Response to Heads of Bill of Protection of Life During Pregnancy Bill 2013

Doctors for Choice welcomes steps to deal with the X-case. 21 years after the Supreme Court decision, compelled by the ECHR, the Irish Government has provided the first draft of legislation that will give those women who have a life threatening illness, and their doctors clarity on whether a termination can be legally performed. However, Doctors for Choice has concerns regarding the practical implications and limitations of this bill.

While Doctors for Choice welcome any improvement in the care of women who choose to have an abortion it remains unclear whether this Bill would provide an ‘effective and accessible’ procedure for someone in the position of Savita Halappanavar or the X case. Women in situations of rape, child sexual abuse and fatal foetal anomalies will have to wait for further legislation to allow for the option of abortion in those cases. Women who are unable to travel risk being denied an abortion or being harassed into travelling to England despite being unfit to do so.

  • In the case of the risk of suicide, imposing a requirement for three doctors is unnecessary and in excess of the maximum of two doctors recommended by the expert group
  • Certification for involuntary detention under the Mental Health Act only requires two doctors: a GP and a Consultant Psychiatrist. The requirement for an obstetrician to certify suicidal ideation is incomprehensible. No obstetricians claim skills in this area. GPs and psychiatrists are the doctors that routinely deal with this presentation.
  • That one obstetrician could veto the decision of two psychiatrists makes no sense except restriction for the sake of it.
  • There is no medical basis for differentiating between a medical emergency and a psychiatric emergency. All psychiatric emergencies are medical emergencies.
  • The requirement that psychiatrists work in a hospital will exclude most Child Psychiatrists who deal with children up to the age of 18 and will have to be amended to include them.
  • The inclusion of a 14 year prison sentence for women who have an abortion outside of these guidelines and describing that as due to the ‘gravity of the crime’ is particularly offensive. Every day more than a dozen women will have an abortion outside of these guidelines; only in a different country The right to travel for an abortion means that no-one in Ireland believes that choosing to have an abortion is a grave or serious crime and this odious section on criminal punishment should be removed.

The role and value of GPs is mentioned in Head 4. As primary care is the most common first point of contact in medicine, a suicidal woman in early pregnancy will most likely go to her GP and be cared for in this setting initially. In reality therefore a woman could be seen by at least 4 doctors before being ‘certified’ as requiring an abortion. A GP and a Consultant Psychiatrist would be the most relevant combination if two doctors were required.

We believe that the safest way to protect all women in Irish society is to decriminalise abortion, leaving medical matters outside the criminal law. This way we avoid legalistic terms and sanctions which have so far served solely to intimidate those who work in the field of medicine. Women should have the choice to access safe abortion services with fully informed consent. To achieve this we will need to repeal the 8th amendment.