Thursday, 6 December 2018
Health (Regulation of Termination of Pregnancy) Bill 2018: Second Stage
She went on to write:
I had an abortion. It was the only option for me at that moment in my life, after much deliberation and consideration. I am not a criminal and nor are those who helped me. The voting down of amendments to decriminalise is perhaps the most chilling of all the outcomes from the Dáil debates, and debating the length of the proposed sentence is to miss the point. Criminalisation serves only one set of beliefs. It will cause barriers to access and will have an inevitable, terrible outcome.
She asks the Minister and this House to not let this happen and she speaks from the heart about the stigma and distress of criminalisation hanging over us in law. She urges us to make criminalisation something to be left in Ireland's past. As we introduce amendments on criminalisation, I know the Minister will bear the words of "Tara" in mind, speaking as she does for the thousands of women who have direct and lived experience of the stigma and distress of criminalisation of abortion choices.
I also want to raise some matters concerning the legislation outlined by the Southern Taskgroup on Abortion and Reproductive Topics, START, a group of doctors in Cork. I campaigned and canvassed side by side with them on the streets of Cork during the referendum. A statement issued by the START doctors in October deserves attention. It states:
It is not workable in practice if the legislation mandates that the doctor who certifies must be available three days later to facilitate the abortion by prescribing medication in primary care or arranging the termination in hospital. It will happen that the same doctor is not available for various reasons including part-time working or leave, as well as commitments to other duties or services. Where termination is carried out in hospitals, it will prevent arrangements for delivery being made in referring or local hospitals, where a person has been referred to specialist foetal or maternal medicine tertiary services.
The START doctors when on to state:
There is no medical reason for this requirement and it poses a serious risk to the implementation of abortion services in clinical practice. There are numerous examples of well-established protocols in primary and secondary care which allow the hand-over of care from one doctor to another so as to ensure continuity of care for patients.
Work was done on this aspect of the legislation in the Dáil but it would be useful if the Minister could clarify the position, particularly on abortions that take place in hospital between nine and 12 weeks. It has been fixed for GPs but I do not know that it is altogether clear in respect of hospitals. START doctors also recommend a two-way pathway of care between our tertiary and regional hospitals. In addition, they prefer the use of the phrase "consult" in section 10. We may not debate deleting "examination", although I would like to see it gone, but we might include "consult" as well as "examine". I hope the Minister might be open to that.
The START doctors are also concerned about the prospect of criminalisation for practitioners being retained. In their view, that will lead to an interpretation in law that is conservative. Lawyers have also raised important issues on over-criminalisation, "consultation" versus "examination", "avert" and "mitigate", certification and termination of pregnancy by the same practitioner and, of course, the waiting period of three days. I am also curious to know what is the definition of "serious" in section 9(1)(a) and the rationale for it in section 10(1)(a). Surely harm is harm, something that is not good for the woman. It sounds to me like a vague, non-medical term.