Draft ‘could discriminate on mental health grounds’

A leading doctor and barrister has warned that under the draft abortion legislation, a woman who wants to terminate her pregnancy because she is suicidal could have grounds to take a discrimination case on the grounds of mental health.

Under the legislation, such a woman will have to have her procedure certified by three doctors, including two psychiatrists, whereas a woman with a physical ailment only has to have the procedure certified by two doctors.

According to Dr Simon Mills, it might be argued that the process is a form of discrimination on the grounds of mental health “by placing a greater onus on those with psychiatric disorders”.

He also said that the lack of definition of a “real and substantial risk” to a woman’s life allows a doctor to use his or her clinical judgment “based on clinical risk”, and an abortion could possibly be allowed “earlier than would have been allowed when there was no legal guidance”.

He warned on RTÉ Radio that it could be difficult for some doctors to take part in decision-making in these cases as “some have nailed their colours to the mast” by writing letters to newspapers or expressing a public view objecting to abortion in different scenarios.

This opinion was echoed by Dr Anthony McCarthy, consultant psychiatrist at the National Maternity Hospital. He warned that if the process is to be respected, any woman seeking certification for an abortion will need to be assured that they will be given “objective professional advice.

Perinatal psychiatrist Dr Joanne Fenton said suicide in pregnancy was “rare but real” and she and her colleagues were trained to “differentiate between suicidal ideation and a suicide risk”.

The Irish Medical Organisation (IMO) has said that it will not comment on the heads of bill immediately but will discuss it at a meeting in the next two weeks. They will also attend the Oireachtas health committee, chaired by Jerry Buttimer, if the committee asks doctors to respond to the heads. At its annual conference last month, the IMO rejected a motion supporting regulation of abortion in line with the X case. The motion was defeated by 42 votes to 32.

The AGM also rejected abortion in the case of victims of rape or incest who become pregnant and legislation for abortion in the case of a woman with a non-viable foetal abnormality.

The College of Psychiatrists and the Irish Hospital Consultants Association has said it is examining the heads of bill and will not collectively comment on them for the time being.


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