Ireland poised to allow abortion when mother’s life at risk

BMJ 2013; 346 doi: (Published 03 May 2013) Cite this as: BMJ 2013;346:f2875
  1. Muiris Houston
  1. 1Galway

The Irish government has published the heads of a bill that would allow abortion in Ireland in limited circumstances.

In the case of a physical threat to the life of a mother, the Protection of Life During Pregnancy Bill 2013, will require two consultants (of whom one will be the woman’s obstetrician) to approve an abortion.

If there is a “real and substantial” risk to the life of the pregnant woman owing to the risk of suicide, three consultants will be required to certify the need for a termination of pregnancy. While the woman’s general practitioner should be consulted by at least one of those doctors where possible, the general practitioner is not required to certify the need for a termination.

The doctors who will make an assessment of suicidal ideation will comprise an obstetrician and two psychiatrists. They must “jointly certify in good faith” that there is a “real and substantial risk” of the loss of the woman’s life by way of suicide, and that “in their reasonable opinion” this risk can be averted only by termination.

When asked about when the legislation would be implemented, prime minister Enda Kenny said that the parliamentary health committee would consider the issue, after which he hoped that the legislation would be introduced and enacted before the Dail (parliament) rose for the summer. “I would hope that the bill can be enacted and for the first time in 31 years, bring clarity and certainty to this area,” he added.

Publication of the bill follows a government commitment to legislating after the report last year of an expert group tasked with advising on how to respond to a ruling of the European Court of Human Rights, which found that Ireland had failed to provide for abortion in circumstances when a mother’s life is at risk. When enacted, the law will also give effect to the 1992 X case Supreme Court judgment, which declared that abortion was permissible if there was a real and substantial risk to the life of the mother, as distinct from a risk to her health. Such a risk included the threat of suicide.

The publication also comes in the wake of an international outcry after the death of Savita Halappanavar last October, amid allegations that she was refused a termination when 17 weeks’ pregnant.1 The 31 year old dentist died from septicaemia at Galway University Hospital following a miscarriage.

The Abortion Rights Campaign welcomed the bill as a step towards securing access to safe and legal abortion in Ireland. However, it expressed concern about some of its headings.

Spokesperson Sarah Malone said, “Head 19, which outlines a possible penalty of 14 years in prison for illegal abortion in Ireland, is nothing short of barbaric. To threaten women facing this difficult decision with imprisonment is not only wrong in and of itself, but it may prevent women from disclosing information about previous abortion to their doctors, or seeking medical care in the event of complications from illegal abortion.”

The Pro Life Campaign accused the government of ignoring expert psychiatric evidence presented at recent parliamentary hearings on abortion. Commenting on the heads of the bill, Caroline Simons of the Pro Life Campaign said: “There is no evidence that abortion ever helps women’s mental health and in fact it may damage women.

“The government has claimed all along that there is no option but to legislate. This is untrue. If it was really concerned about protecting women’s lives and respecting the unborn, we would have appropriate guidelines drawn up to assist doctors in various cases. The law already protects good medicine and life saving treatments.”


Cite this as: BMJ 2013;346:f2875