Mattie McGrath (Tipperary, Independent) | Oireachtas source

Forcing doctors or other healthcare professionals who have a conscientious objection to arrange for an abortion to be performed is not respecting freedom of conscience. It makes them party to taking the baby's life. The referral obligation forces general practitioners, in violation of their sincerely held convictions, to be involved in a process that destroys that life. Under the Bill in its current form, doctors would not only be entitled, but also obliged, to act in violation of the most fundamental principle of medicine, the obligation to do no harm. They would be penalised for respecting life and exercising their constitutional right to freedom of conscience.

The current proposal has already been opposed by over 600 general practitioners. Many of them have indicated they will not co-operate with a duty to refer for abortion. Indeed, the Irish College of General Practitioners carried out a survey that suggests 25% of general practitioners will not refer. That amounts to between 700 and 800 general practitioners approximately. Therefore, the Minister is heading down a cul-de-sac. He has created a completely unnecessary showdown with doctors over a subsection of a Bill that is, in reality, superfluous. Given the way he treats them, I am aware he does not have great respect for them anyway.

Even as a matter of pragmatism, the country cannot afford to lose a large number of GPs because there are simply not enough of them practising here as it is. If the Minister lived in rural Ireland, he would know this and he should know it given that he represents Wicklow. If he presses ahead with requiring doctors to "make arrangements" for women to access abortion against their deeply held beliefs, a legal challenge seems inevitable as a result of an obvious and easily corrected flaw.

New Zealand law allows doctors with a conscientious objection to abortion not to refer. In US federal law, the Public Health Service Act and the Weldon amendment prohibit the funding of discrimination by public authorities against any "health care entity", which term includes doctors and medical trainees, on the basis that the entity refuses to provide referrals or make arrangements for abortions. We can quote international law when it suits us. In Britain there is no obligation to "make arrangements" to help women avail of an abortion either, and the absence of such an obligation has clearly not impeded access to abortion services there.

The Minister has suggested that the referral obligation is in line with paragraph 49 of the 2016 edition of the Medical Council's Guide to Professional Conduct and Ethics for Registered Medical Practitioners. This is simply wrong. Paragraph 49 states that doctors "may refuse to provide or to take part in the provision of lawful treatments or forms of care which conflict with [their] sincerely held ethical or moral values". The obligation on the doctor in these circumstances is first, to inform the patient that there are options for treatment elsewhere and, second, to give the patient information to allow him or her to transfer himself or herself to another doctor to obtain the treatment. The doctor is only obliged to assist with the transfer where the patient is unable to transfer himself or herself. It is an entirely new departure in Irish law to require someone who objects to the ending of a human life to ensure that that life is ultimately ended by someone with no such objection.

The Government has decided to introduce an opt-in system for the provision of abortion services. There is no basis for mandatory referrals because direct access will be provided. The Minister's scheme will enable women who want an abortion to identify healthcare workers who will provide one, and prospective patients will be able to self-refer. This is quite obvious. There is no rational basis for the argument that respecting conscience rights will prevent access to abortion in Ireland. This amendment would align our law on this point with that of other countries, such as those to which I have already referred.

Amárach Research polling in the wake of the referendum showed that just over 50% of adults, excluding "don't knows", disagree with a referral obligation.

A group of pharmacists recently called on the Minister to specifically recognise the right to freedom of conscience for pharmacists in the practice of their profession in the health Bill before the House. A recent PharmaBuddy poll of pharmacists registered in Ireland showed that 60% of respondents supported the extension of freedom of conscience protection to the pharmacy sector. The Minister knows this better than I do. As a group of healthcare professionals, pharmacists are involved in every aspect of the manufacture and supply of medicines and in the counselling of patients. Pharmacists will therefore play a critical role in the implementation of any future abortion policy. Despite requests from the pharmacists' representative bodies, namely, the Irish Pharmacy Union, IPU, and the Hospital Pharmacists Association of Ireland, HPAI, there has been no engagement whatsoever on the part of the Minister-----

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