|A protestor meets Minister for Agriculture Simon Coveney last week at Government Buildings in Dublin.|
The outline of the government's proposals for legislation on abortion were agreed by the cabinet and published last week.
It's important to remember that what we have so far is the heads of the bill rather than the full detail. There will be much discussion as all the detail emerges in the coming weeks, and the overall bill may be finessed somewhat before it becomes law.
But the heads of the bill give the proposed framework and the outline is clear. The basic structure is unlikely to be changed.
The first thing to be said is that there is no proposal to change the constitutional position here which gives a pregnant woman and her fetus an equal right to life. Our Supreme Court interpreted this 30 years ago to mean that abortion is permissible here only when there is "a real and substantial risk to the life, as opposed to the health, of the mother."
The proposals produced by the government last week aim to make clear what this means, and to provide a legal framework for abortion in such cases.
The second thing to be said is that although women will be able to have a termination here under a legal framework for the first time, the proposed regime is so restrictive that the thousands of Irish women who now travel to Britain for abortions every year will continue to do so. In reality, there will be no change for them.
The core of the proposed restrictive abortion regime will be what one minister referred to last week as the one, two, three structure (the one, two and three being the number of doctors required to allow an abortion in different scenarios).
In the first scenario -- in a case of acute medical emergency requiring a termination -- only one doctor will be required to certify that a woman can have an abortion. In cases like this the "real and substantial risk to the life of the mother" will be immediate. To avoid any delay in preserving the life of the woman, only one doctor will be required to certify that an abortion is necessary.
In the second scenario, where there is a "real and substantial risk to the life of the mother" that is not immediate (in the case of certain diseases like cancer, for example), two doctors will be required to certify that an abortion is necessary. In such non-emergency cases the threat to the life of the woman must be real, even though it is not immediate.
If either continuing the pregnancy or eventually giving birth would be a real threat to the life of the woman, an abortion may be performed. The decision by the two doctors must be unanimous.
One of the doctors must be an obstetrician or gynecologist and the other a specialist in the relevant area (for example, a specialist in uterine cancer). During their assessment one of them may consult the patient's own doctor.
If the two doctors involved refuse an abortion the woman will have the right to appeal, and that appeal will be heard by another two doctors of similar experience within seven days.
The first two scenarios relate to physical medical circumstances. The third scenario relates to psychological circumstances.
In the third scenario, the pregnant woman does not have a physical medical problem but is suicidal because of the pregnancy and wants an abortion. In such cases three doctors -- two psychiatrists and an obstetrician or gynecologist -- will be required to certify that an abortion is necessary to preserve the woman's life. Their decision must be unanimous.
The woman who is claiming to be suicidal because of her pregnancy will be examined by the panel of three doctors to see first if there is a "real and substantial risk" of her taking her own life, and second, if the suicide risk can only be averted by abortion. Again, the decision has to be unanimous. If the three doctors do not all agree on the need for an abortion, the woman will be refused.
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