Hospitals warned they must ensure legal requirements for abortions are met

Hospitals providing abortion services have been told to ensure they meet the legal requirements for carrying out lawful terminations of pregnancy and for notifying the Minister for Health when they have done so.

The reminder was issued by HSE chief clinical officer Dr Colm Henry, at the request of the Department of Health, and sent to all providers of termination services in a letter, seen by The Irish Times, earlier this month.

Although the letter does not refer to a specific case, it deals with issues that arose in the recent case of a couple who had a termination at the National Maternity Hospital after they received test results indicating their baby had a fatal foetal anomaly.

A later, more comprehensive test result, received after the termination had been carried out, showed he had no genetic condition.

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In the letter, Dr Henry said in order for a lawful termination to be carried out, there is a requirement for all doctors involved to examine the pregnant woman and to certify their reasonable opinion that the requirements of the legislation have been fulfilled.

“Where the Act calls for more than one medical practitioner to be involved, it should be noted that it is the responsibility of each medical practitioner to examine the pregnant woman concerned in order to form a reasonable opinion in good faith and to certify that the termination may be carried out,” Dr Henry wrote.

Two doctors

The Health (Regulation of Termination of Pregnancy) Act 2018, which provided for the introduction of abortion services, says two doctors must examine the woman in cases where the termination is being sought due to a condition likely to lead to the death of the foetus.

In this case, the couple say the woman was seen by only one obstetrician at the hospital, though two doctors certified the termination as required by the Act.

The hospital told the department last May it was correctly interpreting the Act and had appropriate policies, practices and procedures in place to ensure full compliance. It is understood the second doctor examined the woman’s test results and the hospital regards this as fulfilling the requirement in the legislation for her to be “examined”.

Dr Henry has also reminded hospitals of the requirement to notify the Minister for each termination by returning a form within 28 days of the procedure.

In the National Maternity Hospital case, two months elapsed from the time of the termination before the notification was submitted.

The letter to the Minister is dated May 13th. On that day, solicitor Caoimhe Haughey, who had been engaged by the couple after they became dissatisfied with the hospital's responses to their questions, wrote to the hospital for the first time about a number of issues, including the absence of certifications of the termination.

Dr Henry also wrote in the letter that he anticipated a clinical lead for terminations of pregnancy will be appointed shortly to support the rollout of services nationally.