Mattie McGrath (Tipperary, Independent) | Oireachtas source

I, too, am glad to be able to speak to this amendment. Informed consent is one of the fundamental principles underpinning the ethics of medical practice. It is a given that, where possible, the patient or person concerned should be adequately and appropriately informed in such a manner that the nature and gravity of the procedure, not to mention its consequences, are made clear to them. This is an entirely acceptable and long-established medical principle all over the world. Once again, our amendment reflects current UK practice. Indeed the abortion provider known as the British Pregnancy Advisory Service, BPAS, whose representatives gave evidence before the Oireachtas joint committee, clearly states a policy that all women availing of abortion services should have a discussion about their pregnancy options, their decision about whether to continue or to end the pregnancy, and in the latter case, their understanding of the available procedures and associated risks as part of the process of gaining informed consent.

BPAS also highlights, as is directly applicable here, that informed consent is entirely separate from the requirement set out in the Abortion Act 1967 for two doctors to certify that a woman meets the grounds for abortion. Although these principles are often confused, they are totally different. The need for consent in healthcare is founded in common law and the principle of bodily autonomy. For consent to be valid and legal, it must be voluntary and informed. The person consenting must have the capacity to make the decision. These principles apply to all medical procedures, including abortion.

I will now outline the definitions of these terms as explained by the NHS Choices website. "Voluntary" means that "the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family". For consent to be informed, "the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment doesn't go ahead". Finally, to have capacity "the person must be capable of giving consent, which means they understand the information given to them and they can use it to make an informed decision".

I note some countries’ different approaches to this issue. In France, the physician must inform the woman about the risks involved and provide her with a guide to the rights and assistance provided by law to families, mothers and their children, as well as informing her of the possibilities for adoption should she decide not to terminate the pregnancy. The Minister has never addressed any of these regimes. In Belgium, the doctor must provide the woman with detailed information regarding the rights, assistance and benefits guaranteed by the law to families as well as regarding the possibilities offered by the adoption of the child. Assistance and advice on resources available to resolve the psychological and social problems posed by the woman’s situation must also be made available. I do not see that anywhere in the Minister's offering, though we spent many hours in the talks on the programme for Government trying to get a commitment to a perinatal hospice. Some Members did not know what that meant at the time. It fell to my daughter and Deputy Harty to explain it to them. We have not seen that rolled out either. Progress has been very limited.

I refer also to the relationship between informed consent and abortion regret. During the Citizens' Assembly this was made absolutely clear by the abortion regret support group Women Hurt. I want to put on the record the points they made in their submission, because they were completely ignored during the course of the referendum debate and have been the subject of mockery during this debate. I have met countless numbers with feelings like that, but they were not listened to at all. They were called fakers, accused of making it up, or called delusional or notional. It was terrible. Deputy Chambers apologised under pressure from others, but I did not hear apologies from other Deputies who said these views were notional, fictitious or airy-fairy. One such Deputy is sitting quite close to the Minister and whispering to him. I did not hear that, and I would like to, because they were totally disparaging remarks.

I quote from the group's submission:

We are writing to you from Women Hurt, a group of women who have all experienced abortion. For us it was the worst decision of our lives and something we deeply regret to this day.

Nobody told us what life after abortion would be like or even what happens in an abortion. Today nobody is talking about what will happen if we repeal the 8th Amendment. All we hear about is the ‘right to choose’ but never anything about the actual abortion itself. If it is such a simple procedure with no drawbacks, why the reluctance to discuss it? Deep down we all know the answer why.

When I took an animated three-minute video to the so-called hearings, no committee members wanted to see it. They would not even look at an animated video. Hear no evil, speak no evil, see no evil. That was intended to inform the members of that committee. The submission goes on:

The published research in this area backs up the evidence that is clear from talking to women. There is a media imposed wall of silence about openly discussing abortion regret. There is no question about that. Almost all of the media focus on the issue is about building the case to justify legalised abortion. There is an unbelievable defensiveness about allowing calm and reasoned debate on the matter, where groups like Women Hurt can contribute without being verbally assaulted.

It is devastating to think of all the women who suffer in silence after abortion, all because those pushing are determined to keep going regardless of the human cost in lives lost or the indescribable human suffering that abortion causes.

Here are some of our stories and experiences. We would gladly present an oral presentation to the Assembly if you intend facilitating such presentations.

The submission then quotes a woman identified as "Lynn":

I aborted my son, Stephen on the 21st September 1980. He would be 35 years old now had he lived. My employer coerced me in to an abortion (which they provided and paid for) giving me the 'choice' in order to keep my job, my income and my home. I had a 'safe & legal' abortion, travelling not more than 10 miles from my then home. In the age of equality, this was meant to make me equal to my male counterpart so that I could continue my career. What nonsense. My male colleague could not become pregnant and therefore would never have to consider abortion. I was not given the facts. No counselling before or afterwards. I suffered from post abortion trauma (PTSD similar symptoms including flashbacks) for a good ten years before I fortunately stumbled across help.

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