15th May 2000
The 'A' word is on the agenda in Leinster House again. The Green Paper on Abortion is being considered by the Joint Committee on the Constitution and the committee members asked those doctors who had made written submissions, and some others whom they felt might have views which should be considered by them, to come before the committee. Any readers who watched the Public Accounts Committee in action will realise how useful these question and answer sessions are. I was very pleased to come before them to elaborate on my own written submission.
The main points of discussion were about a definition of 'abortion' and the possibility of predicting suicide. All agreed the prediction of suicide was very difficult and pregnant women rarely committed suicide. On the definition of abortion, however, views differed considerably.
For my own part, I had put forward the definition I found in most medical dictionaries, that is that an abortion is "the termination of a pregnancy before the child/foetus is viable". This type of definition, and a definition is definitely needed, was agreed to by the majority of the doctors interviewed. The intent of the doctor was considered the most important factor by this minority. Even if the action did result in the termination of the pregnancy they said it was not abortion, it was simply medical treatment. Now, while I can understand what they mean I doubt if legislation could be based on intent. Another difficulty was that one doctor felt this understanding was really only available to obstetricians, that other doctors did not have the same feeling for the unborn child. This idea I reject totally, believing that all who care for pregnant women understand their responsibilities properly.
The questioning by the committee was excellent. The members had obviously read the Green Paper thoroughly. This was a most comprehensive document into which some people had put a great deal of work. In addition, the committee members had studied the Medical Council Guidelines and other documents such as those produced by the Constitution Review Committee and all the submissions made by various individuals and groups to them. I have found that Dáil and Seanad members who serve on the special committees normally do spend a considerable amount of time on research before interviewing anyone and it is advisable for those appearing before them to remember that. There were some very personal touches, Deputy Liz McManus thanked Dr. Michael Solomons for all the efforts he had made to make contraception available here to her generation of Irish women. In my own submission I pointed out that about 30 women died each year in association with pregnancy in the late sixties and early seventies and that in 1966 the six women who died of pulmonary embolism left 65 children between them. While advances in modern obstetrics have been most important many women for whom pregnancy would be risky simply do not become pregnant nowadays thanks to contraception.
The committee intends, over the next two weeks, to meet those groups who made submissions requesting an absolute ban on abortion or a liberalisation of the law. It is regrettable that so many of those who got us into the mess we are in by visiting on us the 1983 amendment seem determined to push for an absolute ban. Those obstetricians who appeared before the Committee and supported an absolute ban seemed to me to feel their medical opinions would never be questioned. I feel those days are gone. The Master, Professor or "Eminent Obstetrician", as they are frequently described in the press, can expect to have his opinion questioned from all sides nowadays. I say "his opinion" because I was the only woman to appear before the Committee. The Masters of the maternity hospitals seemed well aware of this, too. We need to remember other 'A' words, e.g. 'arrogant', 'authoritarian', are frequently thrown at us doctors by aggrieved patients and their relatives.
None of the doctors who came before the Committee advocated a liberal abortion regime such as exists in Great Britain. I suggested the Committee should be sure to look at the situation which exists in other countries, too, and I am sure they will.
Several of us felt, however, that in cases where the child has a lethal condition such as anencephaly, the possibility of terminating the pregnancy should be there. The Chairman, Deputy Brian Lenihan, asked what happened nowadays. I explained the pregnancy might be terminated about 26 or 28 weeks when the child would be viable except that an anencephalic foetus is not viable. I think he felt we were dancing on heads of pins again.
The possibility of abortion after rape was discussed. I hope not to be considered heartless because, while some others said it should be allowed, I did not. My main concern is to ensure that no legislation is enacted which could affect the life of the mother. It is all very well for authoritarian voices to say medical practice will not be affected by an absolute ban, but what if their views are challenged?
Senator Mary Henry, MD
