Catherine Murphy (Kildare North, Social Democrats) | Oireachtas source

Let me first say how glad I am that we are finally at this stage and that we are commencing the legislative process on this issue. It is a testament to the dedication of campaigners, some of whom have been fighting this fight for decades, that we are finally on the cusp of delivering comprehensive maternal and abortion healthcare in Ireland.

The strength of the mandate given on 27 May leaves no doubt in our minds as legislators as to the will of the people. It was a two thirds majority, with just one constituency not voting in favour of the amendment. The process leading up to the vote was very robust, from the Citizens' Assembly to the all-party Oireachtas committee, of which I was a member. The very fact that a very comprehensive report was delivered and that the public had full sight of it in advance of the referendum was incredibly mature and incredibly important. It was very much a product of new politics that the make-up of that cross-party committee could be so broad in coming to a consensus.

I have been involved in committee work on pre-legislative scrutiny in respect of other issues. It is not the case that pre-legislative scrutiny goes to the detail of writing the legislation. It writes the broad script. This is precisely what the all-party committee did. It did the work of what would normally be seen as pre-legislative scrutiny. I therefore believe there is no deficiency in the legislative process in respect of this legislation. If anything, it was more robust than what one would usually see, and the work of the committee was very public in that it had a very wide audience.

While today is an achievement of massive proportions, it would be remiss not to mention some shortcomings in the Bill. We welcome the fact that the Minister has allowed the amendments to be tabled. It is important that this was possible. I understand that the Attorney General's office is responsible for the drafting arrangements of the Bill. I must, however, echo the sentiments of those who expressed concern about the framing of the Bill. Following a mandate which overwhelmingly sought to remove the stigma and criminalisation of women in this country, it is a shame that the entire first half of the Bill is preoccupied with a listing of offences and penalties which may be faced. Experience and research both show us that perpetuating a fear of criminalisation of the medical profession results in a chilling effect and makes medical practitioners fearful of their actions. This is not the environment in which we want our medical practitioners to operate. I am very glad to hear that Dr. Boylan will take the clinical lead on the implementation strategy, and I hope this will address some of these concerns, but I certainly favour reframing the Bill so it does not lead off with the offences.

The basis of the Bill must be access for women who need abortions. Many interest groups have spoken about the ambiguity caused by the reference to serious health risks or serious harm. This potentially leaves definitions open to the subjective opinion of individual practitioners and therefore makes things still somewhat uncertain for women. Similarly, we need absolute clarity as to how the three-day waiting period will operate. I understand from briefings with the Minister that the clock will start ticking when the doctor certifies the pregnancy, but we must factor in the potential difficulties this may cause. I remember asking questions of the witnesses from Holland as to when a pregnancy is counted from. We were all trying to figure out how this would work for people travelling to Holland from this jurisdiction, for example. The witnesses said a pregnancy is counted from first contact. There is much humanity in the thinking surrounding this when one considers someone who may present with, say, a fatal foetal abnormality. What they wanted to do was give people time, for them not to feel they were under duress or pressure. If this is to be included, then it must be included in a way that reflects the experience.

The Bill allows for conscientious objection. It must be taken into account that women, particularly those in rural or isolated communities, for example, may have difficulty sourcing a doctor who will certify a pregnancy. Given that we are trying to ensure that abortion is not only rare but also performed as early as possible in the pregnancy, it is important to manage this aspect of the legislation properly. It is imperative that the legislation takes account of the particular difficulties that may be faced by those in non-city or non-urban locations, those with disabilities and those who are in other ways already marginalised in society. I have a particular memory of Professor Veronica O'Keane talking about someone who had bipolar disorder coming into her office. This person was very stressed and Professor O'Keane wondered how she would make her way home, never mind make the arrangements to go to another jurisdiction. We must keep in mind, therefore, that there can be a broad range of people in different crisis scenarios and that there may not be only one crisis but multiple crises.

Regarding the proposal for conscientious objection, my office has also raised concerns about the possibility of certain medical institutions opting out. While the Minister has assured me that there can be no conscientious objection on the part of institutions, it would be remiss of us to ignore the fact that certain boards of management potentially could instruct staff to adhere to internal regulations. We must ensure the legislation covers such eventualities. Other jurisdictions have also encountered the problem of doctors in public hospitals refusing to carry out a procedure where it will be free to the patient yet offering the same procedure in private practice for which the patient would have to pay. The legislation must be robust enough to ensure this scenario cannot develop.

While I know it has been raised ad nauseam, I must add the Social Democrats' voice to the calls for the definition of "woman" within the Bill to be clarified so as to be fully inclusive of all who identify as female or who have a uterus. This must also take account of adolescent women and girls, and the Minister must examine the potential conflict between the age of medical consent and the age of sexual consent. The World Health Organization is clear about the need for children's voices to be heard in the medical process where their bodies are subject to any abortion procedure. I believe this area needs more thought and clarity in the final legislation and I have no doubt that this issue will be raised on Committee and other Stages. We in the Social Democrats look forward to working with all groups and parties throughout this legislative process to ensure that the final Bill, when passed, provides a best practice example of abortion healthcare in a modern, progressive society.

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