29 key questions in the Eighth debate
With 72 hours to polling day, huge numbers of people a have yet to make up their mind as how to vote. Today, the Irish Examiner is seeking to answer most, if not all, of the questions which have arisen in recent weeks and which remain unresolved in the minds of voters. We want to provide information to all voters to ensure they have answers to any questions they have before going to the polls, without prejudice or favour to any side of the debate, writes
In November 1982 the Fianna FĂĄil Government proposed a Bill for the Eighth Amendment to the Constitution, adding a new article 40.3.3 which stated that:
The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and as far as practicable, by its laws to defend and vindicate that right.
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Although Fianna FĂĄil lost power shortly afterward the succeeding Fine Gael-Labour coalition proceeded with a vote on the issue. A referendum was held in September 1983 with a vote of 67% in favour of inserting the Eighth Amendment into the Constitution and 33% against.
Over the next few years, the Supreme Court held in a number of cases that this provision of the Constitution prohibited information within the state on the availability of abortion services outside of the state.
These rulings were overturned by the Thirteenth and Fourteenth Amendments in 1992, which legislated for the right to travel abroad for an abortion and to receive information in Ireland about abortion services abroad.
This Friday, people are being asked if they want to remove (repeal) the Eighth Amendment from the Constitution.
The people will also be asked to insert a clause into the Constitution to allow the Oireachtas to legislate for terminations of pregnancy.
The referendum will not be about any specific legal framework. You will merely be voting to allow the Oireachtas make abortion laws into the future. That will be for the Oireachtas to decide upon if the people decide to vote Yes.
People will be voting on whether or not to approve the Thirty-Sixth Amendment to the Constitution Bill. If approved, this Bill would see the text of 40.3.3 of the Constitution being removed (repealed) and replaced.
The question on the ballot paper will be: âDo you approve of the proposal to amend the Constitution contained in the undermentioned Bill?â
If you support the proposal you will vote yes and if you do not, you will vote no.
Legislation was introduced in 2013 with the Protection of Life in Pregnancy Act which replaced the 1861 Offences Against the Person Act.
This gave effect to the 1992 Supreme Court ruling in Attorney General v. X (more commonly known as the X Case) that abortion is permitted where pregnancy presents âa real and substantial risk to the life, as distinct from the health, of the mother,â including where the risk is through suicide.
The Protection of Life in Pregnancy Act permits abortion in circumstances where two doctors consider that a woman is at risk of dying unless her pregnancy is terminated. The law permits that one doctor can make the decision to terminate the pregnancy if she is at immediate risk of dying.
Outside these circumstances, the Act states that any termination is a crime that carries a prison sentence of up to 14 years for the guilty parties, which include the woman and her doctor.
Notwithstanding the provisions of the Protection of Life in Pregnancy Act, the existence of the Eighth Amendment poses major challenges for doctors when caring for pregnant women. Doctors have to decide how close to death a woman is in order to proceed with termination of pregnancy. The woman has no input into this decision other than to give her consent.
No. Rape is not a grounds for a lawful termination under our current laws.
In the X case, the Supreme Court ruled that as the complainantâs life (a victim of child sexual abuse and rape) was
at risk from a threat to suicide, she was allowed to have a lawful termination in Ireland. That was legislated for in 2013 with the Protection of Life During Pregnancy Act. So as the current situation stands, if three doctors â one obstetrician and two psychiatrists â all agree and certify that a woman is suicidal and the threat of suicide can only be averted if a termination is carried out, then she can be permitted to have it in Ireland. Since it became law, seven such terminations have been carried out.
The 2013 Protection of Life in Pregnancy Act will remain in force unless or until it is replaced by new legislation passed by the Houses of the Oireachtas. Therefore, there will be no legal vacuum while the new laws are being progressed.
The 2013 Protection of Life in Pregnancy Act will remain in force.
The question being put to the people is to remove the Constitutional equal right to life of the unborn and allow the Oireachtas legislate for abortion in the future. It will be for TDs and Senators to decide on what form that law will take.
The Oireachtas committee, in its report, recommended permitting abortions up to 12 weeks without restriction.
In its determination, the Committee was particularly concerned about cases of rape.
It found that it is virtually impossible to test clinically to prove a rape or sexual assault and said requiring such a process would further traumatise a victim of rape. It found that a verification process would be complex or even unworkable in practice.
The committee also expressed its concerns about the increasing use of abortion pills by women in Ireland which are purchased illegally over the internet. It argued that licensed pills are safe and effective when taken under medical supervision.
They are now commonly used in medical termination up to 12 weeks of pregnancy in countries where termination of pregnancy is legal. However, when taken without medical supervision, there are significant risks. Women may take the wrong dose and may be afraid to seek medical assistance if complications arise.
According to the Royal College of Physicians of Ireland (RCPI), 12 weeks is one of three major milestones in pregnancy. The period up to 12 weeks is termed âearly pregnancyâ. The other major milestones are viability â or the possibility of survival outside the womb â at approximately 23 to 24 weeks, and term at 37 to 42 weeks when fetal development has been completed.Up to 50% of pregnancies miscarry in the first four weeks, typically before a woman is aware that she has conceived.
Of the 50% that progress beyond 4 weeks, there is a significant further rate of miscarriage heavily influenced by the age of the woman. A 30-year-old has approximately a 10% chance of miscarriage, whereas, at the age of 40, the rate is at least 35% and increases steeply thereafter each year to 75% from the age of 45.
Termination after 12 weeks of pregnancy will only be permitted when there is a threat to the life or threat of serious harm to the health of the mother, and in cases of fatal fetal abnormalities.
After 12 weeks, the proposed legislation says a termination of pregnancy would be allowed by law if two medical practitioners certify the following three things at the same time:
there is a risk to the life of the pregnant woman or a risk of serious harm to her the foetus has not reached viability and the termination of pregnancy is an appropriate way to avert the risk.
Viability is at approximately 23 to 24 weeks, which is roughly six months pregnancy. The two doctors â one of whom would be an obstetrician â would have to agree that all of these conditions are being met.
Under Simon Harrisâ proposal outlines how it will be lawful to terminate a pregnancy if a medical practitioner (a registered doctor), in his or her reasonable opinion formed in good faith, certifies that it has not exceeded 12 weeks. The General Scheme adds: âFor the purposes of this Head, â12 weeks of pregnancyâ shall be construed in accordance with the medical principle that pregnancy is dated from the first day of a womanâs last menstrual period.â
A foetal abnormality is a condition which is said to likely result in death before or shortly after birth.
The Committee recommended that it shall be lawful to terminate a pregnancy without gestational limit where the unborn child has a foetal abnormality.
The Government has insisted that Ireland will not see the emergence of abortion clinics. The Government is proposing a GP-led scheme where a woman would discuss options with her doctor.
Her medical history is taken to confirm gestation, to ensure that her decision has not been made under duress and that she has no complicating medical condition.
The process of the termination is described. Counselling includes discussion of the range of emotions commonly experienced after a termination.
A 72-hour pause period is included in the draft legislation, following concerns raised by TĂĄnaiste Simon Coveney.
If a woman who is less than 12 weeks pregnant wants to terminate her pregnancy, she will have to visit her GP. After that initial consultation, she will have to wait three days and return for a second visit before she is prescribed the necessary pills. It is envisioned that she will take the first pill while in the presence of her doctor, and the second three days later at home.
Yes. Included in the proposed law is what is called a conscientious objection provision, which will allow any GP who has an objection to abortion to legally refrain.
The so-called âabortion pillâ is used for the medical termination of pregnancy in early pregnancy through the use of two medications, mifepristone followed by misoprostol. Mifepristone blocks the production of progesterone, the hormone that supports the pregnancy before the placenta is developed. Misoprostol causes the uterus to contract and expel the pregnancy.Different doses are prescribed depending on the gestation of pregnancy.
According to the RCPI, medical termination can be completed in a community and home setting before 12 weeks, with only an occasional requirement for hospital facilities.
Mifepristone is prescribed by the medical practitioner and is usually taken at the clinic or GP practice.
Before 49 days (7 weeks) of pregnancy, 200 milligrams (mg) mifepristone is taken orally (i.e. swallowed immediately) followed 24 to 48 hours later by 400 micrograms (mcg) of misoprostol also taken orally. Increasingly, common practice is that misoprostol is taken by the woman herself at home.
Before 63 days (9 weeks), 200 mg of mifepristone is taken orally followed 24 to 48 hours later by 800 mcg of misoprostol also taken orally including by dissolution in the cheek or under the tongue. If termination has not occurred 4 hours after the misoprostol has been taken, a second dose of 400 mcg of misoprostol may be administered orally or vaginally.
After 63 days (9 weeks) and before 84 days (12 weeks) 200 mg of mifepristone is taken orally followed 36 to 48 hours later by 800 mcg of misoprostol administered vaginally. A maximum of four further doses of 400 mcg of misoprostol may be taken at 3-hourly intervals, vaginally or orally, until the termination is completed.
Should the referendum be passed, it will be for the Oireachtas to decide what abortion regime will exist in Ireland. A majority of TDs and Senators would be required to change any future law.
No. The Citizensâ Assembly had recommended that termination of pregnancy should be lawful up to 22 weeks gestation on socio-economic grounds.
However, the committee said that notwithstanding the difficult and varied
circumstances in which pregnant women may find themselves, termination of pregnancy after 12 weeks for socio-economic reasons should not be provided for and considered that the distinction drawn by the Citizensâ Assembly as regards gestational limits is therefore unnecessary.
No. Simon Harris said he would follow the recommendations of the Oireachtas Committee, which argued against allowing for abortion in cases of disability. âThe committee was absolutely clear that this was not grounds for an abortion and the legislation will be in keeping with that, absolutely not,â he said.
The yes side has said the 1983 Eighth Amendment has done enormous damage to womenâs healthcare since its introduction. They argue the time has long since come for Ireland to stop exporting its abortion problem.
The Yes side says abortion is a reality in Ireland already and legislating for it only accepts that reality. Many on the Yes side say the Constitution is not the appropriate place to deal with a womenâs health issue.
They say the Eighth Amendment is the only absolute protection of the unborn in the Constitution and removing it would leave the unborn vulnerable to unjust destruction. The No side also says what is proposed is a radical liberal scheme which will usher in abortion âon demandâ.
They also argue that politicians are not to be trusted to deal with a life and death issue such as this.
This referendum comes in the wake of a number of high-profile deaths in recent years, where the impact of the Eighth Amendment has been cited as a factor.
Among these cases were the Savita Halappanavar in 2012 and the Ms P case in 2014, which involved the keeping alive of a brain-dead woman until a court decided her fate as she was pregnant. (see below)
Since then, we have had a Citizensâ Assembly, which recommended repealing the Eighth Amendment plus an Oireachtas committee report (published last December) which also recommended changing the Constitution.
The two bodies gave different recommendations as to what legislation should replace the Eighth Amendment, should the people decide to repeal it.
In December 2014, the High Court ruled that a young pregnant woman declared clinically brain-dead could be taken off life-support after three weeks because there is no genuine prospect of her baby being born alive.
The case was incredibly distressing, as her body was beginning to decompose while being kept alive as doctors and lawyers argued about what was to be done.
Due to concerns by doctors at the Dublin hospital about the legal implications of her pregnancy, arising from the Stateâs obligation to vindicate the right to life of the unborn in Article 40.3.3. â the 1983 anti-abortion amendment to the Constitution â she remained on somatic life-support treatment.
Of seven doctors who gave evidence to the court, none argued that the treatment should continue or that there was any realistic prospect of her baby being born intact even if the treatment continued.
The court also heard the womanâs condition was deteriorating, she had an open head wound and several infections and there were concerns about the effect of this, and the drugs being administered to the woman, on the unborn.
Savita Halappanavar, a 31-year-old dentist of Indian origin, died on October 28, 2012 at University Hospital Galway.
She was 17 weeks pregnant. The cause of death was officially recorded as severe sepsis, E.coli in the bloodstream and a miscarriage at 17 weeks.
Controversy arose following an Irish Times story which says her repeated requests for an abortion were rejected by staff at the hospital who told her Ireland is a âCatholic countryâ. Investigations into her death did not specifically examine whether Article 40.3.3 had any act or part in her illness but two of the three recommended further scrutiny of the law of the day.
Both the coroner and the author of the HSEâs independent investigation, Professor Sabaratnam Arulkumaran made clear that changes in law would be welcome.
Hiqa did not mention the Eighth Amendment or the Constitution in its report, but detailed 13 times where there were missed opportunities to intervene and save her life.
During the Oireachtas committee hearings last year, Professor Arulkumaran said: âIt was very clear to me during the inquiry that the thing preventing the physician from proceeding was the legal issue because she repeatedly said she was concerned about the legal issue. I will give a little bit of explanation. The mother was sick. There was no question about that. Even at the last minute, they were using a hand probe to see whether the babyâs heartbeat was present or not. Any junior doctor would have said it was a serious condition and they must terminate. They were just keeping her going because of the mere fact the heartbeat was there. The legislation played a major role in making a decision. Somebody else might say they would have done the termination much earlier. That is a personal interpretation. It is why things are made difficult because of the legislation. I agree that if the legislation had been different, Savitaâs case would not have happened.â
The no side is saying strongly that it will, that the introduction of abortion will merely normalise the killing of babies in the womb.
Those in favour of repealing say it will not. Even if the Governmentâs proposals are introduced by way of legislation, Ireland will still have one of the most restrictive abortion regimes in the developed world.
Many people who feel the status quo requires change but feel the 12 weeksâ proposal goes too far are unsure of what to do. The vote on Friday is not a vote for 12 weeks directly, as it merely is about whether or not to give the Oireachtas the right to set the laws governing abortion in Ireland.
There is also increasing doubt as to whether this DĂĄil will ever get to pass new abortion laws if the people vote in favour of the referendum.
Not explicitly.
In March, the Supreme Court ruled that the unborn have no rights under the Constitution other than the right to life in the Eighth Amendment.
The seven judges of the Supreme Court found that the unborn do not possess inherent constitutionally protected rights other than those expressly set out in the Eighth Amendment.
However, they found that the minister âis obligedâ to consider pregnancies and the rights that the unborn will acquire on birth âas a relevant factorâ in deportation cases.
The Referendum Commission is the official neutral body to give information to the public.
www.refcom2018.ie
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