Caít Keane (Fine Gael) | Oireachtas source

The issue of conscience is to the fore in this discussion, but we should remember that one person's conscience is not better than anybody else's. One might be led to conclude in the course of this debate that conscience is one sided, but that involves a misinterpretation of the word which comes from the Latin word meaning to know or have knowledge. Knowledge of oneself, particularly when it comes to one's morals and instincts about what is right and wrong, is very important to me as a legislator. Pangs of conscience or an uncomfortable inner voice are very helpful when I am trying to decide what is the right thing to do in a particular situation, whether it involves, for example, a reduction in resources for vulnerable people in our society or, as in this case, an issue of life and death.

I want to make it clear that nobody has told me what to do in regard to this legislation. I am speaking and voting for the Bill because I believe it is the right thing to do, not because of the dictates of the Whip. I would not submit to that type of constraint on this issue which I accept is a difficult one for many. What I know with certainty, however, is that I would have great pangs of conscience if, in the absence of this legislation, a woman were to commit suicide because she was denied an abortion. If I did not support the Bill and such an event were to take place, I would have to conclude that I was not just a bit guilty but very guilty. That is why I am supporting the Bill, including section 9. Even if suicidality in pregnancy is rare, it can and does happen, as we saw in the X case. Dr. Anthony McCarthy, an eminent psychiatrist, told the Oireachtas committee that it did happen. I take advice on this issue from scientists and other experts, including the expert advisory group on abortion. The bottom line for me is that in a case of suicide, both mother and baby will die. There is a stark choice to be made and my conscience dictates that I must support these provisions.

My other reason for supporting the Bill is that I am a legislator and these provisions reflects the current law of the land.We are not changing that law but merely giving clear legislative effect to it. I have a religious faith which I value greatly, but my primary motivation must be to fulfil my role as a legislator. As a member of the Fine Gael Party, I knew before the general election that an expert group would be established to make recommendations on this issue. What is the point in seeking the advice of experts if one is simply going to reject their expert scientific advice? The Bill provides for the existing rights of women and offers clarity and certainty to the doctors who treat them. In fact, its provisions will make it more difficult for women to obtain an abortion in this country on the basis of suicidal ideation. We are not bringing in abortion on demand. Any woman who has an abortion in this country in circumstances other than where it is the only means of saving of her life will, under the provisions of section 22, face imprisonment for up to 14 years. Many Senators have commented on the draconian nature of this penalty. The same point was raised in the Dáil, but the relevant amendments were not accepted. The Offences against the Person Act 1861 is the law under which doctors are operating, a situation which could not be allowed to continue. Doctors need certainty and to know they are protected under the law. We are, after all, a litigious society.

On 16 December 2010 the European Court of Human Rights, in its ruling in the A, B and C case, noted "a striking discordance between the theoretical right to a lawful abortion in Ireland on the grounds of a relevant risk to a woman's life and the reality of its practical implementation". The court noted that since the X case, no criteria or procedures had been laid down in Irish law, whether in legislation, case law or otherwise, by which the risk to a woman's life could be measured or determined, leading to uncertainty as to its precise application. This is where we, as legislators, find ourselves today. We are giving the law of the land practical application. It is our duty - whether we like it and regardless of our personal views, religious or otherwise - to remove the legal uncertainty that has pertained for the 30 years since the eighth amendment was endorsed. The people have subsequently given their view in two referendums on the X case ruling. One is forced to conclude that if men could have babies, legislators, who are mostly male, would have changed the law long ago.

A recent report by Dr. Margaret Oates of the Royal College of Psychiatrists indicates that suicide was the main cause of death among pregnant women and young mothers in the United Kingdom. Nobody in Ireland is gathering these statistics. I compliment the Minister and the Ministers of State on the work they have done in setting out this provision of the Bill. It is clear that a great deal of thought went into it. We will now have monthly reports and an annual report to the Minister on the statistics in this regard, which will ensure what is set out in the legislation is implemented, nothing more, nothing less.

A journalist with the Sunday Independent, a person, as she pointed out herself, who has experienced both pregnancy and suicidation, although not simultaneously, observed in a recent article that it was, in her view, highly unlikely that any pregnant and suicidal woman would submit herself to the interrogation, intimidation and potentially fatal mental distress of having to explain herself, first, to her GP and, subsequently, to two psychiatrists and an obstetrician.

She went on to say that therefore, the flight to London will still remain the choice.

It is difficult to judge. Since the X case ruling, 100,000 women have travelled to the UK, or 4,000 per year so far as we know, but there is nobody counting. Senator Marie-Louise O'Donnell asked how many of those would have committed suicide. We do not know because we do not know. Heads are buried in the sand because it is happening somewhere else. It is alright as long we do not know, because it is not happening here.

I have heard it said that the word "suicide" in legislation will normalise suicide, as if it will go away if we do not talk about suicide, or it will be less likely to happen. I am not going to pretend to be an expert on suicide. Indeed I heard an eminent psychiatrist on the radio - I think it was Professor McCarthy - who said we all seem to be experts in here on clinical judgment on suicidology. I am not, and I am listening, but I cannot take the chance of not believing a woman who may be brave enough to present herself to the four people mentioned in the Bill to say that she is suicidal. I cannot say "I do not believe you." I do not believe the women of Ireland would do that. Moreover, I have to trust the experts in the field who will be charged with making that decision following a clinical assessment. I am not a clinician; I am a legislator and I have to abide by the law of the land. It is not made easy in the Bill and rightly so, because we do not want it made that easy, but the 14 year sentence is another day's discussion.

I have listened to views that we should have guidelines only, but the expert report also noted that guidelines alone will be subject to legal challenge. This Bill may be subject to legal challenge as well, but we have to wait to see if that happens. We will provide legal protection to the medical practitioners and that is what they are looking for. The expert group has done its job and presented its report to the Government. Why ask the experts if we are not going to take the expert advice? The Minister has ensured that he will now be able to evaluate what is happening in each hospital and ensure that the Bill is being implemented.

This debate is very sensitive and everybody recognises that. I pay tribute to Deputy Buttimer, who was able to chair the debate in a courteous and sensitive manner. This legislation is very restrictive and fatal foetal abnormalities have not been included. Article 40.3.3° of the Constitution would have to be changed to accommodate this, and such a change would have to be put to the people. This Bill is not opening the floodgates, as has been suggested. At the inquest into Savita Halappanavar's death in Galway, Dr. Peter Boylan stated that if a termination had been carried out on the first, second or third day after she was admitted,then "on the balance of probability" she would be alive today.

We all have to use our best judgment. My conscience is no better or worse than that of anybody else, and I respect everybody's conscience. I will finish by quoting Dr. Rhona O'Mahony, master of the National Maternity Hospital and her contribution on the Bill during committee hearings in this house. She is a lady who I admire and respect and who is in the business of saving the lives of mothers and small babies every single day of her life. She stated:

Women should be allowed terminations if there is a risk of dying by suicide, even without the Supreme Court ruling on the X case, which determined this to be constitutionally lawful. Suicide is death...We are legislating here for the risk of death. When you commit suicide, you die. The baby dies. The Bill is not about legislating for suicidal intent in pregnancy. This Bill is not about suicide, it is about the risk of a woman dying...Any legislators who wanted the suicide grounds removed should ask themselves if they were certain women would not die as a result...Are we all absolutely certain that when a woman, who does not plan to be pregnant, who is so distressed by her pregnancy that she tells us she wants to kill herself, can we all sit here and say 'I am absolutely certain she will not kill herself?'"

She said that here in this House. I cannot choose not to listen. I am supporting this Bill of my own free will.