Brian Ó Domhnaill (Fianna Fail) | Oireachtas source

I support this group of amendments and acknowledge what Senators have said.

As for the rationale for these amendments, first, amendment No. 47 endeavours to reframe section 22(1) so that it provides a positive and substantive protection of freedom of conscience. The current section 22(1) states that nothing in the Bill obliges a doctor, nurse or midwife to participate in carrying out a termination under section 9, 11 or 12. However, the concern is that this leaves a serious gap in protection because it merely states that the Bill does not force doctors, nurses or midwives to participate. It, therefore, does not prevent the imposition of such compulsion by an employer or professional body, and there is where the difficulty arises.

A situation, which I referred to on Second Stage, arose in Norway where a doctor who was not willing to perform an abortion was removed from his position by the public health service because of his conscientious objection. The individual concerned took a case to the Norwegian Supreme Court.In mid-October of this year he won the case on the basis that he deserved to make a conscientious objection. If this matter is not addressed in this Bill then we run the same risk of exposing the taxpayer here to a case. We and other countries should learn from what happened in Norway. Accordingly, the amendment at issue improves the protection by closing the gap and ensuring that no-one can lawfully be forced into carrying out a termination other than in an emergency as provided for under section 10.

This amendment also reflects international best practice models for recognising the right to conscientious objection. It is based on section 46(1) of the New Zealand Contraception, Sterilisation and Abortion Act 1977, which provides:

Notwithstandinganythinginanyotherenactment, or anyrule of law, or the terms of anyoath or of anycontract (whether of employment or otherwise), no medical practitioner, nurse, or otherperson shall be under anyobligation —(a) to perform or assist inthe performance of an abortion.

The UK Abortion Act 1967, which has been referred to here many times, also provides for a substantive protection at section 4(1), which reads: "Subject to subsection (2) of this section, no person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by this Act to which he has" [or she has] "a conscientious objection." There is a similar provision in US federal law. For instance, the "church amendments" ensure that an individual or entity who receives a grant, contract or loan does not entitle a public authority to require the individual to perform or assist in the performance of an abortion if that would be contrary to his or her religious beliefs or moral convictions. In addition, it does not entitle a public authority to require an entity to makes its facilities available for the performance of any abortion if the performance of such an abortion in such facilities is prohibited by the entity on the basis of religious beliefs or moral convictions. The "church amendments" also provide protections against discrimination in the context of employment and medical training based on whether or not someone has a conscientious objection to abortion. Additionally, there is international expert opinion in medical literature that supports the view that denial of conscientious rights is a cause of disillusionment and burnout in doctors, and disengagement from particular areas of practice. I am sure that is something that the Minister would not like to see happen here.

I shall read the prepared note that the Minister put on the record during Committee Stage in the Dáil. He said the following about section 24, which was possibly numbered section 23 but I may be mistaken. He said: "Where he or she has a conscientious objection, a medical practitioner, nurse or midwife shall not be obliged to carry out or participate in the carrying out of a termination of pregnancy." In line with this confirmation of the intent of the section, this amendment revises section 24(1) so as to give it the effect that the Minister told the Select Committee on Health that it would have.

A conscientious objection goes further than just the medical practitioner or the doctor. It extends to those people who would be expected to assist or perform, and I mean other healthcare workers, including midwives. I can categorically state the following. I have spoken to a large number of GPs and midwives who are extremely concerned and frightened at the concept of having to perform an abortion from 1 January. One of those midwives wrote to me and I assure Members that I will not identify her or the hospital where she works. The midwife is highly concerned, which will be evident when I read her letter into the record. She explained everything from her standpoint. I shall not read her full letter, just the main parts. I confirm that I know the lady. She said:

Dear Brian,

I am a midwife at. For the very first time in my 31 years of a nursing-midwifery career I am now facing the biggest moral and ethical issue to ever confront me in my professional practice. Like many of my colleagues, I have very serious concerns regarding the introduction of abortion services to Ireland which is currently going through the Dáil to be passed into legislation.

I trained in the Irish healthcare system and I have never worked abroad. For the first time ever in Ireland, against their ethos of preserving life, nurses and midwives are now facing being told they must partake in the killing of unborn human life. I do appreciate the democracy of the society in which I live. However, I am now pleading with you, the legislator, to give consideration to my position as a midwife working at the front line in the Irish health service. No nurse or midwife would have a problem where the life of the mother is in serious danger. This is not the case with the proposed new legislation. Abortions will now be demanded and planned, and women will be admitted to hospitals for elective procedures. Given that 97% of terminations in the UK are on the grounds of mental health, this is a major concern. To date, in my midwifery career, I have not encountered such serious mental health issues in a pregnant woman as to require termination of her pregnancy.

I am a conscientious objector from a moral, religious, ethical and humanitarian perspective. I cannot and will not take any part in any procedure that involves the intentional termination of the life of an unborn baby. This includes any preparation leading up to the procedure or the transfer of care to my colleague. This must be protected in the upcoming legislation.

Over recent weeks I have had discussions with various nursing colleagues working in the areas of gynaecology, theatre and also with nurse-midwife sonographers. They too have all expressed their personal and professional concerns with involvement in abortion services. Nurses working in gynaecology wards around the country are going to see their practice hugely impacted by legislation to introduce unrestricted abortion in the first 12 weeks of gestation. The severe expected [normal] effects of those abortion pills will undoubtedly result in women presenting to our gynae wards as walk-in cases or, indeed, as referrals from GPs who will not be in a position to manage the care themselves. There will indeed also be a number of these women who will require ERPC and will therefore require hospital admission involving a surgical procedure. [The acronym ERPC means the evacuation of retained products of conception].

Many women suffering spontaneous miscarriage in this gestation range require to undergo this procedure. So those inducing their pregnancy loss carry the same risk for the need for such surgical intervention. In addition to the nurses in our gynaecology wards this then also impacts nurses working in our operating theatre departments.

Aside from the issue around conscientious objection in a deteriorating work environment that is already putting huge pressure on staff, the public health service has neither capacity nor staff resources to facilitate such service. One of my midwife sonographer colleagues said to me at work recently "We are already struggling to provide a service to mothers who desperately want their babies" and that she does not wish to be involved in preparing a mother for a procedure to kill others. Personally, I have myself begun-----