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Special Report
May 13, 2013
Proposed legislation would legalize abortion when the mother’s life is at risk. But the measure is medically unnecessary, many Irish doctors say.
Pro-life demonstrators hold signs during a candlelight vigil outside the Irish parliament in Dublin Dec. 4, 2012, calling on the government not to introduce abortion legislation. (CNS photo/John McElroy, The Irish Catholic)

Ireland’s coalition government is pushing ahead with controversial plans to legalize abortion despite growing opposition from within the medical community.

Pro-life campaigners have also dismissed claims by Prime Minister Enda Kenny that the draft law is limited in scope, saying it will lead to widespread abortion.

Ireland and Malta are currently the only countries in Europe where abortion is still illegal.

A draft of the so-called Protection of Life in Pregnancy legislation was published after protracted negotiations between the center-right Fine Gael and leftist Labor party. It will now be debated before the parliamentary health committee.

Campaigners are furious because Fine Gael—the senior party in Government—made a promise before the 2011 general election not to legalize abortion. The Labor party, on the other hand, has had a long-standing pro-abortion stance.

The draft law provides for abortion when there is a substantial risk to the life, as opposed to the health, of the mother. This would include situations in which a woman says the continuation of the pregnancy leads to suicidal thoughts. The law would also provide for jail terms of up to 14 years for those performing abortions in circumstances other that permitted by the new law.

Prime Minister Enda Kenny has claimed that the legislation will not change Ireland’s law on abortion in other circumstances. He said that an abortion can only be legally permitted where doctors have unanimously decided that it is the only treatment that will avert a risk to the life of a mother.

However, Caroline Simons, a spokesperson for the Pro-Life Campaign (PLC) dismissed the claims. She says the Government has “been talking up the proposal as very restrictive. But, in reality, these reassuring noises are empty and misleading.”

“What matters is what’s contained in the bill and what’s in the bill is dangerous,” said Simons. “For the first time an Irish Government is proposing to introduce a law that provides for the direct intentional targeting of the life of the unborn child.”

Simons said that “talk of the legislation being ‘life-saving’ is simply dishonest. There is no evidence that abortion ever helps women’s mental health and in fact it may damage women.”

Leading psychiatrists have also dismissed claims that abortion can ever be a treatment for suicidal ideation.

Prof. Patricia Casey, a consultant psychiatrist at the Mater University hospital in Dublin, said there are “multiple flaws and diverse flaws arise from the proposals.”

“The first and most obvious is that there is no evidence that abortion is an intervention that reduces suicide. No textbooks of psychiatry or research papers suggest this. There are treatments, psychological and pharmacological, to do this,” Prof. Casey said.

Nearly one in three of Ireland’s psychiatrists agree with Prof. Casey’s position. A group of 113 psychiatrists signed a statement to parliamentarians insisting that the legislation, which would allow for abortion as a treatment for threat of suicide, has no basis in medical evidence. Just 14 psychiatrists publically disagreed with the statement.

Dr. Bernie McCabe, a consultant psychiatrist at Navan Hospital said she was “not surprised that so many of our colleagues agree that the proposed legislation is flawed. As members of the medical profession, we have a duty to our patients to adopt best practice and an evidence-based approach to everything we do.”

“The fact is that there is no evidence that abortion is a treatment for suicidality in pregnancy and may in fact be harmful to women. The Government must take this into account and reconsider its proposals,” she said.

Last month the Irish Medical Organization, the body which represents the overwhelming majority of Irish doctors, rejected a motion calling for the legalization of abortion.

In practice, abortion has been illegal in Ireland under legislation enacted in 1861. A 1983 constitutional amendment created an equal right to life between the mother and unborn baby. However, a 1992 Supreme Court judgment—known as the X Case—found that there is a constitutional right to abortion where there is a substantial risk to the life of the mother, including the risk of suicide, up to birth.

Successive governments have not acted on the issue. However, the European Court of Human Rights (ECHR) ruled in 2010 that Ireland must clarify when women can access abortion under the 1992 ruling. The ECHR found that Ireland had a right to ban abortion, but must clarify the 1992 ruling.

Pro-life campaigners have agreed that the 1992 ruling is flawed, pointing to the fact that the Supreme Court heart no medical evidence in the case. They want the Government to respond to the ECHR judgment by issuing guidelines that make it clear when pregnant women can receive life-saving treatment, even if this results in the unavoidable and unintentional death of the unborn child. They also was a referendum to overturn the 1992 ruling on suicide.

Former Prime Minister John Bruton has weighed in on the debate over the current legislation, warning that any plan to provide abortion in cases where a woman is suicidal is wrong. Bruton said he knows of no other area of law where a threat of suicide is “sufficient to make legal what would otherwise be illegal.”

He said the draft legislation now being considered by the Government “would deny the weakest human beings of all the right to live.”

Church leaders are also stepping up their campaign against the draft legislation, describing the plan as “morally unacceptable” and “unnecessary.”

In a statement, the Irish bishops insisted that the draft would, if approved, “make the direct and intentional killing of unborn children lawful in Ireland.”

“The bill as outlined represents a dramatic and morally unacceptable change to Irish law and is unnecessary to ensure that women receive the life-saving treatment they need during pregnancy,” the bishops said.

The bill also appears to impose a duty on Catholic hospitals to provide abortions. “This would be totally unacceptable and has serious implications for the existing legal and constitutional arrangements that respect the legitimate autonomy and religious ethos of faith-based institutions,” the bishops said. “It would also pose serious difficulties for the conscientious beliefs of many citizens.”

On the issue of suicidal ideation, the bishops insisted that “abortion, in the sense of directly killing the unborn child, is never a remedy for suicidal ideation and therefore should never be cited as a justification for the direct killing of an innocent human being.”

“It is a tragic moment for Irish society when we regard the deliberate destruction of a completely innocent person as an acceptable response to the threat of the preventable death of another person,” the bishops said.

Archbishop Eamon Martin, coadjutor archbishop of Armagh, urged Catholics to continue to lobby lawmakers on the draft legislation.

He questioned the “massive effort” being put in by politicians to legalize the deliberate killing of unborn children.

“If a similar effort was redirected towards establishing with the relevant professional bodies clear medical guidelines, together with robust support structures for medical personnel, towards supporting mothers who have very real anxieties or fears about their pregnancy, towards improving professional development, training, and support structures for doctors, nurses, and other professionals who are faced with these complex and very difficult dilemmas on the ground, then it is still possible to preserve Ireland’s reputation as one of the safest places in the world for mothers and babies during pregnancy,” Archbishop Martin said.

The death of a young pregnant woman thrust the issue of abortion center-stage late last year, with pro-choice campaigners blaming the country’s ban on abortion for the woman’s death. However, even a quick perusal of the facts reveals a much more complex scenario. Pro-life advocates insist the tragic case is being used by those trying to overturn Ireland’s pro-life legislative framework.

Savita Halappanavar—a native of India who moved to the west of Ireland some years ago—was 17 weeks pregnant when she went to the hospital on October 21, complaining about back pain. A week later she had died from septicaemia, a blood infection.

Dr. Peter Boylan, an obstetrician, told the inquest into her death that if Halappanavar had been given a termination she would, “on the balance of probabilities,” still be alive.

“It is highly likely she would not have died” if she had been given a termination earlier, he added.

However, Dr. Boylan’s testimony has been challenged by a group of leading consultant obstetricians and gynaecologists. The group noted that “much of the public attention appears to have been directed at the expert opinion of Dr. Peter Boylan, who suggested that Irish law prevented necessary treatment to save Ms Halappanavar’s life.”

“We would suggest that this is a personal view, not an expert one,” the senior medics said in a letter to the Irish Times. They said “it is impossible for Dr. Boylan, or for any doctor, to predict with certainty the clinical course and outcome in the case of Savita Halappanavar, where sepsis arose from the virulent and multi drug-resistant organism, E.coli ESBL.”

The doctors insisted that Irish law is clear on the issue of when medics can intervene to save the life of a pregnant woman. “What we can say with certainty is that where ruptured membranes are accompanied by any clinical or biochemical marker of infection, Irish obstetricians understand they can intervene with early delivery of the baby if necessary.”

“Unfortunately, the inquest shows that in Galway University Hospital the diagnosis of chorioamnionitis was delayed and relevant information was not noted and acted upon,” they said.

Dr. Ruth Cullen, a medical adviser to the Pro-Life Campaign, said “it is deplorable that those who want to see abortion available here are exploiting Mrs. Halappanavar’s tragic death when the Medical Council Guidelines are very clear that all necessary medical treatment must be given to women in pregnancy.”

“It is also vitally important to acknowledge at this time that Ireland, without induced abortion, is recognized by the UN and World Health Organization as a world leader in protecting women in pregnancy and is safer than places like Britain and Holland, where abortion is widely available,” Dr. Cullen said.

Catholic health-care ethics do allow for actions to be taken to save the life of the mother, even at the risk of ending the life of the unborn child. Pope Pius XII in 1951 told the Italian Union of Midwifes that, “if, for example, the saving of the life of the future mother, independently of her pregnant condition, should urgently require a surgical act or other therapeutic treatment which would have as an accessory consequence, in no way desired or intended, but inevitable, the death of the foetus, such an act could no longer be called a direct attempt on an innocent life.”

“Under these conditions the operation can be lawful, like other similar medical interventions,” Pope Pius insisted.

Church leaders and pro-life campaigners are determined to keep up the fight against the draft law.

“The right to life is such a natural and inviolable right that no individual, no majority, and no state can ever create, modify, or destroy it,” Archbishop Eamon Martin said.

“How can it be argued that it is for the ‘public good’ to legislate for the direct and intentional taking of human life?  How can it be claimed that this is the will of the Irish people, who had enshrined in the Constitution the protection of the life of both a mother and her unborn child?” the archbishop asked.
He also urged Catholics not to be ashamed to bring their faith to politics: “None of us can leave our faith ‘outside the room’ when we are considering these matters.”

“We must face the challenge of putting faith into practice in our lives, and have the courage to follow our informed conscience, no matter what the consequences might be,” Archbishop Martin said.

Primate of All-Ireland Cardinal Sean Brady called on Catholics to “mobilize” and make people aware of the very important issues at stake in the debate on abortion.

He repeated a call for voters to lobby their elected representatives to oppose any change to existing abortion law.

There is some evidence that the message may be getting through. Several Government legislators have vowed to oppose the draft legislation, even though this means they may be expelled from their political party.

Government Minister Lucinda Creighton, who is opposed to allowing abortion, is hopeful there may be a change of heart. “It’s a long way until this legislation will be finalized and we have to go through the process with the committee,” she said.

“Obviously a number of ministers have made it clear there would be a willingness to look at amendments to the legislation, so it’s a long way to go and I’m not going to predict or pre-empt the outcome,” she said.

There has been talk of excommunication of politicians who support the legislation. Prime Minister Enda Kenny is frequently at pains to point out that he is a practicing Catholic. The overwhelming majority of Irish legislators identify themselves as Catholics. However, such is the climate of anti-clericalism in Irish politics at the moment, talk of excommunication may well prove counter-productive with some even seeing the move as a badge of honor. Asked about the issue of excommunication, Cardinal Brady said “that is down the line at the moment, as far as we are concerned.”

“We know what the law is about excommunication, about abortion, that’s a fact” the cardinal said.

Responding to the cardinal’s remarks, Kenny replied: “Well, I have my own way of speaking to my God and it’s not for me to comment on that.”

For opponents of the draft, the issue is clear. If the legislation is passed, Caroline Simons of the Pro-Life Campaign insists “it will mean that ideology has been allowed to win over evidence.”
 
About the Author
Michael Kelly 

Michael Kelly is editor of the Irish Catholic, Ireland's best-selling religious newspaper.
 

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