Jan O'Sullivan (Limerick City, Labour) | Oireachtas source

Aontaím leis an Teachta McDonald go bhfuil sé ceart an cheist seo a chur ar mhuintir na hÉireann arís. Tá an t-am tagtha. Tá mé cinnte nach é Bunreacht na hÉireann an áit cheart don ábhar seo.

I welcome the fact that the Government has published its legislation and its paper on possible implementation of legislation should the referendum be successful. As somebody who campaigned against the amendment in 1983, I welcome this momentous day. It has taken a long time to reach this point.

We have heard much about what will happen if we repeal the eighth amendment. We also need to reflect on what will happen if we do not repeal the eighth amendment. If we do not repeal the eighth amendment, if we keep Article 40.3.3° in the Constitution, we will continue to have the current situation. We will continue to have a variety of cases, regardless of the letters we attribute to them. We have heard about Miss A, Miss B, Miss C, Miss X, Miss Y and Miss D, the late Savita Halappanavar, Ms Amanda Mellet and many others. Apart from the ones we know about, there are thousands of Irish women who have had terminations since 1983. The assessed figure is that 170,216 travelled to Britain during that period. As others have said, that represents approximately nine women every day travelling outside of their own country - away from their own homes, support systems, families and, in many cases, children - to go to another country to have their pregnancies terminated. People seem to be okay about tolerating that into the future. The position is not going to change and all of the evidence suggests that we will continue to have the same kind of termination statistics in this country as other comparable countries. We have abortion in Ireland. We just do not have it on the soil of Ireland in terms of termination by medical means. We have it in lonely bedrooms with pills bought on the Internet by approximately three women every day. I expect that figure will probably rise because women are becoming more aware of this as an alternative.

We really should not close our eyes to what will happen if we retain Article 40.3.3°. We will not suddenly stop what has been happening in the past number of years. No doubt that will continue, but in a context where we will have the kind of cases that temporarily made people in Ireland stand up and take notice and that, for example, led to the 1992 referendum following the Miss X case. I very much remember the campaign at that time. I recallThe Irish Timescartoon - if one wants to call it a cartoon because it seems a misnomer in this case - with a 14 year old girl with a barbed wire fence all around the map of Ireland. That young girl had been raped. The rapist was convicted and, I think, got out of jail after three years. She was only 14. Basically, the Constitution had to be changed subsequently to allow for freedom to travel and freedom of information but we still have the restriction in respect of the equal right to life of the mother and the unborn child, which is in Article 40.3.3°.

We were all hugely affected by the death of Savita Halappanavar. It made us recognise the reality. That reality was described extremely well, not only by Professor Arulkumaran, who chaired the investigation into the death of Savita, but also in much of the testimony that those of us who were privileged to be on the Oireachtas committee heard from medical people. I refer, for example to the master of the National Maternity Hospital, Holles Street, who described the difficulty for an obstetrician in circumstances where a woman is ill - she might have sepsis - and where he or she must determine the exact point at which the woman's health is in danger and then that at which her life is in danger. That is an impossible position for the medical profession. It is a much more impossible position for the woman who is in the situation and her loved ones. We cannot allow that to continue. If we do not repeal the eighth amendment, if we do not remove Article 40.3.3°, that will continue to be the case and there will be an impossible situation whereby if the mother's life is in danger, the medical profession will be able to intervene but if it is her health that is in danger, it will not be able to do so. The master of Holles Street and others - the joint committee heard a great deal of medical evidence - described how difficult it is to determine when that to which I refer happens. They also indicated that it happens quickly in many cases and that there is not enough time to intervene.

I was particularly moved by the medical evidence. I am convinced that we need to regulate abortion in the context of medical care in this country. That has to be the situation. The recommendations of the joint committee are clear in that regard. In case people feel that we somehow or other heard from prejudiced medical professionals or individuals who hold particular opinions, we heard evidence from two current and two former masters of Irish maternity hospitals, two national medical professional bodies, the Irish College of General Practitioners and the Institute of Obstetricians and Gynaecologists, the World Health Organization, four specialists in maternal foetal medicine - three from Ireland and one from the United Kingdom - two specialists in perinatal psychiatry and the chief investigator into the death of Savita Halappanavar. The consensus of those experts is that the eighth amendment is the central barrier to the provision of best practice abortion and maternity care in Ireland and should be removed and that the current law, which includes criminal provisions, is overly restrictive, overly prescriptive and prevents doctors from being able to provide the highest standard of reproductive health care to pregnant woman. This medical evidence is particularly significant.

Deputy Kelleher referred earlier to how the medical profession will not be overwhelmed should we pass the referendum and introduce the legislation proposed by the Government.

I had the privilege to chair this week a briefing meeting at which Deputy Kelleher and Senator Noone spoke. We also heard from Dr. Maeve Eogan of the Rotunda and Dr. Mark Murphy of the Irish College of General Practitioners. The evidence of Dr. Murphy was very clear. He had analysed the statistics around the number of likely medical and surgical terminations, respectively, and how even if only a minority of general practitioners opted in, it would still be very easy to deal with the kind of numbers we are talking about. It is important, therefore, not to have scaremongering and to have clear, factual evidence when we debate the issue.

We must debate it in an atmosphere of honesty. While there has been a great deal of talk about respect, with which I agree, there must also be honesty. The facts we put out there must be real and based on evidence. Unfortunately, I have heard statements as adduced as evidence which are simply not true. We understand that this is a matter for the people of Ireland and that it is a question citizens will decide. I hope they will be given the kind of honest information they require. Part of that involves ensuring the kind of information we got at the committee is made available to people. For example, I refer to the pill, which the Citizens' Assembly suggested specifically the committee should address. We did so. The evidence is that women are accessing abortion pills on the Internet and taking them without access to medical supervision. I support the recommendations that there must be a medical context for all of this, largely through the GP service. We are talking about a situation in which even if women have complications, they feel they cannot go to their doctor or talk about what has happened to them. Certainly, the statistics on abortion in Britain show that Irish women have later terminations than women in Britain. That is not good. If there is access within our own country in the medical context, we will have the care we need.

I welcome the Minister's remarks on the ancillary recommendations of the committee around issues like contraception, sex education and ensuring care exists. Finance will not be a barrier to access to contraception, I hope. The international statistics show that where one has after care and advice on contraception, there are reduced numbers certainly of second or third abortions. The international information provided to the committee showed that in many countries the abortion rate reduced after the introduction of legal abortion. Romania was one of the countries referred to. There is no information to suggest the rates will go up in Ireland. In fact, it is likely they will stay somewhat similar and maybe even reduce because evidence from other countries shows women having access to the kind of wrap-around care and advice reduces the number of women who go for termination. The Dutch model is a good one. We had evidence at the committee on abortion in the Netherlands where it has been legally available since 1984. However, the abortion rate in the Netherlands is one of the lowest in Europe at 8.6 per 1,000 in 2015. One of the factors to which that is attributed is the high use of contraception in the adult population. The Dutch model also includes a waiting period, which the Minister is also suggesting. Certainly, I have no objection to that albeit we did not discuss it or make any specific recommendations in that regard at the committee. It appears to be a successful part of the Dutch model. There are models there and we have a great deal of information as to how we can deliver care for women when they need it in these situations.

I turn to some of the particular evidence that came before the committee in the context of what legislation might follow repeal and the recommendation of a 12-week gestational period as the cut-off point. I pay tribute to the three members of the committee who made that recommendation. I hope the Sinn Féin position will change on this. I welcome Deputy Ó Broin's statement but it is important for Sinn Féin to support the proposal. I was convinced by the evidence as were other members of the committee, in particular in the case of rape. It is unacceptable to put women through the trauma of having to prove they were raped. We have been told categorically that it is not possible to do it in time for the woman who has been raped to have a termination. Ms Noeline Blackwell of the Rape Crisis Centre and Dr. Maeve Eogan of the Rotunda Hospital were both very clear that there is no physical way to determine conclusively that a woman has been raped. There is also no legal way to deal with the issue within the timeframe. I refer to the evidence of Mr. Tom O’Malley, a legal expert who came before the committee. Discussing whether there would be a court decision in relation to rape, he said a number of important questions arose including, who would adjudicate; would the woman bear the burden of proving that she had been raped and, if so, what standard of proof would apply; should the alleged perpetrator be identified assuming his identity is known to the woman; would the alleged perpetrator, if identified, have a right to be heard, for example if he was a husband or partner and objected to the requested abortion; would the woman who claimed she had been raped by a named individual be entitled to immunity from civil or criminal proceedings in respect of that claim; would evidence of the abortion or a request for an abortion be admissible in any later criminal trial; is there a possibility in some cases that an adjudication process of this kind could end up being a criminal trial in everything but name; and should there be, in any case, an absolute requirement that the alleged rape be reported to gardaí.

As such, there are huge questions around the issue of rape and most people who have doubts about what the legislation should contain but feel the eighth amendment is not appropriate would say that in the case of rape, a woman should be entitled to make the decision to have a termination of her pregnancy. Those of us around the committee were absolutely convinced of that from the evidence we heard. There is no way to provide for a woman who has been raped or is the victim of incest without establishing a safe period such as the 12-week period which has been recommended. There is no way to deal with rape as a matter of exception and we must be clear and honest about that.

In conclusion, I quote from my party leader's contribution on the debate here on the recommendations of the committee. He said our laws must be practical, enforceable and humane.

I want to live in a country that treats all its citizens, including its women, in a way that is practical, enforceable and humane.

We should not fool ourselves, and nobody should be allowed to fool the public, that retaining Article 40.3.3° will somehow protect the country from the reality of abortion. Women need to be treated in their own country. They need to have the support of the medical profession, including doctors whom they trust. They also need the expertise of doctors in their own country.

As a country, we have to be honest about this issue. It is simply wrong to suggest we do not have personal responsibility and rights in this area. This is a very personal matter. It is a personal issue for every woman who faces a decision, as well as for the loved ones around her. We would have a much better country if we gave people the freedom and space to make these kinds of personal decisions without trying to impose something from outside that simply cannot deal with the reality.

There is nothing that will stop Irish women in very difficult circumstances from choosing a termination. I have quoted the Termination for Medical Reasons group before so I have not referred to it very much this time round. That group was the most persuasive in arguing why Article 40.3.3° should not be in the Constitution. The individuals concerned were about to have a wanted child and found that child's life would not last. They ended the pregnancy, which was never going to produce a child that would live. They had to go to a foreign country and bring back the ashes or body of the baby in an aeroplane, boot of a car or boat. They had no support within their own country. If it is only for those people, we need to remove Article 40.3.3°. We need to do a lot more than that, however. We need to face up to the reality. I hope the amendment to the Constitution will be made.

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