Alex White (Dublin South, Labour) | Oireachtas source

The issue of involuntary admission is addressed in the Mental Health Act 2001. It is the only law that applies in the case of any individual who is to be subject to involuntary admission. If the conditions or circumstances that are contemplated in the Mental Health Act 2001 apply, a person may well be sectioned. However, there is nothing in section 9 or anywhere else in the Bill that triggers the Act.

I will refer briefly to two other points. Deputy Healy raised an issue regarding an inevitable and immediate risk. In general, it is not necessary to make provision in any legislation for a negative. If something is not required to be the case, in general there is no necessity to include in legislation that something does not have to be the case. The test is that positive things have to happen, in other words, a real and substantial risk to life can only be averted through a termination. That is the other part of the test.

This returns us to the issue of best practice and how prescriptive we want to be for doctors. In the case of a doctor applying his or her mind to a situation where he or she is asked to consider whether there is a real and substantial risk to somebody's life, there is no basis in this legislation or anywhere else for thinking that this risk must be immediate or inevitable. It is not required for the legislation to tell a doctor that the risk does not have to be immediate or inevitable. There is no such requirement and, as such, it is not necessary to include it in legislation. While I have not seen the advice, I expect it is probably the advice the Minister received.

On the expert group, Deputy Boyd Barrett raised a point which, to be fair to him, he subsequently corrected. Deputy Healy raised this issue again when he cited the expert group report. In referring to the role of psychiatrists, the expert group stated the following:

Finally, the role of the psychiatrist is key where a termination of pregnancy is prescribed as appropriate treatment in case of suicidal ideation/intent. There are recognised clinical challenges in correctly diagnosing expressed suicide intent, for instance, the absence of recognised clinical markers. Therefore, it could be argued that this is a more subjective process and requires more safeguards to be put in place for the protection of both the woman and the unborn. The need to keep up to date with clinical research on this issue is highlighted in the Medical Council Guidelines referred to in section 3.6.3 with a view to ensuring that the decision is evidence-based.

In assessing the various options the expert group report states the following:

There may be clinical challenges in correctly diagnosing expressed suicide intent. Therefore, it could be argued that a risk to life from suicide warrants extra safeguards.