Róisín Shortall (Dublin North West, Independent) | Oireachtas source

I welcome the opportunity to speak to the Bill, and I speak as a Deputy who does not label herself as either pro-life or pro-choice. I strongly disagree with attempts to pigeon-hole people into one or either camp.

For too long the debate on abortion has been polarised and we have not heard sufficiently from the middle ground. I believe most Irish people, like me, are turned off by the extremes of the pro-choice and pro-life lobbies. Abortion is much more complicated than some of the public debate indicates. In my view, it is about finding the correct balance between two sets of rights, that of the woman and that of the unborn. To see the issue as merely a matter of choice for a woman is to deny human rights for the unborn. At the same time, to insist on an equality of rights between the woman and the unborn is simply unrealistic.

The majority of Irish people have a very nuanced position on abortion and they certainly do not want abortion on demand, but nor do they want us to pretend that in life, very real and serious dilemmas do not arise for people. A majority of people want a sympathetic but robust system that would rule out abortion on demand but would allow for abortion in a number of specific cases such as, for example, where the woman's life is at risk, in the case of fatal foetal abnormality or in the case of rape and incest. We need to ask the question, "What would I do if I was in any of those positions, or what would I do if my wife, my daughter or my sister was in any of those positions?"

Ideally, in such cases, decisions on termination should be made by the woman concerned on the advice of her medical professionals. Unfortunately, as we know these cases are not provided for in this country under the original 1983 amendment. This Bill is a minimalist response to the A, B and C v. Ireland judgment and is designed to meet the basic requirements of that ruling and the political needs of both Government parties. I welcome the fact that the Bill clarifies the position where there is a real and substantial risk to the life of a pregnant woman arising from a physical illness that can only be averted by a termination. This provision in section 7 is essential for the protection of women and it provides clarity and certainty for medical practitioners. Two medical specialists must certify this risk, which need not be immediate or inevitable. In the case of an emergency relating to a physical illness, certification for the procedure may be issued under section 8 by one medical practitioner, which is reasonable.

Provision under section 9 relates to the risk to a pregnant woman from suicide and this is one of the main sections which has given cause for concern. A requirement to legislate in such cases arises from the X case judgment in 1992 and the outcome of the subsequent referenda in 1992 and 2002. On both occasions the people voted not to remove suicide as a ground for legal termination. In spite of these decisions, no legislation has been produced until now. The January and May hearings of the health committee provided an opportunity for people to tease out the full implications and consider the difficulties involved in legislating for termination in these circumstances. The evidence provided and the views expressed by the medical and legal witnesses were not conclusive. There was conflicting evidence and advice.

It is important to point out that if suicide was excluded from this legislation, the constitutional right would still exist. However, there remains genuine concern that the inclusion of suicidal ideation as a ground for termination could result in a significant rise in the rate of terminations. The evidence would seem to suggest that the number of women who become suicidal in pregnancy is extremely low. In the case of women at risk of suicide due to an underlying psychiatric condition, termination is rarely viewed as a treatment to avert this risk, but what about a case where a woman presents as suicidal because of her pregnancy? Even where three medical practitioners certify that there is a real and substantial risk to her life, the concern remains that this could, in time, result in a significant increase in the number of terminations on these grounds. One of the problems is that we have no way of knowing whether this will happen. I believe the Bill is a genuine attempt to prevent this happening and that there is no deliberate intention to allow for a liberal abortion regime. However, we cannot be oblivious to the experience of other jurisdiction in this regard.

The concern is that medical specialists will be put in an almost impossible position. From a starting position of "do no harm", doctors will be faced with having a duty to save both lives without adequate legal protection. What about a psychiatrist who, in good faith, deems a woman seeking a termination under section 9 not to be suicidal? How will he or she be protected from prosecution or sanction should the person, for whatever reason, later commit suicide? Would the absence of legal protection for the psychiatrist under this scenario lead to a default position where no medical practitioner feels able to deny a request under section 9? It is because of this that there needs to be a thorough annual review mechanism for the legislation in order that we can be assured that it is not having unintended consequences.

It has been suggested that a sunset clause should be included and this would seem like a reasonable safeguard. The Bill, as it stands, is flawed and needs considerable strengthening in this regard.

I also have serious concerns about the absence of any gestational limits for terminations under section 9. I believe most people would find this unacceptable. The Bill, unusually, distinguishes between the termination of a pregnancy and ending the life of the unborn. As a result of there being no gestational limit, doctors will find themselves with a very serious ethical dilemma. Under this legislation, we would have the extraordinary scenario where a woman may be granted a termination on the grounds of suicide and her child may be born unwanted and possibly with multiple disabilities arising from its early delivery. There is nothing in the Bill which sets out the rights of that child or how the State will provide for such a child. In the interests of balancing the mother's rights and the child's rights, I strongly believe that gestational time limits should apply in section 9. It is not acceptable to provide for a scenario which many people would find abhorrent and which will put doctors in conflict with their ethical demands and their medical guidelines. It is not sufficient to claim that there are constitutional obstacles to setting time limits. If it cannot be done here, there should be a clear commitment to hold a referendum on it with other referenda in October and before the legislation is commenced. Both of these key issues were raised at the committee hearings but, as far as I could see, they were not satisfactorily addressed.

See this speech in context