Thursday, 29 November 2018
Health (Regulation of Termination of Pregnancy) Bill 2018: Report Stage (Resumed)
As we all outlined and agreed, there are paternalistic cultures which may force women to have abortions on the basis of gender. We need to have safeguards against that. It is only reasonable to allow the amendment to be made to ensure we have that safeguard. It also ensures that children with disabilities are not discriminated against. We have made great progress on inclusion in this State when we consider the Special Olympics and all the positivity associated with that. It would be a shame to undo all that good progress by not agreeing to an amendment to ensure that no abortion is carried out based on disability or gender.
The legislation does not provide for termination of pregnancy to be carried out on the grounds of sex, race or disability. The Bill provides for termination of pregnancy to be carried out only in cases where there is a risk to the life or serious harm of the health of a pregnant woman; where there is a risk to the life, or of serious harm to the health, of a pregnant woman in an emergency; where a condition is present which is likely to lead to the death of a foetus either before or within 28 days of birth; and where the pregnancy has not exceeded 12 weeks. Terminating a pregnancy otherwise than in accordance with the provisions of the Bill is an offence which may be prosecuted.
The proposed amendment is entirely unworkable in practice and is designed, in my view, only to stigmatise women in crisis pregnancies by allowing its proposers to suggest that these are their motives. If it were to pass, its only possible intention would be to render termination services practically entirely inoperable requiring, as it does, a doctor to be able to determine a woman's thoughts which she may choose to keep private, and in fact be satisfied as to the absence of those described. This would likely have the effect of creating substantial and unnecessary difficulty for doctors in providing certification. It would make the entire premise of the early pregnancy section of the Bill inoperable.
The strong advice of the Chief Medical Officer is that this amendment must be opposed on this basis and I fully support that medical opinion. It is also my strong view that the proposed amendment is completely out of step with the decision of the people and the recommendations of the Oireachtas Joint Committee on the Eighth Amendment of the Constitution. The legislation, as drafted, reflects the majority view that women in early pregnancy should be able to make their decisions in private with their doctor without being required to give a reason.
This is a case of the political tactic of "let them deny it". There is no ground in this Bill for termination of pregnancy in relation to disability, sex or race. It is not allowed under the provisions of the Bill. A suggestion to the contrary is not grounded in fact or in the medical advice offered to me by the Chief Medical Officer and is a serious deviation from the grounds we extensively debated during the referendum campaign.
I wish to put on record Sinn Féin's position with regard to terminations on the grounds of disability. Sinn Féin is opposed to terminations on the grounds of disability. As a party we debated the matter at our Ard-Fheis. More than that, as political activists, we campaign day in and day out for the rights of persons with disability. In our advice clinics at council level and at Dáil level every day of the week we deal with cases involving parents who have children with disabilities.
For our party the issue is a settled matter. We abstained in Committee because we wanted to be certain that this legislation does not provide for terminations on the grounds of disability. We abstained to give ourselves time to consider it and engage with the Minister. We have engaged with the Minister and on the basis of the assurances we have been given which accord with our party policy, we will not be supporting this amendment.
We stand up for the rights of persons with disabilities. We stand up for their families. We stand with them in our communities through our activism. We are very clear on that. We gave ourselves the time and we engaged with the Minister. I thank him for his engagement and for his assurance that this legislation does not provide for terminations on the grounds of disability. It does not and therefore we will be opposing the amendment. However, we do so because the legislation is very clear as is our position. We stand with people who have disabilities. We stand with their families and we will continue to do so.
The amendment was introduced by its proposers as having stemmed from meeting somebody who survived an horrendous attempt at abortion. However, the wording of the amendment has nothing to do with that, but rather is, as the Minister said, an attempt to undermine the entire sentiment of the legislation and the referendum we had to repeal the eighth amendment of the Constitution.
I am not a scientist or a medical person. I read this and spoke to a doctor friend of mine. This attempts to rule out abortion in the case of disability and gender where the pregnancy has not exceeded 12 weeks.
Until now at least, in the medical and scientific community, one could not determine the gender or the presence of disability until approximately 11 weeks. An expensive, hard to attain test called a cell-free fetal DNA test is then required. The chromosomal make-up in the foetal material is examined and if it has two X chromosomes, the foetus will be a female, or if has an XY chromosome, it will be male. If anyone tried to have that test done at 11 weeks, there is no guarantee that they will get the result, and the result would not be available within a week, which would put them outside the 12-week limit this legislation has provided for.
The reason most parents or pregnant people want to have that test is linked to genetic disorders rather than trying to eradicate all the Down's syndrome people on the planet. That is why it is called a cell-free fetal DNA test. It is carried out to identify certain diseases that are linked to the X chromosome, two of which are carried by the female gender. Rather than this being about how China or Pakistan trying to eliminate females from their society, as it was put in what I consider racist terms, the test on the female, if it is carried out, is very much linked to whether there is a genetic disposition to conditions such as muscular dystrophy, haemophilia or Hunter's syndrome. That is where a family is worried if they have a genetic disposition and want to see if it will be the case in their pregnancy. It is a rare test to have carried out. It is expensive and difficult to attain. The amendment is a ruse to try to deny women and pregnant people access to what is rightfully theirs following the May referendum.
The amendment also states: "... because of ... race". There is only one race, and that is the human race. Race is not determined by anything other than the fact that we are all human beings. After that, ethnicity is determined by the combinations of different genetic make-ups. It is shameful for anybody to try make out that race is a factor in this Bill because there is only one race. A parent might take that decision because conditions and disabilities could be detected. Is it not sad that they have to do that because they carry within the family the danger of genetic heredity factors that could limit the lives of their children?
This is a ruse. It is about trying to deny the reality that the people have voted to give women and pregnant people access to abortion without restriction up to 12 weeks. I am sorry, but it will not work. We have to vote against this amendment.
I do not intend to speak on some of these amendments for very long but I felt I had to come into the House to object to the racist stereotyping in the amendment and in the contributions of some speakers. The phrase was used last night-----
The phrase "cultural people" was used last night; it did not even make sense. The Deputy was trying to say was there are people who come from cultures where abortion for sex selection is done. I utterly object to that for a number of reasons. First, I represent a constituency where one in four people was born outside Ireland, which includes people from India and Pakistan. Second, it is just not true, and I did some research following last night's comments. If we voted "Yes" to this amendment, ethnic profiling of pregnant women would be introduced. If a woman from one of these cultures enters a GP's surgery, she will be asked if she is going to have an abortion because her child might be brown or black. Can we imagine that interference in the consultation with the woman? I have researched this and this is what happens.
The other issue is sex selection. I read studies of an imbalance in the ratio between men and women in societies. The fact that sons are favoured in cultures is wrong and shameful, but it stems from the inferior position of girls and women in our world, whom the proposers of these amendments never show any interest in once the child is born. Some of that imbalance can occur after girls are born. When families are poor, girls can get less food, education and so on. There can also be infanticide if the proposers would prefer that prospect. Sex selection for abortion is horrendous, but the Deputies need to cop on. We have a system where women are utterly inferior, taking the planet as a whole. The proposers again care nothing about that.
Mention was made of Pakistan. I looked up a study that was only done in 2016 in which the author stated: "We do not find consistent and convincing evidence that sex ratios at birth (which indicate sex-selective abortion) are increasing." That is important because people who are now Irish citizens could find themselves being affected by this amendment being accepted. There is enough racism in society without people trotting this out in the national Parliament. It is difficult enough for people to integrate into society without the stereotype being thrown out that they do not like girls. The Deputies should cop themselves on. That should be kept out of the debate and we should move on and deal with the main issues.
When we consider whether this Bill should explicitly ban abortions on any discriminatory grounds - disability, race or gender - it is instructive to recall some of the statements the Minister made on this topic. During the referendum campaign, when he sought to reassure the public that this Bill would not allow shockingly high levels of abortions on the ground of disability that occur annually in other countries, and knowing that most Irish people wanted to provide protection against discrimination of the most vulnerable among us, he repeatedly assured voters that it would not allow abortion on the ground of disability or on the basis of the undesired sex or race of the unborn baby.
On 1 February, the Irish Independent reported the Minister as saying that if the electorate votes to repeal the eighth amendment in the referendum, the proposed legislation widening the grounds for abortion would not include grounds for disabilities such as Down's syndrome.
On 14 May, the Irish Independent reported the Minister reiterating this promise when he stated: "We've specifically excluded disability for grounds for abortion in the legislation." On Newstalk, on 22 May, just days before people were asked to vote, he said the people are grappling with this question and they want to be sure they make the right decision. He said that he can tell the people clearly that he has specifically excluded disability as a ground for termination.
What are we to understand from that? When the Minister made those claims, were we to understand that it would be illegal under the new legislation to abort the baby on the ground of disability? Many voters certainly did, and many reluctant "Yes" voters have said that reassurance was a big factor in the way they voted.
It must be made very clear at this point that at no stage and in none of the draft or public versions of the Bill was abortion on the ground of disability ever mentioned. The Minister took a gamble that voters would take his assurance at face value and not search the text of the legislation themselves.
Had they searched the legislation, they would have quickly discovered that the Bill makes no mention of disability. Unfortunately, the majority of the media also chose not to challenge the Minister on the spin that was put out. He would like all of us to believe that if it is not specifically legal to abort on the ground of disability, it will somehow not happen in Ireland. That view is very naive.
In Germany, it is not specifically legal to abort a baby on the grounds of disability, yet some 90% of babies with prenatal diagnosis of Down's syndrome are aborted there. How does that happen? These abortions are usually certified on the grounds of risk to the mental health of the mother. Section 12 allows abortion until viability and until the birth on the grounds of risk of serious harm to the mental health of the mother, in line with Dr. Peter Boylan's assertion that if a woman says the matter is serious, it is serious. It is hard to see how the German loophole will not also find its way to Ireland. Deputy Coppinger tried to make the same point in the Chamber last night that a woman should get to decide how serious a serious risk to her health is. What situation will the Bill lead to in Ireland? Will disability be a specifically allowed ground for abortion? No permission to abort is given based specifically on a disability. It is not, however, "specifically excluded", to use the Minister's words. The Bill is silent on the highly controversial matter of abortion on the grounds of disability, despite all the Minister's fine words before the referendum. His promises are not worth the paper on which they were written.
The Minister deliberately misled the public about what the Bill would permit or prohibit. He remains defiant and determined to be the only lawmaker who can make any changes to the Bill. My fellow Deputies and I were all elected to shape the legislation of this country, and we have the opportunity to ensure Ireland does not follow countries like the UK, Germany, Denmark and Iceland into the eugenic black hole into which they have fallen, where the lives of more than 90% of all babies diagnosed with Down's syndrome in the womb are intentionally ended. We must not allow our unborn babies with disabilities to be discriminated against so callously.
We have made so much progress in recent years in how we treat every member of society with respect and dignity. Who could forget the Special Olympics in Ireland, when we showed the world we valued every person regardless of his or her level of ability or disability or level of additional needs? Many tourists and visitors to Ireland remark how many children and people with Down's syndrome there are. They often make the mistake of thinking it is a condition that is more prevalent here than in other countries, but the truth dawns on them when they realise it is simply because we allow these children to be born and we allow them to live. Children and adults living with Down's syndrome are nothing to be afraid of and, in many cases, bring much joy to their families and communities. That is what makes us different. A diagnosis of disability in Ireland is not an almost automatic death sentence.
Today, we will decide whether we will allow a prenatal diagnosis of a disability to put a target on a child's back or mark the child out for special protection. To think that because it is not specifically legal means it will not happen is to bury one's head in the sand. If Deputies want to ensure the people's desire to protect unborn babies with disabilities from discrimination, and if they want to protect baby girls from abortion simply because they are female, they need to support the amendment. It is not about being pro-life, pro-choice or pro-abortion; rather, it is about human rights.
I must take exception to what Deputy Coppinger said about the proposers of the amendment when she ascribed motives to them that were unworthy. Mentioning them by name was totally unacceptable. Most of us who do not agree with the Deputy's view of the world have always respected that view, and have always said if someone has a different view and believes it sincerely we will respect him or her for it. Unfortunately, with the treatment meted out to some Deputies and, in particular, the reference to Deputy Nolan for her views in this debate, that respect has not been reciprocated.
I will proceed when I have the floor.
Funnily enough, based on what Deputy Donnelly said last night and on what I understand, although I would like confirmation from the Minister, the Minister agrees with the basic thesis of the amendment. As far as I understand from what he and Deputy Donnelly said, it will be illegal to have an abortion beyond 12 weeks on the basis of race, sex or disability. The Minister agrees with the principle, therefore, that it would be an unacceptable basis for having an abortion. I welcome that because at least babies or foetuses of more than 12 weeks will have that protection in law, and because that fundamental right has been conceded. I am told, however, the vast majority of abortions or terminations are likely to take place before the 12 weeks has elapsed. The protection that the Minister so carefully inserted in the Bill, which I have not heard anyone saying should be removed, is moot. The protection is not there and it cannot be there because, as the Minister said, no reason need be given and, as a result, no inquiry into the reason a person may have can be made. I do not expect that to be changed in the Bill but nor do I expect anything in it to be changed.
I wish to highlight, however, that a protection that is there after the period of 12 weeks will not be there before the 12 weeks has passed, and that the opposite impression was given strongly by those proposing the legislation during the referendum campaign. I am delighted the amendment was tabled to highlight the inconsistency of the approach to this matter, an inconsistency that was obvious from the beginning to those who read the small print of the Bill but would not be obvious to those who did not. As I understand it, the Minister, on the one hand, agrees that abortions of unborn children of more than 12 weeks should be utterly forbidden in law with severe penalties, and that the grounds to which everyone on my right takes exception are in the law, should remain in the law and will be in the new law when the composite law on this subject is taken into account. On the other hand, however, he is saying there should be no such protection for that group of people who have not reached 12 weeks
We make law not for today but for the future, if only for a five or ten-year span. As technology advances, it will become much cheaper and much more accessible to test for disability. The argument, therefore, that people will not test for Down's syndrome, to use an example that was mentioned, or that they will not avail of testing or that they will not be allowed to do so, is fallacious.
I listened to the debate last night and this afternoon. The issue of abortion and disability is difficult and complex. In Britain, abortion is generally available up to 24 weeks of pregnancy but it is also legal for any detectable disability for all nine months of pregnancy. There has been discussion about Down's syndrome. Some parents do not like that debate and do not like talking about these various conditions but they are a part of the debate and need to be addressed.
We need to investigate further when such conditions can be diagnosed during pregnancy. In Britain abortion is generally allowed up to 24 weeks, and these conditions can be diagnosed up to that time. Pre-natal diagnosis is improving all the time. 3D ultrasound scans and cell-free DNA testing are now more readily available. Diagnostic tests can now detect Down's syndrome at nine to 13 weeks, or the first trimester. Even if these tests are only available privately the technology is improving all the time. In Ireland we are proposing to allow for termination of pregnancy with no restriction as to the reason during the first 12 weeks of pregnancy. Anomaly scans usually take place at 20 weeks but we need to consider this issue much more carefully.
The Minister can say over and over that this Bill does not allow for abortion on the grounds of disability but that does not make it true.
I believe all life is precious. I have spoken before about embracing disability. I, and many others in this House, have witnessed first-hand the great warmth, ability and talent of children with disabilities, and I have followed the career paths of many. It is not being gospel greedy, but I believe that where there is life there is hope and that people can achieve what they want, whether they have a disability or not.
I believe it is dealt with in the legislation and that, as the Minister said, the only way that an abortion can be sought beyond 12 weeks is in the case of fatal foetal abnormalities. However, I share the concerns of the two previous Deputies in that I want the Minister’s categorical assurance that in the case of technology which is continuously improving, that in the event of scans for disability being possible before the 12 week period, that it would not be allowed as grounds for an abortion. Therefore, I cannot reconcile the 12 week period. My conscientious view on abortion is widely known in my constituency and beyond.
The public, unfortunately, voted to repeal the eighth amendment and mandated this House to legislate through the Health Regulation (Termination of Pregnancy) Bill to allow for abortion in certain circumstances. I am not happy that we are not making this fool-proof in relation to advances in technology that may happen, therefore I want the Minister’s reassurance that terminations will not be available on the grounds of disability, where it is identifiable prior to 12 weeks.
While my conscientious view is in conflict with the majority of those who voted, it remains the same. However, we all, I hope, in this House are democrats and accept the wish of the majority. I like many others do not intend to stand in the way of any of this legislation but I reserve my right, in the final occasion, to decide what stance I will take.
I am very conscious of time. People who are supporting the movement of this legislation are delaying its progress through the House because of the amount of time they took up last night. These are the very people who were dictating to us that we were delaying it. We certainly are not but they are.
On the amendment, I have grave concerns, which the Minister will be well aware of from Committee Stage. Concern is growing among the public. They are starting to become aware of what they actually voted for in repealing the eighth amendment is completely different to what the Minister is now proceeding with. It is completely different. The Members who are seeking all these changes and to make the Bill one of the most liberal abortion laws in the world are doing a grave disservice to the people who voted to repeal the eighth amendment. Those people voted for the repeal of the eighth amendment, not what is contained in many of the amendments before us now.
Sorry. I want to reiterate the concern of many that disability would be a reason for an abortion. Down's syndrome can be diagnosed at nine weeks. We know that these children bring many people much joy, especially their parents, siblings and extended families. Many families love and cherish these children who in some people's eyes might not be 100% perfect although they are 100% perfect because they are who they are, which is themselves.
We are all proud of the many local children who have performed in the Special Olympics in recent years. We must ensure that something like this cannot be given as a reason for an abortion. In the days before the referendum, the Minister promised that he would guarantee it would not be a reason but it is not in the Bill. We are entitled to raise concern about that on behalf of many people out there. I very much resent some Deputy here from Dublin, I will not acknowledge her by naming her, telling us to cop on. We do not have to be told to cop on by anyone. We have common sense; if it is not in the Bill, we cannot be blamed for looking to ensure that it is put in the Bill, which is what we are asking for.
I apologise. There is some confusion as to who spoke last night. Both the record in front of me and the Clerk's record indicate that Deputy Danny Healy-Rae did speak last night and I must go by what I have before me.
During the referendum campaign, the Minister and the Minister for Culture, Heritage and the Gaeltacht, Deputy Madigan, both appeared to agree with a prohibition on abortion on grounds of disability. The Minister for Health said that disability, including Down's syndrome, would be excluded as a grounds for abortion in any legislation. However, there is absolutely nothing in the Government's Bill to rule out abortion on these grounds. He told the Irish Independenton 24 May, the day before the referendum, that the Government would specifically exclude disability as grounds for abortion in the legislation. He also told the Irish Independenton 1 February that if the electorate voted to repeal the eighth amendment in a referendum that the proposed legislation would not include grounds for disability such as Down's syndrome but would be confined to cases of fatal foetal abnormality where the unborn baby would not live. During the campaign, the Minister, Deputy Madigan, shared a graphic produced by Fine Gael Head Office on Twitter which explained the Government's abortion proposal. This said that termination on grounds of disability was prohibited. I ask the Minister to say whether both statements were totally false as there was no provision in the Bill to prohibit abortion on the grounds of disability. Why did the Minister not include a clear provision to put that into effect in legislation?
As I said yesterday, the Minister is wrong. He made a statement today that the Chief Medical Officer has given him advice that he can amend it. Did he ask the Chief Medical Officer before he put these statements in the newspaper telling the people of Ireland that disability would not be allowed as a ground? What is he telling me now? One week he talks to the Chief Medical Officer and the other week he just goes away and does his own thing. Did he or did he not ask the Chief Medical Officer's advice before he made these statements instead of leading the Irish people wrong? He is the Minister for Health. He is responsible for these people in Ireland. He has given false statements. He is totally and utterly wrong. He is trying to blame the Chief Medical Officer for what is happening.
In my family circle I know two young people with disabilities who are very close to me. I ask everybody in this House and outside it to please understand the views of those of us who have some reservations in this regard. Let me make it clear that I fully accept the result of the referendum. I would never stand for damaging any woman's health in regard to this issue. However, the facts are that there has been an issue with this in England, particularly in regard to Down's syndrome, and we do not want that to happen here.
I believe the Minister was sincere when he gave those commitments prior to the referendum. Like many of my colleagues, all I am looking for is assurances. I do not want to go down this road. We cannot, on the one hand, rush out to the gates of Leinster House every time the disabled are out there, and have our photograph taken with them, and then, on the other, not support the parents, brothers, sisters and many others who have come to people like me seeking that we would stand up here and make this case for them.
That is my contribution. I appeal to everybody in the House to think of the families who have people, particularly young people, with disabilities. They bring such joy into homes. They may on many occasions have very short lives but they bring a lot of joy into people's lives.
There is a danger that the debate is drifting off in a direction which was never intended. In the Second Reading of a Bill one can suggest what should be in the Bill, one can complain about what is not in the Bill and one can announce what one intends to do on Committee Stage. However, we are gone past that. We are now in a situation I have never seen before, where it has been suggested in an acrimonious way that the Minister did not keep his word. That is not true. The committee sat for three months. One of the first things we did was to eliminate the disability area as a reason for accessing abortion. There was no dissent and everybody agreed to it. The reasons for this have already been put forward by my colleague across the House. It would not be right. I gave an interview to a well known journal at least 20 years ago and I held the same view, and I believe the reasons for that are still good.
The suggestion that, because it is not specifically in the Bill, it is by default going to be in the Bill is not true. People should not be saying things like that. It is totally untrue. The Bill is in line with what was committed to the public in the heads of the Bill published before the referendum, and that still stands. In fact, if we did not follow that line, we could be accused of not remaining true to our word.
The other thing we took out of the proposal at that time was the ability to seek an abortion on social or economic grounds. We took that out without any question because we felt they were not grounds that should be considered and that they were way too frivolous.
I come from a family that had many losses when my siblings were very young. I would have first-hand knowledge of the little boxes some of the witnesses told us about when we heard the evidence this time last year. Far from it being, as was portrayed, that women are callous and cold-blooded and would seek an abortion as if it were for their own satisfaction, in fact, the reverse was the case. That was so in every single case, including the ones of fatal foetal abnormality, where the pregnant woman went out of her way to have her baby, but it was not to be and there was a disappointment because it was not going to happen. From announcing it to their friends in the first instance, it was suddenly an appalling disappointment. They still wanted that baby to be born. They even wanted to have a decent funeral for the baby because it was theirs. What really takes me to the fair at this stage, when I hear the begrudgery that we spent three months listening to, as well as listening to the reports from the people who were directly involved at the coalface, to be suggesting they were cold and callous-----
It is implicit in what is being said. Everybody here had a mother. Everybody here has siblings - sisters and brothers. There is no use trying to get away from this. We either face up to the reality or we do not.
There were particular circumstances where a young woman found herself in a desperate situation, with nowhere to go, with no help from any quarter. The only place to go was across the water, to leave the country or disappear into what were once the Magdalen laundries or the mother and baby homes. It is time we grew up a little. It is time we learned that women had lives as well, that they are entitled to due and fair consideration and that they do not find themselves, at this time, in the 21st century, isolated, alone and forlorn.
We were there for three months. We listened in great detail. We were there all of the time and we missed none of the debate. We did not read about it afterwards; we got it first-hand. I compliment my colleagues, some of whom I did not always agree with, but we did what we had to do and what we were obliged to do, which was to take our responsibilities seriously and to recognise there was something that needed to be dealt with. The people responded and they made it quite clear.
Last night it was suggested that minorities have rights. Yes, they do, and so do majorities. The one has to be balanced against the other, and that is democracy; that is the way it has always been. However, we should not exclude a group of people representative of 52% of the population, whether we like it or not - that is, women - and say, "In the future, as in the past, you are not really a first class citizen. You are not equal because you do not control your own future."
I will leave Members with this. Let us assume one puts oneself in the shoes of a woman in those circumstances. I am sorry I am hoarse, a Cheann Comhairle.
Let us assume this woman found herself, as women have done before, in a hospital situation when a crisis arises, and everybody stands around saying, "What have we the right to do? Where do we go?". They ask whether this woman has any rights or whether they have been set aside for some future discussion in court or at an inquest, or whatever the case may be. I plead with the Members who are regurgitating what went on before the referendum and in the course of the referendum. This is a serious issue. We were given responsibility. We should stand up and carry that responsibility, recognise we have a job to do and do it.
We are a couple of minutes into the debate and the name-calling, etc. has started. Just two nights ago, a Deputy was reduced to tears as a result of the level of aggression in the Chamber. Character assassination, sneering and name-calling do not constitute political debate, they represent an effort to close down discussion and censor people.
That type of behaviour should stop. One of the reasons I oppose abortion is because of its effect on minorities. Someone from a low-income family who is female and has a disability is far more likely to be aborted. Abortion is an inequality. People who do not believe that information should look at the Guttmacher Institute's website, which is a pro-choice site. It shows that minorities suffer most from abortion. I think it was Deputy Lisa Chambers who stated last night that gender selection abortion does not happen in this country or at all, which is patently untrue. Deputy Donnelly stated that he is against abortion in the case of disability and that the Bill does not allow for this. The Minister also stated that a few times. A ten year old child studying a Venn diagram in school will know that if abortion is made available for every reason, it will be available for cases involving disability. I cannot understand why the Minister and the people speaking on his side of the debate cannot understand the simple premise that if abortion is available without indication and on request and if it cannot be refused up to 12 weeks, then, by definition, it is available in respect of cases of disability. It is that simple.
-----to their counterparts in Britain, Denmark, Iceland, Norway, France and Germany, the same will happen here. The only reason they could vote against an amendment such as this is because they prioritise access to abortion in all circumstances.
We have heard both sides and I am appealing for a reasoned debate. There is no need for the sideshows. This is too serious an issue as Deputy Tóibín and others have stated. We know what has happened around the world. We know the experience in Finland, where they parade the fact that they will be Down's syndrome free by 2020. That is a shocking indictment. Deputy Durkan and others seem to think that we should trust the Minister in everything he says but he has changed his stance more times than it has rained in this country in recent years. That is a fact. How are we to live horse and get grass? Unless something is written into the legislation, we cannot be expected to believe it. That is true of any legislation, whether it be the Social Welfare, Pensions and Civil Regulation Bill 2018, which we discussed earlier, the Finance Bill 2018 or whatever.
We often argue about the words "shall" and "may". Unless what we are seeking is specifically mentioned in legislation, how can we be expected to believe and trust this Minister who was elected on the basis of his pro-life stance. He wrote letters to his constituents in Wicklow, promised that he was pro-life and asked for their number one votes. I have a copy of one of those letters and can read it out if necessary. In fact, I will read it out later.
How can we be expected to believe anything the Minister or the Government say in respect of this matter, particularly as many of those who are in government were elected on the basis of the same stance? However, they have been on these so-called "journeys" in the interim. They all made these famous journeys. One of them was a journey across the River Lee in Cork and, as a result of it, we got the three days - the 72 hours. The Minister used the word "disgusting" and other adjectives when referring to the Tánaiste. That is all fine if that is the way those opposite want to deal with it. Some of us have credibility, accountability and consciences and we want to keep it that way. We are not twisting and turning to suit the times or our political masters. I thank the Ceann Comhairle for allowing us to speak in a dignified manner on this issue and not be silenced.
This amendment is about the period of up to 12 weeks. The debate in this regard began with references to race, sex and disability and ended up focused on disability because it is possible to tug at the heart strings of the population by consistently referring to people with Down's syndrome despite the fact that the Down Syndrome Ireland has asked people advocating what is proposed not to do so. The reason the period is up to 12 weeks without restriction relates to the existence and widespread use of the abortion pill and to the evidence given to the Joint Committee on the Eighth Amendment of the Constitution and the Citizen's Assembly on the use of that pill. The danger of letting women and girls take abortion pills in isolation without medical supervision is unconscionable. We have a duty to ensure that when these pills are administered people have support, cover and medical supervision. Deputies can table whatever amendments they like. Even if those amendments are passed, that would not stop people accessing abortion pills on the Internet and putting their health and lives at risk. It is nonsensical in the extreme for Deputies to use this to try to pull at the heartstrings of the population when they have been asked by the relevant representative organisations not to do so. The case for using this amendment in the context of race and sex has been shown to be nonsensical and the only thing those advocating it have to go on is disability. Their choice in that regard is immoral in the extreme.
People talk about their credibility being questioned. As one of the proponents of the 12-week limit and as someone who was a member of the Joint Committee on the Eighth Amendment of the Constitution, I think it is important to say why was proposed. There were several specific reasons for putting the 12-week limit in place. The backdrop is that the Citizens' Assembly proposed 22 weeks in most contexts. The committee considered the evidence that was presented to it and we made our individual judgments on the basis of that evidence. Having listened to much of the debate, particularly the medical evidence, most but not all members of the committee proposed that 12 weeks, the first trimester, would be a time limit in the gestational periods when terminations could take place without restriction. In other words, if a woman or a girl requested a termination up to 12 weeks, it would be granted under medical supervision. One aspect of the debate focused on the issue of rape and how defining a rape would require a conviction and so on. We believe that we should trust a woman, which I expect all of us in this Chamber do. That was one reason. The other was that women find themselves in very difficult situations for many reasons, and we will not judge those reasons but they are many and varied, individual and personal. We decided a termination should be granted, if a woman requested it, up to 12 weeks.
The committee considered disability as well and went to great lengths to assess this as a grounds for termination, bearing in mind the Citizens' Assembly had recommended that a termination could be sought in respect of a disability. What we said - this view was endorsed, regardless of whether people in this House or elsewhere accept it - was that it was central to the debate during the referendum campaign. Those who opposed the referendum were very clear in bringing it to the fore in the debate. Let us be honest about that.
People did know but disability is not covered in the Bill because it is not possible to have termination after 12 weeks for any reasons other than serious risk to the health or life of the woman, and fatal foetal abnormality. They are the grounds. Why would we introduce into the legislation proposals that would identify circumstances in which terminations should not be granted when the only circumstances in which they can be granted after 12 weeks involve a threat to the health and life of the woman and fatal foetal abnormality?
We have to be honest with ourselves here. Tests have been identified with the potential to identify disability in advance of the 12th week. That is a fact. However, we have said that a woman can have a termination without reason, or rather for her own reasons, up to 12 weeks. It is disingenuous, therefore, to suggest that the issue of disability was not, first and foremost, central to the debate; it was. I recall distinctly many people bringing it to the fore, rightly from their perspective. It was a robust debate and the matter has been decided emphatically with the Irish people saying that up to 12 weeks, unrestricted termination should be available under medical supervision. To introduce race and disability is against the wishes of the Irish people as expressed in the referendum in May. We can talk about this and look at why it was proposed. Those proposals were included in the heads of the Bill and adjudicated on by the Irish people. This was central. It was not put in covertly. It was the kernel of the debate that termination would be available without restriction up to 12 weeks.
There is a genuine concern among some Members present that terminations may be carried out on grounds of disability. I have that genuine concern. No Bill is ever perfect in its infancy. We all know that. There is no doubt that unintended consequences arise. I am looking today to the Minister for a clear commitment that any unborn foetus or baby will not be targeted for abortion because it has a disability when the law changes. While the committee spent a great deal of time discussing this particular angle, it was all blown out of the water during the campaign when the Master of the Rotunda stated that a test existed which could determine at nine weeks whether some disability was there. I was happy to go along with the notion that one could not determine a disability up to 12 weeks, but it was blown out of the water when we were told about that test. It is a private test for which one must pay approximately €1,000. However, it is there if one can afford to have it and it can determine prior to 12 weeks whether a disability is present. These are genuine concerns and we would appreciate the Minister addressing them and providing a clear commitment. That is what I am looking for today.
Many Deputies present are looking for assurances. That is obvious from listening to what they are saying. They want assurances that babies with disability will not be aborted. We have not been given those assurances other than verbally whereas we need it in writing in the Bill. Otherwise, we will end up like Germany, Denmark, Iceland and the UK. Every Deputy must think deeply about this. If something is not in writing, a question arises as to why it is not. The Minister is the person who told the electorate that he was opposed to abortion and we can see where those words have gone. He has done a 350oturn on this completely and changed his mind.
This is about following through on what most Irish people understood. The Minister promised that disability as a ground for termination would be excluded specifically. The Minister should note that this is no laughing matter.
A lot of things are laughing matters in here but this is certainly not one. The Minister can hang his head in shame in time, perhaps. Currently, the Bill is silent on disability and other discriminatory grounds. I ask Members to add the protections the Minister promised and failed to deliver. Will they support the amendment or open the door to eugenics? The choice is theirs but I urge that they accept this humane and compassionate amendment, which embodies equality and is in line with what the people expected when they voted in May. It is also in line with human rights law and common decency. If passed, it will be in line with our responsibility to protect the most vulnerable from discrimination. I implore the House to vote in support of the amendment.
Why we are rerunning the referendum tonight? Not only are these are the Final Stages of the Bill, we had a debate for months with the population in every constituency. We knocked on doors and spoke to people. I have often been in a minority and I often will be in the Dáil. People may not like the result, but it is disingenuous to come to the House and bring all of these subjects up again. Whether people intend it or not, the effect is simply to delay the Bill.
There are people watching. I ask Members to consider that ten people are leaving the country today or tonight. Studies show that a further five people will take abortion pills which they have sourced online. If we do not get through the debate tonight, so be it. I will be here next Tuesday. There is a reality, however, that people expected the legislation to be in place by January while some Members continue to regurgitate arguments that were rejected by two thirds of the population, including in Tipperary, Kerry and the other constituencies they represent. It is not going to go down well among the people who vote for them to bring those topics up again and again. People are paying €1,000 and €1,500 to travel and all the Members are doing is delaying the process.
As to the request for assurances, people knew what they were voting on in respect of the 12-week provision. Hopefully, someone will be able to go to the doctor and have an abortion without having to give a reason. We cannot anticipate matters and provide Deputies with the assurances they seek. It could be for any reason. After 12 weeks, unfortunately, given that it should be the person's right, the person will have to go abroad. That is the reality. Can we move on, therefore, and let the Bill progress?
Deputy Kelleher summed it up perfectly. This section was front and centre of the entire debate. The 12-week period was front and centre and whether one liked it or not, that is what one was voting on. These issues were unbelievably well rehearsed during the referendum and arguments were made for and against. The comfort I take is from Deputy Kelleher who I understand formulated the proposal at the committee with Deputy Chambers. Deputy Kelleher is on record as saying he is not in favour of abortion for reasons of disability. He set out the reasons for the 12-week period in the referendum, as did others while some people set out the reasons against it. However, the public voted for this section. If there is anything in the Bill that they voted for, it was this given the extent to which it was rehearsed. The 12-week limit was the signature issue in the referendum. People need to remember that. There has been an effort here to rerun the referendum and to sow confusion in the minds of ordinary, decent pro-life voters that somehow Deputy Tóibín and other colleagues are their heroes. They are not their heroes and they know that. Deputy Tóibín is an utter hypocrite.
This issue has been rehearsed by the people. I was on the other side of the debate but I said that I would accept the views of the people and if any of the Deputies putting these amendments forward look at the exit polls, they will see that a tiny proportion of the people said they would not accept the results of the referendum. The Deputy should bear in mind that as far as the vast majority of people are concerned. This issue is now settled and the people have decided. If we are to change that decision, we are taking it out of the people's hands. I am not in favour of abortion for reasons of disability-----
-----and I am confident that it is not provided for in the Bill. For those who are trying to sow confusion on this issue, it is downright disgraceful. It is certainly not an issue I brought up during the referendum because I did not feel there was anything to go on.
I hate to have to do so but I want to disassociate myself from the very personal comment made by my Fianna Fáil colleague, Deputy Thomas Byrne, because the one thing we need in this debate is respect and we should all be big enough, on any side of the House, to listen and to respect people's views.
On the other hand, the exposition by Deputy Kelleher was excellent. He was honest. Under 12 weeks there can be no protection or guarantee against any reason for having an abortion. We just will not know. That is very open and honest.
Many Deputies on this side of the House have an issue with the fact that when we look at the words of the Minister during the debate, he seemed to give a different impression. It is as simple as that.
I was not a Member of this House at the time, because I did not get elected to the Oireachtas until 1989, but I remember 1983. I remember that immediately afterwards, those who were on the losing side continued their campaign. When the law and the Constitution were different from what she wanted, Deputy Coppinger continued to campaign and promote her ideas and none of us ever said the people had spoken but she could do so. The day after, the campaign continued against-----
-----the eighth amendment, and quite legitimately. Those of us who are in the minority now can represent that minority of 33% and continue to try to persuade people that human life should be preserved. It is our right and we should be respected, just as in 1983, 1989 or any other time, I never said that people did not have the right not to fight on to upturn it because the people had spoken. In fact, I said the exact opposite.
Deputy Danny Healy-Rae has the option to speak again for a third time as he moved the amendment. He has indicated that he wants to do so. Does the Minister want to respond first or does he want to wait until Deputy Danny Healy-Rae speaks?
It is my second time to speak. The Minister's attitude leaves a lot to be desired because we are speaking, by and large, about a matter of life and death and he is laughing at us. I regret that and the Minister shaking his head will not change my view on that because every time a Deputy on this side spoke, he was laughing and grinning at them, and that is the truth.
-----and a previous speaker said we should trust the Minister because he said this or that at the committee. All we want is for it to be written into the Bill. I respect Deputy Durkan because he has been in this Chamber a lot longer than I have, but when he asks me to trust the Minister without it being written into the Bill, it puts me in mind of selling sand in the Sahara desert because I do not trust it if it is not in the Bill.
The Government has clearly not spoken to the doctors about this as they are complaining about it. We were not on the committee that met for a number of months because we were not selected for it. We did not have a vote at the Oireachtas committee we attended, so we are entitled to raise issues here and to put them to a vote. That is what we will do because I respect every life - the life of the mother and that of the child. It is absolutely terrible if a baby is aborted because it has Down's syndrome or has a disability. It remains to be decided what a disability is and how serious it must be. That is the problem for many of us, so it is not unreasonable of us to ask that this be written into the Bill. That is all that we are doing.
I do not care whether the Deputy trusts me or not, he should trust women. I hear a lot about human rights and I have some breaking news. Women's rights are human rights and we have been violating them in this country for about 35 years and the people have said "No more", including in County Kerry thankfully, and we will now move ahead and legislate.
Deputy Kelleher is entirely right and he is best placed to speak on this because of the work he did on this in the Oireachtas committee. The 12 weeks proposal was debated the length and breadth of this country and the people voted on it. The issue of disability was considered at length and I gave assurances and not one word has changed from the general scheme that was published in March and the Bill, as published, in relation to disability.
This is a case of saying, "Let them deny it." It is a case of trying to make the Minister vote against putting a clause in the Bill to protect people with a disability, or trying to make Fianna Fáil, Sinn Féin, the Labour, Party Fine Gael or whoever do so, but it will not work. The Deputy said I should talk to doctors. I did talk to doctors and I talked to the very top doctor, the Chief Medical Officer in the country, who says that this amendment would effectively render the 12 week provision in the Bill inoperable. Perhaps that is what the Deputy would like to do but it is not what the people voted to do.
The greatest protector of a pregnancy is not Deputy Danny Healy-Rae, it is a pregnant woman. Women protect their pregnancies day in, day out and they will continue to do so long after the eighth amendment has been repealed. This would make the legislation inoperable. Perhaps that is the intention or perhaps it is not but it is the reality. It cannot be accepted and we cannot continue to drag up the same issues that were debated the length and breadth of the country. The people have spoken and I have no intention of accepting this amendment.
Bobby Aylward, Mary Butler, Michael Collins, John Curran, Michael Fitzmaurice, Peter Fitzpatrick, Noel Grealish, Seán Haughey, Danny Healy-Rae, Michael Healy-Rae, Michael Lowry, Marc MacSharry, Mattie McGrath, Eugene Murphy, Carol Nolan, Frank O'Rourke, Éamon Ó Cuív, Eamon Scanlon, Brendan Smith, Niamh Smyth, Peadar Tóibín.
Maria Bailey, Mick Barry, Richard Boyd Barrett, John Brady, Colm Brophy, Tommy Broughan, Richard Bruton, Pat Buckley, Peter Burke, Joan Burton, Catherine Byrne, Thomas Byrne, Joe Carey, Shane Cassells, Joan Collins, Catherine Connolly, Ruth Coppinger, Marcella Corcoran Kennedy, Barry Cowen, Seán Crowe, David Cullinane, Michael D'Arcy, Clare Daly, Pearse Doherty, Stephen Donnelly, Timmy Dooley, Andrew Doyle, Bernard Durkan, Damien English, Alan Farrell, Martin Ferris, Frances Fitzgerald, Simon Harris, Michael Harty, Séamus Healy, Billy Kelleher, Alan Kelly, Gino Kenny, Martin Kenny, Seán Kyne, John Lahart, Catherine Martin, Helen McEntee, Finian McGrath, Mary Mitchell O'Connor, Denise Mitchell, Kevin Moran, Aindrias Moynihan, Imelda Munster, Catherine Murphy, Eoghan Murphy, Paul Murphy, Hildegarde Naughton, Darragh O'Brien, Jonathan O'Brien, Kate O'Connell, Fergus O'Dowd, Fiona O'Loughlin, Louise O'Reilly, Eoin Ó Broin, Caoimhghín Ó Caoláin, Donnchadh Ó Laoghaire, Thomas Pringle, Shane Ross, Eamon Ryan, Róisín Shortall, Bríd Smith, Brian Stanley, David Stanton, Robert Troy, Mick Wallace.
I move amendment No. 29:
In page 10, to delete lines 34 to 38 and substitute the following:"(2) A termination of pregnancy shall not be carried out under this section unless the medical practitioner referred to in subsection (1)has certified his or her opinion as to the matter referred to in that subsection".
Amendment No. 35 arises out of committee proceedings. Amendments Nos. 35 and 36 are related. Amendment No. 36 is a physical alternative to amendment No. 35. Amendments Nos. 35 and 36 will be discussed together.
I move amendment No. 35:
In page 11, to delete lines 1 to 4 and substitute the following:"(3) The termination of pregnancy shall not be carried out by a medical practitioner unless a period of not less than 3 days has elapsed from—(a) the date of certification under subsection (2)by that medical practitioner, or(4) A termination of pregnancy to which the certification referred to insubsection (2) relates shall be carried out as soon as may be after the period referred to in subsection (3)(a)or (b), as the case may be, has elapsed but before the pregnancy has exceeded 12 weeks of pregnancy.".
(b) where a certification was previously made in respect of the pregnancy by another medical practitioner for the purposes of subsection (2), the date of that previous certification.
I previously spoke to amendments Nos. 13 and 29, both of which preceded this grouping, and set out the substance of my amendment, which aims to address the difficulty that arises if the certifying medical practitioner is, without exception, required to carry out the termination of pregnancy, specifically when we considered the rostering issues and practical realities of medical practice in a hospital setting following a three-day period. For this reason, I propose this amendment to section 14, which would allow a second medical practitioner to become involved following a three-day period should the first be unavailable. The amendment keeps the safeguards and legal requirements that section 14 currently contains but aims to clarify the pathway for accessing the service and to avoid creating an additional barrier. The effect of the amendment I have tabled 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 the three-day period, a second medical practitioner may carry out the procedure without a further time period needing 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 that opinion. From a substantive point of view, we debated many of these issues last night.
Amendment No. 36 is a different version of that. I propose my amendment, No. 35, for the reasons we discussed last night with regard to amendments Nos. 13 and 29.
Amendments Nos. 30 to 34, inclusive, related to the three-day waiting period. Members were under the impression that we would at least be able to vote on them. The Ceann Comhairle moved quite fast and I want to clarify what he is saying. Many Members tabled amendments. He said that they could not be taken because amendment No. 29 had been agreed. We have had the debate and I do not propose that we reopen it but I thought we would put those amendments to a vote.
The debate on amendment No. 35 is similar to the debate we had yesterday. If we cannot vote on that, we might vote on this. Many of us made points on this earlier in the debate and on Committee Stage. As is the way with these issues, many people are only now focusing on the details of it and there is a great deal of speculation on social media and in society about it. Many people are pointing out that they rang their general practitioner, GP, and asked when their next appointment time would be. Many women have posted on social media that they rang their GP and the next appointment time is next Monday. They tested this. This three-day waiting period will be problematic. It will be much longer than a three-day wait. I will not rehearse the argument again but I wanted to register that point with the Minister.
I move amendment No. 37:
In page 11, between lines 7 and 8, to insert the following:“Administration of anaesthetic or analgesic to foetus
15.(1) A medical practitioner who carries out a termination of pregnancy shall take all steps as may be appropriate and practicable to avoid causing pain to the foetus.(2) Where the medical practitioner who is carrying out a termination of pregnancy is of the reasonable opinion formed in good faith that the gestational age of the foetus is 20 weeks or more, he or she shall administer or ensure the administration of an anaesthetic or analgesic to the foetus prior to the carrying out of the termination of pregnancy.
(3) Subsection (2)shall not apply where—(a) 2 medical practitioners certify that they are of the reasonable opinion formed in good faith that the administration of an anaesthetic or analgesic to the foetus would pose a risk to the life, or of serious harm to the health, of the pregnant woman in respect of whom the termination of pregnancy is being carried out, or(4) Where—
(b) a medical practitioner proposes to carry out a termination of pregnancy in accordance with section 11 and it is not practicable to comply with the obligation in subsection (2) because of the particular circumstances of the case.(a) an anaesthetic or analgesic is administered to a foetus in accordance with subsection (2), or
(b) subsection (3)or (4) applies,
the medical practitioner who carries out the termination of pregnancy shall include this information in the notification forwarded or caused to be forwarded to the Minister under section 21(1).”.
This amendment relates to the giving of pain relief to an unborn baby before an abortion is carried out. When I spoke on this on Committee Stage and we discussed it, I was taken aback by people's unwillingness to allow a baby the relief from pain that would definitely be endured during the course of an abortion. I believe in compassion and not wanting to hurt anybody or anything purposely. Who here can say that it is not true that when an abortion is taking place, a baby could feel pain? I would consider it only human to say it would be right and proper to offer and give pain relief to somebody who cannot ask for it.
As legislators and human beings we should be willing to offer it. I cannot see what harm this would do. If anybody can stand up here right now and criticise me and say what I am saying is wrong and that I am not right in what I am saying I beg them to do so. I beg them to tell me where am I wrong in looking for pain relief for an unborn baby. How am I out of order in looking for that?
The one thing that has been said to me by knowledgeable people is that the reason other people do not want to agree to this is because to do so would be to recognise this is a person we are talking about and that it is a baby. They do not want to recognise this fact. Surely after all we have gone through for people to stand up here today to ask the Minister and others to allow for this to go ahead and that pain relief would and could be given to stop an unborn baby feeling pain during an abortion is to make an ordinary request. I plead with the Minister and others to allow the amendment to be passed. If they will not do so and if they will fight against it I would love them to explain why. I would love them to tell me why I am wrong and why it is not a proper human thing to do and to educate me if they are able.
The amendment requires that the doctor performing an abortion takes all appropriate and practical steps to avoid causing pain to the foetus. Where the gestational age of the baby is 20 weeks or more the doctor must ensure the administration of an anaesthetic or analgesic to the foetus prior to carrying out a termination of pregnancy. However, this obligation does not apply in an emergency case, which is quite obvious, where it is not practical or where it is believed the administration of either of these treatments to that baby might pose a risk to life or serious harm to the health of the pregnant woman. This is not in any way our intention with this very reasonable amendment, as Deputy Michael Healy-Rae has said.
Amending the Bill to provide pain relief where an unborn baby may otherwise experience pain is a matter of the most basic humanity. The fact there is a dispute about whether to include such a provision in my opinion is appalling. The amendment merely seeks to ensure that in most cases, not even in all cases, doctors ensure the unborn child is not subjected to pain. The fact this is not already in the Bill and that it is actually necessary to propose an amendment to deal with it is gravely disturbing to me and to many young and old people who have spoken to me.
Some abortion advocates claim the unborn child cannot feel pain until the third trimester but this claim is flatly contradicted by modern evidence. There is increasing scientific evidence from around the world that babies in the womb feel pain before 20 weeks. Anaesthetics and pain relief for babies undergoing surgery in the womb is generally recommended and has been called for in late-term abortions. Some say it should be done from as early as 18 weeks gestation. Surgeons recognise unborn babies as patients and anaesthetics are routinely used for babies undergoing surgery in the womb. Surely the same should apply in the case of surgical abortions. It is a no-brainer, as Deputy Michael Healy-Rae has said. Members should just tell us why they feel it should not or would not be done. Where are we going in humanity? It would be horrific and unnecessary for unborn children to suffer needlessly during an abortion. To prevent this, the amendment, which we have carefully considered, should be accepted without any difficulty. It is clearly the duty of compassionate and humane doctors to act on the precautionary principle of prevention of pain where there is a risk that it may be experienced. I am sure this is the way that all doctors operate under the Hippocratic oath on a daily basis to deal with a wide range of ailments and when patients present with any issue, whether young or old, from the cradle to the grave.
The amendment would not prohibit abortion where the baby can feel pain. It merely requires the administration of pain relief. Who in his or her right mind would not accept the amendment? As I said, we are appalled and aghast it is not included in the Bill in the first instance - appalled and aghast are mild words - and we feel it is totally necessary. We appeal for support from any Member who thinks like us. Many people of all denominations, including people who voted "Yes" in the referendum, have contacted me and others, including other Members, to appeal for this. My goodness, we get emails on an hourly basis on anti-fur farming and anti-hare coursing. Today there was opposition to a Bill on funding the horse and greyhound industries. People are right to feel like this. How can we have these and not want to administer pain relief to an unborn baby? I cannot get that through my thought process. It is unimaginable. Anyone I have asked just shakes his or her head. People have come to me and appealed on this. Other Members have also received the emails. The thought process is just unthinkable. As I have said, doctors routinely do this, as do surgeons on a hourly basis for other procedures. Why would they refuse to do it for an unborn baby before it will be killed?
I appeal to people to listen and respect where we are coming from in the interest of basic humanity. We should try to be as humane as possible. We do not have many amendments in the overall scale of the Bill. We are not delaying it. We have 16 amendments in total, which is the same as on Committee Stage. We listened to the people who voted. Very few people voted for a baby to be destroyed in the womb without administering pain relief. I cannot generalise but I cannot believe people voted for it. This is why we have tabled these amendments. I do not want to be repetitious but for the sake of anybody watching we are not delaying the Bill. We are doing what we have been elected to do with regard to any legislation. We had no pre-legislative scrutiny as the Minister waved it. It is a very valuable tool that was independently reviewed recently. We are trying to table amendments without being scoffed at and scorned and without laughter coming from the other side of the House. This is the most serious issue I will ever deal with in the House. If I am not here after the next election I will be happy to leave it to history to evaluate and see what we have been about here. We are not anti-woman or anti-child. We are pro-humanity.
I am glad to have an opportunity to speak on the amendment. It is a fairly reasonable request to ensure the little baby will not suffer any pain and that any avenues open to the medical profession are used to ensure these children will not suffer pain for the last few seconds of their lives in this world. It is a minimal request. We all have or have had people belonging to us who suffered pain. It is terrible to see people suffering. Many people in many families are suffering pain as we speak here.
We are talking about poor defenceless little babies in their last few seconds. It has been proven beyond a shadow of doubt that they have feelings and that pain affects them. Whether it is anaesthetic or some other avenue available to the medical profession, it is not unreasonable to ask that something be used to ensure that they do not suffer.
Being a Member of the Dáil is an honour. However, if we did not do our best to ensure these infants would not suffer pain by asking for this on their behalf, we would not be worth anything and our lives would not mean anything. I support the amendment. It is not too much to ask. The Minister is providing €12 million for the abortion service. Surely he can dedicate some of that money to ensure that the pain of these little babies, whom the medical profession has said can feel pain, be minimised so they are not hurt. It is not much to ask the Minister to use some of the money, wherever he got it, to ensure that these babies would not be allowed to suffer pain.
It is hard to understand why anybody would be opposed to providing pain relief to a human being about to undergo a painful procedure. I am not sure any Member is actively against pain relief in principle. Sadly, however, many have spoken out against this amendment in recent weeks. When this was raised at the recent health committee meeting, the Minister said this type of detail is best set out by clinicians in their clinical guidelines rather than by politicians in primary legislation, and that it was not for the Oireachtas to prescribe medication or treatments. Although he said it is not for the Oireachtas to prescribe medication or treatments, this Bill does that in many cases by legalising a range of unspecified procedures or treatments to end the life of an unborn child, even though there is no medical condition in a mother where the intentional ending of her baby's life is a medically indicated treatment.
We recognise that there are times when it is medically indicated to end a pregnancy early to protect the life or the health of the mother. However, the Bill seeks to legalise a wide variety of procedures aimed at intentionally ending the life of the unborn baby. Why is it so inconceivable that the Minister would also include a measure of legislative oversight to ensure that if any of these procedures could cause pain to a tiny human being, the medical personnel would be obliged to mitigate against that possibility? People voted as they did out of compassion and for what they believed was best for the mother involved, be they "Yes" or "No" voters. It was not a vote against babies. However, the Minister appears to be interpreting it now. It was not a vote to ensure babies would be treated as inhumanely as possible. It was not a vote on any specific legislation, as he was at pains to remind us when he introduced his draft legislation in March, and as the Referendum Commission and the High Court have reminded us since. It was a vote to allow the Oireachtas to legislate and that is what we are trying to do.
The Minister seems to think that he is the only politician in the Chamber whose views on sections of the legislation should be considered. That is not the case for any other legislative measure and it should not be the case for this one. We are all elected to help shape legislation on behalf of the electorate and I believe there are few among the electorate who do not want unborn babies who are capable of feeling pain to be denied the most basic concessions to their human dignity and to be protected from unnecessary pain as far as practicable. This legislation is the right place to enshrine the principle that the unborn baby who may be subjected to a painful procedure should be protected and given pain relief. The UN Convention on the Rights of the Child is clear that children deserve special safeguards and care before as well as after birth. The convention, which Ireland ratified in 1992, states: "The child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth." An amendment seeking to ensure that a pain capable human being would be guaranteed pain relief, where possible, is reasonable. Special safeguards should be enshrined in our laws.
The amendment also specifies that an analgesic or anaesthetic should be administered where the baby is determined to be at a gestation of 20 weeks or more. Pain relief is typically given to unborn babies when they undergo prenatal surgery in the womb from 20 weeks on and, therefore, it does not seem unreasonable to seek that the same would be guaranteed for unborn babies about to undergo a painful procedure. Nurses who have treated extremely premature babies have testified that these babies react to painful stimuli such as inserting needles and so forth. Why would we not assume that babies of a similar gestation who are still in the womb would also feel pain? Let us be very clear. Dismemberment is painful and fatal poisoning is painful. It would be a gross abuse of human rights not to ensure that tiny human beings were guaranteed pain relief before undergoing a painful procedure.
The Minister said he does not wish to specify what doctors must do, but if he had done any international research on this, he would have quickly discovered that in other countries where this is not specified in legislation, pain relief is not considered for, or given to, unborn babies. In recent weeks, a court case has been ongoing in Texas in the United States, where live dismemberment abortion procedures are routinely performed without pain relief. The state of Texas is trying to outlaw live dismemberment because it causes intense distress to a foetus or unborn baby, but abortion providers are arguing that it would restrict access to abortion. Does that sound familiar? Do we want to have such a case here? If this will happen anyway, there should be no objection in principle to the consideration of pain relief for an unborn baby where appropriate. This legislative safeguard will not cause any harm. However, if the amendment is opposed, it is likely that in future we will back to debate the issue in the type of detail in which people are being forced to debate it in Texas because "abortion doctors" there, and I use the term loosely, deemed that no pain relief was necessary before tearing a child apart.
I apologise if this language is distressing for anybody present or anybody watching these proceedings, but that is the unpleasant and unsavoury reality of some choices being discussed in the Chamber. This procedure is more commonly known as a D&E procedure, which portrays the horror of what it involves. It is not a rare procedure in the UK. In 2017 alone, 13,000 babies died this way. This included 1,800 at a gestation over 20 weeks when pain was likely to be felt. Perhaps even today, as we speak, an Irish unborn baby is having its limbs taken apart in the UK. Would that procedure be any more palatable if was being done in Letterkenny instead of London? It is not easy to ask these questions or to mention these things here but they are facts in other countries. We must prevent that from happening here. I support the amendment to put those safeguards in place.
The amendment imposes a duty to minimise pain for the unborn child where appropriate and practical.
Yet, we seem to have some pushback with this. Most people would understand the scientific definition that an unborn child is an individual, living, human being. Science will tell us there is a physical and biomedical response to injury and research shows us that pain and stress may affect the unborn child in its development. What does it say about this country and this Chamber that anybody would have to fight for that? It is dumbfounding that anybody would have to fight any government to seek for pain relief to be introduced in that regard.
There is disbelief around the country with the stubbornness of the Government to move on this, even among those people who are solidly pro-choice, and that the humanity of this amendment is completely unrecognised by the Government. The stubbornness of the Government is preventing it from putting this measure into the Bill.
The nervous system develops at around six weeks. Sensory receptors, which allow pain to be felt, start to develop at around seven weeks and are across the body at 18 weeks. In 2010, the Royal College of Obstetricians and Gynaecologists report, Fetal Awareness, inferred that the unborn child has the capacity to feel pain from 24 weeks. The further the research and investigation goes into this issue, that age understanding is falling.
Even if a person was unsure about this, would the Minister not, on the precautionary principle alone, instinctually say, "Let us make sure this does not happen"? On the precautionary principle alone, would the Minister's very nature not say, "I need to put this into the Bill"? The Minister will state it is not up to him to do this and that somebody somewhere sometime will do something around this. This Chamber of elected representatives of the South of Ireland are to stand back and say, "Okay, we trust you to do this" and to let it happen. During the Committee Stage debate, we went back and forth a rake of times around the fact that a measure in primary legislation is far stronger than if it is in guidelines elsewhere. I put it to the Minister that this is the place to put such a measure. What would it cost the Minister to put it into the Bill? Does he support the fact that there should be pain relief in all cases of abortion? If so, what is the cost to the Minister to do that?
I can think of absolutely no cost to any Member of this Chamber of including such a measure. This amendment does not seek to reduce access in any fashion. The only reason I can think of as to why the Minister would not want to include it in the Bill is that in some way it reflects a humanity to the unborn child in the womb. This is the only reason I can see that the Minister would be cautious about introducing this into the Bill.
I ask the Minister and the political parties in the Chamber to reconsider. Even those who are instinctually pro-choice and who feel in their hearts and souls that access is the primary issue in this abortion debate, that access is supreme and that nobody should even think about denying access, should have no reason not show the humanity to make sure this goes into the legislation.
I will add to what my colleagues have already outlined in a very articulate and clear manner. I was shocked to find that the Bill did not already cover such a provision. It seems that we have totally lost our way as a society. We have heard much about compassion and human rights. I agree with that wholeheartedly; everyone needs compassion and human rights need to be respected. The sanctity of life needs to be respected. We are talking about the most vulnerable in our society - an unborn baby who is a weak, vulnerable human being.
I am in disbelief that this is not already included in the Bill and I have been contacted by constituents who are on both sides. Some voted "Yes" in the referendum but are stunned this is not provided for in the Bill as are the pro-life constituents, but that goes without saying. I appeal to the Minister to please show compassion and humanity by including this amendment in the Bill. Why would he not do that? It is not good enough to pass the buck and say that it is up to clinical opinion. The Minister, Deputy Harris, is the Minister for Health and has spoken about compassion, human rights and healthcare. Let us give those to the unborn baby who is the most vulnerable in our society.
I will be brief but I did not want to let amendment No. 37 pass without speaking on it. It is a very reasonable request that the Minister should consider pain relief in this case, given that we are referring to babies over 20 weeks. When one considers that a baby is viable at 22 weeks it is imperative that the baby is given pain relief. There is no point in having the baby suffer needlessly. I am sure it would also be of great benefit and cause less stress for the mother. Even if he does not think about the baby in this case the Minister should definitely consider the mother and, hopefully, a reduction in the stress that she might be experiencing at that stage. I ask that the Minister shows compassion with regard to this amendment. It is a reasonable amendment and while the Minister has not accepted too many, perhaps this is one that should be accepted by every Member of the House.
There is increasing scientific evidence from around the world that babies in the womb feel pain before 20 weeks. The nervous system begins to develop at six weeks. Sensory receptors that allow pain to be felt develop at seven weeks and they are present across the body by 18 weeks. It is important that doctors who perform abortions must take all appropriate and practical steps to avoid causing pain to the foetus. This does not apply in an emergency case where it may not be practicable or where the administration of an anaesthetic to the foetus might pose a risk to the life, or serious harm to the health, of the pregnant woman.
Irish people inherently recognise the humanity of unborn children. We need to acknowledge this humanity by obliging the medical professionals to minimise the pain of abortion procedure. Surgeons recognise unborn babies as patients and anaesthetic is routinely used for babies undergoing surgery in the womb. Surely the same should apply in cases of surgical abortion. The Bill envisages surgical abortions in certain circumstances beyond 12 weeks gestation. Clearly, there is a possibility that some of these unborn children are capable of feeling pain, and yet the Bill as it stands has no requirement that unborn children are given appropriate protection from pain during an abortion. It would be horrible and unnecessary for unborn Irish children to suffer needlessly during an abortion. To prevent this the Government must accept amendments requiring that unborn children be given pain relief before an abortion procedure wherever there is a reasonable possibility of their experiencing pain. As I said during the Committee Stage of the debate, abortion by its nature is very violent and invasive. We must ensure that all unborn children are not subject to pain.
I wish to speak to the principle of the amendment, but I will be brief. I approached this amendment from a compassionate and humane point of view. The amendment proposed seeks to ensure that in most cases, not even in all cases, doctors would ensure that the unborn child is not subjected to pain. It is after the gestational age of the foetus is 20 weeks or more. This amendment does not prohibit abortion where the baby can feel pain, it merely requires the administration of pain relief. I look forward to hearing from the Minister in respect of the medical guidelines on this.
I will be supporting this amendment. Even if one was just to go on the precautionary principle, be the person young, middle aged or older, we never want to see or hear of anyone in pain. This will go down and be remembered. Knowledge in medicine is changing constantly.
I do not think we can risk not putting this in the Bill. A few years down the road, if more evidence comes out proving that we neglected to do something here this evening it will not bode well for us. We should support this amendment to make sure nobody and no baby is put under any pain.
I support the amendment. Any of us who have been involved in motherhood or fatherhood and have been involved watching the birth of our children and as they grow up, particularly in the early days, even when we could not understand why they were crying, the one thing that would cross our minds is worry that the child was in pain. I have checked this out medically in terms of what pain may apply to the baby in the womb and it is a fact that pain does apply. I think a lot of people in this Chamber are thinking of not opposing this amendment. I urge the Minister to try to support it out of all the amendments.
I am delighted to speak on this amendment and to have put my name to it. Around my county since the vote, this is one of the issues that has been discussed by a lot of people. It is not unreasonable to require the administration of an anaesthetic to a foetus where the medical practitioner who is carrying out the termination is of the reasonable opinion, formed in good faith, that the gestational age of the foetus is 20 weeks or more. This is an advanced pregnancy and extra steps must be taken to ensure no pain is caused during the termination process. This obligation would not apply in an emergency case where it is not practicable or where it is believed that the administration of an anaesthetic to the foetus might pose a risk to the life or to the health of the pregnant woman. If there is no harm to the woman in this situation, there is no reason this cannot be administered. Anaesthetic and pain relief for babies undergoing surgery in the womb is generally recommended and this is simply an extension of that medical practice. I ask that the Government to accept this amendment.
I support the amendment. One thing we all try to avoid is pain, as adults or in any walk of life. We are speaking here for someone that cannot speak for itself, the foetus or baby, whatever you like to call it. It is a medically proven fact that from 20 weeks onward, foetuses are affected and can feel pain. The Minister should take this on board. It will not affect the referendum in any way and it will protect against something that should not happen, namely pain, when abortions take place.
I request that the Minister support the thrust of this amendment. As previous speakers have said, it in no way hinders or jeopardises the movement of the legislation through the Dáil whether we like it or not. We are coming a long way. At one stage we had the right to life and we are coming to the reverse stage. I listened to some speakers in the last couple of days, yesterday in particular, and they were likening an unwanted pregnancy in terms of women's healthcare to that of women having cancer. I feel very saddened about that kind of comparison being used. We have come a long way from the right to life and maybe a person should have the right to a termination in an orderly and medically approved formula. I would say that we support this amendment.
I support the very reasonable requests put forward by colleagues in respect of this very important amendment. It is very reasonable and I do not know how anyone could have grounds to object to it. I sincerely hope the Minister can accede to this amendment. It is important from the point of view that everything is stressful enough, there is enough of pain and suffering in the termination process so the least that could be done is to try to ease the pain where possible and practicable. I fully support the amendment.
I thank the Deputies for raising the matter. I understand the points they are trying to raise but, as I did outline clearly on Committee Stage, I cannot accept the proposal to include a separate section in the Bill which would provide for the administration of an anaesthetic to a foetus where the gestational age of the foetus is 20 weeks or more because, as I explained on Committee Stage when the Deputies first submitted this amendment, the purpose of this legislation is not to regulate or dictate the practice of obstetrics. That is not what we do in this House. There is a very thin line that we should not cross where we move from being policy makers to being doctors. We have to be very conscious of that.
Medical practitioners are bound through professional regulatory mechanisms to operate in accordance with best medical practice. The requirements in sections 11, 12, 13 and 14 for medical practitioners to be of the reasonable opinion, formed in good faith, emphasise that doctors must maintain professional standards and must uphold medical ethics. It is simply not appropriate to include detailed medical treatment, compulsory care pathways or treatment plans in legislation. There are no such provisions in respect of the woman's health or care in this legislation because that would not be appropriate either. It is not where we put a detailed care pathway. It is not where we put information about medication. This type of detail is set out by doctors as they go about their obstetric practice through clinical guidelines rather than in primary legislation. I have previously assured colleagues in this House that in parallel with the service planning and expansion work, clinical guidelines for medical practitioners on termination of pregnancy are also in preparation. It is right and proper that clinical guidelines are drawn up by clinicians and not by politicians. My Department has provided a grant to support this work to enable the timely and efficient completion of the guidelines.
I am extremely disappointed and flabbergasted that is all the Minister would say, that he could just say we would be interfering with the clinicians and obstetricians. It is a feeble answer. Am I surprised? No. Why do we want to see this in the Bill? Because we do not trust you. A sizeable majority of people do not want you, even people who voted yes do not trust you. How could they? I am going to read something to the Minister-----
-----that was sent out in 2011 by him, when he was Councillor Simon Harris, to pro-life people in Wicklow. "Dear [whoever], I am contesting the general election in Wicklow for Fine Gael and am happy and proud to assure you that I am pro-life."
"In response to your two direct questions, ... yes, if elected to the Dáil I will oppose any legislation to introduce abortion in Ireland. ... Yes, I will support legislation that protects the human embryo from deliberate destruction and I will oppose any legislation that does not. Please be assured of my support. I need number 1 votes on Friday so I can be in a position to support these positions in Dáil Éireann."
I am speaking to the amendment. I am horrified that the Minister will not accept the amendment. I have a copy of the letter in my hand to give to him when I finish. Many thousands more letters were sent out by Phil Hogan. I will ask this Parliamentary Usher to please pass the letter to the Minister for Health. I thank the Usher. That is what it is. It is just a mockery. If people know the Minister cannot be trusted in his writing, how can they trust any utterance that would come from his mouth? None. I do not think the Minister of State, Deputy McEntee, can stop me from asking an Usher to hand a letter to the Minister. That is standard practice here.
I am very disappointed with the Minister's reply to our amendment and our request to have pain relief ensured for a little infant and for the little infant's last seconds in the world. He gave us an answer that it is up to the medical profession; that is not acceptable.
It is not unreasonable for us to table this amendment because we did not have abortions in this country up to now. It is not just a few of us in this House who are asking for this; many more people outside in our constituencies are really concerned about this since it was raised in the Oireachtas committee a number of weeks ago. It is not too much to ask for an assurance from the Minister that pain relief would be given to these little infants. We are very sorry and disappointed that he is not acceding to this. We will be putting it to a vote because it is the last thing we can do given that the Minister is not agreeable. We will be doing that to ensure that we have tried our best on behalf of those little infants we are talking about.
The point on compassion has been well made on this amendment. The amendment appears very reasonable and it even takes into account cases where there are issues and it is not practical. I listened to what the Minister had to say on it. It would be reasonable and compassionate to give pain relief in this situation. I ask him to clarify the point Deputy Butler raised.
I repeat a question I asked earlier. Does the Minister think pain relief should happen in all cases? There is another question we, as politicians, are all asked. Do we accept the answer that someone somewhere will do something about this sometime or do we understand that it is our responsibility to do it now? If the Minister thinks it is someone else's responsibility, by all means he should not put this into the Bill. However, if he feels he should have a role in ensuring there is some level of humanity in this, then the answer is clear.
Up to now 450 nurses and midwives have signed the petition saying that they are outraged at what is being proposed and the fact that pain relief will not be offered. It is a bit rich for the Minister to say that he, as Minister and a legislator, thinks we should not be interfering with the medical profession. It is a human right for somebody who might suffer pain to be offered pain relief. I asked the Minister to give an intelligent and thoughtful response as to why he believes we are wrong. I still have not heard that from him. I would still dearly like to hear that from him. He should give me a factual reason it is wrong to offer pain relief to an unborn child. I want a straight answer to that.
I saw the horror and shock. I saw how the Minister tried to interfere with the Acting Cathaoirleach. He tried to stop Deputy Mattie McGrath from reading out this letter. Other people may not have noticed it. In case anyone was not looking at the Minister, he badgered the Acting Cathaoirleach to try to stop Deputy Mattie McGrath from reading out this letter. The Minister refused to accept a copy of the letter when it was given to him. This happens to Ministers every day; they are handed letters. The Minister did not want this letter because it contained the commitment and promise he gave to the electorate when he said he was pro-life. He has gone a long way from that now, but he showed an awful lot when he showed how shocked and horrified he was at the idea of Deputy Mattie McGrath reading into the record of the Dáil the letter the Minister sent to thousands of people saying, "Dear pro-life campaign" and signed "Kind regards, Simon". Well Simon has changed an awful lot since then.
Potassium chloride is an extremely corrosive and painful thing to have going into anybody. All we are asking is to have pain relief for that. My God, it does not get any simpler or more humane than that.
I am also very disappointed the Minister is refusing to accept our amendment. We can no longer bury our heads in the sand. The Bill currently passing through the Dáil would legalise the procedures I mentioned in my previous speech, with no regard for any human rights of the child, with no regard for any human dignity of that child and with no regard for any pain or suffering those procedures may cause to those children. The intention of this amendment is to recognise that these procedures often cause suffering to unborn babies. The very least we owe those babies is to protect them from pain.
It is worth reminding ourselves that despite the misleading Title of the Bill as the Health (Regulation of Termination of Pregnancy) Bill, the definition of that phrase in the Bill makes it clear that the Bill is all about the termination of life. Section 2 defines termination of pregnancy as a medical procedure which is intended to end the life of a baby. The Minister would like us to believe that doctors who want to participate in the intentional ending of a child's life usually on the request of the mother, would then, of course, also consider the matter of pain relief for the baby, but this is just not logical.
Surely that means it is up to us to ensure the child's interests are represented in some small way in the Bill. These procedures are in stark contrast to procedures specifically intended to deliver a baby early to end a pregnancy that way. We are speaking here of the only procedures regulating this Bill - those intended to end the life. I am sure the Minister is well aware that he has not made it clear exactly which procedures to end the life of that defenceless baby would be legal. Therefore, we can only assume that the most barbaric and inhumane ones would be legal unless the Minister outlaws them. Up to now the Minister has neglected to put any protections for unborn babies in the Bill. We will not hold our breaths on that one.
It is already horrific enough that we are even discussing how we would end the life of an unborn child. As Members will all know at this stage, I would always favour trying to help every unborn baby to live as well as helping the mother through whatever difficult situation she is in.
I have a very brief point to make. I was not going to say this, but over the past couple of weeks I spoke to the Minister privately about different parts of this legislation. I like to be honest. On every occasion I spoke to him, he gave me time. He explained things to me as late as today. We need to speak to the amendments. We are all trying to get solutions here and do the right thing from the perspective of our own conscience.
I would like the Minister to give us more clarification on the medical guidelines. I reiterate that neither I nor any of my colleagues would do anything that would damage women's health. We should all be honest and honourable. I will not publicly run down the Minister because every time I approached him he tried to explain things to me.
Since the referendum I have spoken to many people - people who voted "Yes" and people who voted "No". Since the referendum, I have not met one person who would begrudge giving painkillers to a foetus. I cannot understand what the Minister is doing. Is he going by the recommendations of the Chief Medical Officer again? I cannot understand it. Anyone who has any kind of compassion whatsoever would agree. If one saw a cat or dog in pain on the street, one would take them to the vet to help them out. I cannot understand why a foetus that is in pain is not being allowed to have an anaesthetic. I ask the Minister to stop blaming the Chief Medical Officer.
I think it is better than taking medical advice from politicians, including me, who are not medically qualified in how to carry out obstetric practice. However, that is just my view of the world.
This unearthing of a commitment I made in 2011, which obviously does not relate to the amendment, but which a number of people are referencing, is no unearthing. The Deputy is right; that was my position in 2011. It is my party's position; it echoes in it. I have changed my view. I am delighted I changed my view. I am delighted I campaigned and voted to repeal the eighth amendment of the Constitution.
My constituents have endorsed my view by voting overwhelmingly in favour of repealing the eighth amendment, as did Deputy Mattie McGrath's.
To answer Deputy Tóibín's question, it is somebody else's job to this. It is the job of the obstetric community. Those pro-life Deputies in the House - and I think we all consider ourselves to be pro-life - who are against the legislation must agree with that also. If they believed that a pain relief provision must be included in primary legislation, surely to God they would have included it for women as well. They have not done so, however, because they know doctors will do that, just as doctors will also take every appropriate step to protect babies. That is what they do. To suggest anything else would be a slur on their profession.
Deputies Butler, Aindrias Moynihan and Eugene Murphy asked for assurances. I cannot write the clinical guidelines, nor would anybody want me to, but I can assure them that our clinicians know how to carry out procedures and operate in an ethical manner in accordance with the Medical Council. I have absolutely no doubt about that. Our doctors go into hospitals every day to ease pain and I have no doubt that all these issues will be considered when the clinical guidelines are being drawn up. What we cannot do in this House is don the white coats and the stethoscopes and become obstetricians and gynaecologists. We are policymakers. Pain relief and care pathways come from doctors, not politicians.
I am saddened and shocked - we all are. We said all along - and I repeated it earlier - that we accept totally where an intervention has to be made in an emergency in terms of anything that would affect the health or the life of the mother. The Minister does not have to pick up on that. That is quite clear and understood by all of us.
Some abortion advocates claim that the unborn child cannot feel pain until the third trimester. However, that claim is contradicted by the modern evidence to which, increasingly, the Minister does not want to listen. There is growing scientific evidence from around the world that babies in the womb feel pain before 20 weeks. Anaesthetic and pain relief for babies undergoing surgery in the womb is generally recommended and has been called for in late-term abortions. Some say that should be done from as early as 18 weeks' gestation. Surgeons recognise unborn babies as patients, yet the Minister tells us that the reason he is refusing to accept this amendment is that we might be interfering with that. Surgeons understand this issue. All the people in labour wards understand it. We are not trying to be cruel. I did not want to say it but Deputy Fitzpatrick said that if there was a dog, a pup or a kitten lying on the street, we would lift it up and mind it by providing warmth, pain relief or whatever. It would be horrific and unnecessary for unborn children to suffer needlessly during an abortion.
To prevent that, this amendment should be accepted without any difficulty. It is a clear duty of compassionate and humane doctors to act on the precautionary principle of prevention of pain where there is a risk that it may be experienced. This amendment does not prohibit abortion where the baby can feel pain; it merely requires the administration of pain relief. It is the most humane request in the world and the Minister has set his face against it. I am shocked.
Bobby Aylward, Mary Butler, Michael Collins, John Curran, Michael Fitzmaurice, Peter Fitzpatrick, Noel Grealish, Danny Healy-Rae, Michael Healy-Rae, Michael Lowry, Marc MacSharry, Mattie McGrath, Aindrias Moynihan, Eugene Murphy, Carol Nolan, Kevin O'Keeffe, Frank O'Rourke, Éamon Ó Cuív, Eamon Scanlon, Brendan Smith, Niamh Smyth, Peadar Tóibín.
Maria Bailey, Mick Barry, Richard Boyd Barrett, John Brady, John Brassil, Colm Brophy, Tommy Broughan, Richard Bruton, Pat Buckley, Peter Burke, Joan Burton, Catherine Byrne, Thomas Byrne, Joe Carey, Joan Collins, Catherine Connolly, Ruth Coppinger, Marcella Corcoran Kennedy, Barry Cowen, Seán Crowe, David Cullinane, Michael D'Arcy, Clare Daly, Stephen Donnelly, Timmy Dooley, Bernard Durkan, Alan Farrell, Frances Fitzgerald, Charles Flanagan, Simon Harris, Séamus Healy, Billy Kelleher, Alan Kelly, Gino Kenny, Seán Kyne, John Lahart, Catherine Martin, Helen McEntee, Finian McGrath, Mary Mitchell O'Connor, Denise Mitchell, Imelda Munster, Catherine Murphy, Paul Murphy, Hildegarde Naughton, Jonathan O'Brien, Jim O'Callaghan, Kate O'Connell, Fergus O'Dowd, Fiona O'Loughlin, Louise O'Reilly, Eoin Ó Broin, Caoimhghín Ó Caoláin, Donnchadh Ó Laoghaire, Thomas Pringle, Shane Ross, Róisín Shortall, Bríd Smith, Brian Stanley, David Stanton, Mick Wallace.
I move amendment No. 38:
In page 11, between lines 18 and 19, to insert the following:
“Protection of Infants born alive
16. (1) In this section, “born alive” means the complete emergence of a foetus from the body of the woman, regardless of the state of gestational development, who, after emergence, whether or not the umbilical cord has been cut or the placenta is attached, and regardless of whether the emergence occurs as a result of natural or induced labour, caesarean section, termination of pregnancy or otherwise, shows any evidence of life including, but not limited to, one or more of the following: (a) breathing;
(b) a heartbeat;
(c) umbilical cord pulsation; or
(d) definite movement of voluntary muscles. (2) In this section, “infant” means a foetus who has been born alive as a result of the carrying out or attempted carrying out of a termination of pregnancy under this Act.
(3) A medical practitioner shall take all steps as may be appropriate and practicable to preserve the life of an infant.
(4) For the avoidance of doubt, the fact that the infant has been born alive as a result of the carrying out or attempted carrying out of a termination of pregnancy under this Act shall not be a relevant consideration for a medical practitioner when determining what constitutes an appropriate and/or practicable step under subsection (3).”.
The amendment requires that a doctor take all appropriate and practical steps to preserve the life of an infant who is born alive as a result of the carrying out, or attempted carrying out, of a termination of pregnancy. It provides for a basic humanity that should have been included in the Bill from the outset, and it is strange and perverse that it was not. It gives clarity and certainty to doctors on how to proceed where an abortion does not result in the death of a baby. It makes clear that where there are indications of life after birth there is a duty to act to save that life. It does not dictate to medical practitioners what steps are appropriate in any given case.
This will vary in the circumstances, particularly the stage of gestation. Different considerations will apply, such as if the infant is born alive after the point of viability. That will be a matter for clinicians at each delivery.
Abortion survivors being left without care is not a theoretical problem Official figures show in a ten year period starting in 2000, 491 babies who survived botched abortions were abandoned by medical staff and left to die alone without care in Canadian hospitals. In the UK the confidential inquiry into maternal and child health revealed that in 2005, 66 babies in England and Wales were born alive and left, unaided, to die after failed abortions. The amendment, if accepted by the Minister and his colleagues, would ensure that such a scandal will not happen here. It will do nothing to prevent access to abortion but it will avoid the gross human rights abuse that happens when a law does not protect babies who survive abortions. It is unimaginable and unthinkable that such a thing can happen in any right-thinking hospital or care situation where there are medics who have taken the Hippocratic oath and love what they do and do it well and where what they do 99% of the time is save lives.
The Minister used the word "compassion" often during the referendum campaign and since. The amendment is all about compassion and care to one of the most vulnerable in our society, the tiny vulnerable baby who just survived the trauma of an abortion. There is no justification for a cold conclusion that the baby does not deserve compassion.
Amárach Research conducted polling in the wake of the referendum which showed that 69% of respondents believed that where an unborn baby survives an abortion procedure and is born alive that doctors should be obliged to give it medical care to preserve his or her life; only 9% disagreed and the others said they did not know. These and the figures from Canada and the UK inquiry shine a light on the chilling reality of legalised abortion without protection against practices which are rarely discussed in public. However, it is a conversation that we must have.
It is no good for the Minister to say that this will not happen in Irish hospitals when we all know that abortion clinics will inevitably become the main providers. It is happening across the water and in many other jurisdictions. Any mealy-mouthed assurances from the Minister will cut no cloth with any of us or with most right-thinking people, including the 69% in the Amárach poll.
I have stood outside the gates of this House and heard a very brave woman in her 40s tell her story of her botched abortion. Thankfully, she survived and is able to talk about it all over the world. She has a family of her own and is expecting grandchildren. As I said last night, I have heard about more than one case and I have heard many others give testimony. We know there are countless numbers of people. Anything can go wrong in a safe delivery but when one is out to destroy life, one might not always succeed. I have seen the evidence. It was a pity that when that woman came to Dublin during the summer and hotels were booked for her to tell her story, they were forced to cancel the bookings. That was not the case in Cork, however, where we held the event in the hotel without a problem. In Dublin, it had to be held in candlelight, where she gave her testimony on the street in front of a hotel. We talk about democracy and about choice, but what of the choice adults might make to go and listen to this woman whose name, which I should have read into the record, eludes me? I salute her telling her story about the trauma she went through for days, after saline material was injected into her. A caring nurse was passing and heard her squeals for protection, like any infant born, or animal, for that matter, and had compassion and took her into her care and gave her heat and liquids. Now she has life to tell the tale. What a wonderful story. To think that after meetings were booked, arranged and deposits paid, hotels in this city were bulldozed and intimidated and staff followed home to ensure that woman could not deliver her story in three different quasi-public places and that the meeting had to be held in candle light. It was more powerful in candlelight by the Liffey in Dublin, where hundreds of people with compassion and humanity listened to the story. We are asking for nothing more than some shred of humanity to be put into this barbaric legislation. All we are asking with these amendments is for some shred of humanity. We will not be ridiculed for doing so as we do so honestly and respectfully.
I support the amendment. As the previous Deputy said, it is basic humanity that if a baby survives and is seen to be viable that there is an onus on everyone, obstetricians and all other medical personnel, to ensure they are given every chance to survive. The Minister should take this on board. It is only giving basic rights to an infant that was born and was breathing, that they should be given the opportunity to live.
I emailed the Chairman of the committee on the eighth amendment during its hearings to ask if she would invite an abortion survivor to appear before the committee. I had met one who had undergone practically the experience that is dealt with in the amendment. She was a grown woman who wanted to tell her story and was happy to do so to the committee. The Chairman said “No”. I approached another member of that committee and asked if he might make representations to the rest of the committee that this abortion survivor would make a presentation. He responded by asking whether there was such a thing. That individual had sat through the whole debate at the committee, had formed a particular view on the amendment, and was unaware that there are actually individuals who have survived abortions. That person made no effort to have that woman make her presentation. I would have thought that a committee such as that would have inputs from both sides of the debate which would help the members make up their minds. We have heardad nauseamfrom Deputy Durkan that he was at the committee and he heard all the information and was strengthened by it to make the decisions he made around the issue, yet people such as abortion survivors were denied access to that committee. It shocked me that would be the case but that is how politics works in this country.
Around the world, unborn children survive abortions. I do not like to talk about it in much detail as it is something that is difficult to discuss, but they survive in a very injured state. In most cases they are simply left to expire and they are not given comfort or medical treatment. Many people will say that does not happen and that I am talking baloney. It might make it easier for those people to have their opinions if they convince themselves that is the case. However, the statistics mentioned, which were produced by the departments of health in Canada and Britain, illustrate that it does happen. It happens in countries beside us and that have very similar values to us in many of these things. When one goes down the route of a competition of rights, that the primary and untouchable right is the decision to end the life of the unborn child, then resuscitating an infant which is about to expire becomes less of an objective.
I had this debate with the Minister at the committee. He stated that this would never happen here and how dare I even consider that a doctor would allow it to happen, as if to say that doctors in Ireland are somehow morally superior to their counterparts in Britain, Canada or anywhere else. The truth is that we have had a pro-life culture within the society and within the health services for decades. As a result, most doctors would find the type of situation we are discussion very difficult to deal with. It is one they would not allow to arise in the first instance. We know, however, that in countries where abortion is freely available, the culture changes. If it happens elsewhere, it will happen here. The Minister was vociferous on Committee Stage in stating that it would not happen here. The question I would ask is what it would cost the Minister to simply codify it in law. Again, why is there a difficulty in doing that?
There are many with older heads than me in this Dáil. Many Members have fought the Government in bigger battles. Everyone knows that sometimes, when a Minister just does not want to deal with an issue, he or she will think of a reason it cannot be done and why it is difficult to codify it in law. The Minister will not say, "I do not want this to be done", but will just give an excuse as to why it cannot be done. In that type of situation, most of us know it is transparently the fact the Minister does not want to codify it. My view is that we have a responsibility to do that.
This is one of those issues that resonates deeply with people. This is another amendment that does not seek to reduce access in any way. Even for people for whom access is the prime objective and ambition and those who are maximalist in the context of their wish for abortion to be made available on all occasions, this amendment does not interfere with their goals. What it does is reflect the humanity of the unborn child. I have spoken to many people who are pro-choice and who have similar views to some Deputies but they baulk at the refusal of the Government to codify this in primary legislation. The excuse is that somebody somewhere will do something about it at some point. They say that it is not our problem, not our responsibility. They say medical care for that infant is not a policy decision in some way. It is a policy decision; it is 100% a policy decision.
Anybody who looks at law will say that comparative politics is very important. We are not living in complete disconnect from the rest of the world. Obviously, some of the laws we are implementing are part of trends that have happened in other parts of the world. Logic will dictate that the way this legislation operates in Irish society is going to follow the general trends in other societies.
I again appeal to the Minister. This is a logical, humane response to a very difficult situation that does not seek to reduce access one iota. All it seeks to do is give confidence to people that if that situation were to arise here and if a clinician who had worked in the British system and was acting with regard to the cultural understanding he or she had of that system was in any doubt, he or she would know that in Ireland he or she would have no choice but to intervene to protect the life, where possible.
The people voted and we respect their decision. However, they depend on us to legislate and put a sensible Bill together in which we would respect humanity. It is difficult for me to stand here, hour after hour, talking about ending life because that is not what I was brought up to do. From a very young age, I was taught to appreciate life, not to hurt anyone but to do anything that could be done to help anyone. Even with cattle and other animals, I was told that if I wronged them, it would turn back on myself. I refer, for example, to situations where I might neglect animals that could not talk for themselves or defend themselves when they were tied to a stall, needed feed and so on. That is the way I was brought up by my parents and grandparents. We are supposed to legislate and that is what we have tried to do. We have tried to ensure that common sense applies in the context of this Bill.
It can happen that babies who are aborted end up alive. During my first year in the House, 2016, I met a woman downstairs in Buswells, as did other Deputies. She was 39 years of age at the time, so she must be 41 now. She told us of her experience. She had been aborted and she was placed in some kind of a vessel - a bucket. I am sure that is what she told us. Some nurse-----
I did not interrupt anyone. She told us clearly that her mother was forced into having an abortion. That is what happened. She ended up alive because some good nurse came back, took her out, saw to her and she survived. She came to Buswells to tell us her story. It frightened me to think that actually happened. We have figures on this but they are not as real to me as that person telling me her story. The figures indicate that, in 2005, 66 babies in England and Wales were born alive after failed abortions and then, breathing unaided, were left to die. This amendment makes sure that such a scandal will not happen here. Of course, the amendment will do nothing to prevent access to abortion but it will avoid the gross human rights abuse that happens when the law does not clearly protect babies who survive abortion.
The breadth of the top of my nail is the difference between being dead and being alive. A small bit of extra attention can ensure that the person is alive rather than dead, and it is likewise with a baby. This amendment provides clarity and guidance for doctors by creating a duty to save the life of a child who is born alive after an attempted abortion. The Minister said to us at the committee that this is what doctors would do in any event. All we are asking for is to be sure about that.
Heretofore, we did not have abortion in this country.
The doctors that we know were dedicated and trained, and the midwives, to ensure in the maternity ward that everything was done to ensure that they would live. We know that is what they are doing and have been doing. This is different. This is an abortion clinic and all we are asking is that the same effort is put into ensuring that if the baby arrives out alive he or she gets every chance at life the same as the baby that was born in the maternity ward. That is all we are asking. It is not unreasonable. The Minister should not criticise us or say that it is unfair of us to ask for this. It is only a small thing in all of this Bill but to us it is a very big thing, to the little baby that might come out alive it would be a chance at life and that is all we all want, a chance to live as long as we can. That is all we are asking. Until the day I die, whether I win or lose the next election or the one after that, I will never be sorry for asking for this here in this Chamber because I may never again get the chance to do that.
I support this amendment that all protection should be offered in the legislation to infants born alive as a result of carrying out or the attempt to carry out termination of pregnancy under this Act. It would be very cruel and wrong to allow an infant born alive simply to die when the medical professionals make every effort to save the lives of others. In addition to the medical ethics there is a moral duty to fight for every person born, regardless of the circumstances of their birth. This is a reasonable amendment. I will not go into the cases that we have heard. We have all heard and read about them and I do not want to see anything like that happening here in Ireland. We respect the decision of the Irish people and this legislation will pass here in the Dáil but we want to put a few safeguards in there that if a child is born alive and there is some hope that the child can be saved we would like to see it in this Bill that every effort will be made to save that infant.
The Minister said on Committee Stage that he did not need to put anything into this Bill to ensure that doctors would give care to infants born alive as a result of a failed abortion because our doctors know how to care for the infants. However, the Minister seems to have forgotten that in this case the doctor was likely to be the doctor who had been tasked with ending the baby's life, therefore surely the Minister can appreciate that there may be a conflict as to what he or she should do at this point. The doctor was asked to end that baby's life and now the baby is born alive, possibly unwanted by their mother. This is not as cut and dried as the Minister likes to suggest.
During the abortion debate I spent time speaking to everybody. People would not have the same views as me but I have to respect their views. As late as two weeks ago I had a lengthy debate in my constituency office with a person who would not agree with my views but we both shook hands when it was finished and we accepted that we were each entitled to our views. I did listen with interest because I educated myself along this road. There is a lot of discussion about the Canadian lady. Did the Minister meet her? Did he spend a little bit of time with her? He has met with so many people who approve of his Bill and on Committee Stage he said something along the lines that he would meet and discuss with people who want to progress this Bill. There was no harm in meeting and listening to the other side of the story. It was an astonishing story. I will not go into the details because others have done that. There are others out there who have met different individuals. She had an extraordinary story to tell. She was an abortion that went wrong but she lived thanks to the nurse who saved her. The one good point about all of this is that she and her mother are now inseparable. That is the message for the whole of this island: sometimes abortion is not the answer; sometimes there is another answer. That lady got that little twinkle of light and that little chance to live and she and her mother are inseparable now. They have a great relationship. I can see Deputy O'Connell behind the Minister nodding away mad against what I am saying but that is because she probably did not meet this lady either and hear the other side of the story. It is necessary to talk to people, whether one agrees with them or not. It is good to listen. That is something the Minister does not want to do but that is his prerogative.
I think we all, including the Minister, agree with the principle that if an infant is born alive during a failed abortion procedure they would be guaranteed to be given the same medical care that a premature baby of that same gestation would be given. Why then can we not enshrine this principle in our legislation to ensure that no doctor will have any conflict in the area?
It is reported that in the UK 66 babies were left to die in one year with no care after being born alive during failed medical procedures. That is incredible. Unfortunately, that is the road we are now travelling. The Minister has an opportunity to turn that around and change that and at least have something enshrined in the Bill that protects the child that was born after an abortion. I hope that the Minister might give more careful and considered time to accepting this amendment. Like all the amendments we have put forward, we are fair and honest and we spent time putting them together to make sure that we did not flood the whole Bill with amendments that would not reflect the feelings of the public. This is one that does reflect those feelings and I would appreciate if the Minister gave time to considering support for this amendment.
We may talk about compassion. This evening we are talking about a baby who has just survived an abortion. It would be unbelievable if the Minister was to reject an amendment that does nothing to prevent access to an abortion but is all about saving lives. We cannot have a situation in Ireland where doctors in one part of the hospital are doing everything possible to save a premature baby born at say 23 weeks, while in another part of the same hospital a baby born at 24 weeks, after surviving an abortion, is left without life-saving care for whatever reason. This amendment is sought to give clarity and certainty to doctors on how to proceed when abortion does not result in the death of the baby.
It makes it clear that where there are indications of life like breathing, heartbeat, umbilical cord pulsation or a definite movement of the voluntary muscles there is a duty to act to save that life. Nothing can be more compassionate and clearer. This amendment will significantly assist doctors in carrying out their duties.
We must also be cognisant of the human rights abuse of children who survive an abortion and are left without care. This is not a theoretical problem as we have plenty of evidence of such cases in England, Canada, Wales and elsewhere, where babies born alive after botched abortions are left alone in hospitals to die without the care of medical staff. We cannot allow such human rights abuses to happen here. Abortion in Ireland will be legal up to six months into a pregnancy in some cases. We can only hope that the number of children who experience the cruel after-effects of failed abortion procedures will be few and far between. At the same time, however, we must ensure that they are cared for and that is what this amendment is all about, clarity and certainty for doctors.
Article 40.3. 2° of the Constitution states: "The State shall, in particular, by its laws protect as best it may from unjust attack and, in the case of injustice done, vindicate the life, [and] person,...of every citizen."
In fact, there is an onus on us to follow the Constitution which includes the phrase "by its laws protect". From the beginning, the amendment has sought to do exactly what the Constitution enjoins us to do. I am surprised that the Minister did not accept the amendment in principle on Committee Stage. He would have probably got a better wording from the Office of the Parliamentary Counsel. However, the spirit of the amendment is clear and it is very much in line with our constitutional obligations as legislators.
We hear a great deal about how doctors care and I do not dispute that they do. At least, I hope all doctors care. We have had rogue doctors in the past, however, and we should not pretend otherwise. There have been rogue individuals in every profession. Despite the fact that we trust doctors, this land is full of laws, regulations and guidelines which doctors can be severely penalised for failing to follow. The reason is that even though we trust all of these people - just as, I hope, we politicians are trusted by them - we must ensure that no professional can act in a way that does not conform with good standards. A general question has been asked as to whether some allegation is being made here, but that is not so. Every profession is subject to the law. It is nothing new and there is no reason to make an exception in this case.
I thank Deputies for the debate. I am not in a position to accept this amendment which is indistinguishable from the amendment on the same subject put forward on Committee Stage. We had a long discussion and vote on that amendment then. While I can see that the amendment is proposed with the care of infants in mind - and I do not question the Deputy's bona fides in that regard at all - the purpose of the legislation is not to regulate obstetric procedures which do not constitute the termination of pregnancy nor is it to dictate the practice of obstetrics or medicine more generally. It should be borne in mind that the legislation bans termination of pregnancy once viability is reached, unlike other jurisdictions, including many referred to during the debate. Medical practitioners are bound to maintain professional standards and uphold medical ethics at all times. They are bound by their professional regulatory mechanisms to deliver medical services in accordance with best medical practice. Any Deputy who wishes to read the transcripts from the health committee to which representatives of the Institute of the Obstetricians and Gynaecologists gave evidence will see that this is already the practice.
Notwithstanding our differences on this legislation, I am very concerned that word might go out from this House that there is some question or doubt as to what a doctor would actually do if a baby were born alive. I agree with Deputy Ó Cuív that there is an obligation on all of us once someone is born. That is why we also have a ban on termination once viability is reached. I heard a reference to the idea that these might be pregnancies which are unwanted. However, in the situations we are discussing, there is a serious risk to the life of the woman or of serious harm to her health or there is a fatal fetal abnormality. This is a situation where a pregnancy has gone wrong and the medical profession is intervening to protect and save the woman. As Members have heard countless times, in doing so they will always endeavour, where possible, to protect the life of an unborn baby also. There is absolutely no question about that. It is also the case, I suggest, with the mother. The idea that a baby would be born and left in a corner of a hospital is not in accordance with what happens in the Irish health service. It is not what is allowed under Medical Council guidelines, regulatory guidelines and ethical standards. We cannot get into regulating obstetric practice which does not relate to the termination of pregnancy in a Bill which is about access to abortion services.
The Minister referred to current practice. How can we ensure that practice is incorporated? We do not know exactly where these abortion clinics are going to be. As such, how can we ensure the same regulations will move over to these practices?
I support the amendment, to which I signed my name. This is about dignity in death and the protection of infants born alive. It is reasonable to save a child who defies the object of what is trying to be achieved, namely his or her death. If an infant is born alive, what we are seeking here is just basic humanity. It is basic dignity for a person to have a fighting chance at life if he or she is born alive after what we term a "failed abortion." I will not repeat the horror stories such as those Deputy Mattie McGrath highlighted whereby people survived abortion, but we have to cater for such cases. The Minister would be the first to say that one has to allow for every eventuality. This is an eventuality which could happen and we should legislate for it. We should legislate for the protection of the baby who survives an abortion. I support the amendment.
I support the amendment also. Quite rightly, we hear in the House and at every committee people advocating strongly for support for the most vulnerable in society. It is a basic tenet which we should all support. There is no one more vulnerable than the baby catered for in this particular amendment. The protection offered if this amendment were accepted would provide support to infants born alive as a result of the carrying out or attempted carrying out of termination of pregnancy under the Act. It is important for the Minister to give favourable consideration to the very fair proposals put forward in this amendment. There is a moral duty on everyone in the medical profession and among its support staff to fight for every person born regardless of the circumstances of his or her birth. The amendment merits approval by the House. In that context, I hope the Minister can revise what he has just said.
I am sorry I missed some of the Minister's contribution. I had to go out to get a charger for my phone. This is a most basic request regarding an abortion which goes wrong in the eyes of the unfortunate woman who wants it for whatever reason unfortunately and in those of the professional engaged to carry out the act. We have cases and I have given them to the Minister. I have provided him with figures from Canada and England. Are we going to shut our eyes and ears to that evidence? We have heard from the lady from Canada who also spoke to many thousands of people across the country and all over the world. It is a wonderful story. I forgot to mention that she and her mother - who was forced to go for an abortion by her own mother - have an eternal bond and are very close. Her mother is now a grandmother. These things happen and we are not leaving it up to whim. We will be discussing conscientious objection later but no conscientious person could hear the squeaks and squalls of a little infant delivered in the middle of an abortion process. That professional should be allowed the space and encouraged in the legislation to offer human aid and should see that there is nothing wrong or harmful in doing so. It is basic humanity. The animal world would kill a third person after giving birth. I have had experiences with cows calving and sheep. Those animals would kill a person to protect their young. Are we, as a human race, going to be forced to allow our young to perish in this way?
This is a difficult issue. I am not sure about the circumstances where Deputy Mattie McGrath and others spoke about a baby surviving a termination of pregnancy but there are four areas in this legislation where a pregnancy can be terminated.
One area is before 12 weeks, so that will not apply to this amendment. The second area is when there is an emergency and it quite possible that a woman's health would be at risk and one is on the cusp of the baby being viable. For instance, if it is at 30 weeks, the baby will be delivered as normal. There will not be a termination of pregnancy but there will be a normal delivery and at 30 weeks that baby will most likely survive quite healthily. If it is at 20 weeks, the baby is very unlikely to survive but it may be on the cusp of viability at 22, 23 or 24 weeks and there may be a possibility that it can survive. Medical ethics will of course kick in and it will be ethically required of the medical profession to do what it can to continue the life of that baby. The circumstance which is being described here is very unlikely to occur in this jurisdiction under this legislation.
The other area where a baby would be born alive is with a fatal foetal abnormality, which will have been accurately diagnosed before the delivery and some of those children will continue to live for some time, be it a few hours, a few days or maybe a few weeks. Of course, every effort will be made to help that baby to survive and for the family to interact with that baby.
What is being proposed in this amendment is not possible within this legislation but if it was to be the case that a child was delivered and it was alive, medical ethics would kick in and would give every assistance to that baby, provided there was a possibility that the baby would have a time to survive and to live. The amendment may be well intentioned but it will not arise as a practical situation in this legislation because if a baby is born alive and is viable, everything will be done to preserve the life of that child through medical ethics. I do not know if medical ethics can be introduced into this legislation but the possibility of a baby being left to die at the side of a bed without any intervention is completely unlikely in the medical system that we have today.
I support what Deputy Harty has just said. Perhaps those Deputies who have spoken to these alleged survivors of botched abortions in other jurisdictions would take a trip to one of the special care units in one of our maternity hospitals where every day, every effort is made to preserve life.
I have witnessed a case of a woman's life being at risk. A very good friend of mine had a baby born at 25 weeks who is now in school and every effort was made and that child survived. Instead of listening to anecdotes, fairy tales and stories that essentially have dubious sources, perhaps the Deputies could educate themselves by visiting those units and speaking to the consultants who save lives every day.
In terms of viability-----
Viability is fluid and for those Deputies who engaged with the committee and listened, viability depends on whether it is a twin pregnancy and what weight the foetus or baby or whatever one wants to call it is. It is not up to us in these Houses to legislate on the point of viability because the experts tell us that it is not possible because hopefully with science, which we are heavy on here today, in time we will be able to assist early deliveries to survive from 22 weeks or so in the future.
This amendment might be well intentioned but it is certainly ill informed.
I am very disappointed that the Minister is not supporting our amendment. It is clear that he is not listening to what we are saying or does not understand what we are saying. We are simply asking for something basic and humane, which is that if a baby survives an abortion, he or she gets the same attention as a baby in a maternity ward. We are talking about two different places because when a woman goes into the maternity ward, the ambition is to ensure that the baby is born and looked after. We are not sure because we did not have abortion here in this country heretofore.
A number of us, and I am sure a number of Deputies on the other side as well, definitely met this lady across the road in Buswells. She told us what happened to her, we believe her and she gave us a firm account of what happened. Herself and her mother are good friends now. The mother was forced into having the abortion by another family member and gladly, she survived all that trauma. We are simply asking that everything possible is done and every medical intervention available is utilised to ensure the baby gets a proper chance at life.
Again the Minister rejects one of our amendments. It is disappointing that he would reject an amendment that seeks to protect an infant born alive after an abortion. That is astonishing to say the least but it is along the same lines on which he has been travelling with omissions from this Bill to protect a baby in what is an unlikely situation, albeit one that does happen and there is proof out there.
As Deputy O'Keeffe said, what we are trying to put forward in this amendment is the same as what is in our Constitution and I fully agree with him. The Minister says that this is not what we do in our hospitals but we do not perform abortions in our hospitals yet so how do we know what will happen? There are some excellent hospitals which have brought infants into the world who have fought bravely. I have been there myself and the aftercare for children in this country is astonishingly brilliant. It is probably second to none to date, but going forward with a Bill that does not cover all aspects and leaves things wide open in our hospitals, we are now travelling on a different road because we have no protection in this Bill for infants born alive after an abortion.
My colleague Deputy Harty said that after 20, 21 or 22 weeks, it is very unlikely that a baby would be viable. There are situations where this happens and it might be very unlikely but if we can save one child in this country with this amendment, I would be very proud that it was brought forward and we have to make sure that such a protection is there.
Deputy O'Connell has left and she was going on about our fairy stories. Of course she does not want to hear the other side because she has her mind made up. I listened to the other side but she obviously did not, judging by her comments. We did meet the woman who was left to die and we discussed that and it is not fair for Deputy O'Connell to say that unless she spoke to that woman herself and was not in the same mood as ourselves. She also stated that it looks like we have not visited the special care unit but I have been there and we have all been there down through the years.
I have great respect for Deputy Harty and I find him to be a very decent man. I want to believe that if a child survives an abortion, the doctors will do everything they can to save the child. However, as I said earlier to the Minister, who is not in the Chamber at present, we want to give doctors clarity and certainty - that is all we want to do - to ensure they know what will happen. As one of my colleagues on the opposite side of the House said earlier, who would ever think that 66 babies born alive in the United Kingdom were left unaided to die after failed abortions. I would never think that would happen in the UK. Also, officials figures show that over a ten year period in Canada, starting in 2000, 491 babies who survived abortions were abandoned by medical staff and left to die alone in the corner of a hospital. I would not want to see that happen in this country, but it happens in the UK, in Wales and in Canada. In terms of trying to save one life, I ask the Minister to provide clarity on this matter. I cannot understand why he will not consider accepting any of the amendments. This is a simple request. As I said from day one, this is one of the safest countries in the world in which to have a child. I have three children-----
We are a partnership. I hear the commentary about men and women. I have nothing but respect for women. I have nothing but respect for my wife who I have been married to for 35 years, and we are still very happy. I would do anything for my wife. All I am trying to say is that we just need clarity and certainty on this issue. That is all I have asked the Minister to do. It is a very simple request.
I was very disappointed with Deputy O’Connell’s contribution. It seems rather than debating the issues her approach was to attack motives and allege total ignorance with no examination of the issues. I have great respect for Deputy Harty. He strikes me as one of the most caring of people. I bow to his knowledge. I accept that, until now, the entire practise of medicine has been towards saving lives.
It was gratuitous to say we had not thought about this issue. Viability varies, as the Minister said, with the child, the mother, gestation and various other factors. We have all experienced that with family members and we see that in everything to do with the human. There are so many variables in that regard. The idea that we did not understand that is wrong. That is the reason viability is not defined in any specific term of time in the Bill, and all of us agreed on that last night.
Deputy O'Connell referred to intensive care units. If one goes to Britain, one will find some of the greatest care units for born and unborn children that one could find anywhere in the world. Twenty-five years ago, a lady in my parish went to England to have an in-the-womb operation, and that was the early days of such operations, and she now has a fully grown adult son. We all collected money for the hospital. It is also true to say that, side by side with that fantastic care, there is a very vibrant industry whose sole purpose is to take the lives of children. I believe, therefore, that we need to vindicate in the law what the Constitution states, namely, the second one is born one is a citizen and one has a right under law to the vindication of one’s life.
I want to make some brief points. I listened to Deputy Harty with interest and he spoke very well. What he said was that if, as the amendment seeks, it happens that a baby survives abortion, the baby will be looked after. All this amendment would do is enshrine in law that this would happen. It is not too much to ask that this can be done.
I think this is horrific and despicable. I respect what Deputy Harty said. He is a member of my group and I respect his knowledge. I too, thankfully, have a very healthy grandchild. How dare Deputy O'Connell lecture us about fairy tales or anything else. She shut me out of the committee. I brought in a video of an animated abortion. I asked the chairperson and everybody at the committee to look at it or examine it but, no, they all knew about it. I asked that women hurt by abortion be brought before the committee. They were shut out too. The committee could not get a pro-life doctor. I complimented RTÉ on a national programme it broadcast one night and it was able to get one to participate in it, no problem. The committee could not get one.
Deputy O'Connell suggested we should visit a special care unit in one of the maternity hospitals. I have five daughters and thankfully four granddaughters and we are expecting two more grandchildren, thanks be to God. My little Amy-Berry was born at 30 weeks. Her mother, Tríona had suffered from pre-eclampsia. The care she got in South Tipperary General Hospital, formerly St. Joseph's, in Cork University Hospital and from the neonatal team there was exceptional. I accept that.
It is ill-becoming of Dr. Harty to suggest we are imagining things. We have the figures from England and Canada. Is there some precious line of protection around Ireland such that this will not happen on the island of saints and scholar, that the abortion industry will not get its greedy claws in here and that this will not be done by private industry and private people? We are putting our heads in the sand if we think that. We are appealing for the most basic humane action be taken if an abortion goes wrong.
As Deputy Ó Cuív said, this practice is happening side by side with great care in hospitals in England, and it will happen side by side in our hospitals, according to the Minister, the messiah. He is going to tell them all to do it, even though he will not meet or listen the doctors or the nurses who do not want to do it and there can be no conscientious objection. It will be happening side by side in Ireland as well.
All we want is that it would be enshrined in law, as stated in the Constitution, that every child once they are born, once they breathe their breath, would be protected, as they are supposed to be, but, no, the Minister, Deputy Harris, knows better. He is better than the Constitution now all of a sudden since he went on his journey and changed his position from pro-life to being madly pro-abortion.
Bobby Aylward, John Brassil, Declan Breathnach, Mary Butler, Pat Casey, Michael Collins, John Curran, Michael Fitzmaurice, Peter Fitzpatrick, Noel Grealish, Danny Healy-Rae, Michael Healy-Rae, Michael Lowry, Marc MacSharry, Mattie McGrath, Aindrias Moynihan, Eugene Murphy, Carol Nolan, Kevin O'Keeffe, Frank O'Rourke, Éamon Ó Cuív, Eamon Scanlon, Brendan Smith, Niamh Smyth, Peadar Tóibín.
Maria Bailey, Mick Barry, Richard Boyd Barrett, John Brady, Colm Brophy, Tommy Broughan, Richard Bruton, Pat Buckley, Peter Burke, Catherine Byrne, Dara Calleary, Joe Carey, Lisa Chambers, Joan Collins, Ruth Coppinger, Marcella Corcoran Kennedy, Barry Cowen, Seán Crowe, David Cullinane, Michael D'Arcy, Clare Daly, Pearse Doherty, Stephen Donnelly, Timmy Dooley, Bernard Durkan, Alan Farrell, Charles Flanagan, Simon Harris, Michael Harty, Séamus Healy, Billy Kelleher, Alan Kelly, Martin Kenny, Seán Kyne, John Lahart, Catherine Martin, Helen McEntee, Finian McGrath, Michael McGrath, Denise Mitchell, Imelda Munster, Margaret Murphy O'Mahony, Catherine Murphy, Paul Murphy, Hildegarde Naughton, Darragh O'Brien, Kate O'Connell, Fergus O'Dowd, Fiona O'Loughlin, Louise O'Reilly, Eoin Ó Broin, Caoimhghín Ó Caoláin, Donnchadh Ó Laoghaire, Thomas Pringle, Bríd Smith, Brian Stanley, David Stanton, Robert Troy, Mick Wallace.
I move amendment No. 41:
In page 14, line 29, to delete "or section 14certification" and substitute ", section 14certification or section 23certification".
Amendment No. 41 relates to certification of the records that are kept and the fact that practitioners and people carrying out abortion procedures will be expected to keep records. In the discussion on previous amendments, the Minister and many others set their faces against any compassion or intervention whereby the unfortunate unborn baby would be given medicine or an injection for pain relief. Amendment No. 38 dealt with the most basic human right of all time. I hate equating this with the animal world but many of us born and raised on farms, particularly on mixed farms, understand what is involved, as do people with pets. More importantly, those involved in the equine industry understand the effort, the special funds, the special scanning machines and everything else necessary to ensure the safe delivery of prize foals.
The legislation will be passed and none of the amendments - reasonable and humane as they are and so badly needed for humanity's sake - to offer pain relief where an abortion goes wrong have been accepted. We have given the figures from Canada, England and other jurisdictions where large numbers of babies have been born during abortions and survived. Deputy O'Connell and others ridiculed us for moving the amendment and told us to visit a maternity hospital or a neonatal unit. I have made such visits, as have most of my colleagues. We are all proud parents and grandparents. We also have constituents who, every day of the week, have the joy of bringing new life into this world. This is especially important because tá Mí na Nollag ag teacht Dé Sathairn and that encourages to think about our Creator and the joy Christmas brings. We have been lectured about visiting those places. We have been told that we are insensitive and inhumane and that we listened to fairy stories and fiction about the woman we met. Hundreds and thousands of other people also listened to her story. Listening to what she has to say would bring tears from a stone. She has now bonded with her mother, who was forced to have an abortion and there are now grandchildren. We saw what was forced on that woman because of financial circumstances. It was not fiction. She survived the abortion and is now able to tell that tale all over world in her 42nd year. She came here to talk about it.
The amendment makes a very small change regarding certification in order that there might be records kept and accountability and some transparency, albeit for the wrong reason as far as I am concerned, in the context of the taking of human life. We do not have carte blanche. It would not be for me anyway because I am a layperson. Earlier, Deputy Harty spoke about situations whereby it would not happen in Ireland. I will not question his medical expertise. I would not even dream of doing so. I would not be able to and it would be wrong of me to try to do so. However I would question his judgment as to why it would never happen here. He mentioned the legislation in the context of the 12-week gestation period, but we know that, in the reckless money-grabbing industry that abortion is throughout the world, there will be late-term and surgical abortions. We know this. Our eyes and ears are closed to the facts, to the information that is there, to the records worldwide and to the industry we are discussing. It is a money-craving industry that involves the sale of body parts and everything else. How can we be sure this will not happen here? We cannot guarantee it.
The intended delivery of a baby can go wrong and unfortunately has gone wrong. There is great grief. Others have mentioned fatal foetal abnormality. I do not want to be repetitive but I travelled to Geneva with a brave cohort of ladies from Ireland and other countries to testify at the United Nations in order to try to get that horrible criminal terminology removed from the vocabulary relating to healthcare and children. Despite the diagnosis, some of them live to be minutes, hours, days or weeks old. I know of parishes that have had the most joyous celebrations of people with a life limiting diagnosis. The HSE has adopted the phrase "life-limiting conditions" instead of "fatal foetal abnormalities".
There have been celebrations of life.
The mother has the joyous experience of carrying the baby to full term, feeling the baby kick, the delivery, holding the baby, its first breath and giving it its first food and drink before having to part. However, she has the fingerprints and the footprints, and she has had the joy of creation even if the baby is delivered not healthy and with a life-limiting condition. She has the joy of having it for hours, days, weeks or months. Then there is the sadness, grief and trauma but, importantly, there is a funeral and a marked grave that the parents can visit. All the neighbours - ní neart go cur le chéile - and the meitheal of the community come to help at the wake. That is what we do in Ireland, certainly in rural Ireland and, indeed, in urban Ireland as well. I will not demonise urban Ireland. That is what we are about.
This amendment provides for certification of what happens in the delivery ward, which it should be, although in this case it is the destruction ward. That is the sad thing for our hospitals. I salute the midwives, nurses and the neonatal care, but the two will be side by side in small cubicles in hospitals that are overstretched, overutilised and under pressure. That is the reason I am proposing the amendment.
Certification and records will be very important in every way in the future. Yesterday, I mentioned that a high percentage of women in the UK have had two abortions. I do not wish to discuss that issue but the large percentage who have had up to eight abortions. I believe, and the experts believe, that a high percentage of these women are being abused. It is unknown and is not recorded. They are simply left by themselves and after each abuse are dragged in and basically forced to abort. The fact that there are no proper records of these events taking place is leaving the woman completely violated.
I hope the Minister will accept this amendment. It would provide another protection for the woman in this case, although that is true of many other parts of the Bill. To date the Minister has not accepted any of our amendments no matter how passionate we were or how compassionate they were. We have all been in hospitals where babies have been born. Listening to Deputy O'Connell, it was as if she was the only person who ever went to one of these hospitals, but we have all been there. Thousands of babies have been born in hospitals throughout the country that are second to none and have given them excellent care. This is a new route we are travelling and, if we do not keep records of what is happening, it will be difficult for us to see the mistakes that will be made here, and it is certain they will be made.
This is another amendment that does not seek to change access to abortion in this country. All it seeks to do is collect information that is necessary to analyse how the service is being provided and to allow people to develop policy on how the service should perhaps change in time. The amendment seeks to broaden the level of information collected. In Britain, for example, a large amount of information is collected. That enables the health service, the government and people who are interested in the subject to analyse what is happening in the system. The development of proper certification and information would shine a light on how it is being delivered. That should be neutral, regardless of what side of the debate one is on. Whether one is pro-choice or pro-life, it is logical that we should have a good understanding of what is happening. This amendment seeks to collect information that would be collected elsewhere. It is hard to understand why the collection of information is a threat to anybody, so I ask the Government to consider supporting it.
It is very clear. Amendments Nos. 41 and 44 are related and will be discussed together. I already said this. If Deputies wish to contribute they have seven minutes in which to do so. I will give Deputy Tóibín two minutes.
Yes. Regarding the provision of ultrasound, again this is another issue that is difficult to understand. The issue of abortion was dressed up by the Minister as a choice which was logical and beneficial and should be introduced into Irish law. All this amendment regarding ultrasound desires is that a choice is given to a mother whereby she would be able to look at the ultrasound if she wishes. It is a choice that also can be declined if the mother so wishes. There is no effort here to force anybody to see information that the person does not wish to see.
We know that informed choices are the best choices. I have met a large number of individuals who have suffered from abortion regret. It is one of the dirty little secrets that society does not wish to talk about, but a significant proportion of individuals suffer from abortion regret. Abortion regret is a very serious issue. People often suffer great pain and anguish for their entire lives as a result. The provision of information allows people to be able to make informed decisions. I have spoken to people who told me that they did not realise the heart was beating at such a young age or that the unborn child was so well formed at 12 weeks. They did not realise the decision they were making. Asking the person if she wishes to have this information would be the logical thing to do. Ultrasound is not a threatening device in any way. It is a medical device that is designed to help in healthcare. I cannot understand why that choice is not being afforded to people.
There is also great unease among doctors about this. They are being asked to provide abortions in many cases without the technology to enable them to understand the exact health situation of the mother and unborn child. There is significant worry and fear among doctors that if they do not have an ultrasound to make the necessary decision, first, they will not be doing the best for the mothers or the unborn children concerned and, second, they will put themselves in a very exposed situation because they will be making decisions without the best clinical diagnostic tools that are necessary. It is beyond comprehension. I had this debate with the Minister previously. He admitted that in many, if not most, cases where these decisions are made, an ultrasound will probably be necessary, although he also said that he did not yet have clear information from his advisers that it would be necessary. I am asking that this amendment be considered for the protection of the mothers, the unborn children and the doctors.
The importance of ultrasound for determining the gestational age of the unborn child and for protecting the life or health of the woman who is undergoing an abortion cannot be overstated, particularly in circumstances where there are concerns about dating the pregnancy or where there is an ectopic pregnancy. Dr. Peter Boylan, chairperson of the Institute of Obstetricians and Gynaecologists, explicitly informed the Joint Committee on Health on 19 September 2018, when it was discussing the clinical guidelines for the introduction of abortion services, that from nine to 12 weeks women will require hospital management which in turn raises the question of ultrasound as a dating mechanism.
According to Dr. Boylan’s testimony at the committee, figures can vary but in Scotland, for example, approximately 30% of women will require a scan for uncertain dates and the figure here will probably be similar. He also spoke about the risks of introducing a termination of pregnancy service without having adequate scanning facilities in place and noted current infrastructural deficits in the provision of access to ultrasound services during pregnancy in Ireland. This deficit raises very serious concerns with respect to the intention of the Minister for Health to have abortion services rolled out nationally as early as January of next year. These concerns were confirmed by Dr. John O’Brien, speaking on behalf of the Irish College of General Practitioners, ICGP, in reply to a question from Deputy Stephen Donnelly. Dr. Mary Favier of the ICGP also informed the committee that the evidence base on the need for ultrasound scanning is becoming clearer. Dr. Favier added that if ultrasound is required, rapid access to this facility, including the expert provision and interpretation of sonographs, will be a critical element of the pathway. In addition, a 24-hour helpline, staffed by appropriately trained clinical staff, will be required. Dr. Favier further noted that GPs have expressed concern regarding capacity and resourcing challenges in areas such as staffing, facilities and training, the potential lack of appropriate specialist support, the possibility of medical complications for patients, and a fear of litigation. All of these points underscore the necessity of introducing a legal obligation to perform an ultrasound for both the woman and her doctor. The taking of mifepristone and misoprostol, the so-called abortion pills, in the absence of an ultrasound can lead to potentially catastrophic blood loss for the woman concerned.
Confirmation of gestational age is also required for compliance with section 13 of the Bill, which deals with certification relating to early pregnancy, that is, prior to 12 weeks. This underscores the fact that ultrasound will become a routine part of care in this area.
In light of the experts' view of ultrasound as forming a key part of dating pregnancy and determining foetal age, it appears to be reckless in the extreme to even contemplate rolling out abortion services nationally in the face of such challenges in accessing ultrasound. It was a key concern of the Citizens’ Assembly in its ancillary recommendation that all pregnant women, regardless of geographical location or ability to pay, should have access to early scanning and testing. Amendment No. 44 seeks to ensure there is a clear framework in place regarding the duties on medical personnel to use ultrasound in a manner that is clear in law. The amendment offers clarity and certainty for medical personnel, which the Minister repeatedly insists he wants to be provided in the legislation. It also provides clarity and certainty for women and in no way restricts their access to termination of pregnancy.
I will first address amendment No. 41. Records are important to ensure that doctors are made aware when a woman who has already had an abortion is about to have a second or third abortion. I am sure there are implications for the women in question and they need to be protected given the level of care they need. It is very important that proper records are kept to determine if there is an external reason for a woman having more than one abortion.
On amendment No. 44, I have been asked a lot of questions about the issue of ultrasound and how a general practitioner would determine if the baby to be aborted is less than 12 weeks in gestation. Will the Minister clarify if a doctor can determine the exact number of days or weeks of a pregnancy without having access to an ultrasound? I am also aware that ultrasound scans are not available to every GP in rural areas. We are lucky to have such a facility in Kenmare but that does not mean it is available to all the GPs in the town at the same time. Will the Minister provide funding for ultrasound equipment for every GP? If so, will GPs be able to operate this equipment? This is an important issue. A woman or girl is entitled to see the ultrasound of her baby. Failure to support this amendment would mean we are not supporting a woman's entitlement to see an ultrasound of her baby if she wished to do so. It is clear that we should support the amendment. I ask Deputies to support the amendment and the important reason for tabling it.
I thank the Ceann Comhairle. There was a bit of confusion because I did not realise that we were taking amendments Nos. 41 and 44 together. I was neglectful in failing to spot that. I am glad we are discussing the two amendments together and I am glad of the opportunity to speak to them.
With regard to amendment No. 41, in my honest and humble opinion having all types of clarification and certification of records is terribly important. It would be very remiss of us if we were not to make this important amendment to the Bill. As I said earlier, I cannot understand why people would not want to have certification and clear records because it is in the interests of everybody concerned, including the lady and the medical practitioners.
This leads me to amendment No. 44 and the use of ultrasound imaging. The purpose of the amendment is to provide protection for the lady and doctor. It is about facts and information and I believe the best clinical advice would be to have an ultrasound. It is amazing to see the Minister for Health agreeing to fund ultrasound services. This is great coming from a Minister who cannot fund hip operations or cataract removals. He is now able to produce money all of a sudden. That is fine. We debated that issue last night and I will not repeat the arguments. It is definitely best medical practice and it is also in the interests of everyone concerned to make provision for ultrasound imaging. One aspect of our proposal to offer a person the right to see or hear an ultrasound has been misrepresented. Nobody has said this would be compulsory, as some in the media like to portray it. There was no such proposal.
If the Minister is sincere in his wish to implement the will of the people, I see no reason to reject amendment No. 44. On Committee Stage, I stated that the importance of ultrasound in determining the gestational age of the unborn child and protecting the life or health of the woman who is undergoing an abortion cannot be overstated, especially in circumstances where there are concerns about dating of the pregnancy or in cases of an ectopic pregnancy. I cannot understand why people would be against this proposal. That is all I want to say on the matter.
Beidh mé ag labhairt ar leasú Uimh. 44.
I reiterate what has already been said. This is a very reasonable amendment. It is about giving choice and opportunity. Nobody is forcing anything on anybody or on any woman in a distressed situation. The woman who comes in in an emergency situation is exempt from this. We simply wish to make the point that the importance of ultrasounds for determining the gestational age of the unborn child and for protecting the life or health of the woman who is undergoing an abortion cannot be overstated, particularly in circumstances where there are concerns about the dating in the pregnancy. There was much discussion on that element through the committee and so on. It seems very reasonable that we would have this amendment provided for. It also would relate to cases of ectopic pregnancy, as has been pointed out.
We have heard here already that the Amárach survey findings published last month show that 79% of adults agree with offering this choice to women on seeing an ultrasound. I do not think that survey result should be discarded or ignored. The results of it need to be respected. We cannot just decide to go with something as we please. The results of that survey are plain to see. Contrary to the false reporting that has taken place on this matter, the amendment does not oblige or force a pregnant woman to view any ultrasound image or to receive any other information relating to the imaging and monitoring performed. The amendment in no way restricts women's access, as we have pointed out on a number of occasions. I feel it is worthwhile repeating this point to ensure it is not misrepresented in the media. That point has been made over and over tonight and hopefully it will be conveyed very clearly. As we have stated, a woman is of course entitled to see the ultrasound and not supporting this amendment means not supporting a woman's entitlement. We have heard so much about the right of a woman to information and all the rest of it and why not? I cannot see why the Minister would go against such a reasonable amendment. It is interesting that the only way to manufacture any controversy about this amendment was by false reporting, which I found very offensive as a woman. It was mentioned that we were forcing women to view ultrasounds and I find that very offensive.
Yes, and I hope the media carry that as well and report the truth. According to Dr. Boylan's testimony at the committee, figures vary. In Scotland, for example, approximately 30% of women will require a scan for uncertain dates and it will probably be something similar here. Why would we be any different from Scotland? I think that is a good indication. Dr. Boylan also spoke about the risks of introducing a termination of pregnancy service in this State without adequate scanning facilities and highlighted how at present there are infrastructural deficits in the provision of access to ultrasound in pregnancy in Ireland.
Go raibh maith agat, a Cheann Comhairle, sin na príomhphointí.
We hear a lot about opinion polls, Amárach being one, but we had a really big one where people went out and voted in the referendum in May. The people have made their decision. As politicians, we all take passing interest to various degrees in opinion polls but the only one that matters is the ballot. People made their decision in respect of this.
This is not an amendment about choice, far from it. This is an amendment about a bunch of politicians telling doctors what to do in terms of the diagnostic tools they use and, if they do not follow that mandate, offering them a prison sentence of up to a year. To be clear, that is what Deputy Nolan's amendment does. She is right that the woman has to have the ultrasound according to this amendment. Deputy Nolan is not going to force her to look at the heartbeat or the screen but mandatorily, under her amendment, every single woman would have to have an ultrasound and every single doctor would have to carry one out. This is about choice. Of course there is a need for ultrasound in obstetrics; that is not really the question. It is not for Deputy Nolan or me to tell our doctors when to use the ultrasound machine. The idea that we must scan every woman to date her pregnancy is kind of bizarre. Many thousands of women will have gone to their GP today in early pregnancy and with their doctor, based on their last menstrual period, LMP, will have worked out the stage of pregnancy they are at.
I get frustrated, and we also had a bit of it last night, by this idea that until every other issue in the health service is sorted out and no one is waiting for any other procedure, we cannot invest any money whatsoever in crisis pregnancies and women's healthcare; that women's healthcare must come last. Until every man has a new hip or every man has had his cataract done, we cannot invest in women's healthcare. This is healthcare and just as the Deputies come in here and demand that I should do more in all the other things, they should be demanding we do more on this and it is worrying that they are not. This amendment would force doctors, based on no medical reason but the views of politicians, to scan every women mandatorily, to face a prison sentence if they do not do it and to subject every woman to an ultrasound. It would be a terrible use of what people rightly point out is a scarce resource in the health service.
I can categorically state that Dr. Boylan would not be supporting this amendment as somebody offering me clinical advice on the implementation of this service. I am sure he would not like to be quoted in any way suggesting he is supportive of it. Dr. Boylan is absolutely to highlight, as many doctors have, that we absolutely do need to provide ultrasound for cases when our doctors believe we need to use them, not for when politicians do. I am not in a position to accept the amendment.
We are merely asking that ultrasounds be offered and be taken and that any professional standards be maintained. Dr. Boylan, who was quoted, has been appointed as a lead on this whole matter. I would love to know what kind of a contract he has and what kind of remuneration he is on because this is a very lucrative position.
They are being wasted now. I will not be repetitive but am just saying the Minister knows of a situation in Clonmel. He visited a medical practice that wanted to provide ultrasound services for the people of south Tipperary and west Waterford and gave eight months to discussing it. After the Minister's intervention and many senior meetings, hey presto, they rang me on Friday evening and were delighted.
They got an offer to enable them to provide what the Minister should be doing, namely, provide for the people who are on a waiting list for six months and clogging up the accident and emergency departments in South Tipperary General Hospital and University Hospital Waterford. After eight days, the contract was pulled. The Minister told me himself when I chatted to him privately and publicly that he had no money to pay for it.
There was talk about money and leaving people go blind or to leave the hips go. We are not like that at all. We are compassionate people and have compassion for everybody. As for those appalling messes over which the Minister is presiding in the HSE, it gets worse by the hour. We want the Minister to make some effort on that and to have some impact but he is unable to do it. If he had any respect for the Parliament, he would have resigned long ago but that is another area. We make no apology for wanting to help people with cataracts or for the lads bussing them up to Belfast and getting them done under the European directive. The Minister should be ashamed. Meanwhile our medics are going out to Third World countries and doing this operation in field tents for people who are going blind out there. They are doing it voluntarily all over the world. This amendment does not say that we would coerce any pregnant woman to look at an ultrasound.
Many pro-choice GPs have expressed concerns about the lack of availability of an ultrasound. It should be made available for doctors and offered to women to see the ultrasound. In many abortion clinics it is used but women are often discouraged from looking at the screen or hearing their baby's heartbeat.
Sadly this is not to protect the women because they know if a woman sees or hears the baby's heartbeat, she often changes her mind, as within the abortion industry more abortions are good. I recently attended a meeting in Bandon where this was discussed. A lady had travelled 95 miles to the clinic and after seeing the ultrasound she changed her mind because that clinic provides the opportunity to hear the ultrasound which is great. If compassion for the woman was at the heart of the vote in May, why would we not ensure women are offered information about their babies, information that has been shown to impact abortion decisions?
The Minister mentioned putting women first. He is dead right; we should put women first. I ask him to come to west Cork or parts of Kerry tomorrow morning where they will be getting up at 5 a.m. to go for cataract operations because of the efforts of Deputy Danny Healy-Rae and me. If it were not for that, they would be going blind. Those women were not put first by the Minister. He has had ample time to resolve that mess. They are going to have their hips attended to because they are in agony and cannot get a hip operation here. The Minister talks about putting women first; I ask him to look at other areas where women could be put first and have been put last. They were going blind and have got their sight back thanks to the people in Northern Ireland under the cross-Border health directive. The Minister should not tell us that we would not put women first. We certainly have, but he has failed to do so in the past few years and he will have failed to do so if he refuses to accept this amendment.
The Minister said that the ultrasound will not be available in all GP practices. When the girl or woman goes to her GP and he does not have ultrasound equipment but her medical card only covers her for him, what will happen then? We need an honest answer to that.
As Deputy Michael Collins said, it is regrettable that the Minister is portraying us as if we have no care for pregnant women or women who just choose not to have their baby. That is not true. We have, as we have stated, high regard for life. Where the Minister in his role has let them down, we are doing our best to get people looked after in the North. A woman will need to leave Dingle tomorrow morning and travel all the way up to Belfast just to save her eye. We are doing our best to ensure her eyesight is saved. It is wrong for the Minister to say we have no care for women.
We have care for men too because they are facing the same dilemma. They are not being looked after and they are losing their sight as well, as we have told the Minister in this House several times over the past two years. The Minister still has not made a difference or changed anything. He is just not listening. Maybe he will look after the people in urban areas, on the east coast or inside the Pale, but he is not looking after them where we come from. We regret that he made that comparison. I am very disappointed.
It is not really us, but the elderly people who are travelling all that distance who need to be admired. They are trying to do their best to save their own faculties and ensure they see daylight for the bit of time they have left in this world.
The issue of ultrasound is quite complicated. I will try to clarify it within the four parameters the legislation proposes. Under the first parameter it is proposed that termination can occur if there is a risk to the life or health of the mother. In that instance, that baby is a much-wanted baby. Circumstances have overcome that pregnancy such that the life or health of that woman is at risk. That woman will have had several ultrasounds because her pregnancy will be monitored. There will be no necessity for her to have a compulsory ultrasound. She will have ultrasound carried out during normal obstetric practice. In the issue of the risk to the life or health of the mother, there will be ultrasounds to monitor that pregnancy. It will be a much-wanted pregnancy and it will be devastating for that mother if that pregnancy has to be terminated to preserve her life or preserve her health.
In the case of risk to life in an emergency, there may or may not be an ultrasound, or there may or may not be time for an ultrasound. It is not relevant in that situation.
When we come to the condition likely to lead to the death of a foetus or fatal foetal abnormality, again there will have been many ultrasounds in that circumstance. There will be high-definition ultrasounds to identify accurately the fatal foetal abnormality. Again it is not an issue regarding this amendment.
The fourth issue relates to early pregnancy. Ultrasound may or may not be clinically indicated in such a pregnancy. It may be necessary to have an ultrasound to date that pregnancy, but that will be a clinical decision. This amendment contains the word "shall" which means it must take place at least 24 hours before termination of pregnancy. I accept that people seeking a termination before 12 weeks gestation may from a clinical point of view need an ultrasound to date their pregnancy or possibly to identify an ectopic pregnancy. Those are very reasonable reasons to seek an ultrasound. However, enshrining that in legislation is not the way to go about it. That will be a clinical decision.
I am reading one part of the amendment which may make the amendment invalid. The proposed new section 23(9)(i) states:
(i) in the case of a termination of pregnancy to be carried out in accordance with section 10 or 12, the obstetrician by whom the termination of pregnancy is to be carried out, and
Those are the wrong sections because a new section was inserted on Committee Stage. Therefore that should read section 11 or 14, I think. In the proposed new section 23(9)(ii) I believe section 13 should be section 14. Therefore there are technical issues with the amendment anyway.
Ultrasound is a complex issue, but for many of the circumstances in which women will seek a termination, ultrasounds will already have been carried out. It is only in early pregnancy that there may be a need for an ultrasound to date the pregnancy or to rule out an ectopic pregnancy.
The emergence of this proposed mandatory ultrasound reflects exactly the mindset of those trying to reverse the decision in the case of Roe v. Wade in the United States. We discussed this in Committee. In discussing this amendment we need to consider to whom we are doing it. This is placing a necessity on a woman to have an ultrasound in the most difficult of circumstances. The amendment in its essence is designed to inflict pain and to attempt to impose some sort of guilt. Deputy Harty outlined the scenarios, showing it is unnecessary. This is a direct derivative of the carry-on in the United States that attempts to reverse Roe v. Wade. People should be aware of where some of these notions come from.
We spoke about this in Committee. This and many of the other amendments are designed to shame women and to make them feel bad about something that could be extremely traumatic such as a case of fatal foetal abnormality or other severe abnormality.
The Deputies want somebody to be forced to have an ultrasound and, as proposed in some of the other amendments, to watch a DVD or be shown images on a website. A relative of mine recently had a fatal foetal abnormality with twins and when she read these amendments, she contacted me. She was horrified and asked if those people had any idea about this entire situation. I had not intended to speak but that should be put on the Dáil record. I am aware it is on the record of the select committee.
It is now 8.40 p.m. It is clear we will not get this Bill passed tonight. It is now urgent that on Tuesday, or whatever day, sufficient time is provided to conclude this debate because the filibustering has an impact. Women have had to travel since May, and people have had enough. Two thirds of people voted in the referendum, including in the constituencies of the Members who are present, and that mandate has to be respected. Every amendment has been put to a vote. Every one of the proposers has taken their seven minutes and two minutes-----
This is a democratic Chamber. All sorts of parliamentary devices and methodologies have been used over the years and provided they are in order and appropriate, I do not see any difficulty. Deputy Michael Healy-Rae wanted to make a point of order.
First, if we did, we only used what we were entitled to use. Second, the Deputy is factually incorrect. For instance, I stood up here several times when I was entitled to speak for seven minutes but I spoke for less than two. The Deputy should not put lies on the record of the Dáil. She should not mislead the Dáil.
I respect the decision made in the referendum. Two thirds of the population voted "Yes" and one third voted "No", therefore, we have to speak on behalf of more than 725,000. We have to go back to our constituencies, as do the Deputies opposite.
The Minister said a few minutes ago that he would like to start spending money. He can start by buying ultrasound machines.
He spoke about the amendment. The amendment requires a doctor, nurse or midwife to perform an ultrasound and to detect a foetal heartbeat when present. It also ensures that a woman who wishes to view the ultrasound and hear the heartbeat can do so. The amendment also includes a requirement to certify that those steps have been taken as well as specifying that certain minimum standards for the monitoring are carried out. That is to ensure clinical best practice as part of a routine monitoring procedure that ought to be carried out as a matter of course. The amendment makes it clear that it is up to the woman concerned whether she wishes to view the ultrasound image and hear the heartbeat. It is up to the woman to decide what she wants to do.
I want to put on the record that we tabled fewer than 20 amendments out of 66. In the debate at the Select Committee on Health, we tabled one sixth of the total amendments. It is factually incorrect to say all of us spoke for seven minutes and then two minutes. I would like the House to be aware of that and the record to be corrected, but I do not think it will happen. As Deputy Fitzpatrick said, we have never said that the woman would have to look at an ultrasound image.
Can I continue? We have more of it here, a Cheann Comhairle. Where is the democracy? I appeal to the Ceann Comhairle. An offer will be made to the woman to view the ultrasound image and to listen to the heartbeat. If that is impossible for some people, we do not want to be cruel about that. I was present when my wife gave birth to all my babies and it was wonderful to hear the heartbeat and see the movements. It was the most delightful occasion I could ever experience. To be told here by Deputies O'Connell and Coppinger that we have notions or that we are raving. Thankfully, we are not all backward, as they like to portray us. We have wives and families as well.
We have given careful consideration to these amendments. We tabled a limited number and we are not coercing anybody to do anything. I thank the Ceann Comhairle for protecting our right to speak. Some would like to silence us.
I will be brief. I did not intend to speak on amendment No. 44 but its proposers and those who spoke in favour it are being deliberately disingenuous and selective in what they have read from to the House. I ask them to note the first point in it, namely, "The relevant medical practitioner shall perform ultrasound imaging of the foetus".
Not to look at it. I will not go into any personal details but that implies compulsion. If that does not happen, the amendment further states: "...the relevant medical practitioner shall obtain the signature of the pregnant woman on the certification referred to in subsection (5) verifying that it is factually correct". Do the Deputies believe that is the appropriate time to ask an expectant mother who might going through a crisis pregnancy to do that? Furthermore, if the practitioner does not do it, the amendment states that a person who is guilty of a criminal offence is liable to 12 months in prison or "on conviction on indictment to a fine or imprisonment for a term not exceeding 4 years, or both,". That is for not carrying out an ultrasound. The practitioner then may ask the woman if she wants to see the image. Are they being serious? There is compulsion implied in that amendment and we should be straight and honest with people about that.
I had not intended to speak on this amendment either but, to be brutally frank, despite the play and messing around with words, the amendment is clear. It states: "...the relevant practitioner relevant medical practitioner or a qualified person assisting the relevant .... shall perform [an] ultrasound".
For the benefit of those who signed their names to the amendment, there is no version of ultrasound that does not involve the woman being present. A pregnant woman cannot have an ultrasound in another room and, therefore, it is clear that she will be present and she will hear and see. In case she does not, she must sign at the end anyway.
I struggle with this because I am not sure what the point is. Any pregnant woman can ask for an ultrasound. Nobody in the Chamber has asked more questions about the provision of scanning facilities than me, which the Minister will know.
It is woefully inadequate and, as an Opposition spokesperson on health, I intend to hold the Government to account in this regard, but that is not what the amendment is about. There is an element of shaming or judgment in it, and there is no version of this that does not involve causing distress for a pregnant woman. Any pregnant woman can ask for an ultrasound if she feels she needs one or if she needs help making her decision and has not fully made up her mind. It is the job of the Minister to ensure the facilities are there, and we will do all we can do make that happen. To suggest, however, that somehow there must be an ultrasound is unfair and judgmental, and no good can come from it.
There is no choice in the amendment because it states "the medical practitioner shall perform the ultrasound imaging of the foetus". We must be clear about that.
I did not intend to speak on the amendment either and I will be brief. This country has a dark and shameful history in its control of women, their health and their reproductive rights. It all comes down to controlling women, their bodies and their reproductive health. It has gone on for a long time and we are still finding out some dark things about our past.
Whether or not it is the intention of those tabling it, the amendment feels like the foregoing. The amendment provides that a woman who presents at her general practitioner, or as Deputy Harty - a doctor - said, a woman who gets in trouble and whose life or health is at serious risk, will be forced to travel to a hospital, undergo multiple diagnoses and, when she says that she does not want to see an ultrasound, she will be forced to sign a form confirming that she has refused to see these forced diagnoses. If the doctor does not do all of that, he or she will go to jail, which is what the amendment states. It is deeply regrettable that we must have a debate about treating women and trying to control them in this way during the debate about this legislation or any debate about legislation.
I intend to make the majority of my contribution on the section which is related to conscientious objection, on which I have strong feelings.
Subsection (7) of the amendment states: "A medical practitioner who contravenes subsection (1), (4), (5) or (6)shall be guilty of an offence." In a few days, I will contribute to the debate about the rights of medical practitioners, including doctors, pharmacists and midwives, to conscientiously object and opt out of the legislation. I cannot make an argument, nor can I see how anyone could, that a medical practitioner who contravenes the amendment shall be guilty of an offence. The amendment is poorly thought out and I ask those who moved it to withdraw it because it significantly weakens other arguments which they and I may have. It makes no sense to me.
I wish to provide some clarification on this issue. Professor Boylan gave testimony to the Committee on the Eighth Amendment to the Constitution to the effect that he felt it would be necessary for an ultrasound to be available to women in the provision of abortion services. He also stated that it would be logical for an ultrasound to be a device used in the provision of the service. An ultrasound is a medical device used to help people; it is not threatening in any way. Many doctors have stated that, in cases of ectopic pregnancy or other situations where women may present at the surgery and may be provided with an abortion pill and so on, it is important for those doctors to have the diagnostic tools to ensure their care for the woman in those scenarios is care they can confidently stand over. We had this conversation in the committee, which was a more reasonable debate on this. There was not any suggestion that this would in some way be a threat to an individual-----
-----by most people in that regard. The ultrasound is useful for establishing the gestational age of the unborn child, which is necessary, and the woman will be asked whether she wants to see it. It is included in the amendment because abortion regret is a significant issue.
We represent citizens who have told us they have experienced abortion regret. On many occasions, abortion regret is significant, and some of those individuals have told us they did not know all the information at the time and they would prefer to have had more information. The amendment is simply to provide information to the woman.
Abortion regret is made up and it does not exist. The amendment is faux concern for women and what it suggests is frightening, namely, mandating ultrasound. There is no choice for women. It is not about protecting women but rather judging, embarrassing and making them feel bad in the hope that if they are shamed, they might continue with the pregnancy because it suits the Deputies and their agenda.
The amendment goes on to mandate prison sentences for doctors who do not comply with it. It states "Before or during imaging" the woman will be asked whether she wants to look at the ultrasound. In practice, is the doctor supposed to rock up, scan her stomach and ask if she would like to take a look at it? It is utterly ridiculous. If the screen is there, it is hard to avert one's eyes. There is nothing in the amendment that speaks to consent, permission, bodily autonomy or the woman and what is best or right for her.
Ultrasound is diagnostic tool and it is for the doctors to decide. Many Deputies seem to believe they have acquired the expertise of medical professionals but they have not. We have all discussed the issue for some time, but I am not a doctor and nor are most of the Deputies, although there are some. The suggestion that the Deputies know what is best about how a diagnostic tool should and can be used is utterly ridiculous. The concern for women is misplaced at best.