The Masters of the two biggest maternity hospitals in the country have both declared their support for abortion where a child suffers either from a fatal or a non-fatal foetal abnormality. If implemented, this would mean that unborn children suffering from conditions such as Down Syndrome could be aborted in Irish hospitals.
The two Masters were Professor Fergal Malone of the Rotunda Hospital Dublin, and Dr Rhona Mahony of the National Maternity Hospital. Last week they appeared before the Joint Committee on the Eighth Amendment.
Professor Malone doesn’t want any limits placed on the type of foetal abnormalities that can lead to abortion, or any limits placed on the point in the pregnancy when an abortion for such conditions can take place. He wants abortion in this context decriminalised.
He told the committee: “Obstetricians and maternity hospitals in Ireland should be able to provide for a legal termination of pregnancy in the setting of fatal or complex foetal abnormalities if a patient chooses to follow that course of action.”
He said it would not be appropriate to provide a list of specific foetal diagnoses that should be considered “eligible” for an abortion but, instead, that “the individuals best placed to make such a decision are the patient and her doctor, without the direct involvement of external agencies”.
Moreover, he did not consider it appropriate to specify a precise gestational age limit in weeks beyond which a pregnancy termination would be illegal because, he said, the definition of foetal viability is not precise and is likely to change. According to him, the mother and her doctor only should make such a decision, without a legal cut-off.
This practically means abortion on request for any foetal abnormality, without gestational age limit. One couldn’t think of a more liberal regime.
Fine Gael Deputy Peter Fitzpatrick found it “disturbing that the witness refers to the abortion procedure as ‘care’ as it is certainly not care.” He noted that: “what is meant by ‘care’ is a procedure that would lead to the ending of a baby’s life”. He asked at what point it is decided that the baby is no longer the patient. In answering this question Professor Malone continued to refer only to the mother as “the patient”, never mentioning the other patient, namely the unborn child.
Dr Mahony also supported decriminalisation. She didn’t specify on what grounds but quoted without any qualification the Royal College of Obstetricians and Gynaecologists in the UK which recently voted by a large margin in favour of removing criminal sanctions that still cover some abortions in Britain, for example, late term abortions except in cases of disability.
She claimed that an error in clinical judgement regarding the real and substantial risk to the life of a woman, which would qualify for a legal abortion in Ireland, is potentially punishable by a custodial sentence of 14 years for both the mother and her doctor if an identified risk is deemed not substantial enough. “I believe that the definition of substantial risk to life can provide problems for doctors who are worried that if they make a wrong clinical decision, a custodial sentence of 14 years is hanging over both them and their patient.”
But when challenged by Senator Ronan Mullen, she admitted there has been no case law of doctors being prosecuted in Ireland and “one or two cases where doctors have been accused of inappropriate termination of pregnancy” in Northern Ireland, were not on their assessment of risk but on a completely different ground.
Deputy Mattie McGrath noted that at the Oireachtas committee hearings in 2013, “Dr. Mahony and other obstetricians agreed that they did not know of any instance where a needless maternal death had occurred because doctors had felt unable to act to save a woman’s life under the Eighth amendment.”
Deputy Mattie McGrath also asked Dr. Mahony for what specific health conditions she would recommend should be a ground for abortion. She answered: “It would be impossible and would not be wise to provide a comprehensive list of either conditions that can kill someone or cause adverse health outcomes. … What doctors and their patients require is the flexibility to work together in the context of clinical disease in pregnancy to make good sound decisions that will ensure that women are safe.”