Ms Leah Hoctor:

Most European countries include an explicit health ground in their law and most do not impose any time limit on that. Some countries do impose such a limit. Some countries do, as the Citizens' Assembly did, and differentiate between a health risk and a serious health risk. The most common practice, however, is to have a health ground and not to impose any time limit.

I have put together a quick run-down of the terminology involved: "health is at risk"; "damage to women's health"; "continuation of pregnancy endangers women's health"; "medical reasons" is also a common terminology; and "necessary to prevent". Of the 40 European countries we looked at, given that I focused mostly on the green and light yellow countries that also have socio-economic access and access on request, there is no qualification on the risk. Some countries use the language of "serious", "severe" or "grave" health risk but most, approximately 25 or more of the 40, have no such qualification. That is because, as Deputy O'Reilly mentioned herself, there is a view that best practice in law-making is to treat women's mental or physical health as a clinical matter for the relevant doctors and physicians and for the woman herself. That is the best practice approach.

In response to Deputy O'Reilly's other question about sexual assault, it is critical to understand that the 40 countries we looked at by and large allow access to abortion in early pregnancy on a woman's request or for socio-economic reasons. Where these countries have an explicit assault ground in their law, then, it co-exists as a separate ground side by side with the on request ground. As we saw, only 19 or 20 countries have that explicit ground in their law. I was not around in the 1970s when these countries were in the process of reforming their abortion laws and in the 1980s I was too young to be aware of such matters. I would not be surprised, however, if part of the reason why many European countries have a request ground but no explicit sexual assault ground is because they were concerned about the situations of survivors of sexual assault and thus did not want to set up and then put these women through an onerous certification process. They knew that legalising abortion in early pregnancy would mean that victims of sexual assault could get access to services within that timeframe. Someone would have to actually go back to look at the legislative records in the relevant parliaments, however, to understand whether or not that was a consideration.

Also, it is important to understand that where these countries would have a sexual assault explicit ground in co-existence with a non-request ground or a socioeconomic ground, they would have a later term limit usually associated with that. It is quite few that would. In the majority of these countries, the process would involve medical professionals, and sometimes social workers. It would be a similar process to that applied in the situation of a health risk. I cannot give the committee information about how the few that refer to prosecutors or police authorities - these are in the minority - operate in practice. In one country in Europe, Poland, which has legalised access to abortion on grounds of sexual assault but has not legalised access to abortion on request, we see evidence that it is difficult for survivors of sexual assault to access abortion in practice under that rape ground. I would refer the committee to a case that came before the European Court of Human Rights, called P. and S. v. Poland. That case illustrates, as was mentioned, some of the severe impacts of these kind of certification schemes. Poland is one of the countries that requires a certification from a prosecutor. That case concerned a minor, an adolescent girl who had been raped and who faced very severe impacts and barriers in attempting to gain access to what was a legal service.