Clare Daly (Dublin Fingal, Independent) | Oireachtas source

A number of our amendments are included in this group so I will try to deal with them briefly. They largely relate to a requirement to consult the woman, ascertain the views of the woman and other issues in terms of serious harm and the issue of risk. It is quite a broad berth but I will be as brief as possible. First, in the Bill, as drafted, there is no requirement to consult the pregnant woman. That is very problematic and is not reflective of the rights based approach to the provision of women's healthcare. Amendments Nos. 15 and 16 seek to do this in part. Amendment No. 15 deals with the pregnant woman having a right to deem that the risk to her life or health is unacceptable. We have discussed this. Pregnant women are competent adults. We removed the eighth amendment to recognise bodily autonomy, and we should do that.

Examples were given at the committee of where a woman knows best. A doctor might think there is a risk to a woman's health but the woman might think, "I am in my early 40s, I have no other children, I desperately want a child so I want to take the risk and continue with the pregnancy even though it may result in a risk to my health." She makes that decision, whereas perhaps a younger woman with children at home and other responsibilities might feel that the risk to her health is too great a risk to take. There was much talk during the referendum campaign about trusting women and that was very much a sentiment of the electorate, but it is not reflected anywhere in the Bill. The amendment is an addition. It is not eliminating anything but allowing the voice of the woman to be put centre stage in the legislation.

Amendment No. 17 relates to the term "serious harm". We have discussed this a great deal so I will not labour the point. The term is not helpful given the climate we have come from on this issue. It is not women centred and the points made repeatedly to the committee were about the challenges in fixing risk and that it is best considered in a clinical setting, not defined in legislation as serious or severe. Many of the medical practitioners made the point that risk of the development of serious harm can fluctuate and in that context mothers can slip through the net. We cannot have that situation.

Amendment No. 19 is also important and deals with the issue of risk. It proposes deleting the word "avert" and substituting the word "reduce". This would ensure access to abortion if it reduces the risk to the woman's health even if it does not eliminate that risk. With the current wording the intervention would have to eliminate the risk. That is very dangerous so we must change the language. There will be scenarios where the pregnancy is a significant contributing factor to the risk to the health or life but not the sole determinant, and its termination may significantly mitigate but not entirely avert the risk. We must be very careful and amend this to support the medical practitioner's clinical judgment.

Good information has been brought forward by Lawyers for Choice on the legal sense of the word "avert", which Deputies will have read. Avert in the legal sense means prevent. That is a definitive view in the context of risk and harm. Lawyers for Choice give the good example that in situations where an abortion would reduce the risks to health but not fully avoid them, there is a legal risk that the pregnant person could be forced to continue the pregnancy on the ground that the need for aversion rather than reduction or considerable reduction had not been met.

Lawyers for Choice gave examples of conditions that might develop as the pregnancy continued where it would be safer for the person to have an early termination but where it did not quite tick that box. They suggest the ending of such a pregnancy at the earlier gestation would reduce but not eliminate the risk. In other words, under the current wording, a person who is at 14 weeks gestation and requires an abortion owing to a condition that might get worse during the pregnancy would meet the criterion of risk to health. As the pregnancy had not reached the point of viability, that box would be ticked, but the person might not meet the criteria in section 10(1)(c), as the abortion would not completely avert the risk; it would only reduce it. That is why we need to have the word "reduce" in order that the person would not have to travel to access abortion care. That is why we have put forward many of these amendments. If we do not have them, there is a risk the person who needs to access this service might have to continue to travel. Amendments Nos. 21 and 22 in this group for the purposes of discussion are really just technical amendments to facilitate amendment No. 15.

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