Medical Council to bring out new guidelines following commencement of abortion law

The Medical Council is in the process of redrafting its guidelines on abortion following the commencement of legislation yesterday.

The work is being carried out by its ethics and professionalism committee.

Though passed by the Oireachtas last summer, the Protection of Life During Pregnancy Act 2013 did not commence until yesterday.

It provides for a termination of pregnancy where there is a real and substantial risk to a woman’s life from a physical illness and from the risk of suicide.

For a termination to take place, two medical practitioners will have to examine a woman and jointly certify that the risk to her life could be averted only by carrying out the procedure.

Regulations also provide for the review of a decision to allow a termination and they set down the procedures for recording terminations and notifying them to the Minister for Health.

Savita Halappanavar
The law was drafted following the death of Savita Halappanavar in late 2012. She died a week after being admitted to University Hospital Galway when she was 17 weeks pregnant and miscarrying.

The council’s current guide to professional conduct and ethics was drafted in 2009. It states that abortion is illegal in Ireland “except where there is a real and substantial risk to the life (as distinct from the health) of the mother”. In exceptional circumstances, “it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, while making every effort to preserve the life of the baby”, it says. It also suggests where there is a risk to a mother’s life from a threat of suicide, practitioners should carry out “a full assessment of any such risk in light of the clinical research on this issue”. This is at variance with the new legislation.

Consultation
The Institute of Obstetricians and the Royal College of Psychiatrists has also been in consultation with the council on guidelines for its members. They are expected to be brought forward early this year.

However, a leading consultant obstetrician, who did not wish to be named, said he did not believe the guidelines would be of any great significance.

“The lack of guidelines isn’t really a big problem. We do know what to do in the vast majority of cases and it’s usually quite obvious,” he said.

He envisaged potential difficulties with psychiatric cases but said they were likely to be very rare.

It all came down to the specifics of individual cases which had to be discussed with colleagues and midwives, he said.

Under the legislation, the decision-making should have been transferred to the doctors, he said, but this had not happened. There had been cases in which his team was not certain whether it was acting within the law and had to consult lawyers, he added.