Screening for suicide an ‘insult to women’

A reported plan for a panel of doctors to assess suicide risk during pregnancy was an "insult to women", according to a clinical psychiatrist and Trinity College professor.

Such a screening process went against a women’s human right to receive effective ways of accessing abortion if her life was in danger from suicide, as demanded by the European Court of Human Rights 2010 ruling on the issue, said Prof Veronica O’Keane.

Proposals for abortion legislation whereby a woman would have to meet a panel of doctors would be an “obstacle” to that ruling , she added.

"This idea for legislation is obstructive, unworkable and an insult to women," said Prof O'Keane, who appeared before the Oireachtas hearings on abortion in January to give evidence as a psychiatrist.

The idea of women going before six doctors amounted to an “inquisition” with the “implication that women may be untruthful about suicide”. It was important when treating people to minimise the number of times they had to explain their history as doing so was stressful, she added.

Fears
Even in cases where patients are detained in psychiatric hospitals against their will, only two doctors, one of whom is their GP and both of whom often know the patient, assess them.

The Savita Halappanavar case showed how legal constraints could prevent doctors from giving women the best care. The fear was that delays with setting up a panel of doctors could also prevent women being treated swiftly.

“Doctors need freedom to practice, freedom from the law to deliver standard international best practice care for women,” Prof O’Keane added.

If a woman was assessed suicidal because of a pregnancy then she should be allowed an abortion, she added.

No evidence
But Prof Patricia Casey, professor of psychiatry at UCD and the Mater hospital, said there was no evidence abortion was a treatment for suicide. Psychiatrists should not be involved in assessing a woman's need for abortion since the procedure harmed women, added Prof Casey, who also appeared at the Oireachtas hearings.

“As a psychiatrist I cannot support a proposal which involves a procedure which would cause women harm,” she said.

“Whether it is one or 10 or 20 or three psychiatrists, the bottom line is that there is no research-based evidence to show that abortion should be used as a treatment in these cases,” she said.

Pregnant women she had seen who were suicidal and wanted an abortion were being coerced into having the procedures, she added