Dr. Rhona Mahony:

The risk of dying is covered in sections 7 and 8 of the Protection of Life During Pregnancy Act 2013. Section 7 covers the substantial risk to maternal life while section 8 covers emergencies. In the context of an emergency like a haemorrhage, a doctor can make a decision on his or her own and interrupt the pregnancy to save a woman's life. They do not need a second opinion but can go straight ahead. In respect of a substantial risk to life, it requires two doctors to come to that opinion, one must be an obstetrician, one can be another relevant practitioner and preferably a general practitioner would be involved as well in the decision-making. Again, it comes down to the determination of what is a substantial risk to life. We will have patients presenting who may have a disease like advanced cystic fibrosis or portal hypertension. They may not have planned to get pregnant but now they are. When the question arises, we are not quite sure what the clinical course will be. We know there are risks but is there really a risk of the woman dying or will she just become ill? How do we factor that in and what is our opinion? What is really required in these situations is the ability for the doctors and patients to look not just at the risk of dying but at the risk of a serious impact on a woman's health in order that they can make a sensible and timely decision. I believe that the definition of substantial risk to life can provide problems for doctors who are worried that if they make a wrong clinical decision, a custodial sentence of 14 years is hanging over both them and their patient.