Where does the much-trumpeted legislation for the abortion of unborn children introduced by the Republic of Ireland’s Government now stand? Currently it seems to be in some trouble. It sounds even worse – depending on your point of view – that President Obama’s Obamacare debacle.

The Irish College of Psychiatrists has advised its members not to participate in reviewing cases where women might look for an abortion expressing suicidal thoughts. They want proper clinical guidelines and the provision of these is fraught with difficulty – indeed some would say are impossible because they will be unable to provide doctor with any kind of legal protection.

The College has described the enactment of the Protection of Life During Pregnancy Act without clinical guidelines as “very haphazard and unsatisfactory” and has expressed  “extreme concern” at the absence of any guidance for general medical practitioners on accessing suitable psychiatrists to assess a pregnant woman showing signs of suicidality; at the absence of guidelines for a psychiatrist seeking a second psychiatric opinion; and the lack of training for obstetricians in up-to-date psychiatric issues as well as for psychiatrists in obstetric issues.

The Protection of Life During Pregnancy Act came into force on January 1^st. A “Guidelines on Implementation Committee” was appointed last year by the Department of Health to draw up clinical guidelines on how the legislation would work in practice but this has yet to report.

The Act provides that a pregnant woman who is expressing suicidal thoughts and seeking an abortion may have one if three medical practitioners, including two psychiatrists, have “jointly certified in good faith” that there is a real and substantial risk to her life by suicide which can only be averted by an abortion.

There is also provision for a review panel, to be “established and maintained” by the Health Service Executive (HSE) “of at least 10 medical practitioners”. On this basis the HSE must request medical bodies, including the College of Psychiatrists, to nominate members to be appointed to it. Psychiatrists are not at all happy with this.

Miriam Silke, representing the College, told The Irish Times that until the guidelines were issued the college would not recommend to its members participation in the panel. “We simply do not know when they will be issued. We have not heard anything since the Bill came into law. I presume work is progressing but they aren’t imminent. It is very haphazard and unsatisfactory.”

“Dr Anthony McCarthy, perinatal psychiatrist at the National Maternity Hospital and former president of the college, said the new legislation failed to provide ‘real solutions’ for women in distress. A pregnant woman expressing suicidal thoughts would be seen by a psychiatrist, he said, but if that psychiatrist wanted to get a second opinion it was unclear how this would be obtained, the Times reported.

Dr. Ruth Cullen of the Irish ProLife Campaign issued a statement on the latest debacle on Saturday saying that “the deep-seated flaws in the Government’s new abortion law are starting to reveal themselves.”

Dr. Cullen added: “The Government knew perfectly well when it introduced the law that abortion is not a treatment for suicidal feelings and may in fact be detrimental to women’s health.

“The fact that the Government this week activated the new law without any clinical guidelines in place is further proof that the push for abortion legislation over the past year had everything to do with achieving an ideological goal rather than concern for women’s lives or the lives of their unborn babies.

“The truth behind the deep-seated flaws in the new legislation are starting to reveal themselves. This will only continue as more and more people begin to realise that the new law was never about evidence based medicine but about introducing an abortion regime in Ireland.”

Another fine mess from Prime Minister Kenny and his gifted Minister for Health, Dr. James Reilly.