Experts divided on the clarity of law on abortion

Two of the country’s most senior experts in maternity care expressed divergent views yesterday on whether Irish law is clear about the circumstances in which a pregnant woman is entitled to an abortion.

While both agree legislation on the matter would be preferable, one consultant asserts that there is no confusion among doctors about the legal position while another describes the situation as “like a sword of Damocles hanging over us”.

Dr Sam Coulter-Smith, master of the Rotunda Hospital in Dublin, said he had not seen confusion among doctors on whether a woman is entitled to an abortion on clinical grounds.

However, doctors have no legal clarity on abortion, according to the former master of the National Maternity Hospital in Dublin, Dr Peter Boylan, whose wife, Dr Rhona Mahony, is the current master.

Dr Boylan, of the Institute of Obstetricians and Gynaecologists at the Royal College of Physicians of Ireland, said we need to act like an “adult state” on the issue of abortion.

“There are some situations where it is very clear that a termination is necessary to save a woman’s life and we will go ahead and do that because we are protected by the law, but in grey areas where there is a probability that a woman might suffer something very serious, up to and including death, where that probability doesn’t reach a level close to certainty, we are in a very grey area and that is where we have great difficulties. We are not protected by the law.

“We do our best but we have to be very careful because if we terminate a pregnancy where a woman’s life is not at great risk, then we are committing a criminal offence and the consequences of that are very grave for the people looking after the woman. Clearly, in certain circumstances, they are even more grave for the woman.”

He added: “I feel the State has a duty to protect the people who are looking after its citizens.”

Speaking on RTÉ radio yesterday, Dr Boylan said: “What we would like to happen is that we can practise medicine in a safe environment legally because the current situation is like a sword of Damocles hanging over us. If we do something with a good intention, but it turns out to be illegal, the consequences are extremely serious for medical practitioners.”

He added: “If it is legislation that is needed, then that is what should be done. What we need is protection and the women need protection. We need to have the threat of doing a criminal act removed from us in order to practise medicine to the highest standard.”

Dr Coulter-Smith said that while it would be preferable to have legislation to bring clarity, he saw no evidence of confusion in medical ranks in Ireland.

“I think most of us who work in obstetrics and gynaecology, there may be individual differences, but the majority would be of the view that if the health is such a risk that there is a risk of death and we are dealing with a foetus that is not viable, there is only one answer to that question: We bring the pregnancy to an end.”

Referring to the death of Savita Halappanavar, Dr Coulter-Smith said: “This case probably does not have a lot to do with abortion laws.

“It is a clinical scenario — someone in the process of miscarriage and had infective complications as a result of that process, whether or not the situation had been actively managed in the 24-36 hours preceding the tragedy of the baby’s death, would that have changed anything? No one can answer that.

“But from the medical point of view it would be nice to have clarity — what is and isn’t possible and feasible.”

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