Ciara Conway (Waterford, Labour)

We personally know the women involved in these issues. They are our sisters, friends, cousins, neighbours and, in some cases, our mothers. For a variety of reasons these women cannot continue with their pregnancies and the isolation these women experience heading over the water for an abortion, as described so bravely by a group of women today, exacerbates the difficulty, stigma and silence which forces them to manage their own mental health in isolation and without significant or humane compassion.

The Government has published the terms of reference of and named the expert group tasked with addressing the outcome of the A, B and C v. Ireland ruling at the European Court of Human Rights. The ruling, which dates to December 2010, reaffirms the Supreme Court X case judgment of 1992, and the expert group must now propose concrete measures to implement the ruling of the court and to comply with the wishes of the peopleas expressed in 1992 and 2002. It is clear that the State cannot ignore any longer the imperative to legislate so that women and girls needing life-saving abortions are guaranteed access to appropriate services in an effective, timely and humane manner. This requires both legislation to provide for lawful medical treatment and medical guidelines so that doctors can make a practical assessment of what constitutes a real and substantial risk to the life of a pregnant woman.

Doctors require workable guidelines on conditions likely to be worsened by the continuation of pregnancy. Decisions in these cases are not always straightforward, as it is not possible to predict every possible medical condition, but they are always urgent. In cases where every day counts, doctors must have sufficient room for discretion to allow them to treat their patients. In many such cases, women are forced to travel overseas without even getting a referral from a doctor outlining their medical history, which is unacceptable. A doctor would not expect any patient to access any other medical treatment in this way, in particular in the case of a patient with a life-threatening illness. If it is to give full legal effect to the judgment of the European Court of Human Rights, the expert group must also propose draft legislation and guidelines which ensure the right of patients to access life-saving medical care can never be held hostage to refusal of care by individual doctors, institutions such as hospitals and medical clinics or third parties such as hospital personnel not directly involved in providing the treatment. We have seen this over the past 20 years. The expert group also needs to address the lack of a clear framework to examine and resolve differences of opinion between a woman and her doctor or between doctors. In any such case, the paramount consideration must be that the woman's health is not further endangered by a delay.

The rights of pregnant women to privacy, freedom and dignity must be respected and represented in any dispute resolution process. Doctors must also be free from the fear of criminal prosecution.

One of the most chilling issues highlighted by the European Court of Human Rights was that the criminal penalties attached to abortion included life imprisonment. However, clinical guidelines will be unworkable as long as this law remains on the Statute Book. Ireland is not the only country in which abortion is a sensitive political issue but one of the few countries which have failed to make legal provision for abortion.

Unfortunately, I cannot support the legislation because, like Deputy Anne Ferris, it does not go far enough. I ask that the expert group take submissions from interested parties on the issue. Members heard earlier from a group of women who were denied the health care they badly needed when it was determined they were pregnant with babies who could not live outside the womb. Women such as these must be listened to and engaged with. I will keep a close eye on the expert group and look forward to its report in July.

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