I’ve been approached by two groups, the Pro-Life campaign, and the RepealEight campaign. Both requested me to indicate my views on the 8th amendment, specifically whether I am for it or against it, from the pro-life campaign, and whether I would support a referendum on the amendment, from RepealEight. This is a key issue for many people.
My own views, which may not be popular with either side, are not simple, in that I favour repealing the 8th amendment, but oppose unrestricted abortion. I do not claim that I am right, but this is where I am starting from.
Some background first. I’m a doctor, and started my working life as a paediatrician. I spent several years working in the Coombe hospital, mostly caring for very sick premature babies, and a range of babies with congenital anomalies and chromosomal problems. I’m a man, I’ve never been, and never will be pregnant, so I don’t have that experience, but I have seen many mothers with critically ill and dying babies. I have a bit more experience than most people of both the tragedies and the joys of birth. I now work in public health, and a good deal of my recent work has been on intellectual disability, specifically my work with Special Olympics Ireland, and on autism.
In 1983, I was in my final year in medical school, when the 8th amendment was brought in. The purpose of this amendment was to prohibit any legislation regulating abortion in Ireland. Abortion, was, and is, illegal under the 1861 Offences against the Person Act. At the time, my father, a solicitor, and many other lawyers, including Alan Shatter, argued that the effect of the amendment would be to bring in a right to abortion, under the constitution. This subsequently turned out to be correct. Truthfully, I cannot now remember how I voted in 1983. I do remember watching SPUC in action, and later their trying to use the courts to muzzle people. At the time, I disliked them, – they did little to protect any child, born or unborn.
So, now, I think the 8th amendment was a bad idea. Abortion ought to be the subject of legislation, not an item in the constitution. Placing it in the constitution let the Oireacthas off the hook. There will be, almost certainly, be a vote to repeal it, and it will almost certainly fall. Both of these I support.
The hard question is what ought to replace it. At the moment, in the UK, abortion is available on demand. My view is that once a woman is pregnant there are two sets of rights involved – hers, and the baby’s. I also believe that rights impose duties, both on individuals and on the wider society. If they do not, they are vacuous. I do not believe that any right, of anyone, trumps all others in every circumstance. Managing rights, and the conflict of rights, is hard. I also appreciate, very clearly, that I am not ever going to be in the situation of being pregnant and not wanting to be.
What about unwanted pregnancy? I said earlier that I disliked SPUC. This was because for all their rhetoric about protecting babies, they did little to support women who found pregnancy difficult. Women can and do find themselves in bad situations, often because of poverty, which are made much worse by pregnancy. For me, the right social response is to support the woman, not terminate the pregnancy. I accept that others disagree, but having cared for a baby born at 22 weeks, and seen her parents interacting with a child who was going to live for less than an hour, I believe strongly that babies have rights, both in-utero, and after delivery. As a country, we have obligations to vindicate these rights, but also to balance these with the rights of the mother. This may not be easy, but there is no guarantee that a serious rights based approach will be easy.
In other countries, many babies affected by congenital anomalies, and chromosomal anomalies are terminated, purely because of their condition. I am unalterably opposed to selective termination based on gender, race, anatomy, or chromosome count. I take a firm rights based approach to disability, and this includes a right to live. Please try to imagine what people with Down syndrome think of quasi-routine termination of babies with trisomy 21, or better yet, ask someone.
What about fatal foetal anomalies? By far the commonest of these is anencephaly. This is a condition in which the brain fails to form. Such babies miscarry, or die very shortly after birth, and are now usually diagnosed on the first routine ultrasound in pregnancy. I do not see any realistic objection to termination in such a case if that is the mother’s choice. Other conditions are proposed, as ‘fatal foetal anomalies’, for example Edward’s syndrome (trisomy 18) and Patau’s syndrome (trisomy 13). Many children affected by these two disorders die within the first year of life, but some do not. I do not believe that these, and the many similar disorders, are in the same category as anencephaly.
Are there difficult cases? Of course. The tragic death of Savita Halappanavar is a good example. I said earlier that it is hard to balance the rights of mother and baby. This may show what can happen when you fail to do do the work of finding the correct balance (there were several distinct issues in her care, besides her pregnancy). For me, (bearing in mind that I am not an obstetrician), a reasonable treatment for a woman in her condition might have been a termination. What about another tragedy – a woman raped, and pregnant, as in the X case? I try not be a hypocrite. If my daughter were in that situation, I would ensure that, if she so chose, she could have a termination. I’m well-paid, well-educated, and well-connected. I would have no difficulty arranging for this. I don’t see that I can argue that other women should be denied this.
I think we need comprehensive, but quite restrictive, legislation on abortion. I respect most of those who disagree with me, on both sides. I admire the courage of James Reilly and the Fine Gael/Labour government bringing in the Protection of Life During Pregnancy Act 2013. This Act is, literally, tied in knots by the constitution. It needs to be un-knotted. If the Oireachtas does not do it, I think the courts will, perhaps following the very recent judgement in Northern Ireland.