Obstetricians clash over suicide grounds fears

There may never be an abortion carried out in Ireland on the grounds that a woman is suicidal because she is likely to travel to England in such circumstances, according to the Master of the National Maternity Hospital , Rhona Mahony.

However, her counterpart in the Rotunda Hospital, Dr Sam Coulter Smith, took a different view, saying the suicide grounds in proposed legislation may lead to an increase in demand for terminations.

Both of the country’s leading obstetricians were speaking during the Oireachtas Health Committee hearings on the Protection of Life during Pregnancy Bill.

The question of whether the inclusion of suicide grounds will lead to an “opening of the floodgates” for widespread abortion is continuing to exercise a number of Fine Gael TDs with concerns about the legislation.

Dr Mahony said there should be no distinction to a threat to life from physical illness or through what the legislation describes as self-destruction.

She said women should be allowed terminations if there is a risk of dying by suicide — even without the Supreme Court ruling on the X case, which determined this to be constitutionally lawful.

“Suicide is death. We are legislating here for the risk of death. When you commit suicide, you die,” she told the committee hearings.

“This bill is not about legislating for suicidal intent in pregnancy. This bill is not about suicide, it is about the risk of a woman dying, whether that is mental or physical.”

Any legislators who wanted the suicide grounds removed should ask themselves if they were certain women would not die as a result, said Dr Mahony.

“Are we all absolutely certain that when a woman — who does not plan to be pregnant, who is so distressed by her pregnancy that she tells us she wants to kill herself — can we all sit here and say ‘I am absolutely certain she will not kill herself’? I can’t.”

All medical experts who appeared before yesterday’s committee agreed that it was extremely rare that a pregnant woman would seek an abortion on the grounds that she was suicidal.

“We may never see a woman presenting through this process with suicide intent, she will likely go to England,” said Dr Mahony.

However, Dr Coulter Smith said: “It is my view, and the view of many of my colleagues, that the inclusion of suicidality within the legislation may, and I stress ‘may’, in the long term lead to an increase in demand for termination in this country.”

Under the proposed laws, the risk of suicide will be assessed by one obstetrician and two psychiatrists — including one attached to the hospital where the abortion takes place.

The Irish Medical Organisation - which represents over 5,000 doctors — told the committee that an obstetrician should not be required to determine the risk of suicide. This should be done by two psychiatrists in consultation with the woman’s GP, it said.

The Irish Medical Council also said the certification of two psychiatrists would suffice.