Scope for wide divergence of medical opinion

Despite the extensive replies to Fine Gael's questions on the proposed abortion legislation and amendment, the debate is likely…

Despite the extensive replies to Fine Gael's questions on the proposed abortion legislation and amendment, the debate is likely to continue on "emergency contraception", the extent of the discretion doctors will be able to exercise and the impact of the Maastricht Protocol on the proposed amendment.

The Bill is intended to protect the morning-after pill and the IUD. There is some uncertainty as to how they work. There are also different varieties of these products, which work differently. The morning-after pill certainly delays ovulation, if it has not already taken place, and it appears to stop implantation if taken within not more than 72 hours. After that, it is generally ineffective. The IUD is kept in the womb to prevent pregnancy, or can be inserted after intercourse or rape as emergency contraception, and works for at least five days after fertilisation.

Both are seen as abortifacients by some anti-abortion campaigners. This is conceded by Mr Ahern when he points out that in the UK the Society for the Protection of the Unborn Child is taking proceedings to have the morning-after pill banned.

At least some anti-abortion campaigners are concerned about this. The former High Court judge, Mr Justice Rory O'Hanlon, said in The Irish Times on Thursday: "I cannot vote in favour of a Bill that denies the protection of the Constitution to unborn human life after fertilisation and before the second stage of implantation has taken place."

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In its answer to question four, the Government is saying that the purpose of this Bill is limited to outlining the criminal offence of abortion and seems to imply that it is up to anyone who wishes to do so to take legal proceedings under Article 40.3.3 to prohibit suspected abortifacients.

There are also now a wide variety of products on the market which can cause early miscarriage. While those which set out to do so are not licensed in this State, the status of medication used for other purposes, but which can also cause miscarriage if taken by a woman in early pregnancy, is not clear.

In his answer to question nine, Mr Ahern makes it clear that "medical practitioner", as defined in the Bill, is any registered doctor, and that, for the purpose of terminating a pregnancy to save the life of the woman, he or she can decide alone that this procedure is necessary.

This means that there is still scope for a wide divergence of opinion between doctors. The reply to question 12 makes it clear that doctors can exercise discretion.

This states: "If there were an issue in any criminal trial as to whether the opinion of any medical practitioner in question was a 'reasonable opinion' within the meaning of the Act, the onus would be on the prosecution to prove beyond reasonable doubt that one or more of the following necessary attributes of a 'reasonable opinion' was absent", going on to list them. It also states that, in order for a jury to convict in such a case, it would have to be satisfied beyond reasonable doubt that the opinion was not reasonable.

It seems highly unlikely that, faced with doctors differing on what was a "reasonable opinion", a jury would convict.

There has been much uncertainty about the compatibility of these proposals with the Maastricht Protocol, with the Taoiseach giving different answers at the outset. Here he states categorically that the amendment and the envisaged legislation have no EU law content or implications.

But in the discussions preparing the Maastricht and Nice treaties the issue of a Charter of Rights for the EU came up. It was envisaged, at least by some, that the EU would give legal recognition to the European Convention on Human Rights and the jurisprudence built up around it. This includes case law on the right to life that, while not giving a right to abortion, stresses the right to life of the mother as against that of the foetus.

The Maastricht Protocol has never been tested in the courts, and it is not possible to predict with confidence what the outcome might be if it was.

Despite the best efforts of Mr Ahern and his advisers, the electorate may end up as confused over this amendment as it was in 1992.