It wasn't the same as it used to be - there was objective information and, for the first time, dispassionate debate.
public hearings of the Oireachtas Committee on Health and Children on
the options on abortion were the most informative and interesting ever
held on this contentious issue.
They provided objective facts on Irish
medical practice for the first time. We are in a different country and
the debate has all changed now.
Anyone under the age of 30 would
not have any personal knowledge of the viciousness and divisiveness that
was visited on Irish society by the abortion issue in the run-up to the
first referendum in 1983. It was the closest thing to the divisions in
the Civil War: family member against family member. Indeed, there were
busmen and taximen proclaiming their support or opposition to the
amendment to insert a so-called pro-life anti-abortion clause into the
The attorney general of the time, Peter Sutherland,
warned publicly that the proposed wording could be the means of
The leaders of the Pro Life Campaign,
including William Binchy, Caroline Simons and others, derided and abused
him. But, so it came to pass. It was that wording, not the Supreme
Court, which brought lawful abortion into Ireland.
the age of 21 would not know the effect of the X case in 1992 when a
14-year-old girl who was raped was prevented by the High Court from
travelling to England for an abortion. The Supreme Court subsequently
overturned that judgment.
It held that if it was established as a matter
of probability that there was a real and substantial risk to the life,
as distinct from the health, of the mother and that this real and
substantial risk could only be averted by the termination of her
pregnancy, such a termination was lawful.
There have been more
abortion questions put to the people in referendums than any other
single issue in the history of the Constitution: including two
unsuccessful attempts to exclude suicide as a ground for lawful abortion
in 1992 and 2002. The people approved the right to information and the
right to travel for an abortion in the 13th and 14th amendments in 1992.
historical perspective is important to prove the point that it wasn’t
the same as it used to be at the abortion hearings chaired by Cork Fine
Gael TD Jerry Buttimer this past week.
There was objective information and,
for the first time, dispassionate debate. And, as Dr Simon Mills and
Judge Catherine McGuinness noted in their separate contributions, a
middle ground has emerged on the most contentious political issue which
is not represented by the so-called pro-life nor pro-choice positions.
was extraordinarily interesting at the committee hearings, in fact, was
that these groups seemed to have lost some of their vigour.
had moved from the mainstream to the margins of the political debate.
But, it was the position of the Catholic Church that had changed most of
There was courtesy – but no deference – shown to its
representatives, Bishop Christopher Jones, chair of the Catholic
Bishops’ Council for Marriage and the Family, and Fr Timothy Bartlett.
was clear that the Catholic Church had lost its moral authority to
dictate policy on the life of the unborn after the dreadful disclosures
on the way that it allowed the lives of the born to be abused and
sodomised over the years.
So what was new to emerge at the
hearings that will influence members of the Government and the
Oireachtas in their decision-making on abortion legislation and
The first thing stated most emphatically by the masters of
the maternity hospitals was that they would always do all in their power
to save the life of the mother and the baby during pregnancy. That was
their job. It was important that they stated that without equivocation.
second was that they wanted the Government to legislate on the
termination of pregnancy and repeal the criminal provisions of the 1861
Offences Against the Person Act in order to protect doctors and
obstetricians in the carrying out of their duties.
of the Medical Council, Prof Kieran Murphy, added weight to this view
when he confirmed that doctors were expected to adhere to the council’s
guidelines but that they were not a legal code. It will come as news to
some politicians that abortion is covered in paragraph 21 of the current
The hearings were particularly valuable because the
medical representatives provided facts and figures about terminations of
pregnancy in Irish maternity hospitals for the first time.
There was no
dispute about them.
Dr Sam Coulter Smith, master of the Rotunda, said
six terminations had taken place in his hospital last year.
Mahony, master of the National Maternity Hospital Holles Street, stated
that three had taken place there. And pressed to speculate on the number
nationally, they deduced that it could be as low as 10 or as high as
The information on the risk of suicide during pregnancy was
even more interesting. It would be fair to say that all medical experts
before the committee said they were not aware of any such case in the
Prof Patricia Casey produced figures from a review of the
three Dublin maternity hospitals 1980-2011 showing that no suicides were
reported during pregnancy in that 31-year period, when 685,511 gave
birth to live babies.
She did concede that it is presumed that
among the 4,000 women who travel to Britain for abortions each year are
women who are suicidal or potentially so. But, she said, there is no
data to substantiate this claim since the UK figures do not classify
suicide as a specific ground for abortion.
One of the most
relevant contributions to the hearings was made by Dr Anthony McCarthy,
consultant perinatal psychiatrist at the National Maternity Hospital
since 1996, because he addressed the argument that legislating for the
ground of suicide could “open the floodgates” to abortion. Suicide is
rare in pregnancy, he said, but it does happen “and is a risk we always
have to consider”.
went to the nub of the political issue. Suicidal ideation in pregnancy –
meaning that the person has ideas in their mind about ending their life
– is much more common than completed suicide.
There are very
significant differences between suicidal ideation and suicidal intent
“We are trained to assess whether patients have suicidal
ideation or intention or both, to diagnose whether the person is
suffering from a mental illness or not, and to make or recommend
appropriate therapeutic interventions and plans,” McCarthy concluded.
is clear from the committee hearings that suicide is the most
contentious question to be addressed by the Government in its proposed
legislation on the X case.
It is also clear that a number of
unanticipated ancillary issues will have to be tackled. If sections of
the 1861 Offences Against the Person Act are repealed, for example,
won’t there need to be a provision somewhere banning abortion in
circumstances outside the X case?
What evidence-based procedures will be
put in place for medical specialists to decide that there is a real and
substantial risk to the life of the mother during a pregnancy?
are complex issues, but there is a political appetite to deal with them,
in a restrictive way, for the first time.