Derek Nolan (Galway West, Labour) | Oireachtas source

I commend my colleague, Deputy Conaghan, on what was a very thoughtful speech on his personal experience and engagement with the issue over the past 30 years. I also commend the late Jim Kemmy and another former Member of the House who lost his seat for taking a courageous position on the issue, namely, the President, Michael D. Higgins.

As a constituency representative of Galway West I wish to express my deep sympathy to the family of Savita Halappanavar, her husband Praveen, their relatives in India and their friends in the Indian community in Galway. They and their family were affected by a huge shocking human tragedy and inquiries are under way. I look forward to seeing these inquiries obtaining responses and clarifying the facts at the earliest opportunity.

During my short time in politics the issue of medical termination of pregnancy has been the most divisive and polarising issue with which I have had to engage. It has been around for a long time, since the 1983 amendment when people such as Jim Kemmy, Michael D. Higgins, Mary Robinson and others took the brave steps outlined by Deputy Michael Conaghan to fight for a more rational and nuanced approach recognising the vagaries of life, the grey areas which can creep into discussions and the circumstances which may require compassion and leniency rather than strict orthodoxy.

The X case resulted less than ten years later in 1992, and the Supreme Court upheld a different interpretation, stating there is a right to termination where there is a real and substantial risk to the life as distinct to the health of the mother. This decision caused uproar throughout the country in the time before I was involved in politics. It is interesting to look back now at the viciousness of the exaggerations and hyperbole involved in the discussions because the same exaggeration and hyperbole has come back into the discussion again today. Nothing dramatic has happened in the past 20 years. It is also interesting to note what happened in the aftermath of this decision. Three referendum were put to the people in which they were asked three distinct questions, namely, should a woman have a right to travel to have a termination to which the people said "Yes"; should a woman have the right to information about accessing services abroad so she can know where the services are and how to procure them to which the people also said "Yes"; and should we overturn the Supreme Court decision which stated suicide is a grounds which justifies risk to the life of the mother to which the people said "No". The people deliberately and with discernment voted "Yes" in two cases and "No" in the other.

We should not forget the details of the X case. A 14 year old girl left at home to be minded by a family friend was raped and impregnated. She was left in a terrible mental health state and suicidal. She wanted to travel to the UK to terminate the pregnancy. This is the case we are discussing. We are not speaking about a woman of majority age deciding she wanted to go for another reason. We often forget the cruel and human story behind the X case.

It is always worth keeping that in our minds.

On the judgment in A, B and C v. Ireland, we must be clear, first as legislators. We cannot distinguish ourselves from this as legislators. The European Court of Human Rights, of which we are a signatory and which is designed to uphold human rights in Europe, makes clear that we must implement the law that our country has on its books, we must make clear when a right to termination exists, we must make clear how that right is assessed and we must make clear how that service is to be provided. Let us never say anything other than that the European Court of Human Rights is telling us that our law, that has been voted on by the people, ought to be implemented. That is what it is, nothing more. We are not being told we must offer services. We are being told that our existing law, that we have voted on and that the Supreme Court has dealt with, must be implemented. We are legislators. Indeed, we are members of the community, representatives and members of families. We are, as Deputy Mathews stated, fathers, grandfathers, brothers and sons, but we are still legislators and there is a law in this country that needs to be implemented.

I note the atmosphere within which this debate can often take place. The downright viciousness of those on the extremes of the pro-life lobby cannot be underestimated. I campaigned in the past general election to legislation for the X case, this extremely specific set of circumstances that is the law in this country. There were protests outside my office. There were illegal posters put up all around my constituency stating that Labour would introduce abortion on demand and there were 200,000 abortions per year in the United Kingdom. There were leaflets handed out at churches, one of which was given to my father telling him that the position on which I was campaigning was a pro-choice abortion-on-demand service. That is what this discussion often becomes saturated with, this invidious atmosphere with vicious uncompromising, unrealistic, unnuanced and non-factual arguments. However, I have real respect for persons of genuine belief and reasoned debate who are of a pro-life position because it is a perfectly tenable and respectable place to be, but I would argue that what we are discussing today, which is the implementation of the X case ruling, is perfectly compatible with and, indeed, should appeal to those of a pro-life position.

The X case sets two issues. The first is where there is a real and substantive risk to the life, as distinct from the health, of the mother. We are saying that a termination should be afforded where there is a risk to the life. We are not concerned here with any other reason, but about life-saving treatment. Where a termination is a life-saving treatment to the mother, it must be available. That ground, or area where that decision can be made, has not been clarified by law. There are doctors, including the highly respected Dr. Peter Boylan, former master of the National Maternity Hospital, who have stated that where the risk is clear there is no problem and it works fine, but there are grey areas. There are situations where doctors, practitioners, nurses, etc., worry about these grey areas. One such is the need to make a critical medical decision quickly and in good faith. Another is the fear of the risk that one could be reported by a colleague who holds a contrary opinion with the result that one could be prosecuted under the Offences Against the Person Act 1861. We need to give doctors legal certainty, clarity and assurance when they are acting in good faith to save the life of a mother.

The second issue which causes major problems in terms of the public discourse is the ground that a risk to the life of the mother includes the risk of self-destruction or, as we call it in more everyday language, suicide.

It is worth listening to the experts who operate in this area. One of those to whom I have listened on the radio is Dr. Anthony McCarthy, a consultant perinatal psychiatrist. Another, and with whom I have discussed this issue, is Professor Veronica O'Keane of Trinity College, Dublin. As professionals, they are very much of the view that the suicide issue is a real one that has to be taken seriously. These people of sound medical practice are a rock of sense. They say the suicide issue is serious and the assessment of it should not be a tick-the-box exercise where we simply go through the motions. At the end of the day, their duty as doctors is to the mental health of their patients. That assessment therefore should be real, not a tick-the-box exercise.

In our debate, we run the risk of talking about women's suicidal feelings as something that should be ignored or stigmatised. The cavalier manner with which the risk of suicide and mental health is dismissed by some people on the pro-life side of the argument is very worrying. We regularly have debates in this House on suicide, depression and destigmatising mental health. Yet as soon as it comes up as an issue to do with the termination of a pregnancy it is to be dismissed as fake. As one psychiatrist said - I think it was Patricia Casey - there is a book one can get which will tell one how to fake suicidal tendencies. She said that one can just read the book and have one's script ready when one goes in to the doctor. It is appalling and scandalous for someone who works in our medical services to be saying that kind of thing to the public, including women, in this country. Women in my constituency have told me that the last person they would go to see - and from whom they would refuse treatment - is that lady. I will leave it at that, a Cheann Comhairle, and I apologise for straying.

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