Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank Deputy Tóibín. I have great difficulty with this amendment for quite a few reasons. The first and the broad reason relates to our good discussion yesterday, which was of considerable length, about the issues of consent and of clinicians fulfilling their duties under the Medical Council guidelines. I struggle to believe that Doctor, or rather Deputy, Tóibín - a Freudian slip - would believe that a doctor would not, before carrying out any procedure, discuss it with the woman, seek her consent and make her aware of her options. In the proposed subsection (2) of his amendment there is the idea that a doctor must give medically accurate information to a woman and describe the treatment and the medical risks. This is what happens today in our health service. We do not feel the need to codify this for any other procedure because this is what doctors do. There is a long-established principle of informed consent whereby doctors set out the facts for Deputy Tóibín or me or a woman when we go to a doctor. The doctor then ensures that the woman is aware of any relevant information and has consented. We had quite a lengthy discussion about this, and I read to the committee from the Medical Council guidelines yesterday regarding the principle of consent. That is the first issue I would raise.

The second issue is that the amendment seeks to change the principle of consent because it specifically seeks to change the age of consent to 18, whereas the medical age of consent in this country is 16. This is another change, and it is quite a significant one, but it was not mentioned in the Deputy's introduction to the amendment. It is a substantive amendment in this regard.

One of the lines in the amendment that greatly worries me is the proposed subsection (2)(b)(ii), which states:

(b) a suitably qualified person has informed the woman, orally and in person, of:...

(ii) the fact that the father of the foetus is legally liable to assist in the support of the child, even in instances where he has offered to pay for the termination of pregnancy.

I am genuinely a little confused about this because the statistics collected by the UK Department of Health show that the majority of Irish women who access termination in Britain are in relationships, that is, they are married or have partners. This provision seems to suggest or imply something, and while I am not going to use some of the language I think is behind it, it seems to imply that it is only a certain type of woman who seeks a termination. The reference to the father being liable to support the child's upbringing is quite peculiar. It is also important to note that in certain crisis pregnancy circumstances in which a woman seeks a termination there will be victims of rape and incest and issues of sexual assault. The amendment runs the risk of being quite traumatising in this regard.

I do not wish to be flippant about a serious matter, but the idea that the health service is going to start producing DVDs, handing them out to women before they access terminations and saying, "Go home there now and stick that on and have a look at it," is really offensive but also entirely unnecessary. Women are intelligent human beings who will have researched the issue, consulted their doctors and made informed decisions. The legislation is already quite prescriptive, and in the eyes of some people too prescriptive, in how this deliberative process will be followed. The idea that a DVD would have to be made available to women seeking terminations is wholly unnecessary, to put it mildly.

Similarly, as for the issue of a website being available, as Deputy Tóibín will know, the HSE already runs a number of websites concerning sexual health and well-being. There is also Positive Options and the like. Since, thankfully, it will soon be legal in Ireland to make this information available because we repealed the eighth amendment, information about the options - all of them - available to women will now be made available. Legally, we could not make this information available previously. I appreciate the fact that the Deputy said he did not agree with that position. We will now make that information available.

The Deputy referred to counsellors. I do not think this amendment relates substantively to the issue of counselling but, to be clear about the Government and the Oireachtas fulfilling its commitment, counselling is already available through the HSE's crisis pregnancy agency at locations throughout the country. Doctors and doctors' practices already know, as I am sure Deputy Dr. Harty will be aware, through their engagement with the HSE, how to access crisis pregnancy counselling. We will significantly further increase this provision and invest in it. We are providing a 24-7 helpline that will be operated by healthcare professionals - nurses, doctors and counsellors. We will also regulate counsellors and psychotherapists so they are real counsellors and psychotherapists and not people pushing agendas that are anti-woman, anti-choice and anti-best medical evidence. I hope everyone in this House will support me in this regard.

To return to this amendment, and as I said yesterday on other amendments, the issue of consent is addressed in section 22. I know that Deputy Tóibín and I have different views on this, which in fairness the Deputy acknowledges, and he outlined his view yesterday. Termination of pregnancy should be a part of the public health service like other health services. Therefore, I do not see any reason to differentiate the issue of consent in this legislation relative to any other procedure provided as part of the public health service. The Guide to Professional Conduct and Ethics for Registered Medical Practitioners of the Medical Council 2016, a document I have used and on which I have relied quite a lot in recent days, provides thorough information on the appropriate process to be followed to obtain valid, informed consent for medical procedures. The HSE has also published a national consent policy which includes detailed information as to what constitutes valid and genuine consent and how to obtain it. We had a very good conversation yesterday about the issues of consent, parental notification, what one should do in difficult and horrific situations in which something very troubling, for example, a woman having been abused or a child - a girl - having been sexually assaulted and the like, is brought to the attention of a doctor. Our Chairman, with the benefit of being a doctor, outlined to us the obligations a doctor would have in such a situation, which entirely tallies with what the Medical Council guidelines state.

I am aware that there is sometimes a case to be made for special provision to be made in respect of consent to a termination of pregnancy in the case of an adolescent. This is the case the Deputy has been making in recent days.

I am of the view that issues around consent arise across medical practice and are not limited to this particular issue. As I said yesterday, one could argue that many of these issues also arise in contraception, gender realignment and cosmetic surgery, but we have not changed the laws or codified it in any other way. The issue of consent is dealt with adequately and comprehensively in section 22. Some of these things, intentionally or otherwise, would be viewed as extraordinarily offensive by women who have accessed termination. The idea that women would have to watch a DVD or that someone would need to tell them about the legal requirements for the father of that foetus or baby and explain to them what is going on in their own body, health and well-being nearly seems condescending. It is back to trusting doctors and trusting women and I am satisfied to do both and that the legislation deals adequately with the issue of consent.