Proposed Irish abortion law demands referral by objectors, denies freedom of conscience to denominational institutions

Protection of Life During Pregnancy Bill 2013

The general scheme for a new Irish abortion law will permit abortions when there is a “real and substantial risk” to the life of a woman by reason of physical illness, suicidal ideation, or emergency medical conditions.  The scheme is called a “heads of bill”, with each “head” corresponding to what is likely to become a section of the final
bill.  However, the wording and content of each head are not settled.

Protection  of Conscience Provision

The General Scheme for the Protection of Life During Pregnancy Bill 2013 includes a protection of conscience provision that is limited to medical practitioners, midwives and nurses.  The commentary states that the provision is derived from a bill passed by the Irish Parliament in 2001 (which ultimately did not become law), but it is narrower provision than the original, which extended protection to all persons.

All hospitals and institutions operated by the state or by persons contracted by the state will be required to provide abortions if they provide maternity or neonatal care.  No exemptions are permitted for facilities operated by religious denominations or persons who object to abortion for reasons of conscience.

Section 2 of the protection of conscience provision may deny freedom of conscience to psychiatrists and other medical practitioners who do not wish to participate in panels convened to approve abortions for women who are threatening to commit suicide.  One third of Irish psychiatrists have already signed a letter to the government asserting that abortion is not a treatment for suicidal ideation.

Finally, the bill demands that medical practitioners who do not want to participate in the procedure must find someone willing to do so.  Many conscientious objectors are unwilling to refer patients for morally contested procedures because they believe that by doing so they become morally complicit in wrongdoing.

It is not clear how much difficulty the mandatory referral requirement will cause, since the bill envisions abortion only in circumstances involving a substantial risk to the mother’s life.  This is very rare, and in such circumstances there is much less likelihood of conscientious objection, so it may not prove to be troublesome in operation.  On the other hand, government comments accompanying the bill note that medical practitioners do not need to be of the opinion that the risk to the woman’s life “is inevitable or immediate.”  The more broadly this interpretation is construed, the more likely it is that conflicts of conscience will occur.

While the proposed bill is the product of the controversy generated by the death of Savita Halippanavar in Galway in October of last year, it does not appear to propose anything that would have made a difference to the outcome of that case.  Her death was caused by a particularly virulent infection that is not normally found in maternity settings.  An emergency induction of the kind contemplated by Head 3 in the proposed bill was legal at that time and had been decided upon when she spontaneously delivered a stillborn daughter.  (See A “medical misadventure” in Ireland: Deaths of Savita and Prasa Halappanavar)

Conscientious objection becomes issue in Ireland

Enda Kenny, the Taoiseach (prime minister) of Ireland, has declared that all members of his Fine Gael party must support the new abortion law being proposed by the government.  All must follow the party line; none will be allowed to vote according to conscience.

“Conscience objection doesn’t absolve people from responsibility,” he said, saying members would be expected “to act and vote in accordance with the decisions of the party.”  [The Journal]

The proposed law is a response to world-wide controversy over the death of a woman at a hospital in Galway in October, 2012.  (See A “medical misadventure” in Ireland)

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Discrimination at the doctor’s office

New England Journal of Medicine

Perspective

Holly Fernandez Lynch

Doctors dedicate themselves to helping others. But how selective can they be in deciding whom to help? Recent years have seen some highly publicized examples of doctors who reject patients not because of time constraints or limited expertise but on far more questionable grounds, including the patient’s sexual orientation, parents’ unwillingness to vaccinate (in surveys, as many as 30% of pediatricians say they have asked families to leave their practice for this reason), and most recently, the patient’s weight. [Read more . . .]

A “medical misadventure” in Ireland

Deaths of Savita & Prasa Halappanavar

Galway, Ireland: 21-28 October, 2012

Sean Murphy*

Savita Halappanavar was a 31 year old woman who was 17 weeks pregnant when she presented at the University Hospital, Galway, on 21 October, 2012, with a miscarriage.  She spontaneously delivered a stillborn daughter, Prasa, on the afternoon of 24 October, and died from sepsis early on 28 October.  The circumstances of her death generated a hurricane of controversy in Ireland and around the world about Irish abortion law.  A coroner’s inquest held in Galway in April, 2013 resulted in the classification of Savita’s death as a “medical misadventure.”

What follows is a chronological account of Savita’s care and treatment from 21 to 28 October, drawn from newspaper reports of the evidence taken at the inquest.  [Read more . . .]

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