Professor Fergal Malone:

I believe the Rotunda Hospital is providing services to the utmost level of quality and could be easily standardised or benchmarked against international best practice.

I will not comment on the experience of other hospitals with pregnancy termination because I am not in a position to do so. I can tell the committee the statistics I quoted, which show that about 57% of our patients with a prenatal diagnosis of Down's syndrome do travel for a termination of pregnancy and 50% with a diagnosis of Trisomy 18 travel for a termination of pregnancy but 50% do not. To me, this demonstrates absolutely good and balanced counselling of patients. Almost an equal number of patients who are diagnosed with Trisomy 18 or Trisomy 21 in the Rotunda choose to continue as compared to those who choose not to. One cannot get any more balanced that. If I had statistics that were 99%, 1% one way or the other, that would raise the question of someone else doing something wrong in terms of their balance. I do not think our numbers could be any more balanced than what we are seeing.

The Deputy referenced the study in Prenatal Diagnosis. I am very familiar with the study by Cope and colleagues that suggested that there was an increased incidence of various measures of psychological trauma or upset after they terminated for various abnormalities. I would not accept that paper as being a good example to learn from. When one looks at the methodology in that paper, one can see that many of the patients who were recruited came from social media campaigns or were tracked down or recruited through social media. As a clinician scientist, and I carry out and have published a lot of research studies, how one recruits patients into a study is crucial to the outcome. If one recruits patients who might have a certain viewpoint already and go to social media to recruit them into the study, it is not all surprising if the results are in a particular direction. The unbiased recruitment of patients is crucial to any science in any speciality. That would be my concern about the Cope paper cited by the Deputy.

I believe all of our patients have rights to health, well-being and dignity and that is what we strive to do day in and day out with our patients. We listen to our patients and what their personal values are and provide them with the information. One set of parents might decide in one direction while another might decide in another direction and that is okay. That is acceptable because it is our job to be professional and I think we continue to do that.