Standing up for Mothers and Children in Ireland

Both BBC and Ireland’s state broadcaster RTE reported this weekend that most Irish people want new legislation on abortion in Ireland, but their reports were misleading, to say the least.

According to both broadcasters, 85pc of adults surveyed for the Sunday Business Post said they were in favour of legislation to realise Ireland’s controversial 1992 Supreme Court ‘X’ judgement, allowing abortion when a mother’s life is threatened, including by suicide.

While the poll found this, it also warned against taking this result out of context, as it had produced contradictory results, 63pc of adults favouring a new referendum on the Irish constitution to limit the scope of the X judgement.

TOPSHOTS-IRELAND-INDIA-ABORTION-RIGHTS-RELIGIONPat Leahy, the Sunday Business Post’s political editor, says that the death of Savita Halappanavar, although it may have been unrelated to Ireland’s abortion laws, has had an important effect on the abortion debate, having been eagerly seized upon by pro-choice campaigners because “People have identified with a real person, rather than an abstract proposition.”

That pro-choice activists seized upon Savita’s death from ESBL e.coli-induced septicaemia when the story first broke was clearly irresponsible, given how few facts were in the public domain; for them to do so now looks cynical and even dishonest.

Kitty Holland, who originally broke the story of how Savita died a few days after a miscarriage, admitted more than two weeks ago that it had not been established that a termination of pregnancy could have saved Savita’s life; she has since described Savita’s widower Praveen’s recollection of events as ‘muddled’, saying it might even transpire that Savita had never sought the termination of her pregnancy.

Anger and confusion has thus formed the backdrop against which the Irish government has received and published the findings of an expert group set up to consider how the government could implement the European Court of Human Rights’ judgement in the 2010 case A, B and C v Ireland that Ireland requires an accessible and effective procedure by which a woman can establish whether or not she qualifies for a legal abortion, since Irish law theoretically recognises a legal right to abortion in certain conditions.

CarolineSimonsThe expert group restricted itself to proposals within the current constitutional framework, shunning the possibility of a referendum on a constitutional amendment to overturn the Supreme Court’s 1992 decision that allowed for abortion on mental health grounds. As Caroline Simons of Ireland’s Pro Life Campaign points out, “This is surprising since the European Court of Human Rights makes it clear that Ireland is free to have whatever abortion law it wants.”

The Pro Life Campaign has long believed that this would be the best option.  William Binchy, then Regius Professor of Law at Trinity College Dublin, wrote in the immediate aftermath of the 2010 judgement that,

“Ireland is perfectly free to provide constitutional support for the present admirable situation in Irish hospitals where doctors and nurses do their very best for mothers and their unborn children, ensuring that all necessary treatment will be given to mothers – even where this may result in the death of the child.”

The Pro Life Campaign has consistently argued that the X decision was flawed, as the Supreme Court made a decision on the basis of the opinion of a clinical psychologist but without hearing any medical evidence; the expert group, in deeming only medical practitioners – notably psychiatrists –qualified to make such decisions, seems to be at least sympathetic to this view.

ClareDalyThis stands in stark contrast to the recent unsuccessful private member’s bill put forward for a second time by the Irish parliamentarian Clare Daly, which would have placed medical decisions in the hands of people who are not medical practitioners.

The expert group envisages decisions being made solely on the basis of strict medical necessity, and stresses that the X judgement does not simply allow abortion in cases where a mother’s life is deemed to be in danger. Rather, it says,

“The Supreme Court in the X case held that the correct test was that a termination of pregnancy was permissible if it was established as a matter of probability that:

1) there is a real and substantial risk to the life of the mother; and

2) this risk can only be averted by the termination of her pregnancy.”

The second criterion – that termination of pregnancy is not permissible if there is any other way of averting risk to the mother’s life – is usually disregarded by pro-choice campaigners and commentators. It is encouraging that the expert group recognises the importance of this criterion, and has advised the government accordingly.

Doctors regularly state that there are no medical conditions which necessitate the deliberate destruction of the unborn child in order to save the life of the child’s mother, and it seems that this principle applies as readily to psychiatric conditions as to physical ones.

The Samaritans and the Irish Association of Suicidology advise that “suicide is never the result of a single factor or event”, noting that “The reasons an individual takes their own life are manifold, and suicide should not be portrayed as the inevitable outcome of serious personal problems.”

Britain’s Royal College of Obstetricians and Gynaecologists in 2011 issued extensively revised evidence-based guidelines on the care of women seeking induced abortions, stating that:

Recommendation 5.13: Women with an unintended pregnancy should be informed that the evidence suggests that they are no more or less likely to suffer adverse psychological sequelae whether they have an abortion or continue with the pregnancy and have the baby.”

And that:

Recommendation 5.14: Women with an unintended pregnancy and a past history of mental health problems should be advised that they may experience further problems whether they choose to have an abortion or to continue with the pregnancy.”

Abortion, therefore, should not be regarded as a plausible cure for any mental health problem, and certainly should not be prescribed as such, let alone as the only possible cure; it may not make things worse for women, but it is unlikely to make things better.

Unfortunately, while in principle it ought to be possible to construct legislation to reflect this, Britain’s experience is that without proper monitoring a slippery slope is inevitable. Contrary to popular belief, especially in Ireland, abortion remains illegal in Britain under the 1861 Offences Against the Person Act, although the 1967 Abortion Act provided a small number of defences for doctors who carry out abortions on medical grounds. Now, however, almost all of Britain’s almost 200,000 annual abortions are carried out on mental health grounds, and may therefore be technically illegal, with the best evidence showing — as the RCOG guidelines recognise — that terminating unwanted pregnancies does not improve mental health.

LeoVaradkarAs there seem to be no grounds for believing that abortion could ever be necessary to save a mother’s life, it is perhaps unsurprising that Irish government minister Dr Leo Varadkar admits that, “we can’t exclude the possibility that any legislation that we do produce could turn out to be unconstitutional, in which case we could end up back at a referendum.”

The Pro Life Campaign would advise that it would be best to have the referendum now, but in the meantime, Irish women can be assured of maternal health care that is among the best in the world. As Ireland’s Bishops recently observed:

“Whereas abortion is the direct and intentional destruction of an unborn baby and is gravely immoral in all circumstances, this is different from medical treatments which do not directly and intentionally seek to end the life of the unborn baby. Current law and medical guidelines in Ireland allow nurses and doctors in Irish hospitals to apply this vital distinction in practice while upholding the equal right to life of both a mother and her unborn baby.”

A pro-life vigil will take place today at 4.30 p.m. outside Ireland’s Parliament, where pro-life groups will assemble to send Irish politicians a strong message about this crucial question of human dignity.

Petra Conroy, co-ordinator of Catholic Comment, the Irish sister organization of Catholic Voices, says “this is a critical time for the protection of unborn children in our country, an issue that is at the heart of the Catholic vision of the dignity and value of every human being, but that is also of concern to all who value human life and human rights.”

The vigil, she says, will send a positive, clear message about “the importance of protecting our two-patient model of maternal care. It’s about protecting pregnant mothers and their unborn babies.”

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