Analysis of the Abortion Bill

The Life Institute has produced an analysis of the Abortion Bill as it now reads, which explains the scope and effect of the legislation and also reports on some of what happened at the Special Health Committee looking at the bill. Please take time to read through the report below and use it to take action on calling your TDs.

The 2018 Abortion Bill – Analysis and Comment 

Introduction 

The euphemistically titled Health (Regulation of Termination of Pregnancy) Bill 2018 has passed through the Select Committee on Committee and the Dáil and is now in the Seanad

Thank you to the 15 heroic TD's who voted against Simon Harris's disgusting abortion legislation

• Sean Canney, IND, Galway East
• Michael Collins, IND, Cork South West
• Michael Fitzmaurice, IND, Roscommon/Leitrim
• Peter Fitzpatrick, IND, Louth
• Noel Grealish, IND, Galway West
• Michael Healy Rae, IND, Kerry
• Danny Healy Rae, IND, Kerry
• Michael Lowry, IND, Tipperary
• Mattie McGrath, IND, Tipperary
• Carol Nolan, IND, Offaly
• Peadar Tóibín, IND, Meath West
• Mary Butler, FF, Waterford
• Eamon O Cuiv, FF, Galway West
• John McGuinness, FF, Carlow/Killkenny
• Marc MacSharry, FF, Sligo/Leitrim

Stated Purpose of the Bill 

The Bill can be found here on the Oireachtas Website: https://data.oireachtas.ie/ie/oireachtas/bill/2018/105/eng/ver_a/b105a18d.pdf

The Bill states that this shall be “an Act to provide for and regulate termination of pregnancy” and “to make available without charge certain services to women for the purpose of termination of pregnancy in accordance with this Act. In short, it’s an Act to legalise taxpayer-funded abortion. 

Definitions are included in Part 1, Section 2 of the Bill 

The most revealing definition in this section states that: “termination of pregnancy, in relation to a pregnant woman, means a medical procedure which is intended to end the life of a foetus. “It is spelled out in black and white – the bill legalises procedures to end the life of an unborn human child. It also describes a “foetus” as an “embryo or a foetus during the period of time commencing after implantation in the uterus of a woman and ending on the complete emergence of the foetus from the body of the woman”. This definition is clearly designed to allow for the late-term abortions permitted in Section 13  

• Viability is defined as “the point in a pregnancy at which, in the reasonable opinion of a medical practitioner, the foetus is capable of survival outside the uterus without extraordinary life-sustaining measures.” The bill does not say what ‘extraordinary life-saving measures are, and the definition is in marked contrast to that produced by the Royal College of Obstetricians in 2014 which stated that “viability may be defined as the quality or state of being able to live independently, grow and develop”. 

Part 2 of the Bill is entitled Termination of pregnancy 

PART 2, SECTION 11 – ABORTION TO 6 MONTHS ON GROUNDS OF RISK TO LIFE OR HEALTH

Section 11 of the Bill states that a baby can be aborted until viability (6 months) where there is a risk to the life, or of serious harm to the health, of the woman. 

The risk of ‘serious harm’ to health is not defined, and is open to interpretation.Health means both physical and mental health. 

From the Bill – Section 11: Risk to life or health

(1) A termination of pregnancy may be carried out in accordance with this section where 2 medical practitioners, having examined the pregnant woman, are of the reasonable opinion formed in good faith that —

(a) there is a risk to the life, or of serious harm to the health, of the pregnant woman,

(b) the foetus has not reached viability, and

(c) it is appropriate to carry out the termination of pregnancy in order to avert the risk referred to in paragraph (a).

(2) Of the 2 medical practitioners referred to in subsection (1)—

(a) one shall be an obstetrician, and

(b) the other shall be an appropriate medical practitioner.

(3) A termination of pregnancy shall not be carried out under this section unless each of  the medical practitioners referred to in subsection (1) has certified his or her opinion as to the matters referred to in that subsection.

PART 2, SECTION 12 – ABORTION TO BIRTH IN AN EMERGENCY  

This section of the bill allows for abortion without term limits where the risk to life or health is immediate. 

Previously, doctors were free under the 8th amendment to induce the baby and end the pregnancy where there was a risk to the life of the mother, in cases of severe pre-eclampsia for example. 

The bill proposes to allow abortion until birth where a doctor is of the opinion that there is a risk of serious harm to the health of the mother. 

The risk of ‘serious harm’ to health is not defined, and is open to interpretation.  

Health means both physical and mental health.

From the Bill - Section 12: Risk to life or health in emergency

(1) Notwithstanding the generality of section 11, or any determination made or pending pursuant to section 18 of an application under section 15(2), a termination of pregnancy may be carried out in accordance with this section by a medical practitioner where, having examined the pregnant woman, he or she is of the reasonable opinion formed in good faith that—

(a) there is an immediate risk to the life, or of serious harm to the health, of the pregnant woman, and

(b) it is immediately necessary to carry out the termination of pregnancy in order to avert that risk.

PART 2, SECTION 13 – ABORTION TO BIRTH WHERE BABY HAS A LIFE-LIMITING CONDITION 

Abortion is permitted without term limits – up to birth – where the baby has a condition which might mean he or she will not live for at least 28 days after birth. 

The reach of this section of the bill has been extended since the referendum. The first draft of the legislation (in Head 6) stated that abortion was permissible where “there is present a condition that is likely to lead to the death of the foetus either before birth or shortly after birth.

Clearly, the amendment to the draft bill was to make sure that abortion was permitted in as many cases as possible once a diagnosis of a life-limiting condition was made. It has already been established in the medical literature (BJOG, 2012) that doctors can’t say with certainty how long a baby will live after birth, but the Bill allows a doctor to make that judgment based on a ‘reasonable opinion’. 

Most disturbingly, the bill does not include an obligation for pain relief in late-term abortions, although it is undisputed that unborn babies feel pain in the third trimester. 

The Royal College of Obstetricians and Gynaecologists recommends feticide for abortions after 21 weeks + 6 days, and specify that potassium chloride should be injected into the heart of the preborn child to ensure demise. The legal execution of adult prisoners in the United States also uses an injection of potassium chloride, a method which can cause such pain and suffering that both an anesthetic and a paralytic are administered prior to the dose of potassium chloride, according to a recent article in the Washington Post. 

Most disturbingly, the Health Committee – including Fianna Fáil TDs, Stephen Donnelly and Margaret Murphy-O’Mahoney – voted against an amendment which included an obligation to give pain relief for babies enduring such late-term abortions. 

From the Bill – Section 13: Condition likely to lead to death of foetus

(1) A termination of pregnancy may be carried out in accordance with this section where 2 medical practitioners, having examined the pregnant woman, are of the reasonable opinion formed in good faith that there is present a condition affecting the foetus that is likely to lead to the death of the foetus either before, or within 28 days of, birth.

(2) Of the 2 medical practitioners referred to in subsection (1)—

(a) one shall be an obstetrician, and

(b) the other shall be a medical practitioner of a relevant specialty.

PART 2, SECTION 14: ABORTION ON DEMAND TO 12 WEEKS 

Section 14 of the Bill permits abortion for any reason to the twelfth week of pregnancy.
An amendment which would give women the option of seeing an ultrasound or of receiving factual information as to the development of her baby was rejected by the Health Committee.

From the Bill – Section 14: Early pregnancy

(1) A termination of pregnancy may be carried out in accordance with this section by a medical practitioner where, having examined the pregnant woman, he or she is of the reasonable opinion formed in good faith that the pregnancy concerned has not exceeded 12 weeks of pregnancy.

Subsection 4 states that:
(4) For the purposes of this section, “12 weeks of pregnancy” shall be construed in accordance with the medical principle that pregnancy is generally dated from the first day of a woman’s last menstrual period.

PART 3, SECTION 24: CONSCIENTIOUS OBJECTION  

The Bill seeks to force doctors, nurses, midwives, pharmacists, and other medical professionals, to facilitate abortions. 

Section 24 states that such medical practitioners must refer the pregnant woman for an abortion, an action which many doctors have pointed out, goes against their deeply-held moral and ethical beliefs and which will force them to fail in their duty of care to one of their patients, the unborn child. 

The Health Committee has refused to accept amendments protecting the right of medical professionals to conscientious objection, despite fears that the legislation will drive hundreds of GPs out of that field of medicine at a time when a serious shortage of GPs is a significant threat to accessing healthcare. 

More than 600 GPs have signed a petition calling for an EGM of the Irish College of General Practitioners to uphold the right of doctors not to refer. 

In a National Association of GPs poll of members, 85% of GPs felt abortion should not be routine general practice, while only 20% indicated they would be willing to induce abortion.  The NAGP also said its members overwhelmingly agreed that doctors should not be forced to refer and that doctors who wished to provide abortions should avail of an “opt-in” system. 

Doctors were also critical of the fact that Simon Harris proposes to pay €450 to GPs to carry out an abortion over three visits to the surgery, while GPs currently get paid €250 to provide antenatal care for a woman for the duration of her pregnancy.

Nurses for Life have also gathered more than 350 signatures from nurses and midwives seeking to have their right not to facilitate abortions upheld. 

Simon Harris has refused to meet with doctors and nurses on this issue. Amendments proposed to the Bill at Committee stage were rejected. 

Sinn Féin’s Louise O’Reilly stated during the Health Committee debate that doctors should be sanctioned if they would not facilitate abortions. 

However, legal experts have said that, following the victory of the Asher’s Bakery freedom of conscience case in the British Supreme  Court, a legal challenge may be required to ensure freedom of conscience is upheld. 

From the Bill – Section 24, Conscientious objection

(1) Subject to subsections (2) and (3), nothing in this Act shall be construed as obliging any medical practitioner, nurse or midwife to carry out, or to participate in carrying out, a termination of pregnancy in accordance with section 11, 13 or 14 to which he or she has a conscientious objection.

(2) Subsection (1) shall not be construed to affect any duty to participate in a termination of pregnancy in accordance with section 12.

(3) A person who has a conscientious objection referred to in subsection (1) shall, as soon as may be, make such arrangements for the transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the termination of pregnancy concerned.

AMENDMENTS TO THE BILL

16 pro-life amendments were proposed to the Bill. All were rejected by the Select Committee on Health. The amendments sought to: 

• Ensure pain relief for the baby in late-term abortions 
• Outlaw abortion on disability grounds 
• Outlaw abortion on the grounds of gender 
• Ensure aborted babies remains were dealt with in a humane and dignified fashion 
• Ensure the body parts of aborted babies could not be sold 
• Ensure women had the option of seeing an ultrasound of their baby before undergoing an abortion 
• Ensure that women had access to information on the development of their baby before undergoing an abortion 
• Ensure that the right to conscientious objection was included in legislation
• Ensuring that doctors would be obliged to intervene if a baby survived an abortion  

All the amendments were vigorously opposed by the Health Committee members, including Simon Harris who told pro-life TDs from the outset that he wouldn’t be accepting any of their amendments.