Michael Harty (Clare, Independent) | Oireachtas source

I support the holding of a referendum on repealing the eighth amendment of the Constitution to allow Irish people to have their say on this very important and difficult issue. The recommendations of the Oireachtas all-party committee should be the basis of any proposed legislation to be put in place should the people decide to repeal the eighth amendment. Such legislation will be the legal mechanism that will govern termination of pregnancy in the future.

It is the Dáil's responsibility to present clear and unambiguous proposals in order that people can decide on the issue. There is a necessity for constitutional change whether that is complete repeal - repealsimpliciter- or the insertion of a clause which gives the Oireachtas freedom to introduce legislation free of constitutional challenge. It is a debatable but important legal issue on which the Government will have to make a judgment. However, repeal of the eighth amendment is what people want.

The Protection of Life During Pregnancy Act 2013 put on a statutory footing the Supreme Court ruling in the X case of 1992 to allow for termination of pregnancy if there is a real and substantive risk to the life of the mother, including suicide. The Act does not make provision for the substantive risk to the health of the mother, however. It took 21 years for that limited legislation to be brought forward. To allow for any additional criteria for termination of pregnancy will require constitutional change. I believe there is widespread support for such constitutional change. Many complications can present during pregnancy which need to be faced up to rather than ignored. Substantial health risk to the mother can develop as pregnancy advances. It cannot be predicted but it is a reality. Fatal foetal abnormality is another reality which must be faced, as are circumstances where the pregnancy follows rape or sexual assault. A further reality is that Irish women can decide to terminate their pregnancies, either legally by travelling to abroad to avail of services in other countries or illegally by obtaining abortive medication via the Internet. Each year, several thousand women avail of these options and up to 170,000 women have availed of terminations since the introduction of the constitutional ban in 1983. These are the realities we face. As such, our present prohibition on abortion is ineffective and ignores the reality of what is happening in Irish society today. Ireland cannot continue to ignore these realities and pretend to have a prohibition on abortion except in life-threatening situations.

Ireland is now a modern European state which exists in a global world and it cannot be insulated from the outside world regarding how it thinks or behaves. Our moral code has to come from within ourselves and should not be imposed by institutions or organisations inside Ireland or abroad. Moral values should not be forced on anyone in this modern age. Ireland is becoming a diverse arid increasingly secular society with multiple nationalities, religions and influences, all tolerating one another and respecting one another's identities. Increasingly, political parties recognise that this is a social issue that requires them to give their members a free vote on the substantive issues on the holding of a referendum and on any subsequent legislation. On such a fundamental social, medical and moral issues, this is correct and it is what a modem democracy should be about. After all, the people will have the ultimate say on any constitutional change.

No one person or group has the correct answer to this issue. There is no correct answer. What is correct for one person or one situation is wrong for another person and another situation. We have to accommodate our differences and try to give people reasonable options and choices. The extremes of no abortion whatsoever versus unrestricted abortion without any limitation should not dominate the debate because neither is desirable or attainable. If this referendum is to have any true and lasting meaning, it must find a sensible acceptable middle ground which makes as much medical and moral sense as possible. In such circumstances, we must separate the medical from the moral. Many difficult medical decisions are made every day which have moral and ethical content. Difficult decisions relating to termination of pregnancy are not an exception. These decisions are very personal and should be allowed to take place within the doctor-patient relationship.

The Citizens' Assembly and the Joint Committee on the Eighth Amendment of the Constitution heard voices and opinions from all sides, particularly moral, medical and legal. Having been presented with the best available evidence, they made the following recommendations: abortion should be decriminalised; contraception should be made available free of charge and every effort should be made to avoid unwanted pregnancies; sex education, relationship education and education regarding consent should be provided in all primary and post-primary schools in order that men and women are as informed as possible about safe sex; universal high-standard obstetric care should be available, including anomaly scanning, pregnancy counselling and support in crisis pregnancies; perinatal hospice services should be freely available when perinatal death of a baby is imminent; termination of pregnancy should be permissible should an unborn child have a fatal foetal abnormality that is likely to cause death before or shortly after birth but not in cases of non-fatal foetal abnormality which are compatible with life; termination of pregnancy should be permissible when the life of the mother is at risk, which is already the case under the Protection of Life During Pregnancy Act; and termination of pregnancy should be permissible when there is serious risk to the physical or mental health of the mother.

The risk to physical or mental health can change substantially during pregnancy. A woman may have a medical condition which presents no risk as the pregnancy commences but that can change as the pregnancy advances, quite suddenly in some circumstances. This is an issue which must be addressed given the huge medical uncertainty as to when the termination of a pregnancy can be advised. Is it when there is a 10%, 20%, 30% or 40% risk to a person's life? Where does one have to go before life is deemed to be at risk? These are difficult medical decisions which should be kept to the doctor-patient relationship and which must be addressed in any legislation.

The most controversial of the committee's recommendations is that, in view of the complexities of legislating for the termination of pregnancy for reasons of incest and rape, it is more appropriate to deal with this issue by making termination of pregnancy lawful without restriction as to reason up to a gestational limit of 12 weeks through a GP-led service or in a clinical context and to be determined by law and licensing practice in Ireland. This is the provision which is going to be most controversial. It is a provision I have difficulty with myself. However, I understand the reasoning behind it. How does one determine, within a short period in respect of a pregnancy, whether someone has been raped or is the victim of incest? The committee's solution to incidents of rape and incest broadens the availability of terminations without restriction as to reason up to 12 weeks. This is the issue most people will have greatest difficulty getting their heads around. I can see and I understand the medical reasons for the proposal but they will have to be explained in depth as the debate on a constitutional referendum advances.

The legislation must make provision for conscientious objection to participation in termination of pregnancy. Many obstetricians and general practitioners will have great difficulty with the legislation should it go through and there must be a provision for conscientious objection. According to the ethical code of the medical profession, a doctor who is unable or unwilling to provide a service is obliged to refer a patient to a practitioner who is willing to provide the service. Provision for conscientious objection is particularly necessary if termination of pregnancy is available without restriction up to 12 weeks. Also, it is not clear how a GP-led service would operate and what function general practice would have in the supervision of medical termination of pregnancy. This issue must be teased out.

I turn finally to male involvement in the decision making process in termination of pregnancy.

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As a male, I will never have to make the final decision regarding termination, but men are not absolved of responsibility. Some men are indifferent to the plight of their pregnant partners and offer no support. Some are very supportive and play an active part in the decision to continue pregnancy or to terminate it, and some are emotionally devastated when their partners opt for terminations against their wishes or without their knowledge. Men have an important role to play in the debate and in the decision-making in the termination of pregnancy.

This is a very complex medical, social and moral issue which needs to be resolved in a sensible and inclusive manner. The current constitutional provision needs to be repealed and legislation put in place to define the circumstances in which a termination of pregnancy is allowed in a legal manner. It is now up to the Oireachtas to make sense of all that and put an option to the people that they can accept or reject having been fully informed of the reasons underpinning each proposal.

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