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Thursday, February 21, 2013

Sizeable majority support legal protection of unborn, according to new research

Today, the Pro Life Campaign launched a recently commissioned Millward Brown opinion poll, which was carried out on various pro-life issues including current medical practice on the treatment of women in pregnancy.

Áine Ascough, Wendy Grace, Maria Ó hAodha, and Claire Moore at the launch.

Research was carried out between 16-25 January 2013 on a nationally representative sample of 970 people aged 18+ by face-to-face interviews. The findings show a high level of support for current medical practice in Ireland.

Q1. In current medical practice in Ireland, the doctor treats the expectant mother and her baby as two patients and does his/her best to safeguard both in a crisis situation. Do you consider that this practice should be protected and safeguarded by law or not?

Result
66% answered YES 
15% NO 
19% gave no opinion 
Of those who expressed an opinion 81% answered YES.          
                            
Q2. Are you in favour of, or opposed to constitutional protection for the unborn that prohibits abortion but allows the continuation of the existing practice of intervention to save a mother's life in accordance with Irish medical ethics?

Result
63% answered YES
19% NO 
18% gave no opinion 
Of those who expressed an opinion: 77% answered YES.
What marks these findings out from other research is the way important ethical distinctions are clarified for the benefit of respondents.

A number of polls published recently citing support for abortion used the word “abortion” in the question without defining just what it meant. These questions could only lead to uninformed answers. Polls using lists of emotive circumstances also tend to distort results.
In the Millward Brown polls published today an attempt was made to differentiate between life-saving medical interventions in pregnancy and induced abortion (where the sole aim is to terminate the pregnancy). It is clear from the results that a sizeable majority supports legal protection for the unborn child, while ensuring that women receive all necessary medical treatments when pregnant.

The findings published today challenge the notion that there is broad middle ground support for abortion in Ireland.



Separate from the survey results, but very relevant to the debate on abortion, Caroline Simons (legal adviser to the Pro Life Campaign) made the following remarks at the press launch today: 

 ·         As the latest World Health Organisation report on Trends in Maternal Mortality shows, out of 171 countries, Ireland is consistently in the top five in safety for women in pregnancy over the past 25 years. This is a remarkable statistic showing Ireland to be a world leader in maternal healthcare and safer for women in pregnancy than places like Britain and the US, where abortion is available on demand.
·         Rather than introducing an abortion regime that blurs crucial ethical distinctions, the Government should set about reassuring the public on Ireland's outstanding record of care in protecting women during pregnancy.
·         The European Court of Human Rights judgment in A, B and C v. Ireland does not oblige the Government to introduce abortion legislation. Instead, Guidelines could be drawn up in consultation with the appropriate bodies of expertise within the medical profession based on best medical practice, addressing the requirement of clarity for women in pregnancy.
·         Any legislation based on the X case would mean that for the first time members of the Oireachtas would be sanctioning the taking of innocent human life. Once that principle is conceded, there is no going back. Not only would legislation based on the X case put the right to life of the unborn at risk, it would also potentially put women's lives at risk based on the independent expert evidence presented to the recent Oireachtas hearings. This evidence highlighted the link between induced abortion and adverse mental health consequences for women. If we are genuinely concerned about women's health, the Government simply cannot ignore this peer-reviewed evidence. 

You can see the full results from Millward Brown by following this link

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Monday, February 18, 2013

Fianna Fáil leader opposed to abortion being legalised on basis of suicidality


In an interview with TheJournal.ie, Fianna Fáil leader Mícheál Martin has expressed his opposition to abortion being legalised on the grounds of suicidality, as well as opposing widening grounds for cases of rape and poor pre-natal diagnoses.

In July, Mícheál Martin wrote an opinion piece in the Irish Examiner that set out his opposition to legislation based on X. You can see our blog from July by clicking here.

Mícheál Martin, leader of Fianna Fáil

The Cork Deputy is one of an increasing number of politicians, doctors, and commentators who are concerned by the prospect of abortion being legalised on the flawed basis of treating suicidality - a claim that was completely demolished at the recent Oireachtas Health Committee Hearings, when all the consultant psychiatrists that went before it testified that abortion is not a treatment for a pregnant woman who is suicidal.


Friday, February 15, 2013

John Bruton says Government abortion legislation contrary to Constitution


John Bruton - former Taoiseach and Fine Gael leader
In today's Irish Times, former Taoiseach and Fine Gael leader, John Bruton says that Government plans to legalise abortion are contrary to the Constitutional protection of the unborn, and that there can be "no equal right to life if law embraces suicide risk". 

He says that "a provision allowing a suicide threat to be a basis for ending the life of an unborn child" would not be consistent with the wording of the Constitution, which states that the State has a responsibility to "defend and vindicate” the right to life of the unborn child. 

He points out that the 8th amendment in 1983 was "put there with the explicit approval of the people", and that inclusion of a suicide risk as grounds for an abortion was decided, "to the surprise of many", in a court, and was not introduced by the will of the people in a referendum.
[When the question of abortion based on perceived risk of suicide was put to referendum in 1992 and 2002, all pro-life people opposed the proposed amendment the first time and some pro-life groups opposed the proposed amendment the second time.] 


We have human rights because we are human beings, not because other people or a legislature deems us "worthy" of rights. Bruton recalls Judge Hederman's words from the Supreme Court judgement in 1992: “The right of life is guaranteed to every life, born or unborn. One cannot make distinctions between individual phases of the unborn life before birth, or between unborn and born.” Mr. Bruton makes the important point that human rights are not stripped from specific groups of persons based on taste or opinion at a particular point in time. He says "The underlying idea behind putting human rights in the Constitution is to ensure that they cannot be easily reduced".  

Bruton concludes "to introduce a law providing that an expression of a threat of suicide by one person would be sufficient ground for the taking away of the life of another, would not be in accord with the actual words in the Constitution. There would be no “equal” right to life in such a law, and an equal right to life is what the Constitution requires. ...  It would institute a rule of convenience, at the expense of a rule of rights." 


See John Bruton's full article on the Irish Times website by clicking here
See related piece by Stephen Collins, Irish Times Political Editor, by clicking here

Click here to see the Pro Life Campaign's briefing document, which outlines how guidelines - not legislation - are the way forward. 

Thursday, February 14, 2013

Cora Sherlock says reporting of latest Irish Times poll "gross distortion" in letter to the paper


Cora Sherlock with Reggie Littlejohn of Women's Rights Without Frontiers and
Joe McCarroll of the Pro Life Campaign at an event in 2012. 

In a letter in today's Irish Times, Cora Sherlock, the Deputy Chairperson of the Pro Life Campaign says that the Irish Times' presentation of the recent poll "was a gross distortion of the true picture". 
Reporting on the poll at the time of its release, Stephen Collins, the Political Editor of the Irish Times, claimed that public support on abortion has increased from 23% in 1997 to 71% today. As Cora points out, in reality the poll in 1977 found that 77% of people supported abortion (given the question made no distinction between abortion and necessary medical treatments during pregnancy). In responding to Cora's letter in today's paper, Stephen Collins dismisses her point, claiming that his comparison still stands. 

Below is Cora's letter in full. 

Sir, – The presentation by The Irish Times of the latest Irish Times/Ipsos MRBI poll on abortion was a gross distortion of the true picture.
In his analysis, Political Editor, Stephen Collins (February 11th) states that public support for Oireachtas legislation on abortion has risen from 23 per cent in 1997 to 71 per cent today.
The 1997 MRBI poll he cites actually found 77 per cent of people supported abortion in a variety of circumstances, depending on how the question was asked. The 23 per cent mentioned by Mr Collins was just one of the findings in a multiple choice question that included other options.
Five years later, in 2002, when the electorate had an actual choice to make in a referendum, 49 per cent voted Yes to row back on the X case ruling. An IMS poll conducted just afterwards found an additional 5 per cent voted No on pro-life grounds.
In other words, despite findings like the one cited by Mr Collins from 1997 and the latest Irish Times/Ipsos MRBI poll, when the people have an actual democratic choice, a clear majority rejects abortion.
Polls showing high levels of support for abortion are nothing new. Whenever the question suppresses the distinction between induced abortion (that targets the life of the baby) and necessary medical treatments to preserve the life of the mother (where every reasonable effort is made to save the life of the baby), the results show high support for abortion.
Such polls, however, significantly under-represent the opposition among the electorate and create an inflated perception of the extent of public support for abortion.
– Yours, etc,
CORA SHERLOCK,
Deputy Chairperson,
Pro Life Campaign,
Lower Baggot Street,
Dublin 2.

Stephen Collins writes: The Irish Times poll in December 1997 found that 23 per cent of people felt the government should legislate for abortion in line with decisions made in the courts. Other findings in the same poll or other polls about the complex issue do not alter that fact. The finding in the latest poll that 71 per cent of people favour legislation is directly comparable.

Wednesday, February 13, 2013

Guidelines urgently needed regarding treatment of mothers in pregnancy, following reports on Savita Halappanavar case


Responding to today’s leaked extracts of the draft HSE inquiry into the Savita Halappanavar case, the Pro Life Campaign called for the “urgent introduction of Guidelines regarding treatment of mothers in pregnancy.”

Commenting on the leaked extracts of the report, Dr Berry Kiely of the Pro Life Campaign said: “Assuming the media reports are accurate and reliable, a picture is emerging of a tragic series of missed warning signs that should have alerted doctors to the fact that Ms Halappanavar was suffering from an infection posing a substantial risk to her life, a condition that was treatable, but necessitated urgent intervention.”




Dr Kiely said: “The story is made all the sadder in the light of the unanimous evidence from the obstetricians speaking at the recent Oireachtas Hearings that they always intervene to expedite the delivery of the baby where they see a risk to the life of the mother.  


“It is striking that the Royal College of Obstetricians and Gynaecologists in the UK issued a new set of Guidelines on sepsis in pregnancy last year, following a 2008 report showing sepsis was the single largest cause of death for women in pregnancy.


“Rather than proceeding with legislation for abortion, the Government should ensure that Guidelines are drawn up, for example, by the Irish Institute of Obstetricians and Gynaecologists, on the recognition and management of sepsis in pregnancy, which seems to have been the key issue in this sad case.


Dr Kiely said that “those pushing for abortion legislation based on the X case ruling are ignoring the crucial ethical distinction between necessary life saving interventions in pregnancy and induced abortion, where the sole purpose of the intervention is to end the life of the baby. The obstetricians who gave evidence at the recent Oireacthas Hearings made it clear that they always intervene to save the life of the mother but in doing so do not target the life of the baby. It is shameful the way some people, including some senior members of Government, are using the tragic death of Savita Halappanavar to open the door to an abortion regime in Ireland.”



Download our new briefing document by clicking here. This document is brand new, and gives an excellent overview of the current situation, and outlines why guidelines - not legislation - are the way forward. 




Sunday, February 10, 2013

Prof. Ray Kinsella: 'Best practice' guidelines would be better informed than legislation based on the flawed X Case

In today's Sunday Independent, Prof. Ray Kinsella writes that there is no need to legalise abortion to protect life of the mother. 'Best practice' guidelines would be better informed than legislation based on the flawed X Case. 

Click here to go to the Sunday Independent's website. 



The recent three-day hearings of the Joint Oireachtas Committee on Health and Children on abortion, established by the Government and including representation from across the Dail, heard expert evidence from witnesses with authoritative clinical experience in obstetrics and psychiatry.
The key point for Government, political parties and for individual TDs is this: the weight of the evidence from the Joint Committee indicates that it is not now tenable for the Government to base its response to the European Court of Human Rights (ECHR) judgement in Applicant 'C' in the ABC judgement, on the 1992 Supreme Court decision in the X Case.

More positively, the hearings also identify an alternative, and far less risky, way forward, based not on legislation on the X Case but on guidelines which were directly aligned to 'best practice' maternal healthcare in Ireland.


The outcomes of the hearings have wholly altered the debate on abortion. The Government and political parties are now in a position to say, in effect, "we established the Joint Committee to establish the truth and the facts. It did. We will now proceed to respond to the ECHR judgement by way of guidelines based on 'best practice' of those who actually deliver care and support, day in and day out, for mothers and babies."


There is a narrow 'window of opportunity' to get things right before the Cabinet announces its decision, and the tone and substance of the debate then become set.


Governments sometimes believe foolishly that to change a decision is necessarily to lose face. The great economist John Maynard Keynes was once criticised for changing his mind on a matter of high policy. He responded: "When circumstances change, I alter my conclusions. What do you do, Sir?" No truer words could be spoken in the present circumstances.


A body of evidence presented to the Joint Committee from psychia
trists specialised in the whole field of suicide, in particular as it relates to women expecting a baby, is compelling. It undermines, beyond retrieval, any claim that the X Case decision is in line with good medical practice in regard to the proper medical treatment of a threat of suicide.

This is perhaps not surprising. No specialised psychiatric evidence of the nature delivered to the hearings was heard by the Supreme Court in the X Case.

There are some that may still regard abortion as a 'treatment' for an unwanted pregnancy. They may assert, on this basis, that abortion may sometimes be appropriate for a woman who presents with suicidal intent on account of an unwanted pregnancy. The evidence of three perinatal psychiatrists – Dr Joanne Fenton, Dr Antony McCarthy and Dr John Sheehan – to the hearings on this point is compelling.


Dr Sheehan, for example, noted that: "I refer to (the) question on whether we, as perinatal psychiatrists, have ever seen a situation in which termination of pregnancy has been the treatment for a suicidal woman. To reiterate our statement, with more than 40 years of clinical experience between us, we have not seen one clinical situation in which this is the case." (Page 74.)


Turning specifically to the X Case on which the Government – prior to the hearings – proposed to address the ECHR judgement, Professor Patricia Casey, who runs the attempted suicide service in the Mater Hospital which sees and assesses more than 400 attempted suicides in women every year, made the point that: "X Case legislation would expect doctors to recommend an intervention – an abortion – that has not been shown to be of benefit to mental health, in order to prevent a rare outcome – suicide – that cannot be predicted. In my view, legislation for the X Case that includes suicide risk is not supported by any scientific evidence.


"The two tests envisaged in the X Case – that suicide will occur, on the balance of probability, and can only be averted by abortion – cannot be met."


Turning to the views of experts who provide obstetric care, the evidence is no less compelling. Presentations given by some of the leading obstetricians to the committee confirm that there is no need to legalise abortion to ensure that women in pregnancy receive the medical care needed to safeguard their lives.


This is what the Medical Council's guidelines say (S.21.4): "In current obstetrical practice, rare complications can arise where therapeutic intervention (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, while making every effort to preserve the life of the baby."


And this is what Dr Rhona Mahony, Master of the National Maternity Hospital, had to say as part of her presentation to the Joint Committee: "Occasionally it is required that we deliver a pregnancy before the baby is viable or capable of surviving in our neonatal intensive care unit. When there is any possibility at all that we can preserve the life of the baby we will do so. We are able to do so from very low gestations, from 23 weeks on, and in those cases members can be very certain that we will make every effort to preserve life.


"In other cases, we are required to terminate a pregnancy as part of a treatment of a medical condition because we feel a woman will die. That is not killing the baby. That is simply delivering the baby before it is viable. There is a difference. It is always our wish to preserve life and society should be very reassured about that." (Hearings, January 8, 2013, page 42.)


The evidence given by consultant obstetricians to the hearings make clear that current 'best practice' in Irish maternal care offers an alternative basis for the Government to proceed on in responding to the C Case in the ECHR judgement. How so? Because obstetricians confirmed that they already give women in pregnancy all essential medical care to safeguard their lives, even in the few rare situations where the treatment results unavoidably in the death of the baby.


Guidelines based on 'best practice' in Irish medical care Ireland are a better – more informed, less risky – alternative to legislation based on the flawed X Case. Such an approach would be consistent with the ECHR judgement, which does not require that Ireland respond by primary legislation. It would seem clear from the hearings that the best, and most responsible, way forward is by way of guidelines that would be fully in line with the commitment that Fine Gael gave, prior to the last election, not to legislate for abortion – and would of course vindicate all of the protocols and assurances given over the years since the Maastricht treaty, regarding Ireland's position on abortion.

The Government will have to deal with the reality that, because the X Case is not in line with 'best practice' for mothers, it must be put to rights. It would be unsafe to leave uncorrected a situation where doctors were being advised to have regard to a judgement now recognised as contrary to medical 'best practice'. This need not be contentious.


The key 'building blocks' of an evidence-based alternative approach to the Government's present stance – which in fairness was formulated prior to the Joint Committee hearings – are as follows.

Firstly, an undertaking to the ECHR that the X Case will be addressed. Ireland can now also provide an undertaking that the necessary clarity to which women are rightly entitled will be provided by way of 'best practice' guidelines.


Crucially, this means the Irish maternal medical professions can continue to provide evidence-based care to mothers and babies that are exceptional in terms of outcomes, by international standards.

Secondly, the Irish Government is now in a position to invite the relevant bodies of medical expertise to draw up these procedures in the form of guidelines. The objective, which is certain to be widely shared across the medical and midwifery professions, will be directed towards providing the necessary certainty whereby mothers, in the course of their pregnancy, may have clarity about the medical treatment to which they are entitled, in their specific condition.


The advantages of guidelines rather than primary legislation are that the medical professions are used to working with them.


Guidelines are more quickly and easily updated. 
By contrast, legislation changes societal norms and standards in relation to, for example, cherishing all individuals equally, irrespective of physical or intellectual disabilities or syndromes with which such individuals may be born.

Guidelines, based on 'best practice', and vindicated by the data and which go with the grain of medical and midwifery protocols, uphold these norms and values – which encompass Ireland's present outstanding record in delivering 'best practice' maternal healthcare.

Reassurance about the lawfulness of medical treatments in the rare situations where the death of the baby may result can be provided by amending, rather than repealing, sections 58 and 59 of the Offences against the Person Act, 1861.


This would also meet the concern expressed by a number of obstetricians at the hearings for legal reassurance that their actions were lawful – while maintaining the present national law on abortion which is consistent with the provisions of the Convention and with recent rulings of the ECHR.


The substantive threat to the public interest now arises from a momentum to legislate generated when the facts elicited from the hearings were simply not known to Government, individual TDs or to the general public. 


They are now.


Economist Ray Kinsella is editor of 'Acute Healthcare in Ireland'