Medical Treatment (Termination of Pregnancy in Case of Risk to Life of Pregnant Woman) Bill 2012: Second Stage
Wednesday, 18 April 2012
Dáil Éireann Debate
Deputy Clare Daly: That is correct. When I was president of a students’ union involved in legal battles with SPUC over the distribution of abortion information in students’ union magazines, I would never have dreamt that 25 years later we would still be largely fighting the same issues. When so much has changed in Irish society in the intervening period, legally everything has remained the same.
Despite the fact that this is long overdue, I feel privileged to be in a position to be able to move this motion on the Bill today on behalf of myself and Deputies Wallace and Joan Collins in the Private Members’ time of the ULA so that we can play our part in what we would have to acknowledge is an historic proposal before this House. It is the first time in the history of the State that a Bill is being put forward to advance, positively and constructively, the position of abortion rights and to attempt to deal pro-actively with a situation that is so often ignored. We acknowledge the fact that we are only in a position to do this as a result of the input and assistance that we got from Mr. Brendan Young, Ms Alison Spillane and, particularly, Ms Yvonne Murphy, without whose support this would not have been possible.
I think I speak for all of us when I say we are humbled to be moving this motion on the Bill on behalf of the 150,000 Irish women who have been exported from this country since the 1980s to access safe abortions in Britain, without adequate support, away from their families and friends and at significant financial cost, additional emotional trauma and stigma, and whose voices have been sidelined for decades and ignored. We are saying clearly today: “Not any more.”
Women are not prepared to sit back and be silent any longer. We saw that clearly yesterday with the move of Arlette, Amanda, Jenny and Ruth, who over recent days went public and told their stories of the heartbreak of having to leave Ireland to terminate their pregnancies as the foetus would not have lived. Those women have lifted the lid on this situation in Ireland. They have been a real inspiration to us and to many thousands of people throughout this country in highlighting the complexities and sensitivities around these issues. They have given, and we are giving, a clear signal that people are not prepared to endure the pretence and hypocrisy that there is no abortion in Ireland when thousands of women must leave the country every year. I refer to women who need to access life-saving medical treatment, women who have become pregnant as a result of rape, women whose foetus would not survive the birth, women for whom another child would put the family into poverty, women who feel that they are too young or too old to have children, women who would have lost their job, and women who would make that decision for a number of reasons, none of them ever easy and all of them valid. We absolutely reject the idea that these decisions are ever made lightly as a lifestyle choice. We know this because the people making the decisions are us — loving mothers, daughters, partners, wives, sisters, friends, etc. — who should be expecting support and assistance from the State, not isolation and condemnation, because the right to control what happens to your own body really is one of the most fundamental human rights of all.
Sadly, the Bill does not deal with all of these aspects and all of these cases. It is being put forward as drafted simply because it is the most straightforward legislation that can be advanced within the confines of the existing constitutional provisions. Our Bill can be legislated for without any complications and that is why we are putting it forward very much as a first step. It has been proofed by the international centre for reproductive rights. We are satisfied that it is well proofed. No doubt the Government will say there are one or two inaccuracies in it. That is normal for any new legislation. The Government itself will dramatically change the Social Welfare and Pensions Bill on Committee Stage. Equally, that can be done with our legislation; it is not a reason for stopping it.
To those who say that this Bill does not go far enough, our response is that we agree. There needs to be a far greater provision than that which we are providing here today, but that does not negate us taking the first step now. If we do so, we can immediately improve the position of women and that, in our opinion, would assist in moving the debate forward by allowing the expert group to concentrate on all the other issues and the need for a broader provision than what we have at present. We do not see any contradiction in that regard.
To explain a few aspects of the legislation, the Bill simply legislates for the X case to allow safe abortion in Ireland where the life of a woman is at risk, including the risk of suicide. We put this forward very much in the knowledge that it is not even 30 years since Ms Sheila Hodgers died in the Drogheda hospital, a woman denied and whose cancer treatment was stopped because it might have harmed her foetus. That woman died an agonising death. Her husband had to listen to her screams of pain. She left behind two young children and a loving husband because our medical system denied her life-saving treatment because she was pregnant.
It is 20 years since tens of thousands of citizens took to the streets to object to the internment of a 14 year old girl made pregnant as a result of rape and to stop the State’s move to prevent her parents bringing her to England for an abortion. Twenty years ago, people voted overwhelmingly for the right to travel, for the right to abortion information and overwhelmingly against the overturning of the Supreme Court ruling which declared that it was constitutional in Ireland to have an abortion where the life, as distinct from the health, of a woman was at risk.
Ten years ago, again the Irish people voted to reject the attempts to row back on that decision. Decades of wavering have intervened. Not a single piece of legislation has been enacted throughout that period to give effect to that ruling. Sometimes we look back and pat ourselves on the back that we have left behind a country of the Magdelene laundries, of women’s babies being basically sold, of the Kerry babies, of Ms Ann Lovett who died secretly giving birth in a graveyard, hidden and unable to talk to people, of symphysiotomy and the crimes to which we had to listen. We say how we have moved on from all of these matters, and yet successive Governments have allowed a situation where legislation lags behind that change by failing to bring the law up to date with the requirement that exists now.
We should acknowledge in truth that the only reason there is not more pressure to change on this issue and the only reason more women have not died as a result of successive Governments’ inaction is our proximity to Britain which has acted as a safety valve in that regard. That is not good enough any longer. Particularly now in this era of economic austerity when people simply do not have the means to come up with thousands of euro to travel, it disproportionately affects working class women, poorer women, refugee women, of course, and women whose status in this country is insecure and who cannot avail of the option to travel in that regard.
The Bill allows for abortion in Ireland where it is necessary to save the life of a women based on the medical opinion of two medical practitioners, one of whom must be a clinical psychologist or a consultant psychiatrist where the risk to the life comes in the form of suicide. Those who have been lobbying against the Bill and contacting us over the past while, giving vent in the media, etc., have stated that this Bill is not necessary because life-saving treatment is available to women in Ireland already. Apart from the question of what the big fuss is about if all our Bill is doing is giving this reality an acknowledgement, of course, this is simply not the case. In Ireland, legislatively, it is still the case that a patient or somebody who provides an abortion could face life imprisonment for doing so except if the life of a woman is in danger. Precisely because there has been no legislation or policy guidelines, however, this means nothing is in place to allow this to happen.
The European Court of Human Rights, which my colleagues will deal with, did not find evidence of a single abortion being carried out on that basis. We have been deemed guilty of violating the human rights of Irish citizens by failing to provide that legislation. Even as recently as late 2010, cases have been documented where women were denied life-saving abortions in Irish hospitals despite the wishes and intentions of their medical advisers. That is a fact.
What our Bill seeks to address is those circumstances, and only those circumstances. If the Bill is not passed, women with life-threatening pregnancies and their doctors will be condemned to remain in exactly the same situation as existed 20 years ago, namely, forced to leave this country and forced to travel. That point has been recognised in opposition by the Labour Party, Sinn Féin and many Deputies from Fine Gael and the other parties. It is not good enough to recognise that and then hide behind the fact we have an expert group when we know the establishment of the expert group was delayed and that it will not issue any findings until July of this year. In effect, with the recess and all the other scheduling issues, this means anything it will come forward with will not see the light of the day for a full year.
We have an opportunity now to do something positive. If the Minister says our Bill is not perfect, and I am sure it is not, let us work together at amending it on Committee Stage. However, we need this Bill tabled and moved to the next Stage to advance the position for women in this regard.
To deal with some other aspects, the Bill provides for a second opinion being available if the woman is not happy with the decision of her medical practitioners. It provides for a right to appeal, with an obligation on the Medical Council to hear the case in a timely fashion because of the time pressures involved, which is in accordance with best international practice.
We also place a duty of care in the legislation on the medical practitioner and the medical institution to provide abortion while, at the same time, we acknowledge the personal beliefs of some people in that regard and, in some instances, a conflict between their beliefs and professional obligations. This is respected in the Bill which has built into it safeguards to prevent women’s access to treatment being frustrated by a practitioner’s personal beliefs. A doctor can object to providing treatment as long as an alternative is available and if his rejection does not endanger the life of the woman who needs the life-saving treatment. That same clause does not extend to the medical institution, which must provide the care, or to administrative staff, who must do their job regardless of their own beliefs on abortion and so on.
We also expressly provide for the fact that efforts must be made to seek consent but that if it cannot be established in line with other life-saving treatment, it will be deemed to have been given. There are penalties in the Bill with regard to people who would frustrate and try to obstruct a woman from getting access to this treatment in a timely fashion.
This debate is not about whether to allow abortion in Ireland. Irish abortion exists; it just does not take place in Ireland. That is simply not acceptable in 2012. We want the hypocrisy to end and we see this Bill as a very important step forward.
It is incredibly ironic that we are discussing this on the same day a landmark change is being proposed to the lone parents system and support for children, which is being removed after the child reaches the age of seven. We very much see this fight in the context of that one. The fight for the right of women to choose what to do with their own bodies is equally a fight for the right of people to decide to have children if they want them, and the right to have an opportunity to rear their children with respect, dignity, economic security and so on. That is what a real choice means. Today is merely a first step to bring our legislation up to date. It can be a turning point in our catching up with what has been long sought by the citizens in this country.
Deputy Joan Collins: I am very proud to be part of the introduction of this Bill put forward by the United Left Alliance and Deputy Mick Wallace, the Medical Treatment (Termination of Pregnancy in Case of Risk to Life of Pregnant Woman) Bill 2012. The Bill is very specific.  It is based on the Supreme Court judgment in the X case. The girl was only 14 years of age at the time and is now a woman, somewhere in this country or elsewhere. I wish her well.
It is very robust legislation, which Deputy Clare Daly has outlined well. It has been checked with the international centre for reproductive rights and we have had legal advice on it. It is definitely a Bill that can be worked on with the support of the Dáil, if we get agreement on it today, which should happen.
I want to bring us back in time. We must think back to 1992, although some in the Chamber might not remember what happened. On 30 January 1992 a rape was reported to the Garda. On 4 February the parents of the child sought advice from the Garda about the admissibility of foetal DNA evidence. On 6 February X and her parents travelled to England and arranged an abortion for the following day. On the same day an application was made to the High Court for a temporary injunction, which was granted by Mr. Justice Costello. X and her parents returned to Ireland that night. On 10 and 11 February the High Court heard in camera the application for a permanent injunction. On 12 February the story appeared on the front page of The Irish Times and was released into the psyche of the country. On 17 February Mr. Justice Costello granted a permanent High Court injunction. On 20 February the parents lodged an appeal to the Supreme Court and applied for an early hearing. That hearing took place on 24 February, again in camera. On 25 February the Supreme Court hearing continued. On 26 February the Supreme Court listed the injunction, with reasons to be given at a later date.
In that period of time, as Deputy Daly said, thousands of people came out on the streets demanding that this child had the right to go to Britain for an abortion. I remember distinctly seeing placards where the country was depicted as being surrounded by barbed wire, expressing the point that women were chained into this country and not allowed to go to Britain for abortions. The Supreme Court in Attorney General v. X case ruled that a 14 year old girl pregnant as a result of rape faced a real and substantial risk to her life due to the threat of suicide and that this threat could be averted by the termination of her pregnancy. Therefore, X was entitled to an abortion in Ireland under Article 40.3.3° of the Constitution, which requires the State to have due regard to the equal right of the life of the mother and the unborn.
It was very important for me to go through that history and reflect that period because it was a very emotional period. It was not an abstract discussion or debate but a very real situation where people in this country saw that this child needed and had a right to go to Britain for an abortion in that serious circumstance. It is very important in this debate to dispel the myth that this legislation is opening the door to abortion on demand. Article 40.3.3° denies a woman’s rights where her health is in danger through a pregnancy with foetal abnormalities, or a pregnancy caused by rape or incest, and denies a woman’s right to choose on social or economic grounds.
It was a very sad occasion today for me and many others who met the women who have had to face the tragic circumstance of foetal abnormalities. It was a turning point in that women came out to say this is not acceptable. They were faced with a situation where they were grieving because the pregnancy would be over and then they had to face travelling out of the country on boats and airplanes like criminals. This was the main point put across today in outlining the experiences of these women. I salute Arleth, Amanda, Ruth, Jenny and Siobhán as well as the hundreds of women who are obliged to travel from this country every year and who take the serious decision to terminate their pregnancies. It is an outrage that this is occurring and that these women are faced with these circumstances. In many cases these women have been informed that if they gave birth, the child would not survive. One woman in particular explained that the condition of her pregnancy meant she was crushing the baby. She did not wish to continue the pregnancy and she believed the best decision would be for her to terminate it. That was her decision and her choice. The options were to carry through with the pregnancy or to go to England, a terrible situation to be in. I cannot imagine having to face such an experience.
The point was made clearly at today’s meeting that the issue of money is serious. It costs between €2,000 and €3,000 to terminate a pregnancy in Britain. The grief and criminality of the experience of these women should not be accepted by any right-minded person in the country. What kind of society are we living in when we cannot discuss providing abortion for women in these circumstances without anti-abortionists claiming that we are opening the door to abortion up to the last week of pregnancy without any qualification?
I would welcome a debate on the broader circumstances in which women find themselves, including such issues as rape, incest, health and foetal abnormalities and the right for women to chose to have an abortion. Deputy Clare Daly made some poignant comments earlier on which I wish to elaborate. They related to how these issues affect women now that we are in a recession. Women cannot access abortion if they do not have the money to travel. Working women, women on low pay and migrant women cannot leave the country and cannot seek an abortion outside the country. It is accepted in this country that abortion exists but the view is that it simply does not happen on our doorstep. We sweep it under the carpet and suggest it can be dealt with elsewhere. This is outrageous.
There have been six successive Governments since 1992. The Labour Party was in power during this period from 1992 to 1997. Two referendums were held in which the people endorsed the X case rulings. There have been three related Government committees and a fourth Government committee has been formed. Following the outcome of the A, B and C case, the European Court of Human Rights instructed the Government to present an action plan for legislation to allow abortion in Ireland where a woman’s life could be in danger because of a pregnancy. The particular point made related to how the lack of legislation adversely affects a woman who does not have the financial means to seek medical services outside the country and how such women are particularly vulnerable.
Apparently, the Labour Party will not support the Bill on the grounds that it does not go far enough. In our view, there is no contradiction in supporting this Bill or any further legislation to provide for abortion on health or social grounds. The Labour Party should not hide behind the Minister’s expert group and cause further delays in legislation which could help vulnerable women and doctors who wish to help them by providing a legal framework for abortion in Ireland according to the limited circumstances of the X case.
I refer to some of the related issues raised in recent days. Some people claim to represent the majority of people in the country. However, times have changed and moved on dramatically in the past 20 years. Independent research into Irish women’s and men’s attitudes towards abortion was conducted by YouGov plc in 2010. The research revealed that approximately 87% agreed that termination of a pregnancy should be permitted if the pregnancy seriously endangered the life of the woman. Some 78% agreed that termination of a pregnancy should be permitted if a woman’s health is at risk. Some 78% agreed that termination of a pregnancy should be permitted if the pregnancy is the result of sexual abuse, rape or incest. Some 62% agreed that termination of a pregnancy should be permitted if there is evidence of profound foetal abnormality. Some 41% agreed that termination of a pregnancy should be permitted if the woman believes it is in her or her family’s best interests. Only 3% of respondents believed that abortion in Ireland is not acceptable under any circumstances. However, this 3% appears to be holding this Government to ransom and has done the same for previous Governments.
Another study was carried out on 25 November 2011 dealing with doctor’s opinions of abortion. Under this survey somewhat more than 50% of Irish general practitioners believe abortion should be available to any woman who chooses it. A study earlier this year of 500 established GPs along with 250 GPs in training revealed that 48% of respondents had held a consultation in the previous six months involving a woman either before or after she had travelled abroad for termination of a pregnancy. The study, carried out by Dr. Mark Murphy, a GP with the Sligo general practice training scheme, is understood to be the first research to examine the attitudes of GPs toward abortion and their clinical experiences of termination. The study was based on a postal and e-mail survey of randomly chosen family doctors. It also highlighted health problems for woman related to the issue. Some four out of ten respondents believed a woman’s health care suffered because of the requirement to travel to have a termination. GPs reported difficulty with after-care for women affected. One respondent noted that many women do not attend their Irish GP for after-care because they are ashamed or embarrassed and that often they present too late with infection or bleeding. Respondents also noted the psychological stress involved. One respondent commented on how the illegality of the action and having to travel abroad added to the traumatic effects of what was already a complex situation and a decision not taken lightly by women. Of the established GPs surveyed, some 52% stated that abortion should be available to any woman who chose it and 24% said it should be allowed only in very limited circumstances such as a real and substantial risk to the life of the mother. Other specific examples cited by respondents included cases of rape or sexual abuse, maternal cancer and cases involving major foetal abnormalities. Some 11% stated that abortion should never be available while 13% expressed no definite opinion. This is an important reflection of the thinking of the medical profession on the issue. Things have moved on in recent years and people have accepted the reality rather than the abstract of women’s decisions in this country.
It is interesting to note some of the statements sent by e-mail about medical treatments and others to the effect that the Bill represents an attack on vulnerable children. Many of the same people who sent these will vote for the Social Welfare Bill which will reduce the age for eligibility for children of lone parent payments from 14 to seven years. This will put more children and families into the poverty trap. In certain circumstances a person who is not working must sign for jobseeker’s allowance and present for work. What is such a person to do and where will they leave their seven year old child? They will not leave their seven year old child because that would be wrong. These people will be in conflict with the State in respect of the jobseeker’s allowance. The other side of the coin involves cases where women are working. The €60 per week reduction will put them in a difficult situation since affordable child care is not available in this country and there is no after-school care. Will the same people referred to earlier come out against the Bill to be brought forward by the Labour Party later tonight? Where is the condemnation of that Bill from throughout society?
The CSO survey on income and living conditions in Ireland 2010 showed that the inequality ratio has increased with the top 20% of earners bringing home an income 5.5 times greater than the lowest income group. The survey also confirmed that children remain the most exposed group with a consistent poverty rate of 8.1% in 2010. Social Justice Ireland has produced figures to show that 200,000 children are living in poverty, an increase of 92,000 in two years, during one of which the current Government has presided in the Dáil.
Another argument is put forward to the effect that dressing up abortion on medical grounds is wrong. However, this is a medical treatment. We should debate the issue properly rather than the chaotic debate that has taken place in recent years. A further argument is to the effect that not permitting abortion in Ireland leads Ireland to be one of the safest countries in which to be pregnant and give birth. This is not related to the issue under debate tonight and cannot be taken as part of it. We call on all parties to support the Bill. The party Whip should be removed and Members should be allowed to support the legislation with a free vote.
Deputy Mick Wallace: This legislation is 20 years too late. It is hard to credit that successive Governments have failed to deal with the consequences of the Supreme Court judgment in the X case. It is not as if it was a revolutionary judgment even at the time. The Supreme Court found that abortion is legal in Ireland when a woman’s life is at risk, including from the threat of suicide. My colleagues and I have brought forward this Bill to provide a legislative basis for the legal termination of a pregnancy in the very limited circumstances where such treatment is deemed necessary to prevent the woman’s death. We know it is not enough, but it is a start. Six successive Governments have refused to make that start. We hope that failure will be addressed this week.
The right to access abortion is a fundamental human rights issue. The Supreme Court decision 20 years ago was a rational one. It was compassionate and humane. It was the right thing to do. Only a few weeks ago in this House we discussed the horrific nature of symphysiotomy, a violent act carried out on the bodies of women who encountered difficulties in childbirth. It was a violent act driven by a warped religious ideology, designed to maximise the child-bearing opportunities of the mother with no regard to her future health or suffering. This was something that took place in Ireland from the 1940s to the early 1990s, which is difficult to credit. What action has this Parliament taken to redress the wrong done to those women whose lives were irreparably damaged? What has this male dominated Parliament done to put an end to the urge of men to control women’s bodies? Six successive Governments have refused to do anything about the Supreme Court judgment in the X case. The unfairness and inequality which characterise Ireland’s abortion laws are replicated in the Government’s approach to tackling the economic crisis. Just as our extremely restrictive abortion laws disproportionately and adversely impact upon the most vulnerable who cannot afford to leave the State to avail of the service, the political choices made in the last budget targeted the least well-off in our society, such as lone parents and those with large families and young children.
In 2005, three women known as A, B and C initiated a challenge to Ireland’s restrictive abortion laws at the European Court of Human Rights, arguing that the criminalisation and inaccessibility of abortion in this State endangered their health, well-being and life and was a breach of their rights under the European Convention on Human Rights. After much deliberation, the grand chamber of the court announced its unanimous finding, in December 2010, that Ireland’s failure to implement legislation on abortion constituted a violation of the convention. These women asserted that Ireland’s abortion laws did not reflect the position of the people. The referenda in 1992 and in 2002 were attempts by the then Governments to restrict abortion in the State. Both were rejected by the people. The appellants argued that Ireland’s abortion laws are inconsistent with international consensus. Forty-three out of 47 Council of Europe countries permit abortion to protect a woman’s health. We are in the dark ages on this issue.
The existing restrictions are ineffective. They have not done away with abortion but merely served to export the problem to England. Moreover, the situation is discriminatory. Women travelling to Britain for abortion services risk medical complications because of later, and therefore often surgical, abortions. A woman travelling abroad for an abortion must first sort out a range of issues, including finding the money, organising child care, negotiating time off work, and making travel and accommodation arrangements. While dealing with all of this, time is moving on and the agony increases. Such women are more likely to avail of surgical rather than medical abortion to shorten the period of stay abroad. Medical abortion is a less invasive procedure but involves a treatment period of three or four days, which is not an option for most women travelling abroad from this country. Likewise, Irish women are less likely to receive pre and post-abortion medical care due to the limited time most can stay abroad. On top of all of this, the stress involved for women choosing abortion is further exacerbated by the need to leave their own country to avail of an abortion. Four such incredible women told their stories to the media and to Members of the Oireachtas this week. These strong women spoke of how much it pained them to have to leave the State and the feelings of fear and stigma arising from the fact that abortion is criminalised here. They described the secrecy element, the sense of isolation and the lack of support.
My colleagues and I have received a large number of e-mails and letters from people caught in this terrible situation. One of these letters tells a story which many may not have heard. I will read it out in full:
Deputy Mick Wallace: It is very unfortunate that sectional interests or powerful groups have had greater access to decision making in Ireland and have had more say than they should. It is not good enough for the Government to state the expert group will come up with the answers or that it will sort out the legislation in its own time because it knows best and knows what is good for everyone. It is not good enough that women will suffer over the coming months because this law will not be changed unless the Government side votes for this legislation. Such suffering should stop now.
Minister for Health (Deputy James Reilly): I wish to share my time with the Minister of State Deputy Kathleen Lynch and Deputies Olivia Mitchell, Regina Doherty, Anne Ferris and Ciara Conway. I will begin by thanking the Members opposite for raising this important issue. I acknowledge they do so from the best of motivations and for the right reasons. This is an area that touches the lives of many Irish people. It is an area of real concern to Irish women and despite the many considerable complexities involved, it is a matter about which most Irish people have strong views and beliefs. Members will agree on certain matters in this Chamber but must disagree on others. I am sure that everyone present in the Chamber shares my view that, as public representatives, Members have a task to perform. They must take action to deal with a long-overdue responsibility. While I note Deputy Wallace’s comment that no action has been taken by six successive Governments, I assure Members this will not be the seventh. Members will have time to consider the many technical issues involved but to first put it in human terms, they must ensure they take the necessary action to protect the lives of women. They must consider the required action, based on clear information of a clinical, legal, scientific and personal nature that tries to understand the medical and human issues involved. On a technical level, the pressing responsibility is to take action to deal with the ruling of the European Court of Human Rights in respect of the A, B and C v. Ireland case. The Government already has moved in a direction that can give confidence that the action it takes will be well thought-out on all the necessary levels.
Members will be aware that the court ruling places obligations on Ireland and, on 16 June 2011, an action plan was submitted by Ireland to the committee of members of the Council of Europe. As part of that plan, Ireland is committed to ensuring the judgment in this case is implemented as expeditiously as possible. The Government has established an expert group that draws on appropriate medical and legal expertise with a view to making recommendations on how this matter should be addressed properly. It would be wrong of me to pre-empt the report of the aforementioned expert group before its proposals are to hand. However, I can state I am confident the group will produce proposals that are sensible, practical and implementable. I remind Members of the quality of the membership of this group, which is chaired by Mr. Justice Seán Ryan, who in the past has authored the Ryan report. Moreover, the group comprises many doctors, legal people and other experts. Notwithstanding this, the Government will do what is the right thing to do, as advised by the expert group, to make progress in this regard as quickly as possible.
While this Bill as drafted goes some way towards addressing the A, B and C v. Ireland judgment, the Government is clear that in its current form it cannot be accepted because it is lacking in certain legal respects. While I am not, of course, a lawyer, the Government has been advised that, in particular, a serious issue exists in respect of the consent provisions in section 6 with regard to Article 40.3.3° of the Constitution. Issues of presumed consent are among those being examined by the expert group and require the most careful scrutiny to ensure they are compatible with the Constitution. Moreover, the offences provisions found in section 7 also require greater specificity than is provided in the current draft to ensure legal certainty and their compatibility with Article 40.6.1°.ii of the Constitution. This is another matter that is being considered by the expert group. Apart from the fundamental constitutional issues, it is clear that the proposals as drafted require detailed consultation with medical organisations and in particular with the Medical Council. The Government therefore opposes the Bill before the House.
I again thank the Members opposite for having afforded me an opportunity to remind people the Government is moving to deal with the issue. I give the House an assurance that the expert group is clear on the need to deal expeditiously with the highly complex issues involved and people can be sure that Ireland will live up to its obligations in this regard. This group will make its report in the coming months and it does not make sense to pre-empt its advice.
I wish to meet our obligations, not simply to the European Union but more importantly to our citizens. The Government will take the correct action, based on the best advice available to it, to ensure no woman’s life is ever put in danger. The Government will do this based on information, both scientific and personal, but above all to inform the process and outcome with compassion and respect for the women who must face and endure the reality of the current position.
Minister of State at the Department of Health (Deputy Kathleen Lynch): I wish to add my voice to that of my colleague, the Minister for Health, in stating the Government wishes to ensure that pregnant women whose lives are at risk can access appropriate medical treatment in Ireland, including lawful termination of pregnancy. As Members are aware, termination of pregnancy already is lawful in Ireland when it meets the criteria laid out in the X case ruling, that is, if it is established as a matter of probability that there is a real and substantial risk to the life, as distinct from the health, of the mother and that this real and substantial risk can only be averted by the termination of the pregnancy. Our medical practitioners acknowledge this possibility. The Irish Medical Council’s ethical guidelines clearly state that in current obstetric practice, rare complications can arise where therapeutic interventions, including termination of pregnancy, are required at a stage when due to the extreme immaturity of the baby, there may be little or no hope of the baby surviving. I am sure everyone present listened carefully to the details contained in the e-mail which Deputy Wallace read into the record. In the type of exceptional circumstances such as those which I have outlined, it may be necessary to terminate the pregnancy in order to protect the life of the mother while also making every effort to preserve the live of the baby. The Irish Medical Council’s guidelines also make it clear that risk to life includes the risk to the life of a mother arising from a threat of suicide.
We are extremely fortunate in Ireland that we have an exceptional record in respect of maternal mortality. As the Minister indicated, according to the most up-to-date statistics from the World Health Organization, namely, those published in 2008, Ireland was second in the world in the context of its low maternal mortality rate. This would seem to indicate that pregnant women in this country receive a very high standard of care. However, in the A, B and C v. Ireland judgment, the European Court of Human Rights found that Ireland had failed to respect the applicant’s private life contrary to Article 8 of the European Convention on Human Rights, as there was no accessible and effective procedure to enable her to establish whether she qualified for a lawful termination of pregnancy in accordance with Irish law.
It is on foot of this judgment, and to fulfil a commitment included in the programme for Government, that on 13 January the Government established an expert group to examine the court’s judgment. This group will recommend a series of options on how to implement the judgment, taking into account the constitutional, legal, medical and ethical considerations involved in the formulation of public policy in this area and the overriding need for speedy action. The judgment did not find that having to travel in order to access a termination of pregnancy where the pregnancy does not put a woman’s life at risk is a violation of human rights. Therefore, the right of access to abortion in Ireland for medical reasons does not fall within the remit of the expert group. I have been informed that the deliberations of the group are going well and that we can look forward to its report this summer.
Like the Minister, I fully accept that this Bill was brought forward in good faith and for very good reasons. I sympathise and agree with many of the sentiments expressed on the other side of the House.
Deputy Olivia Mitchell: I begin by thanking Deputy Clare Daly for bringing this issue before the House. I fully understand and share her impatience and frustration regarding the fact that action has not been forthcoming on this matter before now. As the Minister outlined, the Bill will not be supported by those on this side of the House. However, there are very few people on either side of the Chamber who would deny that there is not a long-outstanding and long-ignored necessity for a regulatory framework to give effect to the constitutional right to termination services when there is a risk to the life of the mother.
This is an extremely emotive issue and there are strongly held views on both sides. Like most people in the House, I respect that fact. As far as our responsibility goes, however, this is not a matter of morality, religious opinion, personal belief or party policy. Quite simply, we, as legislators, have an obligation to give legislative or regulatory effect to the will of the people as expressed not in a telephone or opinion poll but rather in successive referenda. The Constitution gives the right to termination services in certain, albeit very limited, circumstances. As Deputy Wallace stated, the failure of the Oireachtas and six successive Governments to put in place the necessary framework during the past 20 years has frustrated that right. It is irrelevant whether said right is widely or rarely demanded. Regardless of whether one woman or 100 women claim the right to which I refer, it does not matter. Once the people have spoken, it is our responsibility to provide the necessary framework.
As far as we know, each day 12 women leave this country to obtain abortions abroad. We have no idea how many more women — it is probably a very large number — obtain medication online and self-medicate in order to terminate. In either circumstance, it is a difficult, lonely decision to take, particularly in the absence of medical, psychological or familial support and without access to medical follow-up. Whatever the overall number, probably only a tiny fraction of the cases to which I refer would meet the constitutional requirement for termination services in Ireland. As everyone is aware, such services can only be accessed here in circumstances where a woman’s life is actually at risk. It is beyond my comprehension why there is still an insistence that sick and possibly terminally ill women must undertake arduous, costly and stressful journeys to obtain abroad a service to which they have a constitutional entitlement in this country and in safe and supportive conditions.
The failure to provide clarity has not stopped terminations taking place. It has merely made them less safe and more expensive and stressful. As previous speakers indicated, the European Court of Human Rights found against the Irish State for its failure to give expression to the constitutional entitlement. The Council of Ministers has this matter under enhanced supervision until we comply, and the United Nations Council on Human Rights has condemned us. On several occasions, the Judiciary in this country has called for legislative guidelines of some sort to inform and protect the medical profession as well as the women involved. Regardless of what others say about us, what matters is what the Irish people say. They have said, not once but twice, that the law of the land should allow termination services here. This means that the State must facilitate the entitlement of women in this regard.
After 20 years of inaction, we now have a Government that is willing to deal with the A, B and C case. I welcome what the Minister has said. As stated earlier, the Constitution makes provision for termination services only in specific circumstances. The wording of any regulation or legislation to give effect to this must be equally specific, precise and exact. Every word of any Bill or regulation will be examined, re-examined, picked over and dissected. We had better ensure that what we introduce complies in every respect with the wishes of the people as expressed in the Constitution. For that reason, I agree that we must await the opinion of the expert group. That group has the necessary expertise and has available to it the relevant specialist opinion. It would be a mistake to think that a simple item of legislation or an equally simple regulation is going to suffice in respect of this matter. The relevant Bill or regulation will have to define the circumstances in which there is a threat to a woman’s life and the point at which that threat actually becomes a reality.
It would be foolhardy to believe that meeting the requirements of the European Court of Human Rights and ensuring compliance with the narrow and specific wording contained in the Constitution will be simple or straightforward or that what will be produced will escape the scrutiny of the lawyers. The latter will not be the case. Nevertheless, this debate is a valuable first step towards establishing the parameters of the task ahead. We must await the recommendations of the expert group, particularly as we have asked it to consider this matter. It would be wrong to deny ourselves the benefit of the expertise of and the specialist opinion available to that group.
Deputy Regina Doherty: I thank Deputy Clare Daly for introducing this Bill and I welcome the opportunity to contribute to the debate on it. The Bill relates to a matter which none of us likes to discuss. However, discuss it obviously we must. In the 20 years since the Supreme Court decision in the X case, dramatic changes have taken place in Irish society. However, the debate on abortion remains fraught. Following a public outpouring of sympathy and outrage in respect of the original injunction in the X case, the Supreme Court subsequently ruled that abortion is legal where there is a real and substantial threat — including suicide — to the life of a pregnant woman or girl. Ireland is now a very different place from what it was in 1992. The Irish public continues to support the right to life of the unborn when it is reassured that women continue to receive the medical treatment they require during pregnancy.
Deputy Clare Daly’s Bill seeks to provide for the termination of pregnancy where a real and substantial risk to the life of the pregnant woman exists and for the prevention of any curtailment, hindrance or preclusion of such treatment that may arise as a result of the pregnancy of that woman. If passed, the Bill would allow a medical practitioner to provide any form of medical treatment to a woman, despite its consequences for the life of the foetus, once two medical practitioners agree that there is a threat to the life of the woman or a psychiatrist or a psychologist and a medical practitioner agree there is a risk of her committing suicide.
The Government is acutely aware of the sensitive nature of this complex issue and is currently taking steps to deal with it. It was on foot of a commitment in the programme for Government that the expert group was established in order that it might consider the judgment handed down by the European Court of Human Rights. This group, which is chaired by Mr. Justice Seán Ryan, has been requested to report to the Government within six months of its establishment. The Government believes that this is the appropriate forum in which to examine this complex and very sensitive matter. It is on foot of the fact that the work of the expert group is ongoing that I will be opposing the Bill before the House. The expert group is due to report back to the Government by means of a written document and within six months of establishment. As the group was established in mid-January, the report will be due in mid-July. The group meets regularly and may consult interested parties and additional relevant experts and professionals.
Meanwhile, Ireland remains the safest place in the world for women to give birth, with UN figures showing Ireland as a world leader in protecting pregnant women. The latest UN study on maternal mortality, published in 2010, shows that from 172 countries for which estimates were given, Ireland remains a world leader in safety for pregnant women. Time and again, international statistics show that Ireland has the lowest number of maternal deaths in the world. On the other hand, increasing evidence suggests there are serious mental health risks associated with abortion. A Finnish study in the European Journal of Public Health recently showed that women who had abortions were six times more likely to commit suicide compared with women who had their babies.
Abortion is often presented as being pro-woman but what abortion advocates refuse to confront is the devastating impact abortion has on many women. In 1997 we were convulsed by the C case involving the young girl made pregnant through rape. The courts again decided that the compassionate solution was to send the girl to the UK for an abortion, but 12 years later the woman at the centre of the case spoke of her devastation and deep regret at having the abortion. Current Irish medical practice is pro-woman and pro-child and we should keep it that way. All rights come with responsibilities and these should be explored as we openly and honestly approach abortion from the legal, medical and human rights perspectives of all parties involved. That includes all of us and especially the mother, father and the child.
Deputy Anne Ferris: Today, 12 women will have travelled across the water to access abortion services, and tomorrow, another 12 women will make that journey. This will continue for the foreseeable future, as day in and day out, women are forced to leave their homes to access a service that should be provided to them when they are in need. The story of abortion in Ireland is long and has, as of yet, no satisfactory ending. In the past 30 years alone we have had three referenda, committee reports and recommendations and a multitude of legal cases. I know the Bill before this House today seeks to provide some legislative certainty to the vacuum that has not been filled from these reports, and in that regard I am somewhat supportive of it. However, I do not feel that this legislation goes far enough. It is limited in its scope and does not address all of the issues that I think the expert group is obliged to address.
The expert group, comprising members with appropriate medical and legal expertise, is due to report in a couple of months, and I hope and assume it will address the wider issues not included in this Bill. For example, in legislating for the X case, which is what the Bill before us will do, the risk to the life of the mother will be covered but not the risk to health. The ethical dilemmas in this for doctors are many. A doctor will intervene when a serious health risk presents and will not wait for a patient’s health to deteriorate. It is also quite clear that a risk to one’s health can just as quickly become a risk to life and pregnancy may exacerbate risks to women with pre-existing conditions.
It is also important to note that the law of no other country allows for abortion only to save the life but not to preserve the health of the pregnant woman. Many other points are not addressed by this legislation, including the lack of availability of abortion in cases where there are fatal foetal abnormalities, rape and incest. Another very significant issue not dealt with by this Bill is the reality of the financial, psychological, and physical burdens that so many women experience when travelling abroad, and this reality must be addressed because there is a face and a story behind each decision made. Not one of them is taken lightly, and stories of abortion in recent newspaper publications and which we heard today have highlighted some of them. The face and the heart of a person who goes through with an abortion is given the humanity that can, I feel, be lost when one refers to simple letters of an alphabet like X, C, D and A, B and C. Therefore, I firmly believe that the expert group should address more than what is contained in this Bill and I firmly believe it has a responsibility to do that.
I am a Roman Catholic but I do not need prayers said for my immortal soul because I think women should have access to abortion. One of the women who spoke so bravely to The Irish Times stated that she believed in a loving God and will not be damned for what she did. I fully support her, and like her, I will not be damned for standing by my beliefs. I also believe in the Labour Party and am a proud member of it. The two are not inconsistent, although some in the media would have people believe they are. On this issue, as with so many others, this is not about being liberal or conservative but rather doing the right thing when the wrong course would be easier. As a people, we are all too familiar with what happens when that particular course is taken.
I will oppose the Bill, but in doing so, I hope that when the expert group reports, it will make comprehensive recommendations that will be broader in scope than that contained here. I am grateful that a conversation on this topic has been possible in the Dáil and I thank Deputy Clare Daly for making it so. I am aware that many in power would prefer for this to go away so that the stories of abortion can continue without end. I also note that a Dáil, the vast majority of which is made up of men, is deciding and has decided in the past on the rights of women. I trust the irony of this is not lost on the House.
We must end the practice where 12 women a day have no other option but to travel abroad and I firmly believe that the expert group must deal with the A, B and C judgment in its widest sense and, in doing so, speak truth to power. I am certain it will have the political support to implement the recommendations if it does so.
Deputy Ciara Conway: We personally know the women involved in these issues. They are our sisters, friends, cousins, neighbours and, in some cases, our mothers. For a variety of reasons these women cannot continue with their pregnancies and the isolation these women experience heading over the water for an abortion, as described so bravely by a group of women today, exacerbates the difficulty, stigma and silence which forces them to manage their own mental health in isolation and without significant or humane compassion.
The Government has published the terms of reference of and named the expert group tasked with addressing the outcome of the A, B and C v. Ireland ruling at the European Court of Human Rights. The ruling, which dates to December 2010, reaffirms the Supreme Court X case judgment of 1992, and the expert group must now propose concrete measures to implement the ruling of the court and to comply with the wishes of the people as expressed in 1992 and 2002. It is clear that the State cannot ignore any longer the imperative to legislate so that women and girls needing life-saving abortions are guaranteed access to appropriate services in an effective, timely and humane manner. This requires both legislation to provide for lawful medical treatment and medical guidelines so that doctors can make a practical assessment of what constitutes a real and substantial risk to the life of a pregnant woman.
Doctors require workable guidelines on conditions likely to be worsened by the continuation of pregnancy. Decisions in these cases are not always straightforward, as it is not possible to predict every possible medical condition, but they are always urgent. In cases where every day counts, doctors must have sufficient room for discretion to allow them to treat their patients. In many such cases, women are forced to travel overseas without even getting a referral from a doctor outlining their medical history, which is unacceptable. A doctor would not expect any patient to access any other medical treatment in this way, in particular in the case of a patient with a life-threatening illness. If it is to give full legal effect to the judgment of the European Court of Human Rights, the expert group must also propose draft legislation and guidelines which ensure the right of patients to access life-saving medical care can never be held hostage to refusal of care by individual doctors, institutions such as hospitals and medical clinics or third parties such as hospital personnel not directly involved in providing the treatment. We have seen this over the past 20 years. The expert group also needs to address the lack of a clear framework to examine and resolve differences of opinion between a woman and her doctor or between doctors. In any such case, the paramount consideration must be that the woman’s health is not further endangered by a delay.
One of the most chilling issues highlighted by the European Court of Human Rights was that the criminal penalties attached to abortion included life imprisonment. However, clinical guidelines will be unworkable as long as this law remains on the Statute Book. Ireland is not the only country in which abortion is a sensitive political issue but one of the few countries which have failed to make legal provision for abortion.
Unfortunately, I cannot support the legislation because, like Deputy Anne Ferris, it does not go far enough. I ask that the expert group take submissions from interested parties on the issue. Members heard earlier from a group of women who were denied the health care they badly needed when it was determined they were pregnant with babies who could not live outside the womb. Women such as these must be listened to and engaged with. I will keep a close eye on the expert group and look forward to its report in July.
I welcome the opportunity to speak to the Bill which addresses the complex and sensitive issue of abortion. Despite having discussed the issue on a continuous basis, we have not yet arrived at decisions in the context of a legislative framework. I welcome the establishment of the expert group, an issue addressed previously in the context of our obligations arising from the rulings of the European Court of Human Rights in the A, B and C cases. The court, in its rulings, noted the burden the implementation of Article 40.3.3° would impose on the State and accepted that this would be a sensitive and complex task.
It is important in this debate to acknowledge the complexities of abortion and the diverse views on the issue in society and the Chamber. The views of those who hold a liberal view on abortion also differ, for example, on the issues of the right to the life of the mother and the child and fatal foetal abnormalities, an issue discussed earlier with a number of women in the audiovisual room. The women in question outlined the major challenges and difficulties they had experienced as a result of carrying babies who were not capable of living outside the womb. Several of those who spoke stated they did not want abortion on demand. It is important when we listen to lobby groups or take part in emotive, heart-rending discussions that we do not take the issue out of context or use it as leverage for a broader agenda.
The Bill has clearly been introduced on foot of the findings of the European Court of Human Rights. As the Minister noted, the legislation has deficiencies, may be at variance with Article 40.3.3° of the Constitution and could give rise to other legal difficulties. In 1983 the people decided by referendum to insert into the Constitution Article 40.3.3° which declares: “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, as far as practicable, by its laws to vindicate that right”. As the House is aware, no laws were ever enacted on foot of this amendment and the provision in the Offences Against the Person Act 1861 remain the basic law in relation to abortion. This has left open the possibility that Article 40.3.3° will have to be interpreted by the courts. Apart from the 1861 Act, there is no legislation which makes clear what is permissible under the law should there be a potential conflict between the right to life of the mother and that of the unborn.
In the X case of 1992 a majority of the Supreme Court members held that if it were established as a matter of probability that there was a real risk to the life, as distinct from the health, of the mother and that this real and substantiated risk could only be averted by the termination of the pregnancy, such a termination was lawful. The stated risk to the mother’s life in this case arose because she had threatened to commit suicide if she had to continue with the pregnancy. The experience of the 1992 referendum shows the difficulty in providing in a relatively short constitutional provision for a clear prohibition on abortion, while ensuring there is no obstacle to pregnant women receiving all the care and treatment they need.
The stand-alone Bill introduced by the Technical Group does not give a balanced or effective legal response to the complex and legal issues which surround the protection of human life in pregnancy. We need to be sensible about this issue and avoid trying to score political points. This debate should be above party politics. We must await the report from the expert group before action is taken and, if possible, all-party support should be secured before legislation or referendums are proposed.
Some of the language used in the abortion debate is hurtful and inflammatory. Those who have had terminations are our mothers, daughters, sisters, nieces and neighbours and the language that is sometimes used can have a devastating impact on individuals. It behoves all of us, regardless of our view, to use moderate language in a fair and rational manner to convince others of the merits of our argument. Emotive language can have a destructive impact on those who have had a termination.
The issue of abortion has divided society. As Abraham Lincoln once said, a house divided will not stand. As a society, we have torn ourselves apart on the abortion issue on a number of occasions and we still have not enacted legislation on foot of three referendums on the issue. Tonight we are debating a Bill introduced by the Technical Group.
The expert group chaired by Mr. Justice Ryan includes a number of eminent individuals from the areas of obstetrics, psychiatry, general practice, law, policy, professional standards and midwifery. We should await the findings and recommendations of its report which will be published in July. At that point, we can have a fair and rational debate on all the issues involved and, I hope, arrive at a solution that will address the abortion issue which, as I noted, has been divisive, emotive and destructive at times during the years.
In the C case of 1997 the High Court accepted that where evidence had been given to the effect that the pregnant young woman involved might commit suicide unless allowed to terminate her pregnancy, there was a real and substantial risk to her life and such a termination was, therefore, a permissible medical treatment of her condition where this was the only way to avoid such a risk. At the time the Government decided to produce a Green Paper on abortion and this was published in September 1999. It was then considered by an all-party Oireachtas committee chaired by the late Brian Lenihan. More than 100,000 submissions were received by the committee which held hearings with various interested groups and published a report in November 2000. The evidence given to the committee by psychiatrists highlighted the great difficulty in assessing whether a threat of suicide would be carried out. This issue requires further discussion and clarity in the context of the Bill before the House.
Another referendum was held in 2001, during which we had debates about implantation, the morning after pill and the possibility of ruling out suicide as a reason to intervene, while allowing abortion in cases in which doctors would be required to intervene to save the life of the mother. We know the result of that referendum.
It has been noted that up to 12 women travel abroad daily for a termination. The all-party Oireachtas committee recommended the introduction of as many supports as possible for women involved in a crisis pregnancy. We have an obligation to ensure this recommendation is implemented, specifically in dealing with matters such as funding, contraception, education programmes in schools and universities and highlighting the various issues involved with a view to limiting the number of crisis pregnancies. While the committee’s assessment in this matter was rather simple, it is an important recommendation which needs to be addressed. We should concentrate significant resources on the provision of sex education, advice on contraception and supports for women and girls who find themselves in a crisis pregnancy.
My party believes we should await the findings of the report of the expert group chaired by Mr. Justice Ryan which will be published in July. On foot of its findings, we can have a debate on the issues involved and come to a conclusion in order that we can move on and allow people to live in dignity and without fear.
Deputy Éamon Ó Cuív: We will probably not discuss a more emotive issue in the House during the lifetime of the Government. This is a very difficult issue because it goes to the core of what people believe on two levels. First, most people generally believe human life should be preserved. Second, when does the human life we seek to protect start? This goes to the core of humanistic beliefs. We all believe in people’s right to protection and we have had many debates about protecting children. We always want to protect their lives and protect them from harm. There is a fundamental, philosophical difficulty: when does life begin? When does the protection of human life begin and in what circumstances is it protected? It is important in this debate that we recognise that people have strongly held views on this issue and that whatever side of the debate they are on, we respect the genuineness of the views of others.
What my colleague has said is true. To a certain extent, this Bill is pre-emptory. The Government has set up an expert group to look at the issue. I hope the group will look at it from every angle and review all the medical evidence available in order that we will have well balanced proposals. I regret the subsuming of the Crisis Pregnancy Agency back into the Department because such an agency can do very good work in counselling and providing supporting as a stand-alone agency. I am not as convinced that there is a financial saving in subsuming it into the Department. There has been too much exaggeration of the financial savings to be made in subsuming such bodies. The agency was able to work outside the Department. There is a need for a halfway house where an agency can be given independence without the need for a huge infrastructure to back it up. That is very important.
I believe very strongly in the concept of protecting human life. That is fundamental. I also believe the child in the womb is a person and that, therefore, there is an obligation to protect that human life. On the other hand, I also believe it is absolutely vital to be non-judgmental about the decisions people might take and utterly supportive of them. However, when it comes to the law, the awkward issue is whether we protect the human life in the womb. Because I believe in protecting in human life, there are two human lives to be protected and what we have to try to do at all times is protect both. I accept that there are others who take a radically different view and do not see the life in the womb as being worthy of the same protection. I respect their views, even though I disagree fundamentally and philosophically with that view from a humanistic point of view because I believe in the protection of human life, my definition of which extends to before birth.
The Bill focuses on the X case and I hope the expert group will look at all of the issues arising from it. For example, one of the issues that never arose in the Supreme Court which took the facts as given was that there was no psychiatric evidence provided as to whether this was the best or only treatment available to prevent the threat of suicide in the case. I hope the best medical experts will look at this issue once again in the light of the information now available. It is also important to look at the mental health effects of abortion. I understand there have been cases in which there has been a link between post-abortion stress and a person’s mental health.
Deputy Gerry Adams: I thank an Teachta Clare Daly for bringing forward this Private Members’ Bill which deals with an extremely difficult issue for all concerned, particularly women faced with the situation the Bill is trying to deal with. There are strongly and sincerely held views on all sides of the Dáil, including within Sinn Féin, and across society on this issue. For my part, I am not in favour of abortion. That is my strongly held view. I am also strongly opposed to any attempt to criminalise or be judgmental of women who have had abortions. No woman wants to be in that position, but it is a reality faced by Irish women.
Irish women are citizens and, like all other Teachtaí Dála, I am here to serve citizens. As I am a legislator, I have to set aside my personal views and face up to my responsibilities. I have to deal with the dreadful reality, highlighted by pregnant women confronted with life-threatening conditions, who have had to cope with this awful dilemma. I have to deal with what is an untenable situation for the medical profession which has been tasked with making medical judgments without legal protection for medical practitioners. We have to ask ourselves, as elected representatives and legislators, if we really want to leave Irish women and members of the medical profession in the awful predicament caused by the absence of legislation. Can any of us even begin to understand or imagine how unfair and unjust this is for a woman or young girl?
The background to this debate is provided by the X case which provides some painful insights. It is also an indictment of the way the State treats women and children. Sinn Féin is not in favour of abortion. We believe all possible means of education and support services should be in place. However, in cases of rape, incest and sexual abuse, or in which a woman’s life and mental health are at risk or in grave danger, Sinn Féin accepts that the final decision should rest with the woman concerned. It has analysed the Bill and a number of serious concerns have been raised about aspects of it. These include the issue of consent which needs to be discussed in some detail. I note the Minister’s remarks on it. I have just returned to the Chamber having attended the funeral of Deputy Doherty’s father in Donegal. Therefore, I have not had the chance to study the Minister’s remarks in detail. I note, however, that he has raised issues in respect of this matter, as has our group.
The Government has stated its intention to bring forward its own legislation, but successive Governments have failed to deal with this issue for 20 years. In 2010 the European Court of Human Rights ruled that the State had violated the rights of pregnant women by refusing to allow them to undergo a lawful abortion where that pregnancy could threaten their lives. Its decision has made it clear that there is an onus on the State to legislate within the terms of the 1937 Constitution for the decision in the X case. What is certain is that the time has come for legislation to protect in law the rights of women as decided by the Supreme Court in 1992. This should be done in a reasoned, tolerant and considered matter, with the maximum cross-party consensus.
In this spirit Sinn Féin believes the Bill should be allowed to proceed to Committee Stage where, as I said, it would need to be amended to deal with the concerns raised in our party. I take on board what the Minister said and will consider it overnight.
It is important we approach this issue in its broadest social context. The Government needs to examine whether its policies are pushing increasing numbers of women into positions of vulnerability. Poor health services and inadequate preventative health programmes will increase the likelihood that women will not know of critical health problems, including cancer, in advance of pregnancy.
Tackling violence against women and upholding the right of every woman and young girl to be free from violence and safe in their communities and in their own homes must be a priority. The Government has yet to sign the Council of Europe Convention on preventing and combating violence against women and domestic violence.
We need to ensure the State cares properly for vulnerable young people, including those in care, but it has failed miserly in this regard. On all of these issues this Dáil needs to stand up for and do what is right for Irish women.
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