Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I move amendment No. 13:

In page 9, line 9, to delete “section 14(2)(a)” and substitute “section 14(2)”.

Section 14(1) states:

A termination of pregnancy may be carried out in accordance with this section by a medical practitioner where, having examined the pregnant woman, he or she is of the reasonable opinion formed in good faith that the pregnancy concerned has not exceeded 12 weeks of pregnancy.

Section 14(2) states:

A termination of pregnancy shall not be carried out under this section unless — (a) the medical practitioner referred to in subsection (1)has certified his or her opinion as to the matter referred to in that subsection, and

(b) a period of not less than 3 days has elapsed from the date of certification referred to in paragraph (a).

Section 14(3) states:

The medical practitioner referred to in subsection (1)shall make such arrangements as he or she shall deem to be necessary for the carrying out of the termination of pregnancy as soon as may be after the period referred to insubsection (2)(b) has elapsed but before the pregnancy has exceeded 12 weeks of pregnancy.

The requirement that the certifying medical practitioner must carry out the termination of pregnancy is necessary to ensure the process for accessing a termination of pregnancy is clear for the woman and her medical practitioner. The lack of a direct link between the four stages of the process, namely, examining, forming the opinion, certifying and carrying out the termination has the potential to act as a barrier to the woman wishing to access termination of pregnancy. For example, if the law did not require under the section the termination to be carried out by the medical practitioner who forms the opinion referred to in section 14(1), it could lead to a situation where a medical practitioner certifies in his or her reasonable opinion formed in good faith that the pregnancy concerned has not exceeded 12 weeks of pregnancy and after the required three days has elapsed from the date of certification, the woman could be refused termination by a different medical practitioner on the grounds that he or she is not of the required opinion, which could create a barrier to access that none of us wants to see. Furthermore, the law should not impose an obligation on a medical practitioner to carry out a medical procedure on the opinion of another medical practitioner if he or she does not agree with that opinion.

From a legal perspective, I am advised that not linking the four steps in the process would have the effect of breaking the chain of causation necessary for an unlawful termination of pregnancy to be prosecuted effectively. Having set out the rationale for the policy behind the requirement of the legislation, I must note the following points raised on Committee Stage, concerns raised by medical practitioners and discussions within my Department about implementation and service provision.

A difficulty was identified in the section, which we discussed at length, because it would require without exception the certifying medical practitioner to carry out the termination of pregnancy. Should the section be left as it stands, it may create a barrier to access for women in certain cases, where, for example, the medical practitioner is subject to unanticipated events such as illness or other issues which mean he or she is not available when the woman returns for the termination of pregnancy. In addition, rostering issues and practical realities of medical practice in a hospital setting mean that following the three-day period the same doctor may not be on duty when the pregnant woman returns to undergo the termination of pregnancy. In both cases, the requirement for the same doctor to carry out the medical procedure could result in the woman having to start the process all over again with another medical practitioner and also to have to undergo a three-day wait period again, which no one wants to see happen.

It remains my policy that the medical practitioner who forms the opinion and certifies the termination of pregnancy should be responsible for carrying out the medical procedure. I do not wish to create any other mechanism in that regard, but it is important that we acknowledge the practical realities of service provision. I propose, therefore, amendments in this group to the section, which would allow a second medical practitioner to become involved following the three-day period if the first is available.

The amendments keep the safeguards and legal requirements which the section currently contains but aim to clarify the pathways for accessing the service and avoid creating an additional barrier for women trying to access the termination of pregnancy under this section. The effect of my amendments is to provide that where a medical practitioner has formed the reasonable opinion in good faith that a woman's pregnancy has not exceeded 12 weeks, and certified that opinion, and the woman has fulfilled that three-day period a second medical practitioner may carry out the procedure without a further period having to elapse, where he or she has formed the reasonable opinion in good faith that the pregnancy has not exceeded 12 weeks and has certified the opinion. This does not change the grounds but it recognises that following the period after the woman returns to see the doctor, it may not be the same doctor on duty. The doctor may be ill or on leave and we cannot have a situation where a barrier is put in front of that woman.

This tries to respond to the concerns expressed to us as a health committee by the medical profession and concerns which many colleagues have expressed in this House and discussions in my Department. It is a sensible amendment, which recognises the practical reality that when a woman returns to her doctor, the same doctor may not be able to see her and she should not have to start the process all over again.

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