Rónán Mullen (Independent) | Oireachtas source

In light of the questions I am posing, I hope that the substituting Minister, the Minister of State, Deputy Catherine Byrne, has the necessary background information on the very specific questions I am asking about the interactions between the Minister and various doctors and doctors' representative groups. I have no doubt she does. In the Dáil, the Minister said that to use wording other than that currently used in the Bill could have implications for obstetric practice and could have a chilling effect - that phrase again - on the provision of the service. He asked how doctors would be satisfied that something was 100% necessary as opposed to trusting their clinical judgement and the clinical guidelines.That was an interesting statement by the Minister and it prompted me to look at the existing Medical Council guidelines on the termination of pregnancy in the case of a risk to the life of the mother. The Medical Council's Guidelines to Professional Conduct and Ethics for Registered Medical Practitioners 2016, at paragraph 48.2, state, "In these exceptional circumstances, it may be necessary to terminate the pregnancy to protect the life of the mother while making every effort to preserve the life of the baby." I repeat, not appropriate but "necessary". The existing Medical Council guidelines contain the exact form of words which was rejected by the Minister, Deputy Harris, in the Dáil and which is contained in amendment No. 7 here today. The relevant text of the Medical Council guidelines was not changed between the 2009 edition and the revised and amended 2016 edition. The former was revised by the Medical Council in light of the report into the death of Ms Savita Halappanavar and the introduction of the Protection of Life During Pregnancy Act 2013.

If the Minister, Deputy Harris, intends to reject this amendment today on the grounds that the wording is too restrictive and has a chilling effect, will he please clarify, first, whether he can refer to a specific situation where the current Medical Council guidelines revised after the Ms Savita Halappanavar tragedy and the 2013 Act were found to be too restrictive or to have a chilling effect? Second, will he, or she, in the case of the Minister of State, assuming the Minister does not come back, clarify whether it is current medical practice that this use of the word "necessary" in the Medical Council guidelines is interpreted so that “necessary” means "absolutely 100% necessary", as the Minister stated in the Dáil on Committee Stage. Does the use of the word "necessary" in the Medical Council guidelines mean that doctors under those guidelines cannot exercise their clinical judgment, as the Minister's words suggested? If so, which doctors or doctors' representative body have told the Minister this because this would certainly be news to a great many obstetricians currently practising? If it is alleged that the use of the word "necessary" in the Medical Council guidelines is having some kind of negative effect on obstetric practice, may we have an example of a case, since the guidelines were revised in 2016, where a termination to save the life of a woman was refused because it was not necessary to save her life and where this judgment turned out to be incorrect and lives were lost as a result? Will the Minister explain, if this phraseology is too restrictive and has a chilling effect, as stated on Committee Stage in the Dáil, why the Government did not seek an amendment to Medical Council guidelines when they were last revised in 2016? I would ask for clarity on all of these issues before we vote on this amendment.