James Reilly (Dublin North, Fine Gael) | Oireachtas source

I have received legal advice to the effect that the legal meaning of the word "forthwith" equates to "immediately". This qualification, as well as the proposed phrases, "with appropriate urgency" and "immediately" is unnecessary as this section uses terms such as "shall make arrangements" which render such qualifications superfluous.

As Deputy Ó Caoláin pointed out, doctors fully understand the need for urgency around treatment. To suggest that we would set this out in law is to be prescriptive about doctors' medical practices. Everybody knows that delayed diagnosis can make a practitioner culpable in law for negligence. If I find out that a patient has appendicitis and the appendix bursts because I did not operate until 24 hours later, I know I will be in serious trouble. It would be the same if I know that a patient is having a heart attack and refuse to act on it for 24 hours. The wording is superfluous, although I understand why the Deputy would want to stipulate urgency out of concern that some doctors might delay. I do not believe that adding these words would have that effect. It is clear from medical guidelines that one must always act with expediency. Just because a physician has a conscientious objection that does not mean he or she can wait a week before referring the patient elsewhere. Once a conscientious objection has been made known, the individual concerned must act with all speed to refer the patient to an appropriate physician who can provide the necessary care.