And the abortion debate rumbles on ….
Yesterday Health Minister James Reilly denied that it was ever being proposed that the opinion of six doctors would be stipulated in legislation covering abortion where there was a risk of suicide. This morning, Fionnan Sheahan published details of the draft legislation:
• “One obstetrician and two psychiatrists have jointly certified that, in their reasonable opinion, there is a real and substantial risk of loss of the pregnant woman’s life from self-destruction and this risk can only be averted by medical procedure in the course of which, or as a result of which, unborn human life is destroyed.”
• “One obstetrician and two psychiatrists have reviewed the opinion referred to. . . and certified that they are of the same opinion.”
• “At least one of the psychiatrists referred to in . . . shall be a perinatal psychiatrist.”
There are also images of a draft copy of some of the text on the web.
Sheahan states that the term “jointly certified” means there has to be a unanimous opinion of all six consultants. There was also an appeals process that would see the initial examinations being repeated by two further teams of three doctors. One of the three perinatal psychiatrists employed in the state, Dr Anthony McCarthy, has been scathing in his condemnation of the proposal:
“If a woman is seriously distressed and depressed in pregnancy, and potentially suicidal or having suicidal ideas, the idea that you would bring her through a forum such as this – almost an inquisition – where she would have to tell her story in front of six different people, is frankly abusive. It’s truly idiotic,” he added.
He also said that the profession had spent years trying to de-stigmatise mental health and get people to talk.
“This idea would do everything to say ‘don’t talk’,” he said.
Dr McCarthy added that the idea was completely “unworkable”, and could only have been designed by people who did not understand how doctors work.
It should be noted that the Health Minister himself is a doctor.
A clinical psychiatrist from Trinity College, Prof Veronica O’Keane, has been equally critical in the Irish Times (note that in the same article UCD psychiatrist Prof Patricia Casey responds answering a slightly different question by stating that abortion is not a treatment for suicide):
Such a screening process went against a women’s human right to receive effective ways of accessing abortion if her life was in danger from suicide, as demanded by the European Court of Human Rights 2010 ruling on the issue, said Prof Veronica O’Keane.
Proposals for abortion legislation whereby a woman would have to meet a panel of doctors would be an “obstacle” to that ruling , she added.
“This idea for legislation is obstructive, unworkable and an insult to women,” said Prof O’Keane, who appeared before the Oireachtas hearings on abortion in January to give evidence as a psychiatrist.
The idea of women going before six doctors amounted to an “inquisition” with the “implication that women may be untruthful about suicide”. It was important when treating people to minimise the number of times they had to explain their history as doing so was stressful, she added.
The need for legislation to comply with the X and ABC case rulings was shown into sharp relief by the recent inquest into the death of Savita Halapanavar at Galway University Hospital. The heads of the Rotunda and Holles Street maternity hospitals have been clear on the need for legislation to clarify the law.
Not that politicians seem to care much for expert opinion. Two of the four anti-abortion motions at this weekend Fianna Fáil ardfheis specifically oppose any such legislation, the other two motions simply restate that Fianna Fáil is pro-life. Meanwhile, the two coalition partners are at loggerheads over the delays and their parliamentary parties have had heated meetings. After the Fine Gael meeting, Waterford TD John Deasy said:
“The ministers have been sleepwalking and walked TDs into a haymaker,” one TD said. “TDs aren’t gobshites and are wondering how they got us into this. We haven’t been listened to.”
For anyone unfamiliar with the case, Deasy’s comments need to be seen in the context of a generational delay in legislating for the X case judgement (20 years), the fact that there were already a number of days of Oireachtas hearings (for TDs and Senators) and an expert report on the subject. Several commentators on radio yesterday were claiming that the atmosphere has soured so significantly that both coalition parties have started openly briefing against each other. A high level group is trying to resolve tensions today, but with Oireachtas time running out and, effectively, a requirement to legislate to comply with the European ruling before the summer recess, there doesn’t appear to be any viable and available political parking space where this issue can be parked…