Dr. Anthony McCarthy:

First, I will make a brief response to the first part of what Deputy O'Reilly said, which echoed what Senator Ruane said. Just because a woman has had a mental health problem in the vast majority of cases, it does not in any way affect her capacity to make decisions for herself. That is the response to the question on capacity. In the vast majority of women it is not a question of capacity whatsoever. I wish to make that point.

As regards the 2013 Act, as I said at the outset, before the legislation was enacted, the reality is that for the vast majority of women who are depressed and suicidal in pregnancy, they do not want a termination. However, the vast majority of women who want a termination are not depressed. They do not need to see a psychiatrist. For the majority of those women who are depressed in pregnancy and want a termination, they are not going to go through an Irish process. Why would they? They are going to go to the UK anyway or they are going to order pills over the Internet. Even if there were psychiatrists all over the country, most of them do not feel they need to see a psychiatrist. Most of them do not think they need to see one psychiatrist let alone two psychiatrists. That ill was the result of saying that, whatever about general medical illnesses, in terms of psychiatry it was not going to be about serious risk or moderate risk but about one issue only, and that was the question of suicide, the probability that a woman was going to commit suicide, and if termination was the only possible solution for that, then it followed. Therefore, it is no wonder that for the vast majority of women in this country it is an irrelevancy.

Suicide at least was at the extreme end. On the idea that psychiatrists or anybody - psychologists, counsellors or parliamentarians - would discuss the gradations of a woman's mental health, that would be an impossible one for clinicians. When we are talking about mental health, we can accept a clinician trying to make the best estimate possible over a suicide risk, but bringing it down to an assessment of a woman's mental health, bar excluding the very small group of women who may not have capacity, for the vast majority of women the idea that we could have some system where they all had to go to see a psychiatrist to have a score on their mental health is not going to work.