Professor Fergal Malone:

Regarding getting the diagnosis wrong and terminations being performed on foot of an incorrect diagnosis, I do not believe that this happens in contemporary obstetric practice. Genetic diagnoses are black and white. Some people mistake screening tests for diagnostic tests. It is possible that a screening test that assesses a patient's risk for having a baby with Edwards' syndrome or trisomy 21 may say there is a high risk. That does not mean the foetus has the condition. We would never suggest that a woman travel or see a woman travelling for pregnancy termination for a risk of a condition. We would always recommend in 100% of cases that a patient would have a formal diagnostic test done such as amniocentesis or chorionic villus sampling, CVS, so that does not get the diagnosis wrong. It does not happen in that situation. In terms of structural abnormalities diagnosed by an ultrasound, we are very careful in our counselling with parents as to the accuracy of what we see and the limitations of what we see. Commonly, I will say to a patient that there is an abnormality with the heart, or that there is a hole in the heart and the blood vessels are lined up in such a way but that is what it looks like to the best of our knowledge, or that there is an abnormality of the brain but I cannot tell the patient exactly what effect that will have on brain function. We always express the limitations of the diagnostic test. If it is 100% certain, we will say that. If it is just a set of findings and we do not know what it means, we will also say that so there is no question of people having pregnancy terminations for a wrong diagnosis.

It is very difficult to specify the impact on parents travelling because it would be very useful to have longer-term follow-up questionnaires and studies of depression scores and anxiety scores afterwards. My gut feeling is that there are significant long-term effects from the trauma of travelling. It is very hard to distinguish between how much of the subsequent anguish was due to the original diagnosis, which is understandable, and how much was added to it by the subsequent practical challenges. We do not have any data on that so I cannot give the Deputy a direct answer as to how often that happens. My gut feeling is that it is common.