22
NOV
2016

Eighth Amendment must remain in place

Dublin GP and member of Doctors for Life Dr Orla Halpenny teases out the reason why she believes the Eighth Amendment should remain, and why abortion is ‘not a medical issue’

Over the past few months, positions have crystallised around the question of the Eighth Amendment to the Constitution and the campaign for its repeal. (‘Abortion is a medical issue’, opinion piece in Irish Medical Times, November 4, 2016).

Those politicians and doctors who have declared themselves publicly in favour of repeal view ‘the 8th’ as the single biggest obstacle, not only to selective abortion for unborn children who are terminally ill, but also to the wider availability of abortion as a means of fertility control.

Which is precisely what it was intended to be.

It is with some relief, therefore, that we can face into the next few months of presumably increasingly heated debate about the question of whether or not the Eighth Amendment should be repealed. We can thank those in favour of repeal for clarifying the issue so neatly for us. There is no risk of confusion.

Retention of the Eighth would mean that the current brake on abortion provision in this country would continue. Removal of the Amendment would remove the brake.

If that is what we want.

Savita Halappanavar
There are many things that may cloud decisions about what we might want in this context. For example, we are repeatedly told that removing that brake would have saved the life of Savita Halappanavar by enabling doctors to perform a life-saving termination of her pregnancy. Were this true, then those who voted in favour of the Amendment in 1983 would have cause for shame. It is, however, not true.

The inquiry into the circumstances of her death found that it was medical mismanagement of septicaemia that led to her death. It is perhaps excusable that people with no medical training would fail to distinguish cause and effect in this case. There is no such excuse for doctors and it is disappointing that some in the profession have remained undiscerning.

We might also want to help women who are pregnant as a result of rape or who, for any number of very good reasons, do not feel able to face a pregnancy or to cope with the birth of a seriously ill child.

We might also simply want to avoid conflict, which is an eminently laudable goal in any society.

To quote a recent letter to Irish Medical Times, “Let those who believe that abortion is part of healthcare, access abortion (free, legal and safe); the others? Let them make their own decisions. That way, every citizen has choice” (‘Should our Constitution privilege one belief system over another?’, IMT, November 4, 2016).

There is just one problem. Every citizen does not have choice here. The unborn child has no voice. To paraphrase the HSE, we’re vaccinating for two now, remember?

The baby whose birth was ‘forced’ upon a reluctant mother because she was not found to be suicidal under the risible 2013 Protection of Life in Pregnancy Act, could now, for all we know, be one of our patients. In the future, that baby could marry one of our children or even be our doctor.

Thanks to the Eighth.

Human life

There are relentlessly hard and dark truths about human life and its generation. Babies are conceived who develop life-limiting illnesses in the womb. There are chromosomal defects that affect the person’s development. Pregnant women can develop lethal cancers that must be treated.

The direct and intentional termination of life in the womb is not the answer to any of these medical situations and no doctor has ever proposed it as such. Abortion is not, then, a “medical issue”.

It is an issue of choice.

It is choice, then, and the value we place on it, that determines the outcome. We would like to live and let live, except that in this case, not all of us get the chance to live.

Down syndrome
Sally Philips, in her recent, highly acclaimed documentary broadcast on BBC 2 entitled A World Without Down’s Syndrome?, asked the question: “Where are all these individual choices taking us?”

Herself an advocate of a woman’s right to choose, in addition to being the mother of an 11-year-old boy with Down syndrome, she surveys the present situation in the UK, which has recently introduced prenatal testing for Trisomy 21, and in Iceland, where the termination rate for Down syndrome is now 100 per cent.

“If we’re heading for a world where we can choose who can be born, we need to think about what it is we value. As our powers of choice get even greater and greater, who will we leave behind?”

As doctors, we do not wish anyone to be left behind. We see what can be done for people living with disabilities and we are always surprised at their resilience and enjoyment of even limited life.

Medical research and progress has empowered people born with illness to live independent and fulfilled lives. Doctors, of all people, know how foolish it is to try to say who is “worth” it. The Eighth Amendment should remain.

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