Government likely to face pressure to modify draft abortion Bill

Master of Rotunda Hospital says inclusion in legislation of suicidal intent as grounds for a termination not evidence-based

 Dr Sam Coulter Smyth: the master of the Rotunda Hospital said the inclusion in legislation of suicidal intent as grounds for a termination  posed major ethical dilemmas for obstetricians. Photograph: Eric Luke

Dr Sam Coulter Smyth: the master of the Rotunda Hospital said the inclusion in legislation of suicidal intent as grounds for a termination posed major ethical dilemmas for obstetricians. Photograph: Eric Luke

 

The Government is likely to come under increased pressure to modify proposed legislation for abortion in cases of a threat of suicide after the master of one of the State’s biggest maternity hospitals expressed concerns about its plans.

Dr Sam Coulter Smith, master of the Rotunda Hospital, said the inclusion in legislation of suicidal intent as grounds for a termination was not evidence-based, posed major ethical dilemmas for obstetricians and could lead to an increase in women seeking terminations. While broadly welcoming the rest of the legislation, he was particularly critical of the absence of proposals for a gestational time limit.

His evidence to the Oireachtas health committee yesterday was welcomed by Fine Gael backbenchers who are opposed to the inclusions of the threat of suicide as grounds for a termination in the Protection of Life during Pregnancy Bill 2013.

The suicide clause in the legislation was strongly supported by the master of the National Maternity Hospital, Dr Rhona Mahony, and its clinical director, Dr Peter Boylan.

Saving women’s lives
Dr Mahony said the life of the foetus must be vindicated where it was practicable. It was her experience that the majority of women did not wish to lose their babies, but they did not want to die. The Bill was about saving women’s lives, regardless of whether that risk to life is physical or mental.

Dr Mahony said a woman who was intent on suicide was indeed at risk of dying. She needed to be assessed appropriately, believed, and expert psychiatric care provided.

Responding to the concerns of Archbishop of Dublin, Diarmuid Martin, about the possibility of late terminations, she said obstetricians aimed to prolong viability and there was no suggestion a baby at 28-30 weeks’ gestation would be killed. Dr Boylan described the legislation proposed as highly restrictive in international terms and said suggestions that late terminations would be performed if it were passed had no basis in fact.

Minister for Health James Reilly, speaking at the start of yesterday’s hearing, said the only purpose of the legislation being introduced was to clarify what was lawfully available.

Dr Reilly criticised
Dr Reilly was criticised by members of his own party for leaving immediately after his contribution. Senator Paul Bradford described his absence as “bizarre” while Wicklow TD Billy Timmins said he could not think of a more appropriate place for the Minister to be.

The Minister’s spokesman said later his officials were well placed to answer any questions and that Minister of State Alex White would be present next week. Chief medical officer Tony Holohan indicated the Department of Health may look again at the penalties proposed for illegal abortions, currently set at 14 years in prison.

He said the suicide clause was being included because it was impossible to say such a situation would never arise. He defended the ability of psychiatrists to assess the risk involved, saying it was not a “hocus pocus sort of assessment”.

The Medical Council told the hearing that the assessment of a woman at risk of suicide should not differ from that of women seeking terminations because of physical symptoms.