Sunday 17 February 2019

There's something rotten when legal fees take priority over a hospital bed

Thousands of people took part in the annual ‘Rally for Life’ march in Dublin over the weekend. They were met by Pro-Choice groups campaigning to repeal the Eighth Amendment. Photo: Fergal Phillips
Thousands of people took part in the annual ‘Rally for Life’ march in Dublin over the weekend. They were met by Pro-Choice groups campaigning to repeal the Eighth Amendment. Photo: Fergal Phillips

Fionnán Sheahan

It's not often you see those of a Pro-Choice or Pro-Life perspective agreeing on anything.

As this weekend's march and counter-protest in Dublin displayed, the abortion debate is as polarised as ever.

It is impossible to see how whatever proposal is put forward by the Government in a referendum next year will satisfy either side.

The referendum will be won and lost in the middle.

And yet life and choice campaigners were unified in highlighting a case that shows the complexity of the issue that will be put to voters.

In the Irish Independent on Saturday, the full, and often sad, story of a suicidal girl who gave birth to a baby three weeks after a legal order to terminate her seven-month pregnancy was told.

The distressed 16-year-old was put in a psychiatric hospital when she was seeking an abortion. She was later discharged as it was determined she had no mental health disorder - just three days after being legally granted a termination on "suicide" grounds.

The baby was born seven months into the pregnancy and is now living with the girl and her mother.

Pro-Choice activists point out a suicidal teenager was placed in a psychiatric unit when she sought an abortion.

Pro-Life activists point out the baby was born.

Due to reporting restrictions imposed by the court to avoid identifying the girl and circumstances around the case, the identity of the girl and the names of the facilities where she was treated were not included.

This newspaper went above and beyond to ensure nobody would be identified and also presented the story without any commentary.

However, this case does raise fundamental questions about the existing abortion legislation and the resourcing of mental health services.

Moreover, the pressure on health professionals in our maternity hospitals and psychiatric facilities is brought into sharp focus.

The case of this schoolgirl poses more questions than answers - yet the frontline health professionals have to come up with answers themselves in the absence of clear direction.

The contradiction in law is clearly apparent.

Psychiatrists assessing the girl under separate laws over a 48-hour period gave seemingly opposing views on the girl's mental health:

under the Protection of Life in Pregnancy Act, 2013, she was deemed to be suicidal and granted a termination;

under the Mental Health Act, 2001, she was deemed to not be suicidal and released from a psychiatric hospital.

A District Court hearing to remove the detention order on the girl only heard the evidence from two psychiatrists who concluded she was not suicidal, did not have a mental illness and was not an immediate threat to herself or to anyone else because of a psychiatric disorder.

There is no implied criticism of their assessment.

However, it was at odds with the view of the two psychiatrists who made the assessment on abortion grounds. Legal sources say this wasn't relevant to the case at hand.

So, a 16-year-old girl was both suicidal and not suicidal at the same time.

And in the period running up to the termination of her pregnancy she did not receive psychiatric treatment - despite the State officially diagnosing her as suicidal.

Meanwhile, the obstetrician assigned the case has to weigh up all the complexities.

When she presented at a regional hospital in deep distress, she spent the weekend in the antenatal unit, even though this was an inappropriate setting for a girl deemed to be at risk of suicide and self-harm by the in-house psychiatrist.

However, the staff at the hospital had no choice as despite efforts to get her a bed in an adolescent psychiatric facility, none was available.

A fortnight later, when the girl's case came before the District Court in Dublin, there were five legal teams in the courtroom, comprising Senior Counsel, Junior Counsel and solicitors representing the HSE, the Attorney General, the girl, her mother and the unborn child. Costs were awarded by the State for the five legal teams.

So when this girl needed urgent psychiatric attention, there was no acute bed available. But the taxpayer forked out the legal fees for five legal teams.

Something is rotten in our State when this is the order of priority.

And there's nothing black and white about this debate.

Irish Independent

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