Tuesday 23 May 2017

Eilish O’Regan: Little clarity as medical experts offer conflicting evidence

Doctors might have swept open their surgery doors at the Oireachtas committee hearings yesterday in a bid to bring clarity to the abortion debate.

But their evidence also revealed the tightrope walk ahead for officials who must draw up the legislation.

Their task will be to come up with wording which will not fetter the doctors working in the best interests of their patients while also guarding against opening the floodgates to abortion.

The controversial and burning issue of allowing a suicidal woman to seek an abortion sparked the most conflicting evidence from psychiatrists.

Mater Hospital specialist Dr Patricia Casey suggested that legislating for this would indeed lead to the breach of the flood barriers.

This was rejected by other colleagues. But they all outlined the complexities of medics judging if a pregnant woman threatening suicide, unless she has an abortion, will take her life.

This was compounded by psychiatrists admitting that while they are trained to assess risk, they cannot predict if a woman will go on to commit suicide.

For every 100 suicides they predict, just three will materialise.

So does this open the prospect of 97 pregnancies being terminated needlessly? What sort of checks and balances in the legislation and regulations can minimise the chances of this happening?

While some of the delegation of psychiatrists believed one doctor can make the assessment others said the decision should be made by two. But is this kind of panel an overly bureaucratic hurdle to put in front of a woman in such distress? The easier option would be just to go to the UK for an abortion if she can afford it.

Clarity did emerge, however, on the question of whether there are pregnant women who are at serious risk of suicide unless their pregnancy is terminated.

The majority view is that this kind of crisis can emerge although it affects a very small number of women.

But there was more confusion about the right of doctors to conscientious objection. This has been raised by some obstetricians in the 12 maternity units across the country where there are just three senior doctors employed.

In the evenings and at weekends just one obstetrician is available in the small to medium-sized units. How will the new legislation make provision for conscientious objection while also ensuring the life of the mother is not compromised?

Medical Council President Dr Kieran Murphy said those with conscientious objections must make them known to the patient and make the names of other doctors available to them.

Holles Street Master, Dr Rhona Mahony, was adamant that the new legislation must be broad enough to allow obstetricians to be flexible in their judgment in grey areas where the risk of life of the mother is probable.

"Doctors must be trusted," she insisted.

The voices of one key group of doctors was absent yesterday.

GPs are the gatekeepers who will be crucial in referring a pregnant woman who is suicidal and seeking a termination for psychiatric assessment.

Their role has yet to be clarified.

Irish Independent

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