noted, however, that this requirement does not go so far as to oblige a medical practitioner to disregard a real and substantial risk to the life of the woman on the basis that it will result in the death of the unborn. Essentially, the decision to be reached is not so much a balancing of the competing rights, rather it is a clinical assessment as to whether the mother's life, as distinct from her health, is threatened by a real and substantial risk that can only be averted by a termination of pregnancy.

Concerns were raised about ensuring that the monitoring systems provided for under head 11 would incorporate appropriate requirements to preserve the confidentiality of the patient and the certifying practitioners. The provisions with respect to monitoring have been included in the Bill because there is a need to keep records on the terminations carried out, and the medical reasons that gave rise to same. Information is also required to inform policy, as well as to ensure that the various statutory principles and requirements are being upheld. However, although the Bill provides for the collection of this data, it is not the intention that personal or identifying information will be published. I think it is clear in the explanatory notes to the Bill that it is not proposed that the Freedom of Information Act 1997 will apply to the records collected as part of the monitoring systems.

In closing, the main objective of the legislation, if I may reiterate again, is to clarify what is lawfully permissible in cases where there is a real and substantial threat to the life of a pregnant woman, and to set out clearly defined and specific circumstances in which a termination may lawfully be carried out. As the committee will be aware, a very significant amount of work was involved in producing the heads of this legislation. More than 50 drafts were composed as we moved to produce what we believe to be balanced proposals that meet our obligations. Of course, as the committee is fully aware, the next phase is the drafting and publication of the Bill. Following publication the Bill will go through the Houses of the Oireachtas, where there will be further opportunity for parliamentary engagement and input. I look forward to working closely with colleagues in both Chambers as we consider the Bill.

I thank the Chairman, his officials and all of those who have participated in any way in these public hearings for the invaluable contribution they have made to this issue both now and at the public hearings in January, and for the assistance they have provided to me, the Minister for Health, and our officials in this work.