Ireland's laissez-faire attitude to abortion has not worked, and there is now a need for mature debate, a leading obstetrician, Prof Walter Prendiville, will say tonight.
He will tell a public lecture organised by the Adelaide Hospital Society, that some changes in attitudes and laws are needed if the number of Irish women having abortions is to be reduced.
In the lecture on ethical dilemmas surrounding contraception, sterilisation and abortion, he will say that attitudes are lagging far behind our counterparts in attitudes to reproductive issues.
Prof Prendiville, a consultant at Tallaght Hospital, said it would be fair to say that in other western European countries the arguments surrounding pre-fertilisation, contraception and sterilisation "have had their day".
No ethicist, philosopher, gynaecologist or theologian could tell anyone what is right on the difficult question of abortion, he said. "For many it will be a case of obeying the decrees of their religion; for others it will be peer or parental pressures which dictate the ethical view . . . For every stance there are likely to be serious opposing opinions."
He said the laissez-faire attitude which existed in society towards abortion, including in the medical profession, had not worked. Asking whether abortion was ever right, Prof Prendiville said nobody had a monopoly on being right about issues of conscience.
"I do not pretend to know the answers to all the questions about abortion. But I am sure that we, as a society, will benefit from discussing these very complex issues in public without rancour or acrimony and with the common ambition that prevention is better than cure. I hope that we are mature enough to do so."
He said most Irish women who had a termination of pregnancy did so for social or personal reasons "that have nothing to do with medical, psychiatric or psychological risk to the mother".
Speaking on contraception in Ireland, he said there were probably few people who fervently believed that it was wrong for a couple to plan their family size and timing.
Asking whether natural contraception was more "ethically sound" than artificial, he said the former attempted to prevent conception effectively while interfering as little as possible with the sexuality of intercourse, where the latter was firmly based on avoiding the sexual component of intercourse and accepting a relatively flawed contraceptive effect.
He said there were a number of different viewpoints on whether post-fertilisation contraception, such as the morning-after pill, was abortion. Some believed that life began at fertilisation, others that it was a process only completed at implantation or, lastly, that humanity was only conferred upon the fertilised egg later in pregnancy.
He said over half of all pre-implanted blastocysts - the embryological term for the group of cells about to implant in the womb - would fail to implant. "While the absolute view of humanity beginning with fertilisation has a simple attractiveness, it does not sit comfortably with nature's appreciation of the status of the pre-implanted blastocyst. Indeed, it could be argued that the blastocyst has a near-equivalence to the egg or the sperm in that they are all potential until conception has been completed at implantation."
Speaking about Irish abortion laws, he said they should cover common circumstances - women deciding on a termination because they do not want to have a baby - rather than rare and tragic cases.
Prof Prendiville said the X and C cases, and circumstances where a woman was carrying a foetus with a serious medical condition, or had a medical condition herself, were tragic but very rare cases, likely to meet with sympathy from the public. However, rare circumstances made bad law. "To legislate according to the rare cases almost by definition ignores the reality of the common circumstance."