Health board would be well advised to take guidance from High Court

The latest abortion controversy has brought a complex and tangled issue back to centre-stage

The latest abortion controversy has brought a complex and tangled issue back to centre-stage. The Government last night detailed its response to the controversy. But in the interim it would appear that the Eastern Health Board, which has the young girl in its care, may be about to seek clarification of its powers and responsibilities in this tragic case from the High Court.

Given the significance of the issues involved - and the lack of clarity of certain aspects of the law - this would seem to be a very prudent course of action for the health board to take. The board's statutory responsibilities under the Child Care Act 1991 are reasonably easy to list, even if that might belie difficulties in application.

According to media reports, the girl was voluntarily placed in the care of the board by her parents. In performing its functions in these circumstances, the board is obliged, inter alia, to regard the welfare of the young girl as the first and paramount consideration and, in so far as is practicable, to give due consideration, having regard to her age and understanding, to her wishes, while at the same time having regard to the rights and duties of the parents.

Parents who have voluntarily placed their child in the care of a health board may, at any time, resume care of the child. If the board wishes to oppose this course of action, then it must seek an order from the District Court authorising the board to take the child into care, notwithstanding the wishes of the parents.

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Generally speaking, such an order can only be made if the court is satisfied that the child has been or is being assaulted, ill-treated, neglected or sexually abused, or that the child's health, development or welfare has been or is likely to be avoidably impaired or neglected and that the child is unlikely to receive care or protection in the absence of such an order.

In the event of such an order being made, the board then has the authority, inter alia, to give consent to any necessary medical treatment of the child and to give consent to the issue of a passport to the child to enable him or her to travel abroad for a limited period.

The health board's responsibilities under the Constitution are, perhaps, less straightforward. In the light of the Thirteenth Amendment to the Constitution dealing with freedom to travel, it seems unlikely that the health board, or, indeed, any other statutory agency, could, if it was so minded, prevent the girl from travelling abroad in order to have an abortion. In so far as this amendment explicitly gave priority to freedom to travel only over the right to life of the unborn, it has been argued that other constitutional rights, such as the rights of the family, could be used to prevent a pregnant woman travelling abroad for an abortion.

While this is a plausible argument, one could equally argue that if the constitutional right to life of the unborn may not be invoked to restrict freedom to travel, then other constitutional rights should not be construed to achieve a different result.

One further point which may arise is whether the health board can actively assist the girl to travel to Britain for an abortion by, for example, paying travel and medical expenses. There is a school of thought which would place great significance on the fact that the Thirteenth Amendment to the Constitution refers to a freedom, rather than a right, to travel. A possible implication of the use of this terminology is that while the health board could not prevent the girl from travelling, it would be under no duty positively to assist her in going abroad.

Should that argument find favour with the court then, in the absence of any statutory power to assist a person to obtain an abortion, the board would not be able to assist the girl at the centre of this case in procuring an abortion.

Taking a more long-term view of the issues raised by this tragic case, it is clear that there is much unfinished business in relation to the law on abortion. The most important issue of all is how we should respond to the X case decision. As is well known, on this issue there are two conflicting views. One side argues that the decision in X should be set aside by constitutional amendment, while the other side wishes to retain the X decision and to legislate within its parameters on various aspects of the issue of abortion.

Notwithstanding the central importance of this question, I do not purport here to evaluate the respective merits of either approach as this is a complex political and moral matter rather than simply a legal one. If, however, a decision is taken to legislate within the parameters of X, then the following matters would have to be addressed, in some shape or form, in relation to the substantive issue.

A preliminary, and difficult, issue would be the matter of defining abortion - for example, is the use of post-coital birth control such as the "morning after" pill to be regarded as inducing an abortion?

Moving on from this difficult question of definition, one would expect to see some procedure established for determining when there was such a real and substantial risk to the life of the mother as to justify an abortion; for example, certification by appropriately qualified medical personnel.

One would also expect to see some regulation of the places in which an abortion could lawfully be carried out, the methods of procuring an abortion, and the point in gestation after which no abortion would be permitted. The legislation would presumably also provide protection for those hospital staff who had conscientious objections to assisting at the performance of an abortion. One would expect such protection to apply to medical personnel and, perhaps, also to administrative personnel.

Finally, one would expect the legislation to clarify the position of the criminal law in relation to abortion in the aftermath of the X case. For example, is it a sufficient defence to a criminal charge brought under the Offences Against the Person Act 1861 that the doctor who performed the abortion had a subjective belief that the mother's life was in danger or must the belief also be reasonable, objectively justified?

Gerry Whyte is senior lecturer in the Law School at Trinity College Dublin