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

What is the Government playing at tonight? This nonsense of continuing until 5 a.m. is demeaning of everyone here in the House.

It brings the House into complete disrepute and there is absolutely no need for it. I do not know what the Government's game is. I do not know what it is doing if it believes it is somehow smart or clever to allow people to tease out the legislation until the early hours of the morning. It is completely wrong and there is no reason we could not go home, have a night's sleep and return here at 10.30 a.m. to resume the debate and, if necessary, continue on Friday. The Government is really bringing the entire House into disrepute with its carry-on tonight. It reflects very badly on everybody, but particularly the Government.

Unfortunately, the debate on abortion has traditionally been very much dominated by the two extremes of the argument. Most people are very much turned off by the two extremes, namely, the pro-life side and the pro-choice side. The reality is that the vast majority of people occupy the middle ground. We do not hear from the middle ground often enough. This legislation does not reflect the views of the middle ground. In many ways, it does not go far enough and, in others, it goes too far. It would be much more honest if the Government decided to address the issue of abortion in a way that reflected the reality of the issue and in a way that the public would support.

The vast majority want a regime that does not result in abortion on demand or a very liberal abortion regime. Equally, most recognise the very real and difficult circumstances that arise for people when very difficult calls have to be made in respect of balancing the two sets of rights. For most people, the starting point is a belief that we are talking about two sets of rights, the rights of the woman and the rights of the unborn. It is important that we keep this to the fore all the time. There is, however, a limited number of circumstances in which those rights must be balanced. These are the difficult circumstances. I refer in particular to inevitable miscarriage. Speakers tonight on both sides invoked the name of Savita Halappanavar to support their argument. This legislation has very little to do with that tragic case. However, there are inevitable miscarriages and this legislation does nothing for people who find themselves in such circumstances. It would be serving the memory of that unfortunate woman well if we dealt with this matter and the very close to dangerous circumstances that currently obtain in many of our general and maternity hospitals through under-resourcing of the services. This issue was referred to by a number of speakers who appeared before the health committee. I refer also to the tragic circumstances in which several hundred Irish women find themselves every year when they discover they are carrying a foetus with fatal abnormalities such that it is not compatible with life outside the womb.

There is fairly broad public support for addressing circumstances in which women find themselves pregnant as a result of rape and incest. It would have been much more honest for the Government to have set out to address those real-life issues that force people into circumstances in which they feel the right thing to do is terminate a pregnancy. Legislating for those circumstances would have public support. Unfortunately, that is not the approach taken in dealing with this issue in the round. The principal concern for the two parties in government has been the politics of the matter rather than the reality. We have a political proposal that is not a solution by any means. It is quite disingenuous of the Government to suggest it is addressing this issue. It is failing to address the very difficult circumstances to which I referred and the legislation is quite seriously flawed.

I very much welcome sections 7 and 8 of the legislation, which provide the clarification and certainty that women deserve and which the medical profession has been looking for. However, there are serious flaws in the provisions in section 9 with regard to circumstances where a woman presents as suicidal. There was much talk earlier tonight about the issue of suicide, which is a very pressing issue in our society. It is a major problem, particularly among young people. It should be dealt with and services should be resourced. Services are desperately under-resourced in spite of many promises over recent years.

It is important to bear in mind that what is referred to in section 9 is a very particular set of circumstances. The Bill does not provide for the circumstances of a woman with an underlying psychiatric condition. In such cases, other treatments are provided. This legislation provides specifically for cases where women present as suicidal as a result of their pregnancy. A very peculiar regime is being proposed that would provide for termination of pregnancy but make a distinction between termination of pregnancy and ending the life of the unborn. I am not aware of a regime like that in any other country. That, in itself, raises many issues. Most notably, Dr. Sam Coulter Smith spoke about this at some length at the hearings. The kinds of issues he raised are very serious and he raised them at some length, both in his written submission and oral presentation. He was raising the issues on behalf of a large number of his colleagues. He said on a number of occasions that this legislation raises the most serious ethical issues for the medical profession. Many in the medical profession regard the provisions as unworkable and believe they place doctors in virtually impossible ethical and medical positions. Despite the concerns having been raised, they were not addressed in any form at the hearings, on Second Stage or on Committee Stage. The questions remain hanging in the air and have not been responded to, unfortunately, by any of the Ministers involved with this legislation.

Dr. Coulter Smith made the point very clearly that it is very rare for women to find themselves suicidal as a result of their pregnancy. It was suggested that the rate is one in 500,000. It was also suggested that the medical profession is legally and ethically obliged to practice evidence-based medicine and that there is no evidence to suggest the termination of pregnancy is any kind of treatment for suicidal ideation or intent.

Dr. Coulter Smith raised the scenario of a pregnancy of between 22 and 24 weeks where a doctor is put in an impossible position when a request is made for a termination. The doctor knows carrying out a termination will not be a treatment because there is no evidence to suggest termination is a treatment for the suicidal intent. Doctors have a responsibility to the unborn child and they are expected to carry out a treatment that will likely result in a child being delivered who has serious disabilities. How is a doctor expected to balance the responsibility to the woman with the responsibility to the child to do no harm? As Dr. Coulter Smith said, that places medical practitioners in an impossible position. The legal difficulty and ethical dilemma has not been addressed in the debate on this legislation.

Where doctors have no legal protection for taking action that will result in a baby being delivered prematurely and all that may go with that, there is a fear among many people that in those circumstances about the implications for them, particularly where there is no protection for doctors taking that action and where there is no protection for doctors in the case of them refusing a termination on the grounds that they conclude that the woman is not suicidal,. What if the woman goes on for whatever reason to commit suicide at a later point? Is the doctor liable to be sued? In the case of the doctor taking action to prematurely deliver a child of early gestation and him or her being seriously disabled, what is the legal position of the doctor? Can he be sued? Can the State be sued? Can the hospital that the procedure takes place in be sued? All these serious questions were raised on Committee Stage and answers were not provided for them.

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