Irish legislation on abortion could be psychiatrists’ “nightmare”

The Chairman of the Irish Association of Suicideology has said that legislation based on the X Case – as proposed to the Fine Gael-Labour coalition government in Ireland – would create a ‘logistical nightmare’ for psychiatrists if implemented. Dr Justin Brophy, a consultant psychiatrist with Wicklow Mental Health Service said this in an interview with an Irish language newspaper, Gaelscéal.

The proposal for this has come from an expert set up by the Government to propose options to it for meeting an obligation placed on it by the European Court of Human Rights to clarify the country’s law on abortion. This group has been described as flawed in its composition by pro-life activists in Ireland.

Part of the complaint about the expert group’s work is that it is alleged to have misrepresented the judgement of the ECHR judgement. The Court did not oblige the Irish Government to legislate for any form of abortion in Ireland; it simply obliged it to “clarify” its laws with regard to the position of pregnant women who might be demanding abortions. The group has proposed options for legislation to the government which prolife people say will inevitably lead to abortion on demand because of its acceptance of the terms of the X case admitting threats of suicide as a definition of a threat to the life of the mother.

Dr Brophy said that medical judgements can be wrong and psychiatrists will be on a “hiding to nothing” if asked to adjudicate in these cases. He added if a law were passed allowing for abortion on the terms of the X case that there would be public outrage if a pregnant woman took her own life after a being refused an abortion based on a psychiatrists view that she was not suicidal.” Suicidal intent, he said, is an ‘easily fabricated’ condition.

Meanwhile, public protests against the stated intent of the Government to legislate on this matter and the perception that it will do so on the basis of the X case is mounting. Catholic Church leaders are also giving very clear indications that its voice will be heard giving a very clear account of Catholic moral teaching on the issue.

In their statement issued yesterday the bishops said:

A society that believes the right to life is the most fundamental of all rights cannot ignore the fact that abortion is first and foremost a moral issue.

As a society we have a particular responsibility to ensure this right is upheld on behalf of those who are defenceless, voiceless or vulnerable.  This includes our duty as a society to defend and promote the equal right to life of a pregnant mother and the innocent and defenceless child in her womb when the life of either of these persons is at risk.

By virtue of their common humanity the life of a mother and her unborn baby are both sacred.  They have an equal right to life.  The Catholic Church has never taught that the life of a child in the womb should be preferred to that of a mother.  Where a seriously ill pregnant woman needs medical treatment which may put the life of her baby at risk, such treatments are morally permissible provided every effort has been made to save the life of both the mother and her baby.

Abortion, understood as the direct and intentional destruction of an unborn baby, is gravely immoral in all circumstances.  This is different from medical treatments which do not directly and intentionally seek to end the life of the unborn baby.

Current law and medical guidelines in Ireland allow nurses and doctors in Irish hospitals to apply this vital distinction in practice. This has been an important factor in ensuring that Irish hospitals are among the safest and best in the world in terms of medical care for both a mother and her unborn baby during pregnancy.  As a country this is something we should cherish, promote and protect.

The Report of the Expert Group on the Judgement in A, B and C v Ireland has put forward options that could end the practice of making this vital ethical distinction in Irish hospitals. Of the four options presented by the Report, three involve abortion – the direct and intentional killing of an unborn child.  This can never be morally justified.  The judgement of the European Court of Human Rights does not oblige the Irish Government to legislate for abortion.

Other aspects of the Report also give rise to concerns.  These include, but are not limited to the fact that:

The judgement of the European Court of Human Rights permits options on this matter of fundamental moral, social and constitutional importance that are not offered by this Report.  This includes the option of introducing a constitutional prohibition on abortion or another form of constitutional amendment to reverse the ‘X-case’ judgement.

The Report provides no ethical analysis of the options available, even though this is first and foremost a moral issue and consideration of the ethical dimension was included in the Terms of Reference.

The Report takes no account of the risks involved in trying to legislate for so-called ‘limited abortion’ within the context of the ‘X-case’ judgement.  The ‘X-case’ judgement includes the threat of suicide as grounds for an abortion.  International experience shows that allowing abortion on the grounds of mental health effectively opens the floodgates for abortion.

The Report also identifies Guidelines as an option.  It notes that Guidelines can help to ensure consistency in the delivery of medical treatment.  If Guidelines can provide greater clarity as to when life-saving treatment may be provided to a pregnant mother or her unborn child within the existing legislative framework, and where the direct and intentional killing of either person continues to be excluded, then such ethically sound Guidelines may offer a way forward.

A matter of this importance deserves sufficient time for a calm, rational and informed debate to take place before any decision about the options offered by the Expert Group Report are taken.  All involved, especially public representatives, must consider the profound moral questions that arise in responding to this Report. Abortion is gravely immoral in all circumstances, no matter how ‘limited’ access to abortion may be.

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