Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I support the amendments tabled. Much has been said about the issue of suicidal intent and suicide. The reality is that suicide in pregnancy is a reality, and there is absolutely no doubt about that. The issue is the scale. As I stated on Second and Committee Stages, suicidal ideation is quite frequent in pregnancy. Between one in eight and one in three women experience suicidal ideation at some stage during pregnancy. This is up to a third of all pregnancies and, therefore, the phenomenon is quite common. I am thankful that the number of women who act on their ideation is very small. All possible supports need to be put in place to ensure the rate is reduced.

It is important to remember that there is a differentiation being made between physical illness and mental illness. Deputy Daly, Deputy Wallace and a number of others made reference to that. Let met outline the difficulty. A woman with a physical illness resulting in a threat to her life during the pregnancy is entitled to a termination under this legislation but a woman with a treatable underlying mental health condition is not entitled to a termination. That differentiation has been made in the legislation. A difficulty is that where there is no underlying mental health condition other than suicidal ideation or intent, the psychiatrist has no choice but to certify the woman so as to allow her to avail of a termination if she wants it. It is impossible to prove or disprove suicidal intent. When I raised this point with the Minister on Committee Stage, he said, correctly, that a consultant can use his or her professional skills.

A consultant can also identify underlying mental health conditions but Professor Veronica O'Keane, who gave evidence to the joint committee on two occasions, made it crystal clear that if a woman states she is suicidal, she has no other choice but to believe her. As I stated on Second Stage, I recently spoke to a consultant who pointed out that where someone is suicidal, there is no skill set for a consultant psychiatrist to determine whether the intent is there or not. No consultant can make that determination. One consultant pointed out that the hospital electrician is as equally capable of making that determination as anyone and that is the sad reality of suicidal ideation and suicidal intent. It is impossible for anyone. The hands of consultants left in that situation, where there is no other underlying mental health condition and where a woman presents with suicidal ideation, are tied because if they refuse to certify the woman and she subsequently dies by suicide, the consultant faces a significant personal and professional liability for not certifying her.

I refer to another issue teased out on Committee Stage. The Minister made it clear that where a foetus is viable, it is sacrosanct in the legislation that any procedure that would threaten the viability of the foetus outside the womb cannot be provided for and cannot be used to terminate the pregnancy. That will lead to cases where a woman with suicidal intent who obtains a termination of pregnancy beyond the cusp of viability will give birth to premature babies with significant disabilities who will become the responsibility of the State. We are returning to a situation where we could see children in institutions again and surely none of us wants to go down that particular road.

It is also important to recall evidence given by Professor Kevin Malone to the joint committee hearings about his beliefs. He is, sadly, an expert on the incidence of suicide. He firmly believes there is a strong possibility that this legislation could increase the overall incidence of suicide in this State. That needs to be taken into consideration by every Member.

It is argued that section 9 needs to be included because of the X case judgment. If anyone is of that opinion, he or she should read last week's newspaper article by one of the judges involved, Mr. Justice Hugh O'Flaherty. He did not say that. It would be worthwhile for everyone to take time to read it in advance of making a decision on this issue. This was well argued by an t-Aire Stáit, Deputy Creighton, earlier but I do not wish to revisit it. We are told that because we are legislating, we must legislate for the X case. That is not the case and a number of examples have been given. I outlined one example on Second Stage. The Government parties made the argument well on the issue of blasphemy. We introduced legislation at the time, which we knew could never be implemented, because there is a blatant reference in the Constitution that we must provide for a law of blasphemy. Here we are doing it on a supposition based on a Supreme Court judgment in the X case and Deputy Creighton has made the point well about that.

The Government parties argue that their hands are tied and they must legislate for suicide but that is not the case. I tabled an amendment on Committee Stage that would allow us to legislate for the issue before us to protect a woman's life where there is a risk based on medical issues, and leave the issue of suicide silent until there is an opportunity to amend the Constitution.

The Government parties also argue this legislation is about women and protecting their lives. All of us want their lives protected. I acknowledge where the thrust of the legislation is coming from and the vast majority of Members do not have a difficulty with the principle underpinning it but suicidal intent is an issue. I am disappointed that two issues that focus on the women who unfortunately will have to use this legislation have not been addressed in the Report Stage amendments tabled by the Government. One relates to the review mechanism under both sections 7 and 9. Unfortunately, a woman who has to go before a review committee must do so on her own, face three consultants and argue her case without being accompanied by an advocate. She is not legally entitled to an advocate. I do not know how one can say this legislation is pro-women when a woman is not legally entitled to an advocate when appearing before the review committee.

The second issue, about which I have tabled an amendment, is the legislation does not state that the consultants on the committee must review a woman's case at the closest location to her. In other words, a woman who is physically or mentally ill may in certain circumstances have to travel to the other end of the country to see the consultants on her own and advocate on her own behalf while ill. I cannot understand why those issues have not been addressed in this legislation if its focus is on dealing with women in a sympathetic manner when they are faced with serious illness. This provision is more about achieving an objective in the manifesto of one political party than dealing with what should be the focus, which is improving the health of pregnant women in this State and their lives.

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