Suicide 'test' should now be key focus of abortion debate

The Mills Bill provides, as the report of the expert group chaired by Seán Ryan suggested, that terminations be carried out in designated medical centres, likely to be HSE-run hospitals. It also provides that in each case where a termination is to be lawful, whether on grounds of physical threat to the life of the mother or threat of suicide, at least two doctors must be involved in certifying “in good faith in all the circumstances of the woman’s case” that a termination is the only way to remove the potential risk to the mother’s life. In those cases not involving threat to suicide one of those registered medical practitioners must be an obstetrician.

The draft Bill , however, provides for what he called “more stringent” safeguards where the risk to life of a pregnant woman arises from a threat of suicide. This is necessary, Mills says, because of the “special nature of suicidality” and to make it “less probable that insubstantial claims of suicidality will be advanced”.

For these cases Mills provides that one of the two certifying medical practitioners must be a consultant psychiatrist. He goes further to provide that each of these two doctors must carry out an actual examination and assessment of the patient on two separate occasions “to ensure that any suicidality is consistently present and expressed”. His Bill therefore provides that two registered medical practitioners, one a consultant psychiatrist, each having separately assessed the patient on two separate occasions, would have to certify in good faith that termination was the only way to remove the risk of suicide.

The safeguards for the suicide test in Mills’s draft Bill go somewhat further than those in the Private Members’ Bill on this issue proposed by Clare Daly TD last year. She proposed that a clinical psychologist could be one of the certifying professionals where the threat of suicide was in issue. She did not require assessment on two separate occasions and she provided that in the absence of an available consultant psychiatrist or a clinical psychologist, the opinion of a psychiatrist or psychologist would not be required.

The contrast even between the Mills Bill and the Daly Bill illustrates there is still a debate to be had about the safeguards in cases involving threat of suicide. It is on these detailed issues that the debate on the law should focus rather than simply rehashing the wider abortion debate.