Dr. Suzanne Crowe:

I thank the Chairperson and members for the opportunity to address the committee today. As the Chairperson said, I am a member of the Medical Council. I am also the chairperson of the working group which is reviewing the section relating to abortion in the Guide to Professional Conduct and Ethics for Registered Medical Practitioners. I am joined today by Mr. Bill Prasifka, CEO of the Medical Council. We are here to discuss the council’s role in regard to this important issue, so I will begin by giving a quick outline of the council’s responsibilities and functions which are particularly relevant in the context of the referendum result and pending legislative changes.

The Medical Council is the statutory body responsible for the regulation of doctors within the Republic of Ireland. Its purpose is to protect the public by promoting and ensuring the highest standards among doctors. The council works to ensure that medical education and training is always up-to-date and is benchmarked against the highest international standards. Standards for undergraduate and postgraduate training are set by the Medical Council. The council also requires doctors to maintain their professional competency through updating and maintaining their professional skills on an ongoing basis. The Medical Council is also where the public may make a complaint against a doctor.

The principal functions of the Medical Council relate to the control of standards of education and training at undergraduate and postgraduate levels, the registration of medical practitioners in accordance with their education and training, the determination of questions of professional misconduct or fitness to practise and the operation of EU directives relating to education and training in the practise of medicine. The Medical Council also provides guidance to doctors on matters relating to conduct and ethics through its Guide to Professional Conduct and Ethics for Registered Medical Practitioners. In summary, the key objective of the council is to protect the interests of the general public in their interactions with registered medical practitioners while also supporting doctors.

In terms of the Medical Council’s role following the referendum result and pending legislative changes, it should be noted that the Medical Practitioners Act 2007 requires the council to, among other things, provide appropriate guidance on all matters relating to professional conduct and ethics for registered medical practitioners. However, it is the role of the postgraduate training bodies to set clinical guidelines. The Medical Council sets out ethical guidelines for registered medical practitioners in its Guide to Professional Conduct and Ethics for Registered Medical Practitioners, the current or eighth edition of which was published in 2016. This guide is regularly reviewed and updated when there is a relevant change in legislation. Section 48 of the 2016 edition details guidance on doctor’s actions around abortion. However, the guidance currently relates to the situation prior to the referendum result and will need to be adjusted and updated in the context of upcoming changes in legislation. Section 49 of the current guide puts forward guidance for conscientious objection from a doctor. This section is also of a particular relevance to the changes in legislation and will also be reviewed and updated as appropriate. Sections 48 and 49 of the guide and a full copy of the guidance were provided to the committee as supplementary information in advance of this meeting.

The Medical Council term of 2018 to 2023 has recently begun and reviewing the ethical guide in light of the referendum results was a key item on the agenda for the first meeting. During this first meeting, the council came to the decision to establish a working group to review the guide as there are sections which will need to be updated or changed following the referendum result. The procedure for a section of the Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners to be updated would normally be for a council committee or working group to review relevant information relating to the topic, be it research or new legislation, consult with key stakeholders and then draft guidance on the matter. Once the council is happy with the draft wording, further targeted consultation would normally take place and any feedback would then be taken into consideration. Final proposed guidance would then be brought to the full Medical Council meeting to be decided on. This ethical guidance from the Medical Council is for the use of doctors and should be followed in conjunction with the clinical guidelines set out by the postgraduate training bodies.

The Medical Council is happy to keep the members of the Joint Committee on Health updated throughout the process. I thank the Chairman and the committee for the invitation to address members today. We are happy to address any questions the committee may have.