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

The first number of amendments in this grouping, amendments No. 16, 17, 25, 26, 35, 36 and 55 are around the issue of reasonable opinion. These amendments would have the effect of deleting the words "as far as practicable". In regard to the latter, the words "as far as practicable" are taken directly from Article 40.3.3^o of the Constitution, which states: "The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, in far as practicable, by its laws to defend and vindicate that right."

In relation to the amendment to change the definition of "reasonable opinion", section 7(1)(a)(ii) provides that a termination can only be carried out where the medical practitioners have formed an opinion described in the following terms, "in their reasonable opinion ... that risk can only be averted by carrying out the medical procedure". Section 7(1)(a)(ii) further provides the reasonable opinion must be "formed in good faith" and one "which has regard to the need to preserve unborn human life as far as practicable". These two requirements place further obligations on the medical practitioners before they arrive at a view that in their reasonable opinion the risk can only be averted by carrying out the medical procedure. These requirements and obligations are expressed in a language that follows very precisely the test laid down in the X case. That is why as part of the certification process where there is a real and substantial risk to a pregnant woman's life, doctors are required specifically to consider whether it is practicable to preserve the unborn human life.

The language put forward in the amendments is not expressed in the terms required by Article 40.3.3^o of the Constitution and as interpreted by the Supreme Court in the X case and could have unintended consequences. However, in practical terms, the Bill, as currently drafted, places a clear obligation on medical practitioners to ascertain whether it is possible to deliver the unborn, or indeed take other measures, that would enable the foetus to be brought to the point of viability before the pregnancy was ended in order to safe the mother's life. For those reasons I cannot accept the amendments proposed.

I will deal with the second theme, that of viability, in this group of amendments under amendments Nos. 20, 22, 27, 28 and 41. Again as I pointed out previously, the Bill makes reference to a medical practitioner's reasonable opinion in this regard, which places a statutory duty on each medical practitioner required to form an opinion for the purposes of the legislation to have regard to the need to preserve unborn human life as far as practicable. This imposes a clear duty on medical practitioners to make every effort to preserve the life of a foetus. Not to do so would mean a medical practitioner would be in breach of the proposed legislation and subject to its penalties.

I must point out that the purpose of the legislation is not to regulate obstetric procedures, which do not constitute termination of pregnancy, or to dictate practice of obstetrics. Standard medical practice will provide appropriate mechanisms for assessments of both the woman and the unborn and it would not be appropriate to include this, or other details of medical treatments, in legislation. Therefore I will not and cannot accept the amendments proposed.

On some of the comments made earlier today, to which Senator Healy Eames alluded again, on the issue of pain, I have talked to a number of experts today, including my chief medical officer, and the thalamus which is a very important part in terms of pain experience, does not really develop until the 21st week. As we mentioned earlier, none of the techniques described by Senator Walsh are used. Medical induction of labour and delivery is what is used after the 12th week. There is no instrumental termination used after 12 weeks. It would be considered to be far too dangerous for the life of the woman.

Consequently, while the Senator has some information indicating some possibilities of pain being experienced by a foetus of 17 weeks plus, I would be grateful to have sight of that research and to hand it on to the medical people concerned. As I stated earlier, at all times, care and compassion in respect of safety and as much pain control as possible is what is used in all procedures in hospitals from the point of view of all patients.