Professor Fergal Malone:

Specifically, on numbers of cases, I told the committee that in 2016, 55 women with foetal abnormalities from the Rotunda travelled to the United Kingdom for pregnancy termination. As regards women who decided not to travel, for example, Down's syndrome, in 2016, we had 26 cases in which we diagnosed prenatally Down's syndrome. Some 57% of patients chose to travel to the United Kingdom and 43% chose to stay and continue with their pregnancy. There were 24 cases of trisomy 18, known as Edwards' syndrome, a fatal foetal abnormality, diagnosed in 2016. Twelve chose to travel to the United Kingdom and 12 chose to continue on with their pregnancy. In general, it depends on each abnormality, approximately 50:50 is how it splits out. That reflects the balanced counselling that is done. It reflects the fact that when we make a diagnosis, we give patients the full facts as to what it means. They meet various support organisations, as needed, and they make their own individual family-based decision. Those were the numbers in 2016.

Deputy Durkan asked on fatal foetal abnormalities and how often maybe the mother was in danger. There are some conditions, such as trisomy 13, or Patau syndrome. Patau syndrome is strongly associated with severe preeclampsia and the foetal condition can actually make the mother sick. There is another condition called Mirror syndrome where the fetus gets heart failure called hydrops and that could have the same effect on the mother, and the mother goes into heart failure. There are definitely cases in which the foetal condition can have a tremendously negative effect directly on the mother.

The Deputy asked are we concerned that there may be reluctance on the part of some medical personnel to participate in procedures should there be a change in legislation. We have never had a survey done of doctors in Ireland to see where would they personally stand on this issue.

The issue of conscientious objection is a valid one and we would generally always accept that. In large hospitals, such as the Rotunda, the Coombe and the National Maternity Hospital, I would be confident that we would always have sufficient numbers of personnel available that, even if an individual doctor chose for personal reasons not to participate in a case, we would be able to provide care for the patient. I would perhaps be a little bit more concerned, if one were in some of the smaller hospitals where one had more limited personnel, would the conscientious objection clause prevent a patient accessing appropriate care. That remains to be seen.