Brian Ó Domhnaill (Fianna Fail) | Oireachtas source

I support the amendment. It proposes to create a new section and does not deal with emergency situations. It proposes to replace section 21 with detailed provisions relating to consent, providing healthcare professionals with a clear framework within which to operate. It ensures insofar as possible that the consent of a pregnant woman to an abortion will be true and fully informed. It respects a woman's right to know the facts relevant to her decision and ensures that she is aware of alternatives available to her. It also affords her avenues of redress through appropriate court and disciplinary proceedings where she is not given the information to which she is entitled under the amendment. As is clear from subsection (1) of the proposed new section, it does not apply to emergency situations.

The amendment is about nothing other than ensuring provision of information so as to facilitate informed decision making. It does not limit access to lawful abortion in accordance with the Bill. Moreover, the amendment does not place any obligation on any woman seeking an abortion. Without this information, any consent obtained is not informed consent. Without this amendment, women who would elect not to have an abortion if they had complete information will instead go through with it. This must be unacceptable to all those who regard themselves as pro-choice and, accordingly, it is respectfully hoped that the amendment can be agreed without undue difficulty.

During the referendum campaign, the Tánaiste and Minister for Foreign Affairs and Trade assured people that the waiting period in section 12 of the Bill would involve counselling and offers of alternatives to abortion. This amendment goes some way towards aligning the Bill with what the Tánaiste promised at the time. It is clear that most abortions under the Bill will be elective procedures and the law requires that elective procedures require a high degree of disclosure. However, the scope of that very general obligation in common law is not always clear with regard to the given case. The kind of risks arising will vary from one procedure to another. As the obligation in common law is in nature a general obligation to disclose material risks, arguments sometimes arise in litigation as to whether a given risk was material. In addition, the disclosure obligations in Irish common law are not designed to address the added dimensions of abortion as compared with other procedures. Informed consent to an abortion requires more than just disclosure of risks.

Amendment No. 44 reflects an understanding that abortion decisions are more complex and significant than decisions about other procedures. Accordingly, in recognition of this, the amendment is immeasurably clearer than the general common law obligation and improves upon that obligation in terms of the range of information that it provides for. Amendment No. 44 is, therefore, essential to ensure that a woman is given the information she is entitled to receive to make an informed decision. It is also essential to provide clarity for healthcare professionals, eliminating needless uncertainty as to what should be disclosed.

Paragraph 11 of the eighth edition of the Medical Council's Guide to Professional Conduct and Ethics for Registered Medical Practitionersfrom 2016 addresses informed consent. Section 11 is commendable in that it reflects a patient's right to know, even where the information in question could cause upset. It is understandably framed in very general terms that do not give rise to anything remotely approaching a definitive obligation to provide the comprehensive information referred to in amendment No. 44.On a matter of such importance it would in any event be improper and inadequate to rely on Medical Council guidelines as opposed to the Act of the Oireachtas.

Essentially, when many women seek to obtain an abortion, they will do general scoping through a Google search, trying to inform themselves as best they can via the Internet or other means. This is about women who may not be in a position to do that and they deserve to know the full information and consequences as well. This amendment is about providing the information. The proposed section 21(2)(b), for example, is about offering a leaflet and section 21(2)(c) is about offering a different leaflet as a source of information or having it conveyed in another way where there are literacy issues etc. Either women will have checked this themselves or they deserve to know the information.

Canada has been referred to by me and others and the concept of informed consent is applied. I know the Canadian abortion model operates within the structure of governance there, as there is federal government and the provincial legislative chambers as well. As I understand it from the little research I have done, the private providers there ensure the woman is given information similar to what is contained in this amendment. This is to assist the woman and provide her with the full suite of information. Anybody going for a procedure of this nature should be afforded that consideration, and it is the purpose of the amendment.