Top doctor opposes suicide clause in abortion legislation at hearings

The Master of Dublin's busiest Maternity hospital, Dr Sam Coulter Smith, has said the there are 'major ethical and moral dilemma' arising for Obstetricians from the draft legislation currently proposed by the government.  

He also warned of a possible 'surge' in the number of abortions if the proposal became law. Dr Coulter Smith said that there was no evidence that abortion was a treatment for suicidal ideation or intent and, obstetricians were required to provide and practice evidence-based treatment.

"In respect of loss of life from self-destruction there are a number of issues that need to be raised. First, this is an extraordinarily rare situation with the incidence of suicide in pregnancy of the order of one in 500,000 pregnancies as per United Kingdom figures. Second, our psychiatric colleagues tell us that there is currently no available evidence to show that termination of pregnancy is a treatment for suicidal ideation or intent and, as obstetricians, we are required to provide and practice evidence-based treatment," he said. 

He said the legislation, therefore, created an ethical dilemma for any obstetrician who has requested to perform a termination of pregnancy for the treatment of someone with either suicidal ideation or intent.
Dr Coulter Smith said that the fact that there is no gestational limit in the legislation relating to suicidality was a "a major ethical issue for obstetricians". 

"First, let us consider the case of a patient who is 25 weeks' gestation. If she is deemed to be sufficiently suicidal to require a termination of pregnancy by one or more psychiatric colleagues, an obstetrician who is tasked with dealing with this situation is faced with an enormous ethical dilemma. Delivering a baby at 25 weeks' gestation could lead to death, due to extreme prematurity or it could lead to a child with cerebral palsy or with other significant developmental issues for the future."

"This is a source of serious concern for myself and my colleagues," he said.
Dr Coulter Smith also said that many Obstetricians thought the legislation might lead to a surge in the number of abortion being sought. 

"It is my view and the view of many of my colleagues that the inclusion of suicidality within the legislation may, and I stress may, in the long term lead to an increase in demand for termination in this country," he said