Why our abortion law would be more permissive than the British law

Our new video points out that the abortion law currently being proposed by the Government goes even further than the already very permissive British law. The British law means one in every five pregnancies there ends in abortion each year. Here we will set out exactly how what’s on offer in Ireland is more permissive than the British law.

To summarise before going into the detail; at no point in Britain is abortion permitted “with no restriction as to reason”. Here in Ireland the proposed law would permit abortion for any reason up to 12 weeks. It is during the first 12 weeks of pregnancy that more than 90pc of abortions take place.

After 12 weeks, our law would strongly resemble the British law which, as mentioned, is so permissive that one in five pregnancies end in abortion in Britain annually.

Now for the detail. In Britain, abortion is permitted until 24 weeks of gestation on five grounds:

1. The life of the mother is at risk;
2. To prevent grave permanent injury to the physical or mental health of the mother;
3. There is a risk of injury to the physical or mental health of the mother;
4. There is a risk of injury to the physical or mental health of any existing children of the family:
5. When the child suffers of physical or mental abnormalities.

In 2016, 97% of abortions in England and Wales were performed on ‘mental health’ grounds. Two percent were for abnormalities.

(Here the official report: https://www.gov.uk/government/statistics/report-on-abortion-statistics-in-england-and-wales-for-2016 )

In extreme circumstances, which accounted for 0.1% of the total number of abortions in 2016, terminations are also permitted after 24 weeks on grounds A and B.

Let’s compare this with what the Irish government has proposed.

Health Minister Simon Harris’s proposal follows the recommendations of the Joint Committee on the Eighth Amendment to the Constitution. The big recommendation is that abortions should be permitted “with no restriction as to reason [our italics] provided that it is availed of through a GP-led service delivered in a clinical context as determined by the law and licensing practice in Ireland with a gestational limit of 12 weeks”. (2.40)

The Bill would allow abortion on physical and mental health grounds, if “the foetus has not reached viability”. This is not dissimilar to the British law which permits abortion on ‘health’ grounds up to 24 weeks.

The Bill, following the Committee recommendations, would also allow abortion without any limit if “there is present a condition affecting the foetus that is likely to lead to the death of the foetus either before birth or shortly after birth”.

In one respect only is the proposed law less permissive than the British one; it does not list non-fatal disabilities as a ground for abortion. But this is smoke and mirrors. As in countries like Germany, those abortions will be performed on the ‘mental health’ ground, with no gestational limits.

The proposed law also says that before 12 weeks there should be a waiting time of 72 hours between a woman seeing a doctor and having an abortion. This waiting period does not exist in the UK.

Proposal for a GP-led abortion ‘service’ is impractical as well as unjust

Minister Simon Harris wants GPs in Ireland to be the main providers of abortion, and to prescribe the abortion pills to women ‘with no restriction as to reason’ in the first 12 weeks of pregnancy. The vast majority of abortions take place during this time frame.

It is hard to believe he has thought this through properly because his proposed system seems to be unique both in terms of the extent to which it will be GP-led and how late into the pregnancy GPs will be able to prescribe the abortion pill.

The Netherlands is a country that is often portrayed as a model by the pro-abortion side. Last November the Dutch government withdrew a bill that would have permitted the prescription of those pills until six weeks and two days of gestation. After that period, according to the Dutch Department of Health, “the effectiveness [of the abortion pills] decreases and the chance of complication increases”. Only hospitals and clinics currently provide abortion pills.

The bill was rejected on the basis that it would have increased the abortion rates, which have already gone up since 1990. A new similar bill has been proposed again this week by opposition parties, but there seems to be no intention from the government to support it.

In Sweden, which is another country often presented as a model by pro-choice activists, the abortion pill can be given out only in clinics or hospitals, as they have to carry out an ultrasound beforehand and ascertain the age of the unborn child to make sure that a medical abortion is suitable.

In Australia, since 2012, accredited GPs can prescribe abortion pills up to nine weeks gestation but only 1.5% of them have obtained a certification to do this. A recent study investigates the reason for such a low participation.

Apart from obvious ethical motives, there are practical reservations. Some were concerned about it dominating their work or about the “negative impact provision may have on their practice reputation and how this might change the family-focused practice they aspired to run”. Some practitioners didn’t want to be known as the “abortion doctors” and being inundated by requests, particularly coming from patients they wouldn’t know.

Seventy-five percent of the doctors who participated in the study believed that existing abortion clinics should continue to provide the ‘service’.

Some GPs noted that it is too complicated to provide a proper assistance due to logistical constraints with accessing the pills, coordinating ultrasounds and setting up links with hospital for referral. Doctors “had practical experience of the difficulties establishing procedures and accessing supporting services such an ultrasound in general practice settings”.

They found it arduous “to organise an ultrasound in a timely manner and order anti-D immonuglobulin for women who were Rhesus negative.”

These reservations were expressed in a context where abortion is already provided extensively by hospitals or clinics. One can easily imagine how unworkable would be the model proposed by Minister Harris, where GPs are the primary providers.  A model that doesn’t exist in other countries.

The impression is that this Government, and Minister Harris in particular, have not really considered the full implications of their proposal. In the rush to have a piece of legislation available before the referendum, they simply are implementing the recommendations of the Joint Committee.

It’s no wonder the National Association of General Practitioners has strongly objected to Minister Harris not consulting with them on the proposal.

A conscience provision must fully protect pro-life doctors

Minister Simon Harris has pledged to allow doctors to conscientiously object to providing abortion pills, in the event of the pro-life amendment going. But how much protection is he willing to allow? For example, will doctors opposed to abortion be forced to refer women who doctors who don’t oppose abortion, which is a form of facilitation?

Minister Harris said the provision would be based on the Protection of Human Life During Pregnancy Act 2013. What protection of conscience does this provide?

Conscientious objection has been variously defined but it is based on the principle that a medical professional should not be forced to participate, directly or indirectly, in procedures to which they object for reasons of conscience.  Conscientious objection is a human right internationally acknowledged and its provision is a regular feature of laws regulating abortion.

It could be said that conscience is at the foundation of the medical profession and every action should be inspired by a well-formed moral conscience. Conscience-based refusals are particular instances of the exercise of conscience and require a particular protection. In accommodating them, the State recognises that certain issues are highly divisive both in society at large, and among health care professionals in particular.

The Protection of Life During Pregnancy Act (PLDP) 2013 recognises conscientious objection but only up to a point. Article 17.1 says: “nothing in the Act shall be construed as obliging any to carry out, or to assist in carrying out, any medical procedure …. to which he or she has a conscientious objection.“

So far, so good, but two subsections on, there is the requirement to refer. It says an objector should “make arrangements for a transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the medical procedure concerned.” (17.3)

Let’s consider first the positive elements, with regard to conscientious objection, of the PLDP Act 2013.

The provision is broad in scope and regards anyone who potentially might be involved in an abortion. Let’s recall that the Act permits a termination of pregnancy where the life of the mother is in danger (which was permitted under the 8th amendment anyway), but extends this to include women deemed to be suicidal.

Article 17 doesn’t specify precisely which health professionals exempted but it refers to “any”. Also, “medical procedure” is a broad expression and could include the prescribing of any drug, including lethal ones like the abortion pill.

It is good that it does not limit conscientious objection to doctors, or nurses, but to anyone who might be potentially involved. Medicine, nursing and pharmacy are interdependent in health care, and conscience protection should be extended to as many classes of professionals as possible, including students.

However, there are at least two highly problematic elements in this piece of legislation. Firstly, conscientious objectors are obliged to refer to other doctors, when they don’t want to perform abortions. This is a case of indirect participation in abortion that many would find not acceptable. Secondly, the right of conscientious objection is given only to individuals, and there is no way an institution can opt out, including pro-life hospitals, Catholic or otherwise.

In the unfortunate event that the referendum to repeal the 8th amendment passes, the State should assure that the accommodation of access to abortion does not adversely affect those who don’t want to be directly or indirectly involved. Obliging doctors, or any other professional, to provide information of where the service is performed or, even worse, to make arrangements for a transfer of care, means forcing them into an indirect participation to the procedure. (Should a doctor who will not give a person a lethal injection be forced to refer to a doctor who will, if assisted suicide is ever introduced?)

To those who claim that accommodating health care professionals’ conscience-based refusals should not prevent a patient from receiving the procedure they have requested I answer that it is the State, rather than the conscientious objector, that should be responsible for assuring that this happens.

No matter what happens to the 8th amendment, doctors and other medical professionals must be allowed to practice only medicine that truly heals and which does not result in the death of one patient, in this case the unborn child.