Terence Flanagan (Dublin North East, Fine Gael) | Oireachtas source

I welcome the opportunity to speak on the Protection of Life During Pregnancy Bill 2013. I have no doubt that everyone in this House agrees that pregnant women in Ireland should be entitled to the very best medical care available. In so far as the Bill provides clarity in respect of the interventions that are lawful where there is a physical threat to the life of the mother, no one has any problems with it. Essentially, what is currently the medical practice in our hospitals is being given a statutory underpinning and clarity, as requested by some medical professionals. If that was all the Bill provides for, I would be happy to support its contents but, unfortunately, it does much more.

Section 9 of the Bill is a real problem for me. It concerns risk of loss of life from suicide. In my opinion, this section is not required in the legislation and is completely unworkable. At the recent Oireachtas Committee on Health and Children hearings, barrister Paul Brady stated:

First, it is clear that head 4 marks a change in the law. It is not accurate to say otherwise. It creates, for the first time, a statutory basis in Irish law for what may be a direct and intentional termination of an unborn child's life.

Section 9 provides for the ending of the life of the unborn where three doctors certify that there is a real and substantial risk that the mother will commit suicide and that this risk can only be averted by the termination of her pregnancy. Essentially, it gives statutory effect to the X case decision of 1992 and the Bill goes on to put in place procedures to facilitate abortions on grounds of a threat of suicide. At the hearings, Dr. John Sheehan of the Rotunda Hospital stated:

If head 4 is enacted, psychiatrists will be asked to determine if there is a real and substantial risk to the life of the mother in order that she may procure a termination of pregnancy. This is a role in which Irish psychiatrists have not been involved to date. Many will not see this as their role as medical practitioners. The role could be construed as making psychiatrists the gatekeepers to abortion. Psychiatric practice relates to assessment and treatment of patients, not assessment and adjudication. Psychiatrists are not judges.

For the very first time, we are stating in statute law that it is ok to deliberately and intentionally take the life of the unborn - direct abortion. This signals a real and significant cultural change in the practice of our hospitals and I have a real problem with this.

It was stated at the health hearings by various legal experts, including Dr. Maria Cahill, that the Government is not constitutionally obliged to legislate to introduce abortion on the grounds of suicidal intent. In a newspaper article, Dr. Cahill stated:

The Constitution gives permission to the Dáil and the Seanad to legislate, rather than imposing such an obligation on them. There are examples dating all the way back to 1965 of the court establishing that various rights exist, only to have 14 successive governments decline, in the lawful exercise of their discretion, to legislate to provide an express statutory footing for these rights.

The former Supreme Court judge, Mrs. Justice Catherine McGuinness, stated that "as regards to the question of the Oireachtas having acted unconstitutionally in the past, I do not think that can be said". She also said "it is free not to legislate"

When the X case was decided 21 years ago, no psychiatric evidence was considered by the courts. Over the course of two sets of hearings conducted by the Oireachtas Joint Committee on Health and Children, we were presented with the evidence - compelling evidence - that the courts did not hear. That evidence is quite clear. Abortion is simply not a treatment for suicidal intent and, in fact, it may even contribute to it. Dr. Sam Coulter Smith, the Master of the Rotunda Hospital, has stated that termination is simply not a treatment for suicidal ideation and that Bill is not evidence based. Dr John Sheehan, consultant perinatal psychiatrist at the Rotunda Hospital said: "However, it is true to say there is no evidence base to indicate that abortion prevents suicide."

I am also very concerned by an aspect of this raised by Professor Kevin Malone in his comments at the hearings. He stated:

By foregrounding a theoretical risk of suicide in women, and enshrining "suicidality" in Irish law, the proposed legislation runs the risk of further invisibilising. normalising, and at worst exacerbating the much more real and volatile threat of increased suicide risk in Irish men, and potentially accelerating suicide risk in young women also.

The various reassurances given by supporters of the Bill that section 9 will be rarely, if ever, invoked, that terminations will not be allowed late in pregnancy, or that viable babies will be delivered early rather than killed give me little comfort when I consider what the Bill actually says and what are the scientific facts.

No one knows how many abortions will result from this legislation. We are not talking about the one in 500,000 women who commit suicide during pregnancy, usually due to mental illness. They can be treated if they are identified in time. We are talking instead about an unknown percentage of the women who travel abroad for abortions and about girls in the care of the State. Crucially, no supporter of the Bill has suggested what would be an "acceptable" number of section 9 direct abortions.

In respect of late term abortions, if one accepts the premise of the X case, on which the Bill is based, a threat of suicide is no less a real and substantial threat to the mother's life whether it arises in the first trimester or at eight months. If the mother says she is suicidal due to the very existence of the baby rather than simply due to the fact that the baby is inside her, the only way the cause of her suicidality can be removed is by killing the baby. Both the X case and the Bill speak explicitly about ending the life of the unborn.

Dr. Sam Coulter Smith has expressed serious concern about the idea that an obstetrician might be required to induce delivery of a viable but extremely premature baby under section 9. He stated at the hearings that "the fact that there is no gestational limit in respect of the third scenario relating to suicidality is a major ethical issue for obstetricians". He also said that "delivering a baby at 25 weeks' gestation could lead to death, due to extreme prematurity or it could lead to a child with cerebral palsy or with other significant developmental issues for the future". In effect, a previously perfectly healthy baby, if he or she survived, would have a 50% chance of suffering cerebral palsy as a result and could suffer a range of other disabilities.

The Minister, Deputy Reilly, acknowledged, on the RTE programme, "The Week in Politics", that the Bill will probably result in more babies suffering damage because of their premature delivery.

No country or state has ever been successful in restricting limited abortion legislation on the grounds of suicide. We know for instance that in the US state of California the Therapeutic Abortion Act was passed in 1967 on what legislators believed were extremely strict mental health grounds, yet within three years the number of abortions had risen from 500 to more than 63,000. The UK and other European countries have also seen abortions far in excess of what legislators expected. For these and other reasons, I have serious concerns about the effects of this legislation for as long as section 9 remains part of it.

It gives me no pleasure to dissent from the whipped position of my party but prior to the last general election, Fine Gael gave a commitment to the electorate that it was opposed to the legalisation of abortion. This commitment was given precisely to court the support of those opposed to legislating for the X case. To honour this commitment I may be forced to break my party's Whip. It is not something I do lightly. In deciding how to legislate on such a uniquely life or death issue as abortion, a legislator must have the freedom to follow his or her own conscience on the matter. A free vote on this issue is routinely granted in the UK Parliament at Westminster, to take just one example. We know from recent polling research by Amárach that 86% of the people are in favour of a free vote on abortion. They are right, and I hope, even now, the Taoiseach will reconsider this question before the vote tomorrow.

I do not agree with those who say we should set aside our beliefs and consciences when we deal with so grave an issue. It is precisely by holding true to these beliefs that we best serve those who elected us.

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