The suggestion that psychiatrsts who hold a particular view on abortion could be bypassed by GPs is “deeply insulting to psychiatrists working at the coalface of psychiatry,” Professor Patricia Casey has said.

She was responding to remarks made by Dr Anthony McCarthy, former president of the Irish College of Psychiatry in an interview with the Irish Times.

Dr McCarthy said that guidelines need to be introduced in respect of suicidal pregnant women seeking abortions and that there should be a process whereby a GP can bypass the local psychiatrist if they are concerned about the psychiatrist’s “ideological” stance on abortion.

Writing in the Irish Independent today, Dr Casey, who is Professor of Psychiatry at UCD and consultant psychiatrist at the Mater Hospital, said that Dr McCarthy’s remarks suggested that “he believes that psychiatrists with a particular perspective on abortion are not suitable people to carry out suicide risk assessments”.

Dr Casey is also a patron of the Iona Institute.

She added: “Such a view is deeply insulting to psychiatrists working at the coalface of psychiatry. It implies they are unaware of the evidence-based treatments available to them when managing those who are suicidal, including pregnant women.”

Dr McCarthy was, Dr Casey said, “in effect, recommending the blacklisting of psychiatrists who hold views that question the role of abortion as a treatment for suicide prevention, notwithstanding the absence of any research supporting the use of abortion for this purpose”.

She added that his proposal amounted to “a dual-track system for such assessments — one for pregnant women requesting an abortion because of suicidality and another for everybody else”.

Dr Casey said: “Such a system is unworkable. The law states that an abortion should be used when there is a real and substantial risk to the life of the woman, including by suicide.

“But what if a pregnant woman is clinically depressed and is seen by the doctor from the abortion panel for assessment? Who will offer her the first-line treatments (antidepressants and/or cognitive therapy) she so desperately needs to prevent her taking her life — will it be the psychiatrist carrying out the abortion assessment or will it be the local psychiatrist who possibly has a particular ‘ideological’ view?

“If a bypass system is introduced there is a danger that the woman will not have access to interventions from her psychiatrist, psychologist or the community nurse, as the once-off assessment will focus solely on deciding whether she should be granted an abortion.

There will certainly be a delay in her receiving the necessary treatments from her local service. This process could undermine pre-existing doctor-patient relationships. It will be interesting to see how many requests for an abortion are refused.

“The local psychiatrist should be the person to carry out the initial assessment. In some instances the woman may already be a patient. The psychiatrist may decide that abortion is not the solution to her suicidality and that is a clinical judgment that every psychiatrist has a right to make.

“If, however, the decision is that an abortion may be necessary to save her life, then, even a person with conscientious objections themselves, under the current law, has to refer the woman to another doctor to facilitate access to this service.

“Excluding some psychiatrists from making a decision in respect of abortion simply because of their personal position on the issue is at best discriminatory.

“By the same token, it would be regarded as preposterous if a solicitor wished to have certain judges excluded from hearing a case on the grounds that they might not be sympathetic to their client.

“Short-circuiting an established process for suicide risk assessment by allowing direct referrals to doctors who are disposed towards abortion is arguably against the law. The response of the Department of Health to this astonishing suggestion is eagerly awaited.”