February 2002
Dr Margaret Oates of the Royal College of Psychiatrists in the UK has just published a paper on suicide in pregnancy - it is the commonest cause of death in association with pregnancy nowadays. While some women commit suicide after the child is delivered, seven in her three year survey died during pregnancy. This referendum is not about an abstract idea - it is about women's lives.
I opposed the 1983 Amendment to the Constitution because I thought it was unnecessary and unclear. The Supreme Court in the X case eventually interpreted the Amendment as meaning exactly the opposite to the end its proponents had sought. I oppose the present attempt to amend the Constitution more strongly still. It is unnecessary and every section of it ambiguous.
The Taoiseach says that the judges said after the X case that legislation in the area of abortion was needed. They did not say a Constitutional Amendment which would have to be interpreted by them was the way forward. It is legislation which is needed now, not this complicated procedure to put legislation into the Constitution.
The definition of abortion in the Bill which is proposed is unknown in medical dictionaries. Correctly, in my view, it describes implantation as the beginning of a pregnancy. Usually abortion is described as the termination of a pregnancy before the child can live outside the womb. The proposed definition has no end point except presumably term. I wrote to Cardinal Connell suggesting to him that by acquiescing to the proposed definition he, in a way, gave philosophical support to the notion that procedures such as "partial birth abortions" in the USA were quite properly abortion even though viable children are lost by these procedures. He acknowledged my letter and said he would take advice on it.
Medical procedures to save the life of a pregnant woman even if it means the loss of the foetus are allowed in Ireland at present and can take place anywhere. Naturally, one would try to carry these out in the best possible facilities but in an emergency, for example, haemorrhage, she can be dealt with any where. If this Amendment is passed she can only be treated at "approved places". We do not know where these approved places may be but we do know that a Government Minister can vary the number from time to time. So one could have very few approved places which might be some distance from a woman whose life was threatened thereby putting her at increased risk. A registrar in a county hospital which was not an approved place might be much slower to act in the future than he would now in an emergency.
Worse still for the woman in a life threatening situation, persons involved in caring for her can declare themselves to be conscientious objectors to dealing with such problems. Staff who claim such an exemption do not have to have given prior warning to either patients or the hospital where they are employed. Nor does the legislation require hospitals to ensure that there are staff on duty all the time who are not conscientious objectors. This type of behaviour is unknown in medicine. One's ethical duties to patients are paramount. Even the most depraved murderer in an emergency must be treated by the doctor present. It is in conflict with World Health Organisation directives, too.
The woman's right to privacy is also seriously eroded. Section 5 of the Bill allows a Minister, any Minister, to make an order on behalf of the Government to look at the medical records of a women who has had a pregnancy terminated because her life was in danger. The doctor's opinions are included in the inspection. Any third parties may be in a position to view these records - no controls are stipulated.
Worse again, subsection (3) of Section 5 advises that such orders should be made from time to time to see how the Act is working. This gross intrusion into doctor /patient confidentiality is in breach of Article 8 of the Convention of Human Rights - but why bother about that - it’s only about a pregnant woman at one of the worst moments of her life. In these situations, life being what it is, one can be sure the baby was longed for.
Writing about this proposed Amendment has only made me more angry and determined to do all I can to encourage people to vote " No". The vote takes place on a Wednesday which means many young people studying or working in the cities will not be able to go home to vote and it is their lives which will mainly be influenced if this referendum is carried.
Many of the proponents of the Amendment are the same as those who put forward the 1983 one - Professor Bonar, Professor Brady, Senator Hanafin and the Roman Catholic bishops.
Obstetricians are not unanimously behind this Amendment and those who are may have let their concern to copper fasten the legality of medical life saving procedures unduly influence them. Lawyers are split on even such side effects of the referendum as "the morning after pill ". Reject this Amendment please or we will be in the Four Courts interpreting it for years.
Senator Mary Henry, MD
