Saturday, January 07, 2017

Citizens Assembly will continue to use the 'contentious' term fatal foetal abnormality Citizens’ Assembly will continue to use the “contentious” term fatal foetal abnormality - with a National Maternity Hospital doctor admitting medics can’t predict 100pc a foetus will die.

Ireland’s Catholic bishops and the Pro Life Campaign, criticised the use of the phrase in the Assembly’s agenda with the bishops’ spokesman stating the terminology depersonalised the foetus and sought to “normalise abortion.”

And the Pro-Life lobby stated the term “life-limiting conditions” should be used instead.

Chair Ms Justice Mary Laffoy opened the Assembly telling the 99 volunteers:  “The correct use of terminology in this debate is an issue which has been causing both myself and the secretariat some difficulty in settling our minds to. It is a contentious aspect to the arguments around the topic we are discussing. It is argued, for example, that the term fatal foetal abnormalities de-sensitises what is a very difficult and traumatic diagnosis for a woman and her baby. This is something that we see born through in that many medical practitioners tell us that this is a term that they do not use when speaking to a woman about a diagnosis. Nonetheless, the term is widely used and is very much in common exclude its usage at the Assembly would therefore, in my view, be inappropriate. It will therefore be used and will continue to be used by the Assembly throughout the remaining weekend as appropriate.”
Ms Laffoy instructed the Assembly to “be conscious” of the language they used during the debate given the sensitive nature of the issue of the Eighth Amendment.

Dr Peter McParland, from the National Maternity Hospital, Dublin, said:  “We tend not to use the term fatal or lethal in our practises. We tell the mother this is the condition we think will result in your baby having a short life.

“I don’t know what fatal is. Is it minutes, or if your baby dies in a short time?”

Dr McParland described the limitations of technology, including ultrasound in predicting fully how a pregnancy would end.

“Ultrasound isn’t perfect, it can be fuzzy,” he said, “It has limitations.  We’ve predicted cases that turn out to be worse than they are..but with regards to life limiting cases, we can be sure but not always.”

Dr McPartland said the “vast majority” of women with life-limiting pregnancies continued their pregnancies and they are offered specialist care including bereavement and counselling services.

He said that while most hospitals provided an anatomy scan, which can forecast whether a foetus will be born with an illness or a life-limiting condition, that this test was not available everywhere.

“Not all mothers can avail of this, it’s not available in all units,” he said.   “And ultrasound might not have all the bells and whistles.”

The doctor described how a mother is referred to specialist care when it’s found the foetus has a severe condition.

And she is offered information on a termination - though legally the medical teams in Ireland cannot promote or make calls to any UK abortion centres.

“There are those that decide this is not for me,” he said, referring to those who wish to discontinue a pregnancy.

“There’s a small percentage of patients who’ve thought this through, they know what they’re going to do, they know about travelling over to the UK...and they move on to their next pregnancy,” he said.

“There’s those that get very upset about the words not continuing or termination of pregnancy.

“Some people say they are against termination but ‘this is me, this is my family, I never thought I’d be in this position but i’ll go and think about it.’

“They spend days, hours, weeks, agonising about it…”

The doctor said the National Maternity Hospital carried out between 150 to 180 tests on pregnant women which gave an indication of if a foetus would have down syndrome.

“Now by doing a blood test on the mother, you can take out the foetal DNA, you can tell with virtual accuracy if the baby has down syndrome….and indeed other chromosome problems.

“The impact of this testing in other countries is huge. In Iceland, no babies have been born with down syndrome in the last five years.

“All mothers are offered and avail of this test...but in this country, this is not paid for by the state.

“The UK are about to roll this out on the NHS.  This is the way the rest of the world is going.
“You might ask should we be asking for this test?  But patients have the right to be offered all treatment options.

“You must give patients information to exercise their rights and make informed decisions in their care.”

185,824 abortions were carried out in the UK in 2015. Of these 3,451 women gave addresses in Ireland - but the figure is thought to be higher in reality.

Around 4 per cent have a termination where the foetus is deemed to have “a serious mental or physical risk of mental handicap,” Dr McParland said.

“Many of these patients who have later terminations...69 go over because of chromosome problems and the biggest group, 40, is down syndrome.

“This isn’t a fatal condition.  Many live even into their 80s now but if you think about the figures of Iceland, we would have about 100 babies a year born with down syndrome -  a third will die in the womb.  

“You’re left with 30 babies with down syndrome, who could be born in Ireland and are not.
“We are not Iceland or Greenland but there’s a trend there.”

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