James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank the Senators for their contributions, and I know there is broad support for the Bill overall. As has been indicated since the intention to legislate in this area was first agreed, the sole purpose of this Bill is to make provision for procedural rights for a pregnant woman who believes she has a life-threatening condition so that she can have certainty as to whether she requires this treatment. The purpose of the Bill is not to confer new rights to termination of pregnancy, but to clarify existing rights - that is, within the constitutional provisions and the Supreme Court judgment in the X case - and in order to implement the judgment of the European Court of Human Rights in the A, B and C v. Ireland case. In the judgment of the ECHR delivered on 16 December 2010, the Grand Chamber determined that there had been no violation of the European Convention on Human Rights in relation to the first and second applicants, Ms A and Ms B, but that there had been a violation of Article 8 of the European Convention on Human Rights in respect of the third applicant, Ms C. The court found that Ireland had failed to respect Ms C's right to private life, contrary to Article 8 of the convention, as there was no accessible and effective procedure to enable her to establish whether she qualified for a lawful termination of pregnancy in accordance with Irish law. The aim of the Bill is to provide such a procedure. A pregnant woman whose life is at risk has a right to be able to access appropriate medical treatment, including lawful termination of pregnancy, when she fulfils the necessary medical and legal criteria.

This Bill represents the culmination of a process that was set in train in the programme for Government. This programme committed the Government to establishing an expert group to examine these issues and to advise on how this matter should be properly addressed. The expert group report was published at the end of last year and provided a clear road map for action. While the report examined a number of options for implementation of the judgment in the A, B and C v. Ireland case, it was my reading of the report that legislation with regulations was the preferable route to satisfy the requirements of the implementation process of the judgment of the European Court of Human Rights. That was also the view of the Government.

Legislating for the X case is a serious and legally complex issue, but I believe that this Bill strikes a balance between providing an accessible procedure for establishing whether a pregnant woman might undergo a medical procedure which will end the life of the unborn, and ensuring that safeguards are put in place for the protection of the unborn where possible. It is critically important to emphasise that following the Supreme Court decision in the X case, termination of pregnancy is legal in this country as we speak. That is the reality. I do not know how many such terminations have taken place. I do not know where they may have taken place, or by whom or on what grounds. This Bill sets out to regulate that situation and to confer protection on the mother and the unborn child.

I would now like to turn to the issues raised by Senators during the debate. I am aware that one of the most common reasons for opposing this Bill is the fact that it includes suicide as grounds in some rare cases for permitting the termination of a pregnancy. The reality is that these grounds are already included in Irish law on this area. During the X case in 1992, a majority of members of the Supreme Court of Ireland specifically recognised suicide as a legitimate basis for permitting the termination of pregnancy if it were established, as a matter of probability, that there was a real and substantial risk to the life, as distinct from the health, of the mother that could only be averted by the termination of her pregnancy. This principle was upheld in two subsequent referendums on the issue. Suicide in pregnancy is real. It is rare but it does happen, and when it happens it is always a tragedy.

Many have argued against including suicide in this Bill on the basis that termination of pregnancy is not a treatment for suicide. However, we heard from eminent psychiatrists during the hearings at the Joint Committee on Health and Children who informed us that there is no definitive treatment for suicide. All psychiatrists can do is to try to prevent it, and this entails looking at the causes of suicide and what can be done to address those causes. For the avoidance of doubt, I will quote Dr. Anthony McCarthy, who is the president of the College of Psychiatrists in Ireland:

Suicide in pregnancy is real; it is a real risk and it does happen. This is always a tragedy as at least two lives are lost and many others are affected significantly. We must do everything we can to prevent such deaths. Much has been made and will be made about the so-called lack of evidence with regard to abortion and whether it will ever prevent a suicide. I believe there will never be statistical evidence to prove this point one way or other because trying to prove anything statistically for such a rare event is extremely difficult, if not impossible. Only a study involving thousands of women who were expressing suicidal ideation in pregnancy and wanted an abortion, and where half of them had that abortion and the other half did not, for example, if they were prevented from travelling to the UK, could answer this question about statistical evidence. This study will almost certainly never be done, I hope.

He goes on to state the following:

I will specifically discuss a phrase that is being quoted frequently at the moment that "abortion is never a treatment for suicide". This is true, and abortion is never a treatment for suicide, but neither is counselling, psychotherapy, antidepressants or anything else. There is no treatment for suicide. What society needs to address in general, and what we as psychiatrists have to do specifically, is try to prevent suicide, and this requires looking at the causes of suicide and what can be done to address those causes. The question is not whether abortion treats suicide but is there ever a case where a woman will kill herself because of an unwanted pregnancy, and if so, what can we do to save her life, and would that ever be a termination of pregnancy? This Bill is about legislating for that very small but real possibility.