Joan Burton (Dublin West, Labour) | Oireachtas source

I welcome the opportunity to contribute to the debate on this significant and hugely sensitive legislation. With reference to what Deputy Ó Cuív and others have stated, it is important to stress that the Protection of Life During Pregnancy Bill is a very narrowly confined item of legislation. It is also important to remind ourselves that the Bill is the result of the Government decision of 19 December last concerning the implementation by the State of the judgment in the European Court of Human Rights in the A, B and C v. Ireland case. That decision approved the implementation of the said judgment by way of legislation with regulations "within the parameters of Article 40.3.3^o of the Constitution as interpreted by the Supreme Court in the X Case". In other words, both the Government decision and the Bill remain resolutely within the parameters of the Constitution.

We are introducing legislation to recognise the existing constitutional position and ensure that regulations can be brought forward to give the medical profession clarity and certainty when dealing with cases where a mother's life is at risk. To see evidence of that this is the case, I direct people to the table on page 57 of the Report of the Expert Group on the Judgment in A, B and C v. Ireland. That table summarises the position regarding abortion law in 27 countries of the Council of Europe. It details whether abortion is available in each of the countries on the following grounds: to save a woman's life; to protect physical health; to protect mental health; foetal abnormality; rape or incest; economic or social reasons; or on request. Whereas every other country has abortion available in two or more of those categories, the table accurately states that in Ireland abortion is available in just a single category, namely, where a mother's life is at risk. If and when this Bill becomes law, abortion will still be available in Ireland in that single category of a mother's life being at risk. It will not be available to protect a mother's health, in cases of fatal foetal abnormality or in cases of rape or incest. Thousands of Irish women will continue to travel to the UK each year for abortions and, in many cases, they will never seek or obtain the medical aftercare and emotional support they need upon their return home.

This legislation is extremely confined, recognising the existing constitutional position and no more. I would like to believe that in time, and once it becomes clear that this legislation had not opened any "floodgates" - to use a term uttered by a number of Deputies - as a just and humane society, we would look further. I would, for example, like to believe we will seek to ensure that a mother would not be obliged to carry her child to full term when the tragic reality is that the child would not survive outside the womb. Who can possibly imagine the grief of mothers who wished for terminations in such circumstances, who were obliged to travel abroad to obtain them and who then went through the torture - as one couple described recently - of having their much wanted and loved babies returned by couriers in cardboard boxes?

I am aware, as I am sure are all Deputies, that not every woman would wish to terminate her pregnancy in the case of a fatal foetal abnormality. For those who do, however, it is my personal belief that they should be enabled to do so here in Ireland. I would like to believe that we, as legislators, would be able to reach a position - at some not-too-distant point in the future - when we can provide for this. For now, however, the Government is doing what successive Administrations since 1992 have failed to do, namely, legislating for the X case and providing the clarity that the medical profession and pregnant women need and deserve.

Opponents of this Bill suggest there is no need to legislate. Without wishing to inflame the debate in any way, I must state that they are wrong and in order to see why, it is only necessary to consider the circumstances of the woman known as C in the A, B and C v. Ireland case. The woman in question became pregnant unintentionally while in remission from a rare form of cancer.

When she discovered that she was pregnant she consulted her GP and several medical consultants but felt the information she received about the potential impact of the pregnancy on her health and life was insufficient. Fearing for her life in 2005, she travelled to England for an abortion. Upon her return she suffered complications of an incomplete abortion, including prolonged bleeding and infection. In short, the woman went through the most horrific, harrowing ordeal. Her argument to the court was that the absence of legislative implementation of Article 43.3.3° meant that she had no appropriate means of establishing her right to a lawful abortion in Ireland on the grounds of a risk to her life. The court agreed.

The court found that Ms C had travelled for an abortion "as she mainly feared her pregnancy constituted a risk to her life". The court said that "the uncertainty generated by the lack of legislative implementation of Article 43.3.3°, and more particularly by the lack of effective and accessible procedures to establish a right to an abortion under that provision, has resulted in a striking discordance between the theoretical right to a lawful abortion in Ireland on grounds of a relevant risk to a woman's life and the reality of its practical implementation".

The court concluded that the Irish authorities had "failed to comply with their positive obligation to secure to Ms C effective respect for her private life by reason of the absence of any implementing legislative or regulatory regime providing an accessible and effective procedure by which she, Ms C could have established whether she qualified for a lawful abortion in Ireland in accordance with Article 43.3.3° of the Constitution".

The judgment is absolutely clear - successive Irish Governments failed to put in place a system that would have enabled women to determine if they qualified for a lawful abortion in accordance with the Constitution. The harrowing ordeal Ms C suffered is clearer still. She had been seriously ill with cancer. She was pregnant. She had no idea if the pregnancy could end up causing her death and she could not get the answers she needed in Ireland as to whether she qualified for an abortion or not. She could not get the answers, the court found, because of the lack of a legislative or regulatory regime to give effect to Article 43.3.3°.

Will anybody tell me now that this Bill is not necessary? Will anybody tell Ms C or any woman who found herself in a remotely similar situation that this Bill is not necessary? As provided for in the programme for Government, this Administration is facing up to its responsibilities and putting in place the combination of legislation and regulations that will - I fervently hope - ensure that no woman ever finds herself in the same situation as Ms C.

Let me cite another crucial aspect of the A, B and C judgment. The court acknowledged that providing the clarity required under the judgment would be a "sensitive and complex task". However, it noted that many states had previously managed to specify the conditions governing access to a lawful abortion and put in place the required implementing procedures. Immediately after that point, the court added: "Equally, implementation could not be considered to involve significant detriment to the Irish public since it would amount to rendering effective a right already accorded,after referendum, by Article 43.3.3° of the Constitution." Therefore, this is a right that the court has judged that the people of Ireland, through the passage of Article 43.3.3°, have conferred.

This returns me to my earlier point - in this Bill, we are simply providing legislative clarity to the existing constitutional position. To those who would somehow still insist we are making fundamental changes or "opening the floodgates", I would refer them to a key piece of testimony during the Joint Committee on Health and Children hearings on the Bill. Professor Fionnuala McAuliffe of the Institute of Obstetricians and Gynaecologists was asked specifically about the numbers of women who would seek terminations under the legislation once implemented. She responded as follows:

As to what numbers we are anticipating, the view of the institute is that this legislation provides a legal framework for existing, current medical practice. We are facing pregnant women whose lives are threatened by the pregnant state and need either termination or pre-term delivery. This legislation provides a process for that so that we are not working in a legal vacuum or unsure as to whether a woman's life is in immediate danger or in danger down the line. It provides us with a legal framework for current medical practice. That is our stated view.

There are those, of course, who wish the Government would ignore the constitutional position and would remove the risk of suicide as a ground for an abortion in this legislation. Apart from the obvious perils of any Administration playing fast and loose with the Constitution, those people focus on the argument about abortion not being a treatment for suicidal intent. This is missing the point that a very small number of women may become suicidal becauseof their pregnancy and that, in such circumstances, a termination is required to save the mother's life.

The chief medical officer of the Department of Health, Dr. Tony Holohan, was also asked about numbers at the committee, specifically in relation to risk of loss of life from suicide. He said:

My general expectation is that it is not likely to be significant. We have made provision for the grounds of suicide because it arises as a consequence of the constitutional position and the Supreme Court judgment and because it would be impossible to rule out the possibility of suicidal ideation and a risk to a woman's life as a consequence of self-destruction that could only be averted through termination. Removing this provision entirely would be based on a belief that it could never arise. I would not expect it to be a very widespread or common occurrence but I would not say that it would never happen and I will not put a number on it.

I am aware that for many opponents of the suicide ground, this is a strongly held and utterly sincere view stemming from the deepest personal convictions, and I respect those views. What I cannot respect is the view of a small number who suggest that somehow women would fake being suicidal, simply to obtain a termination. The idea that there are numerous women so desperate that they would fake suicide, I simply cannot accept that view of Irish women. I find the view that women simply cannot be trusted deeply insidious. It is a very difficult issue but the notion that one cannot trust either women, doctors or the medical profession and that large numbers of people would fake suicide is one I cannot accept. I understand why people may be concerned but I do not accept the further argument that has been made by some.

If and when the Bill becomes law, it will preserve the equal rights to life of the unborn and of the mother, as per Article 43.3.3°. It will ensure that there is clarity as to the circumstances when a mother's life is at risk and a termination can be carried out. It will end the uncertainty for pregnant women and the medical professionals treating them. Frankly, this should have been done a long time ago. I am glad this Government is legislating for this now.

Over all of this hovers the case of Savita Halappanavar, a young healthy woman miscarrying a much longed for and desired baby.

In this particular tragic case, everything that could go wrong appears to have gone wrong. The very least that can be expected in these very dangerous situations is that the pregnant mother and her doctors should have clarity in how to save her life. The ultimate issue is that the legislation is about saving the life of women in the small number of cases where a woman's life is in danger because of pregnancy. That is the core important issue.

As a society we have a very long and tortuous history with regard to women having children outside marriage or on their own. There is also a strong history and legacy of the care provided by the medical profession to pregnant women, and people on all sides of the debate have remarked about the importance, standard and quality of the care to pregnant women in Ireland. I ask those who doubt the need for the Bill to consider again those cases - few in number, partly because of the advances in medical science and technology - where a woman's life is in danger. Numerous doctors have spoken both to the committee and outside this House, and they need legal clarity to carry out their job and save the life of a mother when it is at risk. The Government is seeking to achieve this with the legislation.

As I said at the outset, this is very confined legislation. It gives effect to the A, B and C v. Ireland judgment in the context of the constitutional measures that the people of Ireland enacted and which are reflected in Article 40.3.3^oof the Constitution, as well as the judgment of the Supreme Court in the X case. It is no more and no less. It is of the utmost importance that we legislate for this in order to provide protection for the life of the mother when it is required.

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