Stephen Donnelly (Wicklow, Fianna Fail)
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The issue which the Minister and I have been discussing is whether "extraordinary life-sustaining measures" can be used when a doctor is determining whether a pregnancy is viable. The key issue is probably short term versus long term. My understanding of the Minister's response is that the phrase "without extraordinary life-sustaining measures" was added to avoid a situation where, in theory, a baby born prematurely could be physically kep alive; it might be brain dead or have issues such that the foetus would not be not viable but, technically, doctors could use equipment to keep the heart beating. That is not a situation we want to see in hospitals. I am talking about the immediate term.

As the legislation is written, a doctor or two doctors will make a call and say: "We can induce birth and keep the baby alive or we can't, and if we make the call that we could induce birth and have an early delivery, and keep this baby alive, then that is what we have to do, and we cannot terminate." Essentially, that is what the section says. In other words, for termination to occur then the pregnancy must not have reached viability. However, viability has been defined as the foetus being able to exist outside of the womb "without extraordinary life-sustaining measures". Now, a doctor makes a call saying: "This foetus is at a point where if we induce birth we can keep this baby alive and the baby could be fine and healthy but we are going to throw everything we have at this and use extraordinary life-sustaining measures.". As the legislation is written I could see people interpreting it as saying: "We have to let the pregnancy get to a point of viability where the baby can survive without resuscitation, incubation or the aid of a neonatal intensive care unit, ICU." Therefore, I want the term "viability" clarified for obstetricians whereby a pregnancy has reached a point where if they take a foetus out they can use whatever they need to use to have a healthy foetus, and keep him or her alive, while he or she grows strong enough. Obstetricians would do that for a premature birth anyway. In terms of the legislation as written, I am concerned that it is not what the Minister intends and actually says that when doctors make a call on viability we are telling them that we are defining viability as survival "without life-sustaining measures". I do not think that is what the Minister intends. In fact, he has just said the opposite which is that they will throw everything they can at the problem. Unfortunately, that is not what the legislation says. It states that when one defines viability or makes a call on viability, we are telling doctors that it is viability without life-sustaining measures and that is my problem.