Alex White (Dublin South, Labour) | Oireachtas source

Within this grouping, amendments aim to add urgency to the wording set out in the Bill, through the use of terms such as "forthwith" and "immediately". In addition, these amendments propose to reduce the timeframe specified in the Bill for the review process. As discussed on Committee Stage, legal advice has been received to the effect that the legal meaning of the term "forthwith" is "immediately"’. This qualification, as well as such proposed phrases as "with appropriate urgency" and "immediately", is unnecessary, as the Bill uses terms like "shall make arrangements" in this section which render such qualifications superfluous.

While I am conscious that the formal review process needs to happen in a speedy manner to safeguard the right to life of the pregnant woman concerned, it is important to understand that this process requires a number of steps which the HSE, as the convenor for this process, needs to take. The application for the review process needs to be assessed to ascertain the nature of the request, whether it concerns a section 7 or section 9 certification, the identification of the relevant medical practitioners, the making of logistical arrangements in regard to the convening of these medical practitioners, to their duty to examine the woman, and to her right to be heard or for someone on her behalf to address the review committee.

Therefore, reasonable timeframes are provided for in the Bill that strike a balance between the need to vindicate the pregnant woman's right to life and the logistical requirements of the process. During the drafting of this Bill, my officials consulted with the relevant professional bodies and I am satisfied that the timeframes provided are appropriate. In addition, it must be noted that these timeframes refer to an absolute upper limit and, depending on the clinical scenario at hand, the review process may take place much more speedily. Very often it will, as mentioned by Deputy Murphy.

Finally, were the pregnant woman's medical condition to deteriorate, provisions are made for her situation to be addressed through an emergency procedure under section 8. For those reasons, I do not propose to accept the amendments proposed.

As a general proposition, it is not really appropriate for us to operate on an assumption. I am not saying Deputy Ó Caoláin is doing this, but in general it is not good practice in legislation to operate on an assumption that doctors would act other than in an expeditious manner. The assumption must be that they will act in a timely way. My understanding of medical professional practice is that time is of the essence. The principle inherent in best medical practice, which doctors are required to observe, is that they act in a timely way. While it may sound counter intuitive, to insert a requirement into statute that doctors should or must act "immediately" or "forthwith" would give rise to something which could take us into the opposite territory to that we want to achieve.

At the least, it would mean that we would have to put into statute a definition of what constitutes "immediate". We might think the English language is clear, but in the clinical environment, what is "immediate" may not be absolutely clear to us, even in terms of sending forward forms. Therefore, it may happen that we say something should be done "forthwith" or "immediately", but what if something else arises in that clinical environment? For example, a doctor might say to himself that he knows something is the first thing he should do, but now something unforeseen has arisen that should be done before the thing the statute requires him to do. That is not good territory for us to get into in the context of legislation. We should rely on doctors observing best practice and that they will operate with the appropriate urgency the Deputy proposes we require them to do statutorily. We should assume they will do that. In accordance with best medical practice and the guidelines of their profession, time is of the essence.

The other problem if we accept the amendment is that we would then end up having to define "appropriate haste". If we define "appropriate haste", we create a circular issue because we would then have to decide how to define "appropriate". We would have to ask the professions what was appropriate and this would bring us back to the proposition that the doctors are required to know what is appropriate, because it is inherent in medical and professional practice and standards.

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