Protection of Conscience Project
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Service, not Servitude

Service, not Servitude

Seanad Éireann

Report and Final Stage Debate: 13 December, 2018

Health (Regulation of Termination of Pregnancy) Bill 2018

Extracts re: Conscientious objection (P. 375-476)

Copyright the Houses of the Oireachtas. Reproduced under the Oireachtas (Public Sector Information – Open Data) Licence. Links, comparative tables and annotations added by the Protection of Conscience Project.


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[P. 375]

Senator Brian Ó'Domhnaill

I move amendment No. 1:

In page 6, between lines 29 and 30, to insert the following:

“(2) No public moneys shall be provided by the Oireachtas to pay for the carrying out of a termination of pregnancy other than a termination of pregnancy in accordance with section 9 or 10 in a case where there is a risk to the life of the pregnant woman.”.

I welcome the Minister for Health, Deputy Harris, back to the House. This amendment is an attempt to give a voice to the majority of people who indicated, in research carried out by Amárach Research, that they were opposed to funding abortions publicly. According to the research, 44% of those opposed to public funding of abortions also voted "yes" in the referendum. This amendment is also an attempt to recognise that, where possible, the State should provide a mechanism for taxpayers to avoid complicity in the funding of procedures specifically designed to end the innocent human life of the foetus, as the Bill puts it. In this sense, the issue is clearly linked to that of conscientious objection.

Senator David Norris

It is not.

Senator Brian Ó'Domhnaill

This is, in turn, an acceptance of the idea that what we are dealing with regarding abortion is an action in a completely different moral and ethical category to anything else. This is where we will disagree profoundly, as Senator Norris said. To my mind, abortion is a deliberate ending of the life of the foetus and is a wrong action upon an entirely innocent party. To then ask those with profound ethical disagreements with that position not only to offer no objection but also to fund the practice is quite bizarre.

The issue of complicity is, in this instance, not just some vague philosophical idea with no

[P. 376]

real practical implications. We see it in many other areas of our political lives, most notably with respect to the protections ongoing regarding the use of Shannon Airport and the extension of its services. In fact, Deputy Clare Daly, a Member of the other House who ardently opposes the use of Shannon Airport as a violation of our constitutional neutrality, has said that it was "clear by the actions of the Government that-----

An Cathaoirleach

We are not on Second Stage. If this goes on, I will rule very strictly on it. It is not a Second Stage speech. The Senator is speaking about a particular amendment and I do not want him to go into a Second Stage speech or a big rigmarole about this or that. I will be fair today but very strict. Senator Ó Domhnaill is going down the road of a Second Stage speech. I will not allow that.

Senator Brian Ó'Domhnaill

May I ask for a point of clarification?

An Cathaoirleach

I ask Senator Ó Domhnaill to speak to the amendment. He is going on about Shannon Airport on this amendment which is like going on about Niagara Falls and some place down in Kerry.

Senator Brian Ó'Domhnaill

On the point of clarification, am I not supposed to talk about the amendment?

An Cathaoirleach

Yes, but the Senator is making a Second Stage speech. If he keeps going down that road I will rule him out of order. I am trying to be fair but Senator Ó Domhnaill is diverging away from the issue and using material for the sake of using it. I ask the Senator to be cúramach anois.

Senator Brian Ó'Domhnaill

The point with Shannon Airport is critical to this amendment. Deputy Clare Daly in the other House, while making the point about taxpayers funding services to which she objected conscientiously, stated that, "It is clear by the actions of this Government, like its predecessors, that we are complicit in war activities, as promoted primarily by the United States and NATO". I draw the analogy to highlight the perfectly reasonable position we are trying to adopt in this amendment.

Senator David Norris

It is not reasonable.

Senator Brian Ó'Domhnaill

There are those, such as Deputy Clare Daly and perhaps Senator Norris and others, who say that it is hypocritical to adopt the position forcefully that we can somehow wash our hands of complicity just because we are not literally taking part in the action with which we profoundly disagree. Amárach Research has confirmed that people are not comfortable with this action. If we take the 44% figure from Amárach Research on the people that voted "yes" together with the people who voted "no", that is more than one million people who are not happy with taxpayers funding abortions. Interestingly, in other countries where abortion is funded, this is also an issue which has been raised and vigorously contested by both sides of the argument.

In his budget analysis and Department's press release following the budget the Minister announced funding in the region of €12 million for abortion services from January. The figure is irrelevant, but if €12 million is to be made available next year, I note that no regulatory impact analysis outlining where or how the money would be spent was published with the Bill.

Deputy Simon Harris (Minister for Health)

It would not be normal.

[P. 377]

Senator Brian Ó'Domhnaill

The Minister is shaking his head, but no regulatory impact analysis was published with the Bill.

Deputy Simon Harris (Minister for Health)

As I said, it would not be normal.

Senator Brian Ó'Domhnaill

It is when there is an impact on the taxpayer. Good laws are made when we are clear on their implications. For instance, I have looked at some of the figures in the United States where the carrying out of abortions is widespread. The taxpayer covers roughly 24% of abortion costs, which is in stark contrast with what is being proposed here. It has been proposed that the taxpayer cover all of the cost. There are arguments that can be made in that regard. For instance, the vast majority of services available within the health service are based on ability to pay. The medical card system protects those who are not able to access services by allowing them to access care when they cannot afford to pay for it. The Minister is proposing a universal service to be funded by the taxpayer, irrespective of a person's income or financial status.

According to the information I could find, in the United States the cost of an abortion in the first trimester is about $400. In the second trimester it is around $850. Interestingly, the American taxpayer has the protection of legislation. The Hyde amendment which was adopted in 1997 allows the federal government to fund abortion services through Medicaid but only in cases of rape, incest and life endangerment. It tightens the life endangerment exception to permit payment only when a woman's life is threatened by a physical disorder, physical injury or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy. It is quite restrictive and not universally available. In short, the Hyde amendment has never imposed an absolute ban on the provision of federal government funding for abortion services. However, without the amendment, Medicaid would be liable for the cost of an estimated 300,000 to 500,000 additional abortions every year. Only a small fraction of the cost of the 15.6% of abortions financed by Medicaid is paid with federal dollars. In 2010 the federal Government paid for 331 abortions through Medicaid, while states funded 113,000.

The Guttmacher Institute, a pro-abortion institute in the United States, has provided research. We cannot be accused of bringing research to the floor of the House from the pro-life side of the argument only.

Senator David Norris

We are all pro-life.

Senator Brian Ó'Domhnaill

According to the Guttmacher Institute's survey of self-reported reasons for abortion, only 1% of abortions are carried out owing to rape. A further 0.5% are carried out owing to incest. Some 12% are carried out as a result of mothers reporting problems with their physical health, although, according to the Guttmacher Institute, probably only 2.8% of cases involve life-endangering conditions. Its conclusion was that the vast majority of abortions in the United States, or more than 95%, would not meet the stringent Hyde amendment standards. Therefore, the publicly funded system in the United States does not support the cost of 95% of abortions. Here, we are trying to introduce a system under which all abortions will be funded.

Senator David Norris

The Senator is not.

Senator Brian Ó'Domhnaill

In the future we could end up in a situation where the taxpayer would fund private abortion service providers in Ireland. There is nothing whatsoever in the Bill to disallow it.

[P. 378]

Deputy Simon Harris (Minister for Health)

That is incorrect.

Senator Brian Ó'Domhnaill

There is nothing in the Bill to disallow it.

Deputy Simon Harris (Minister for Health)

It is provided for in the Health Act 2007.

Senator Brian Ó'Domhnaill

The Minister can argue that this is not what we are proposing to do.

Deputy Simon Harris (Minister for Health)

It is factually incorrect.

An Cathaoirleach

As Senator Ó Domhnaill is trying to conclude, I ask Members to let him do so

Senator Brian Ó'Domhnaill

I am. There is nothing in the Bill that would prevent the HSE from opening a tendering process for private providers or concluding a service level agreement with them. Therefore, we could end up with a cartel industry funded by the taxpayer.

I continue to be an ardent supporter of the right to life. I am proud to stand with my colleagues to contest an attempt to abridge laws that protect the unborn in our society. I want to reflect on a letter. It is very short.

An Cathaoirleach

The Senator read a letter the other day and it took him six minutes to do so.

Senator Alice-Mary Higgins

It took him 11 minutes.

Senator David Norris

It is happening.

An Cathaoirleach

Please, Senators.

Senator Brian Ó'Domhnaill

It is very short and includes just two paragraphs. It is from Dr. Jarlath Deignan and was recently published in The Irish Times. He wrote:

The HSE, at the behest of the Department of Health, has offered GPs like myself a fee of €450 to provide a termination of pregnancy service to an eligible patient.

This fee is over twice that payable to GPs for providing seven antenatal visits to a pregnant woman (€215), and almost twice the amount payable for an emergency delivery (€230).

Furthermore, the GP care of a newborn child up to the age of six years costs the State a mere €125 per annum.

One wonders if the Department of Health has suddenly become generous after years of cuts, or is simply buying GPs to provide the service.

Either way, it appears that our Government values the destruction of life far more than its protection and care.

Senator Catherine Noone

That is scurrilous.

Senator Brian Ó'Domhnaill

This is exactly what I am talking about. People have a fundamental objection and feel unease at the way the entire agenda is being financed. Surely it is not beyond our wit to devise something along the lines of an opt-in revenue mechanism for

[P. 379]

the publicly funded provision of abortion services. Those who wish to opt in could apply to Revenue which would allow a calculated percentage of their taxable income towards the cost of provision of abortion services. At least, that would avoid forcing those who object-----

An Cathaoirleach

I cautioned the Senator earlier. He keeps wandering from the subject and quoting. If he sticks to the topic, I will be fair to him, but I have already admonished him on at least three or four occasions. He is spreading out the debate as if he was making a Second Stage speech, but I will soon pull the plug on him and it will also affect his colleagues.

Senator Brian Ó'Domhnaill

With respect-----

An Cathaoirleach

The Senator must respect the Chair. I ask him not to get on the wrong side of me. I have been very fair to him.

Senator Brian Ó'Domhnaill

I am talking about an alternative method of funding and speaking to my amendment. I do not see how I am wandering in trying to put forward a proposal-----

An Cathaoirleach

The Senator has meandered a lot like the Mississippi or the Missouri and will soon hit the bank.

Senator Catherine Noone

Also, there are children in the Visitors Gallery.

Senator Brian Ó'Domhnaill

I will conclude soon. I have outlined an alternative mechanism that could be used. It would at least not force individuals who conscientiously object to abortion to pay for the service. More than 1 million people agree that this is a serious issue.

The abortion service is being packaged here as healthcare but I have yet to see where the practice of healthcare can be packaged by killing an unborn baby. That is what this health service amounts to in reality and it is being funded by the taxpayer.

An allocation of €12 million will be provided for abortion services next year, although given the way the Estimates work, additional funding could be provided. Let us take the first trimester figures from the United States and those published by the Department here. I am being generous with the figure. I know the Department has quoted a lower figure than this, but let us say the cost is €500 per abortion procedure and the allocation for the service next year is €5 million. That gives a figure of 10,000 abortions. That is why there is no regulatory impact analysis with this. The Minister does not know the number of abortions, or maybe he does and does not want to tell the public. Will there be 5,000 or 20,000 abortions? How many will there be?

Senator Catherine Noone

The Senator should show a bit of respect for women.

. . .

[P. 380]

Senator Brian Ó'Domhnaill

 . . .

The point we are trying to make is that the amendment is worded to ensure no taxpayer provision would arise. We were not able to word it any other way because of the restriction on tabling amendments that would impose a cost on the Exchequer. Opposition Members cannot introduce amendments that would cost the Exchequer and we cannot tier it. The reality here is that, unfortunately, we do not know how many abortions there will be given that abortion will be unrestricted up to 12 weeks. We are dealing with scarce resources and competing demands. The taxpayer is not left liable for all of the services under the American model. Even if we look at the care provided, as I mentioned, and was outlined by the doctor's letter which I read, it appears that the funding provided for abortion services is much greater than the funding provided for the care the State extends to children who are born. That raises grave questions and would lead us to believe the Government is funding the termination of children to a greater extent than who are born.

Senator Alice-Mary Higgins

The Senator is strongly off topic now.

Senator Brian Ó'Domhnaill

That is the essence of the amendment. This is a topic of grave concern and that is why the amendment has been tabled.

Senator Rónán Mullen

I will try to get through what I have to say on this amendment as quickly as possible.

Senator David Norris

Will I get an opportunity to contribute?

An Cathaoirleach

Yes.

[P. 381]

Senator David Norris

Thank you very much.

An Cathaoirleach

To be fair to everyone, Senator Mullen is reminded that he must formally second the amendment.

Senator Rónán Mullen

I second the amendment and, if I may at this stage, I will also second the consequential amendments Nos. 44 and 47, if that is the Cathaoirleach's wish.

An Cathaoirleach

On a point of procedure, if Senator Ó Domhnaill's amendment is not formally seconded, it falls.

Senator Rónán Mullen

I have seconded the amendment. The amendment arises out of a discussion on Committee Stage but it was not the subject of an amendment on Committee Stage. I raised the issue of the funding of abortion from taxpayers' funds on Second Stage. . .

[P. 387]

Senator Brian Ó'Domhnaill

. . . Taxpayers are entitled to conscientious objection on a moral issue of life or death. This is a life-or-death Bill. . .

[P. 389]

[Fewer than five Senators indicated that they wished the amendment put to a vote.  The amendment was declared lost.]

[P. 391]

Senator Colette Kelleher

. . . I am encouraged by the draft guidelines for general practitioners issued by the Irish College of General Practitioners. They are good, clear, sensible and enabling guidelines. I hope the Institute of Obstetricians and Gynaecologists will follow suit with similar enabling guidelines for its members and not allow any conscientious objectors to hijack those guidelines. . .

[P. 401]

Senator David Norris

. . . The effect of my amendment would be to delete the requirement for a three-day waiting period. This has been discussed so I will not go into it in any great detail. We run up against cases where some pregnant women will have to attend multiple meetings with doctors. A case was also instanced on Committee Stage where a woman was refused an abortion because the doctor had a conscientious objection. She came up against that hurdle and that lengthened the time. I am seeking the deletion of the three-day waiting period. . .

[P. 402]

Senator Lynn Ruane

. . . On amendment No. 18, it is something on which we have never had a clear answer. Where a woman's first access to a doctor results in a conscientious objection, having waited for an appointment and visited the doctor only to be told that an abortion would not be provided for her, I want to ensure that once she had subsequently found a provider who would give her the service she needed, that she did not have to wait a further three days. Awareness campaigns do not always reach every community. Will the Minister justify why we would not allow for the three-day period to begin from the first doctor's appointment, even if it resulted in conscientious objection?

[P. 404]

Deputy Simon Harris (Minister for Health)

. . . I cannot accept the amendment regarding conscientious objection for several reasons but primarily because the legislation states clearly that the certification needs to take place before the three-day period commences.

I worry about the consequences it would have, therefore, throughout the legislation beyond this amendment. We have taken every effort to minimise conscientious objection being a barrier, while respecting the right of people to hold it. Let me be clear on that on the record of the House. We know, however, that women do not operate in the way in which some people have tried to characterise them during this debate. Women will not be going around from doctor to doctor in the hope of finding medical assistance. There will be the 24-7 helpline, the www.myoptions.ie website and advocacy groups will have to be informed of these new provisions. That is to minimise the possibility of a woman ever having to come across the awfully undesirable situation for her where she is asking for help and the doctor states that he or she is not in a position to do so or is not willing to do so. I believe we can significantly overcome the issues, from an access point of view, in respect of conscientious objection through the measures we have taken and the measures our medical community and clinical leaders are actively taking.

[P. 424]

Senator Brian Ó'Domhnaill

I move amendment No. 28:

In page 15, line 8, after “practitioner,” to insert “pharmacist,”.

Senator Rónán Mullen

I second the amendment.

Senator Brian Ó'Domhnaill

I wish to touch on some of the points made on Committee Stage. This amendment relates to the role of the pharmacist, in particular. I understand the Irish Pharmacy Union has written to the Minister on the issue and is awaiting a response. I have noted that the Minister's thinking seems to be along the lines that the code of conduct for pharmacists covers this issue. I know that on Committee Stage Senator Reilly referred to the code as providing for a conscientious objection, but that is not the case. I have since been contacted by pharmacists and their representative bodies to clarify a number of points and raise their valid concerns on the issue of conscientious objection.

The first point is that the current code which is the equivalent of the 2009 set of guidelines of the Pharmaceutical Society of Ireland does not reference conscientious objection and/or freedom of conscience, religion or belief. The second point is that the new draft code which was available during the summer for public comment does not reference conscientious objection and/or freedom of conscience, religion or belief. I have with me a copy of the draft code. Pharmacists believe there is no explicit reference to their right to conscientious objection in either the 2009 code of conduct or the new draft code of conduct. Of course, the main issue

[P. 425]

for pharmacists who have a conscientious objection to the Bill, irrespective of whether it will or will not be mentioned in the code of conduct, is that the matter has not been addressed. Following public consultation during the summer, the 2018 draft code of conduct was published.

It reads: "Always put the patient first and make their health, wellbeing and safety your primary focus". I agree fully with and support such a requirement.

The draft code continues:

Make sure patients' needs are recognised, assessed, responded to and that their dignity is preserved and values respected. Decision making must be evidence based. Apply your knowledge and skills to ensure the patient receives safe and effective care. Recognise that your decisions and behaviour can influence patient care even if you do not work in direct contact with the patient.

The main principle refers to communication and appears to shift in the 2018 draft code is as follows:

Communicate effectively so that patients receive safe and appropriate care. Build successful working relationships with patients, colleagues and other healthcare professionals in order to deliver person-centred care. Ask relevant questions, listen carefully and respect confidentiality. Welcome questions from patients and respond to them.

Pharmacists who have concerns emphasise the shift in care to encourage adapting treatment to suit a person's individual needs. In their view, it blurs the line of who bears final decision-making responsibility for offering or denying a treatment. By way of example, I will outline one of the concerns of pharmacists. Codeine is safe in certain circumstances and a patient may want to take it to treat a cold. However, a professional will tell him or her that it is not appropriate and will refuse to supply it.

The pharmacists outlined additional concerns about the 2018 draft code, which reads:

Work in partnership with patients and members of all healthcare disciplines in order to ensure that the patient receives safe and effective care. Collaborate with your colleagues and other healthcare professionals.

In order to satisfy this principle, you:

1. Must enable patients to make their own choices about their healthcare and wellbeing by involving them and supporting them in decision making ...

5. Must refer patients to an alternative provider if you cannot provide a professional service or medicinal product so that patient care is not jeopardized or compromised.

6. Must work cooperatively with your colleagues and other healthcare professionals and you should respect their skills, expertise and contribution to patient care.

That is a major concern for pharmacists and to completely rewrite the 2009 code of conduct. The new draft code of conduct seems to have been completely rewritten in order to bring this legislation into consideration.

The pharmacists noted that in healthcare the patient was referred to when the practitioner was unable to provide what they considered to be the necessary or appropriate diagnosis of

[P. 426]

treatment. Where the practitioner does not think a treatment is appropriate, he or she does not refer, which is normal practice. Clearly the new section that has been inserted into the draft code of conduct is all about forcing practitioners to act against their own professional and conscientious judgment and the issue of termination of pregnancy is reinforced. It appears that the draft code is in line with the Minister's thinking as it almost forces pharmacists to act without having the fallback position of conscientious objection. There is nothing in the new code of conduct to protect pharmacists with a conscientious objection. The Irish Pharmacy Union has raised this matter, about which it has written to the Minister, but as of today before coming into the Chamber it has not received an assurance. That leaves them in a very difficult position because they are being forced against their conscience and will to do something in which they explicitly do not want to be engaged.

Our amendments revolve around conscientious objection. I refer, in particular, to amendment No. 28. Amendments Nos. 29 to 31, inclusive, also deal with pharmacists. Amendment No. 32 deals with medical practitioners and doctors who have a conscientious objection. They have been unfairly categorised for having a conscientious objection to the legislation. That is very unfair on medical practitioners throughout the country who genuinely conscientiously object to it. There is a medical doctor seated in the Visitors Gallery who has a conscientious objection to it. It would be very wrong if such persons were forced to undertake something about which they have strong views. Our amendments are merely about respecting their religious and moral beliefs and professional judgment.

In addition, some of our amendments cover student doctors, but I suspect they have been ruled out of order. However, on Committee Stage we talked about student doctors, nurses and midwives and I know that the Minister gave an undertaking to Deputy Donnelly when he raised some of these concerns in the other House. The Minister agreed with him on student midwives and nurses.

Deputy Simon Harris (Minister for Health)

We amended it.

Senator Brian Ó'Domhnaill

Late on Tuesday night I read a lengthy letter from a midwife who works in Letterkenny University Hospital. Not everyone agrees with them, but the values and rights of the persons in questin should be respected.

The Irish Pharmacy Union has written to the Minister outlining its concerns. Pharmacists, some of whom are based in Senator Reilly's constituency, have raised concerns with me about this issue. Their rights also deserve to be respected and they are not having a go at anyone. They are professionals who have a conscientious objection to the manner in which the legislation has been structured. All we are looking for is to have their conscientious objection respected in the legislation. We have structured our amendments in such a way as to facilitate and rubber stamp this.

The Minister has referred to the code of conduct for doctors and midwives. I have raised the concerns of pharmacists about their code of conduct. As I have a copy of the new draft code with me, I know that it does not deal with a pharmacist's conscientious objection. In fact, it infers that a pharmacist must refer. That means that when the legislation comes into effect on 1 January, in line with the aim of the Minister, pharmacists will be placed in a position where they will have no right to hold a conscientious objection, which is very wrong. In tabling the amendments my colleagues and I have provided the Minister with an opportunity to address the matter.

. . .

[P. 427]

Senator Ivana Bacik

Amendments Nos. 28 to 32, inclusive, are to section 22 that deals with conscientious objection. As we debated the principle at length on Committee Stage, I will be brief.

Like most of my colleagues on the pro-choice side, I have sat in a very dignified and respectful silence through many hours of debate on Monday, Tuesday and today, but it is important that I outline some of my objections to the amendments. If one looks at the international human rights context of conscientious objection law, one will see that conscientious objection is recognised internationally, but the right is not absolute.

The Committee on Economic, Social and Cultural Rights has held that the exercise of conscientious objection must not be a barrier to accessing sexual and reproductive health services and the UN Committee on the Elimination of Discrimination against Women, CEDAW, has called upon state parties to establish an effective mechanism of referral if health service providers refuse to perform reproductive health services for women based on conscientious objection. Furthermore, relevant European Court of Human Rights rulings establish that governments are obliged to ensure that the exercise of freedom of conscience does not block patients from accessing services to which they are legally entitled.

That is the international human rights framework in which we approach legislating on this important issue and as I said on Committee Stage, this Bill sets that balance correctly. Section 22 gives a right of conscientious objection. Many of us might take a view that this should not be necessary in legislation on abortion as it is not necessary in other healthcare provision legislation, however, I accept that it is here and that there are international legal principles dealing with conscientious objection but where conscientious objection rights are recognised in law, they must be balanced by a duty to ensure that patients can access services and that is critical here.

I have been contacted by pharmacists and I am listening to what those who are putting forward amendments on pharmacy have said. I should also say that my mother worked as a pharmacist for many years so I am very familiar with the pharmaceutical working environment because I have even worked in a pharmacy myself, albeit just as a shop assistant. It is important to note that the current code of conduct for pharmacies about which I spoke on Committee Stage, which was developed by the Pharmaceutical Society of Ireland, already states that where pharmacists are unable to provide prescribed medicines or pharmaceutical services, they must take reasonable action to ensure the services are provided and patient care is not jeopardised.

I know a redrafted code being drawn up to take account of the new legislation and I know the Minister will speak to that but the pre-eminent point in any statement around conscientious objection for any professional, is that pre-eminent duty to ensure that patient care is not jeopardised. That is there in section 22 as it applies to students, nurses and midwives, as well as to other medical professionals and it is there in the pharmaceutical code of conduct.

It is very important that conscientious objection principles are not used as a vehicle to try to undermine patient right of access. I fear that in the lengthy debate on Committee Stage we saw this idea of conscientious objection as conscientious obstruction. I accept that is absolutely not the motivation of some colleagues in putting this forward but we have to be careful that it does not become obstructive of the main purpose of this legislation and the main purpose of this legislation and of the 66.4% of people who voted "Yes" in May was to ensure that women would

[P. 428]

have access to abortion services in Ireland, not medical professionals, and we need to ensure the debate focuses and remains focused on the women who need the services.

Senator David Norris

I will also be brief. If a principle of conscientious objection is allowed, it should extend pretty generally, unless there are specific circumstances that militate against that and that is the question that was instanced by my distinguished colleague Senator Bacik when she talked about conscientious obstructionism. I do not believe for a second that we are at that stage in Ireland. There would not be sufficient people citing conscientious objection to obstruct. I believe in being balanced so I put on the record of the House the judgments of the European Court of Human Rights which said that conscientious objection was perfectly fine except in circumstances where it militated against people obtaining relevant services. An international report on human rights has been cited by my colleague but I would also point to the Irish Human Rights and Equality Commission, which has very clearly said in one of the recommendations I put on the record the other day that it should be extended to other health service workers and that includes pharmacists.

It is a question of balance and we are not at the stage where people would be prevented from having access but if the Minister can produce information on that which shows that access to these kind of services would in fact be seriously obstructed by the operation of this clause, then that is a reason to think about it again. I believe strongly in this Bill. It is an important social advance and I congratulate the Minister on it so I am certainly not seeking to be obstructive but I respect the right to freedom of conscience.

Senator James Reilly

I was not going to contribute because I do not want to delay the passage of this Bill any longer than is necessary. We have had a respectful debate and I appreciate the honesty of Members of this House when they speak honestly, but I cannot attribute that character to Senator Ó Domhnaill. I read directly from the Bill the other day and I read directly from the pharmaceutical code of conduct and I will read it again for the record of the House. Before I even do that, the problem is that the Senator demeans and diminishes everything he has said, some of which was valid, when he tells mistruths in the House because people cannot trust anything he says. That is a real difficulty.

The Senator mentioned pharmacists in my constituency to me. I wonder if he even knows the name of a pharmacist in my constituency. Perhaps he will tell us or he will Google and find out before he responds. The point is that no pharmacist in my constituency has been in touch with me to express concern.

The core point, which Senator Bacik has eloquently put, is that conscientious objection is fully covered in this and on Committee Stage I already made it very clear that I am a staunch defender of that and would defend younger doctors from older doctors in group practice who might be bullied about that. I clearly state here in the House that anybody who has that experience anywhere in the health service, should come to me, anonymously or giving their name, and I will happily defend them here in this House, because that is not something that I would countenance or allow to happen and, as a public representative, I would feel duty bound to highlight it were it to happen. I know the Minister is nodding in assent and I know that he shares those values.

I do not want to delay any further but I refer to part 5 of principle 4 of the new guidelines on page 9 of the proposed code of conduct which makes provision for conscientious objection subject to the pharmacist referring the patient to an alternative provider if the pharmacist can-

[P. 429]

not provide a professional service or medicinal product so that patient care is not jeopardised or compromised. That is crystal clear to me and to anybody who has an honest interpretation of what is on a page in front of them.

With respect to the House, I want to support this Bill and reject these amendments. I fully respect the right of Members to filibuster, prolong and delay as much as they feel they need to and I absolutely respect those 34% of people in this country who decided to vote against the referendum and I have no issue with them whatsoever, but I do have issues with Members who would seek to mislead the House.

Acting Chairman (Senator Gerry Horkan)

I ask Senators to try not to personalise their contributions in future.

Senator Rónán Mullen

As the House would reasonably expect, I will confine myself to grounds not covered by Senator Ó Domhnaill but I will just say that the question of conscientious objection and people's need to express or act in line with their conscience can only be understood in this area by reference to the question of what people believe is legitimate healthcare. The conscientious objection issue arises for people who believe that what they are being asked to be involved with, goes against their deepest beliefs about what is good and true. Whether it is pharmacists, doctors, midwives or students in any of those areas, in the end, they also deserve to be trusted about where they believe they can or cannot get involved.

4 o'clock

Senator Reilly's comments will not be of any consolation to many of the people who have been in touch with me because it is a paternalistic approach that says we will decide how much latitude people shall get if they have a conscience problem in this area.

Senator David Norris

We are legislators. What else would we do?

Senator Catherine Noone

There is total irony in there.

Senator David Norris

He is talking through his hat.

Senator Rónán Mullen

The problem with this is that people who see themselves acting in a context where the State has all the power and all the money, and is in a position to ensure these services will be provided in a way that is widespread, are a million miles away from being what some people would like to call conscientious obstructors even if they wanted to be. It simply has no reality. They are people who for professional and ethical reasons, which may be rooted in faith or, as I said before, in their outlook on life or the simple human rights beliefs they hold that there are two human beings to be cared for and cherished here, do not want to become a cog in a wheel of a corrupt and corrupting process. That is their concern. They are not out to block the State from securing access to what the State now permits. They are people who want to go their own way peacefully and live, work and act professionally according to their values about how they want to care for other people in accordance with the training they received.

Many of them received training at a time when these procedures were unconscionable from a human rights and human dignity point of view. For 35 years, the Constitution had a noble protection of human rights for two patients. Under the guidance of the Government this has now gone but the people who want to care for others remain and they include people who are now in the process of training. We are speaking about doctors, midwives and pharmacists.

[P. 430]

The Minister himself gave a commitment as I understand it. It is not the only promise he has not kept on this legislation. This was that people who were studying or training would also be protected. This is not there in the legislation. Those of us presenting these amendments could have, and perhaps should have, extended our definitions on those studying or training to include student or trainee nurses, midwives and pharmacists.

Senator Ivana Bacik

On a point of information, an amendment was made in the Dáil to include student midwives and nurses. I referred to it in my contribution. The Minister pointed it out on Committee Stage. We have been over this ground several times already. It is there in black and white.

Senator Catherine Noone

Can we also remind Senators not to be personal in their contributions?

Acting Chairman (Senator Gerry Horkan)

I was directing it generally and not specifically at anybody.

Senator Rónán Mullen

I am happy to be directed to the section.

Deputy Simon Harris (Minister for Health)

It is in the legislation.

Senator Catherine Noone

It seems to be fair game when it comes to the Minister.

Senator Rónán Mullen

The Bill states the Act of 2011 means the Nurses and Midwives Act.

Senator Ivana Bacik

May I read it into the record? It states "midwife" includes midwife candidate.

Senator Rónán Mullen

I apologise. I stand corrected. I thank Senator Bacik.

Deputy Simon Harris (Minister for Health)

I did keep my promise.

Senator Ivana Bacik

I am pleased to be of assistance.

Senator Rónán Mullen

It applies to student doctors also.

Deputy Simon Harris (Minister for Health)

Yes.

Senator Rónán Mullen

I am happy to accept that.

Senator Marie-Louise O'Donnell

The Senator is wandering.

Senator David Norris

The Senator was wrong.

Acting Chairman (Senator Gerry Horkan)

I ask Senator Mullen to conclude.

Senator Rónán Mullen

As the Minister can see, I am not allergic to the truth.

Deputy Simon Harris (Minister for Health)

Well ----

Senator Rónán Mullen

Others are.

Senator David Norris

Ha ha.

[P. 431]

Senator Rónán Mullen

People who want to go their way peacefully and, as I said, do not want to get drawn into practices-----

Senator Catherine Noone

Including women who want to go about their healthcare.

Senator Rónán Mullen

I found Senator Bacik's comments interesting. She stated many might take the view there ought not to be any provision for conscientious objectors while acknowledging it is a human right. This goes to the heart of the problem and the heart of the fears that many people have, that there is something about the abortion movement that is not content to let people go their own way peacefully. It wants to co-opt and draw everybody into approval. This is why we have to be very careful to give specific legal protection to those with a conscientious objection.

One person expressed concern to me that the Minister has reassured pharmacists their conscientious objection is provided for in their code of conduct, and averred it is a set of guidelines subject to the law that can change at any time. This person said pharmacists are not satisfied that they are not specifically named in the legislation alongside doctors, nurses and midwives and would like the Minister to clarify why he is deliberately denying pharmacists legal protection under the Bill. It is not enough to say to pharmacists that they are covered by their code of conduct. Doctors, nurses and midwives have similar provisions in their codes of conduct but they are specifically named in the legislation. Senator Ó Domhnaill referred to how they make the point that their code of conduct has no reference whatsoever to the words "conscientious objection" so I will not labour it. This is the principle the Minister is using to imply there is some protection under Principle Four on work with others, and he quoted the fifth point.

Senator David Norris

Can I just point out this is a load of nonsense? Senator James Reilly put on the record of the House the words of the document. I was misinformed and I understand Senator Mullen was also misinformed. I stick by my wish to include pharmacists but there is no point in just simply talking nonsense and putting stuff on the record of the House that is simply not true. Senator Reilly, who is a qualified medical practitioner, has put on the record of the House what the guidelines state and they state, rather to my surprise and I accept this, there is provision for conscientious objection. That is the fact. Could we please move on a bit?

Acting Chairman (Senator Gerry Horkan)

Everyone is allowed to speak once. I take the point Senator Norris is trying to be helpful but I am trying to keep the debate going. People can speak once except the proposer of the amendment and that is it. I ask Senator Mullen to conclude if he can.

Senator Rónán Mullen

I have never claimed to have expertise in this area-----

Senator Marie-Louise O'Donnell

That is quite obvious, Senator.

Senator Rónán Mullen

-----but when it comes to relying on people I have more respect for the professionals who have got in touch with me, who are so worried about this, who have done their homework and who have asked the few in the Dáil and Seanad who share their concerns to represent their point of view, than to allow them to be dissed and dismissed, whether it be by Senator Reilly despite his medical expertise or others in circumstances where there has been so much evasion and misinformation in the Dáil and Seanad.

Senator David Norris

Excuse me, is Senator Mullen challenging what Senator Reilly said? Is he challenging the veracity of what he said?

[P. 432]

Acting Chairman (Senator Gerry Horkan)

Senator Mullen, without interruption.

Senator Alice-Mary Higgins

Misinformation has come from Senator Mullen in this specific debate.

Acting Chairman (Senator Gerry Horkan)

Senator Higgins is next to speak and she will have her time to say what she wants to say.

Senator Rónán Mullen

I am the only one in the House who has shown-----

Senator James Reilly

On a point of order, at no point have I ever said anything that disrespects colleagues, medical, pharmaceutical, nursing or otherwise. I have the utmost respect for them. I am equally happy if the Senator or his colleague-----

Acting Chairman (Senator Gerry Horkan)

That is definitely not a point of order, whatever else it is.

Senator James Reilly

Perhaps the Acting Chairman will allow me a little bit of latitude.

Acting Chairman (Senator Gerry Horkan)

I am giving Senator Reilly latitude.

Senator James Reilly

I thank the Acting Chairman and I appreciate it. I will be very quick. Anybody who has an issue who is in my constituency, as alleged by the Senator, who wishes to write to me directly and identify himself or herself as a medical professional, pharmacist or otherwise I will be very happy to engage with that person.

Senator Rónán Mullen

The trouble is that many people in the constituency in which Senator Reilly resides, and indeed in other constituencies, would not feel comfortable approaching Government figures at this stage because they do not feel listened to or appreciated.

Senator Marie-Louise O'Donnell

That is not true.

Senator Rónán Mullen

In fact, they feel spoken down to.

Senator Aodhán Ó'Riordáin

We can refer them on.

Senator David Norris

They have contacted me, and I am a well-known supporter of this legislation.

Acting Chairman (Senator Gerry Horkan)

Senator Mullen without interruption, please.

Senator Rónán Mullen

At least Senator Norris has a track record of surprising people with his independent thinking on occasions, even if he is - in my view - completely wrong-headed on this issue. What we have had from the Government has been a culture of arrogance and spin right from the get-go.

Acting Chairman (Senator Gerry Horkan)

I ask the Senator to speak to the amendments.

Senator Rónán Mullen

It should come as no surprise to anybody that learn that pharmacists, midwives and nurses do not trust the Minister-----

Deputy Simon Harris (Minister for Health)

Women do not trust the Senator.

[P. 433]

Senator Rónán Mullen

----or, indeed, his predecessor, Senator Reilly.

Senator Catherine Noone

That is a wild generalisation.

Senator Rónán Mullen

It should not come as a surprise.

Senator James Reilly

The Senator does not have an iota of evidence to support the outrageous statement he has made.

Senator Aodhán Ó'Riordáin

This comes from the same crowd that redirected to the Iona Institute's website.

Senator Catherine Noone

It is ridiculous for Senator Mullen to generalise as he has done.

Acting Chairman (Senator Gerry Horkan)

I am trying to keep this debate relatively calm.

Senator Aodhán Ó'Riordáin

If one reads what can be found at that link, one can compare it with the record of the House.

Senator Lynn Ruane

Can the Chair ensure the Senator sticks to the amendments?

Acting Chairman (Senator Gerry Horkan)

I have already made that point.

Senator Lynn Ruane

It is not about making the point; it is about enforcing the point.

Acting Chairman (Senator Gerry Horkan)

I am trying to enforce the point while giving people on every side the benefit of the doubt.

Senator Lynn Ruane

There are specific rules that require us to speak to the amendments. It is not about giving everyone an opportunity.

Acting Chairman (Senator Gerry Horkan)

Yes, but other people have been given a level of latitude as well to make their points.

Senator Lynn Ruane

No, they have not, actually.

Acting Chairman (Senator Gerry Horkan)

Yes, they have.

Senator Lynn Ruane

They have not.

Acting Chairman (Senator Gerry Horkan)

They have.

Senator David Norris

They have.

Acting Chairman (Senator Gerry Horkan)

It is a fact.

Senator Marie-Louise O'Donnell

They have, including yourself, Senator Ruane.

Senator Lynn Ruane

I was given two seconds.

[P. 434]

Senator Catherine Noone

Can we press the amendments?

Acting Chairman (Senator Gerry Horkan)

There are two more contributors after Senator Mullen. I presume the Minister will want to make some points relevant to the amendments as well. Senator Mullen to conclude.

Senator Rónán Mullen

Senator Bacik stated earlier that she and her colleagues had listened in dignified and respectful silence. At the point when she said that, it was mostly true. There had been just a few eruptions over the preceding days. However, there have been more eruptions in the past few minutes, as we are coming to the end of this debate, than there were in all of our debates up to now. I have just one more substantial amendment to present to the House. We are coming to the end of the debate on this far-reaching legislation. I appeal for respect. I am very happy to stand corrected, as I did on a point of legislative detail when it was pointed out by Senator Bacik. I wish other people had been as open to the errors and flaws in their arguments and their legislation. I have repeatedly pointed out those errors and flaws over the past couple of days. I would like to think I have set a standard.

(Interruptions)

Senator David Norris

Out of the mouths of babes and sucklings comes forth truth.

Senator Rónán Mullen

We know who that child is and she is beautiful.

Senator David Norris

She is saying, "Shut up."

Acting Chairman (Senator Gerry Horkan)

Senator Norris, please.

Senator David Norris

I was quoting the Bible.

Acting Chairman (Senator Gerry Horkan)

I know it is nearly Christmas time. People are getting a little giddy. Senator Mullen to conclude, please.

Senator Rónán Mullen

Nuair a bheidh an páiste sin i dteideal vótála, tá súil agam-----

Senator David Norris

Tá Gaeilge mhaith ag an Seanadóir.

Senator Rónán Mullen

-----go mbeidh rotha mór an tsaoil casta agus go mbeidh sí ar ais ar mo thaobhse le formhór muintir na hÉireann.

Senator David Norris

"Rotha mór" is right.

Senator Rónán Mullen

I hope that when that lovely child is in a position to vote, Ireland will again have moved to a better place. I hope she will be on my side of the argument in wanting to protect all human life.

Senator Catherine Noone

Hardly.  I doubut it.

Senator Rónán Mullen

God bless her.

Acting Chairman (Senator Gerry Horkan)

Okay.

Senator Rónán Mullen

Can I just say in conclusion ----

Acting Chairman (Senator Gerry Horkan)

In conclusion.

[P. 435]

Senator Rónán Mullen

-----that regardless of whether the pharmacists who have been in touch with us are correct in their fears, at least it can be agreed that the legislation does not specifically protect them in the way that it protects other professionals? That is why I will support Senator Norris's amendment if he puts it to a vote and that is why we will advance our own amendment. It is important that we respect people's right not to become a cog in the wheel. The Minister was in error when he told the Dáil that there were specific protections to ensure people would not get in trouble arising from their conscientious objection. As I pointed out on Committee Stage, his legislation falls short of that. It provides protection against being victimised by this legislation, but there is no protection in this legislation, as things stand, for people who are made subject to sanctions other than sanctions pursuant to this legislation for wishing to exercise their conscientious objection. That is the problem. The Minister said one thing, but his legislation is doing another. I do not believe Senator Bacik or others can contradict me on that.

Acting Chairman (Senator Gerry Horkan)

Okay, Senator Mullen.

Senator Rónán Mullen

On that basis, I think this will be an area for future legislation.

Senator Mary-Alice Higgins

Most of the comments we have heard were made in response to a very strong misrepresentation of certain individuals. Their statements were misrepresented, as was their relationship with their own constituency, their profession and those they represent. When people are misrepresented and words are put into their mouths or paraphrased, it is appropriate for the record of the House to be corrected. Unfortunately, in this last debate it became necessary for a number of individuals to do that. When Senator Mullen proposed one of these amendments, I was pleased to hear him speaking about "people who want to go their own way" without interference. I presume that when we bring forward legislation in respect of buffer zones to ensure that those who "want to go their own way" quietly can access these services in what might be difficult situations for them, the Senator will be similarly strong on the important principle of allowing them to do so.

Deputy Simon Harris (Minister for Health)

Hear, hear.

Senator Mary-Alice Higgins

The Senator also spoke about people not being "comfortable approaching Government figures". We have had a period of time in history when women were not able to approach almost anybody to talk about the reality of the situations they were in. Now we are bringing in legislation that will bring them some comfort in approaching their doctors to talk about these matters and engage with them. It is clear that what is being spoken about here is not about approach, or freedom, or going anywhere. It is about the obstacles that can or cannot be put in the way. When we considered the last section of the Bill, we heard about proposals to put difficult obstacles that are not medically necessary in the way. I do not wish to go back to that section. In this regard, conscientious objection is clearly provided for. Nobody is saying to any doctor or nurse that he or she must be the person who delivers this service. The point is that the doctor or nurse cannot be an obstacle in the path of somebody who is trying to access an essential service.

Senator David Norris

This is about pharmacists.

Senator Mary-Alice Higgins

Student doctors and nurses are also covered by this section. To be clear, it covers pharmacists as well. I know this because I have campaigned on this issue previously. Right now, there is conscientious objection in respect of the morning-after pill. Young researchers have charted the many obstacles that many young women have faced in trying to access the morning-after

[P. 436]

pill because there is a right of conscientious objection. Conscientious objection exists and is working. It is already being used. Many of those who object to access to the morning-after pill are among those who may become conscientious objectors in this area as well. My colleague has read into the record the simple requirement that exists right now. They do not have to dispense - they simply need to refer onto another pharmacist. This ensures the path being taken by a woman is not blocked. It ensures an arrow is provided so that she can take another direction and go to a different pharmacist. As my colleague has made clear, students are covered in this legislation. It is really important to note that we need to monitor this measure to ensure undue pressure is not put on young junior doctors in the opposite direction. In Italy, for example, conscientious objection was almost a badge that one was expected to wear to make progress up the ladder within medical institutions. I think we are getting the right balance in this Bill. If we are giving people their freedom of conscience, it is very important that we ensure we do not bring about a situation in which there is de facto pressure on them to sign up to conscientious objection in order to make progress within an institution. This comes back to the wider issue of management and progression in our institutions, which I will not open up now. It is a key concern.

On the other side I would want to ensure that any decision on conscientious objection is made by the individual and is not an expectation of his or her working situation.

Senator Aodhán Ó'Riordáin

he issue of conscientious objection is dealt with comprehensively in the Bill but as Senator Bacik has said, if we are to envisage a situation where a woman is in a room with a doctor, and she is distraught and in clear need of a service available as legislated for, and as voted for by the people of this country, are we really going to focus our attention on what the doctor is feeling rather than on the woman? Is that the intent of these amendments? Surely at this stage in our development as a republic, in that very troubling, traumatic and deeply distressing situation the woman and her needs should first and foremost be our focus.

I find it ironic in the extreme that a facade of Christianity is placed over this whole idea of conscientious objection because it is coming from the same stable that would refuse the rights of teachers to conscientious objection when they are asked at interview will they uphold the religious ethos of the school. We can be very sure that their chances of advancement in the teaching profession will be really stunted if they were to suggest that they have a conscientious objection to what they are being asked by a board of management or a principal.

Senator David Norris

Hear, hear.

Acting Chairman (Senator Gerry Horkan)

The Senator should speak to the amendment.

Senator Aodhán Ó'Riordáin

he child to which Senator Mullen referred is mine. I will say this much about my daughter, thank God she has been born in this year so that in years to come she will live within an ideology of care and compassion for women and not the judgmental views of Senators such as Mullen and Ó Domhnaill which would send her across the waves for the care that she needs, feeling like a criminal. Thankfully, in this year we have had a referendum and we are passing legislation that brings her closer to being an equal citizen in this Republic and not a second-class citizen which those Senators would have her remain.

Senator Terry Leyden

I am only participating on this section. I am not participating in

[P. 437]

the other Stages because I totally oppose the Bill.

Acting Chairman (Senator Gerry Horkan)

Can Senator Leyden please stick to the amendment?

Senator Terry Leyden

I will explain why I will speak in this case. I am not participating, except on this section, for a particular reason. I believe a conscientious objection is an honourable thing to have and I will explain why. I take that view in respect of pharmacists, doctors and attendants who bring the patient to the operating theatre. They can conscientiously object and say they will not do that.

I will speak on my own position and want a bit of indulgence here because I did not take time at all.

Senator David Norris

That is the Senator's problem.

Senator Terry Leyden

It might be Senator Norris's problem too. I fully support the idea of conscientious objection because 35 years ago I voted for the eighth amendment. Senator Norris should not be sniffy about it. That Bill was an effort to save the lives of the unborn. Some 139 Deputies voted in favour and 11 voted against. Only six Members of that Dáil are still there and only one Member of the Seanad who voted then is still a Member. I think I should have a small bit of flexibility on this because at least I participated in that particular regard.

Senator Catherine Noone

That is history.

Senator Terry Leyden

Thirty five years later I feel very privileged to be a Member of Seanad Éireann and to uphold the objectives of the eighth amendment to prevent abortions, only in accordance with the wording then agreed. What was lacking in that Bill was that guidelines should have been issued and ministerial orders should have been prepared to assist the work of the medical profession in that regard. That was not provided at that time. It left doctors in a very precarious situation when it came to the question of the equal right to life of the mother or the unborn. I want to make that point clear.

If I voted against abortion then and am against abortion now, and if I was a pharmacist, I would not and could not participate in providing abortion in this country. I would either lose my professional position or go against my conscience.

Deputy Simon Harris (Minister for Health)

That is not true.

Senator Terry Leyden

he Minister can say all he likes. It is a fact that he is pushing this Bill through that has unlimited access-----

Deputy Simon Harris (Minister for Health)

The Senator has not read the Bill.

Senator Terry Leyden

I have read everything about it.

Senator Ivana Bacik

The Senator has not read Section 23.

Deputy Simon Harris (Minister for Health)

It is in Section 23.

Senator Ivana Bacik

On a point of order.

Senator Terry Leyden

Ah, go away out of that.

. . .

[P. 443]

Deputy Simon Harris (Minister for Health)

To get back to the amendments, Nos. 28 to 32, inclusive, I do not have anything useful to add other than to refer to my comments on Committee Stage in which I clearly outlined the way conscientious objection is protected in this Bill. We are at an impasse in terms of people's viewpoints on that and I propose that Seanad Éireann rejects the amendments.

[P. 444]

Senator Brian Ó'Domhnaill

To conclude, and to keep to the amendment, I seek clarification from the Minister. Will he indicate where protection is explicitly provided in the Bill for student doctors?

I want to make a number of points and observations about what has been discussed. The first factual point is that more than 650 GPs have signed a petition to the effect that their rights are not being protected in this Bill. One hundred and sixty-five pharmacists have signed a petition outlining the way their conscientious objection rights are not respected in this legislation.

I want to refer briefly to what Senator Reilly said. It is misleading to suggest that pharmacists' conscientious objection rights are in some way dealt with in the 2009 code of conduct and in the new draft code of conduct, which I have before me. They are not dealt with-----

Senator James Reilly

I ask the Senator to, please, read the document.

Senator Brian Ó'Domhnaill

I will speak through the Chair. They are not dealt with. The document makes no mention of conscientious objection. It merely states that the pharmacist must refer. That is the reason 165 pharmacists have raised their concerns and the reason the Irish Pharmacy Union has written to the Minister but, as of today, it has not received a response. Some of the pharmacists, including pharmacists who have raised this issue with me, would find it a lonely, hollow place if they were to raise those issues with Senator Reilly. That is why I am sure they have raised them with people who are willing to express their concerns in this House.

Furthermore, 500 nurses and midwives have raised concerns about it, while there is a grounding in legislation argument, a 2014 High Court judgment on the issue of conscientious objection and Article 44.2.1° of the Constitution. It was Albert Einstein who once said, "Never do anything against conscience even if the state demands it." We are not following the words of that famous quotation in this Bill.

Acting Chairman (Senator Gerry Horkan)

Does the Minister wish to respond?

Deputy Simon Harris (Minister for Health)

We have acknowledged the fact that I amended the Bill in Dáil Éireann to include student nurses and student midwives. Senator Bacik outlined for Senator Mullen where this had been done in the legislation and he has accepted this. As for medical practitioners, including student medical practitioners, the advice I have received indicates that the definition included in the Bill provides assurance that all medical practitioners who might be asked to carry out or participate in any way in a termination of pregnancy are covered by section 22. Therefore, no further amendment of the wording set out in that section is necessary to provide the protection Senator Ó Domhnaill is seeking.

Acting Chairman (Senator Gerry Horkan)

For the benefit of those in the Chamber, does the definition of "medical practitioners" include pharmacists?

Deputy Simon Harris (Minister for Health)

No. Pharmacists are included in the context of having a conscientious objection, as outlined eloquently by my colleague Senator Reilly who is a doctor and

[P. 445]

quoted from the code of conduct for doctors. . . 


The Seanad divided: Tá [Yea] 11; Níl [Nay] 26;   Amendment declared lost.


[P. 446]

Senator David Norris

I move amendment No. 29:

In page 15, between lines 10 and 11, to insert the following:

"(2) Pharmacists shall also be covered by subsection (1).".

Senator Aodhán Ó'Riordáin

I second the amendment.


Amendment put and declared lost.


Senator Rónán Mullen

I move amendment No. 30:

[P. 447]

In page 15, to delete lines 13 to 16.

Senator Brian Ó'Domhnaill

I second the amendment.


The Seanad divided: Tá [Yea] 10; Níl [Nay] 25;   Amendment declared lost.


Senator Rónán Mullen

I move amendment No. 31:

In page 15, line 25, to delete “2011.” and substitute the following:

“2011;

“pharmacist” means a person whose name is for the time being registered in the register of pharmacists established under section 13 of the pharmacy Act 2007”

Senator Brian Ó'Domhnaill

I second the amendment.


Amendment put and the Seanad divided: Tá [Yea] 10; Níl [Nay] 25;   Amendment declared lost.


[P. 449]

Senator Rónán Mullen

I move amendment No. 32: 

In page 15, between lines 25 and 26, to insert the following:

""medical practitioner" means a medical practitioner who is for the time being registered in the register or a person who is studying or training to qualify or work as a medical practitioner.".

Senator Brian Ó'Domhnaill

I second the amendment.


Amendment put and the Seanad divided: Tá [Yea] 10; Níl [Nay] 25;   Amendment declared lost.


[P. 476]

Senator Rónán Mullen

With goodwill to all, this is a sad moment for hundreds of thousands of people in our country. . .

. . . There will be civil rights activism in the name of that important civil right that is conscientious objection. I refer to a person's right to go his or her way peacefully, to do no harm to others and not to be caught up in processes that are unjust and do harm to others. . .