The abortion referendum is complicated, not confusing. Five issues are being decided but you can only say Yes or No to the whole lot, writes Geraldine Kennedy, Political Editor
You the voter will be asked to decide five questions in the abortion referendum but you can give only one answer: Yes or No. You cannot pick and choose.
These questions are contained in the Twenty-fifth Amendment of the Constitution (Protection of Human Life in Pregnancy) Bill and you will be asked on the ballot paper whether you approve of it. You can only say Yes or No to the whole lot.
The five issues being decided are:
• to row-back on the Supreme Court's judgment in the X case - delivered 10 years ago today - by eliminating suicide as a ground for abortion in Ireland;
• to define abortion as the intentional destruction by any means of unborn human life after implantation, not conception, which presumes to give legal protection to the morning-after pill and the IUD;
• to give legal protection to the doctor/patient relationship during the course of pregnancy, allowing a medical practitioner to carry out any medical procedure necessary to prevent a real and substantial risk to the woman's physical life at an approved place;
• to ban abortion in Ireland and impose a 12-year maximum jail term on anyone who aids, abets, counsels or procures a direct abortion;
• to raise the Protection of Human Life in Pregnancy Bill to the level of constitutional law which can only be changed by the people in another referendum.
The balance of the mix of these five provisions makes it highly improbable you will agree with each and every one of them. Some of them are conservative; others are potentially liberal. The manner in which the proposed changes are being put, however, means you have only one choice: to vote Yes or No to the lot.
Notwithstanding all of the disputes about interpretation, the main purpose of this referendum is to row-back on the X case judgment and ban the threat of suicide as a basis for having an abortion in Ireland.
The Supreme Court decided on March 5th, 1992, it would be lawful for X, a 14-year-old raped and pregnant girl, to have an abortion here because of the risk of suicide. Not one such abortion has taken place in Ireland, however, in the intervening 10 years.
Fianna Fáil, the leader of the Progressive Democrats, Ms Harney, and the Catholic Church are promoting a Yes vote. But, the medical specialists on suicide, the psychiatrists, are deeply divided. Prof Anthony Clare and Prof Patricia Casey say there are no psychiatric conditions for which abortion is the only answer. They are voting Yes.
But 10 consultant psychiatrists have declared publicly they are voting No. They say a total ban on abortion on the grounds of suicide would endanger the lives of some vulnerable women. The Council of the Psychological Society of Ireland is also urging No.
The masters of the three main maternity hospitals in Dublin say they are voting Yes but 25 obstetricians and gynaecologists, practitioners in the same medical field, are urging No.
There is division also on whether defining abortion as the intentional destruction of human life after implantation, rather than conception, will give legal protection to the morning-after pill.
The Government says it will; the independent Referendum Commission and the Catholic bishops say the status of the morning-after pill will still be in doubt.
It is important to realise the morning-after pill and the IUD are not mentioned at all in the Bill. There is, at best, a presumption of legality which will ultimately be tested in the courts. There is no certainty about it.
The masters of the maternity hospitals are, understandably, keen to be given legal protection for their treatment of women during pregnancy. They will be obliged to make and sign a written record setting out the reasons they decide to carry out a medical procedure on a pregnant women in order to prevent a real and substantial risk to her life.
A Minister of the Government will make an Order, after the referendum, for the maintenance of these records in hospitals.
Likewise, a Minister will also make Orders nominating the "approved places" where medical procedures can take place on a pregnant woman where there is a risk to her life.
The Minister for Health, Mr Martin, has suggested that 30 hospitals will be nominated but they are not specified in the Bill. While other provisions of the Bill will be circumscribed by constitutional referendum, there is nothing to stop the Minister from varying these Orders from time to time.
Doctors, in summary, will be able to carry out medical procedures on pregnant women if there is a real risk to their lives and the unborn, as a consequence, may be aborted. But, this is not abortion in accordance with the Bill. It elevates the current ethical guidelines of the Medical Council to constitutional status. If the Medical Council, with the advance of medicine, changes these guidelines in the future, it is not known whether they will have to be approved in another referendum.
The ban on direct abortion, which is defined as the intentional destruction of the unborn, will be an offence carrying a maximum jail term of 12 years.
The mechanism for holding this abortion referendum means, with the exception of the Orders which can be made by a Minister, nothing can be changed unless the approval of the people is sought in another referendum.
There is much dispute and debate about the five main questions being put to you in tomorrow's referendum. There is a lack of clarity in the answers.
The main issue, however, is whether suicide should be outlawed as a ground for abortion. You cannot vote to ban suicide without voting for the morning-after pill. And you cannot vote for the morning-after pill without banning suicide.
There is a final irony. If you want to vote No to suicide, you must vote Yes in the referendum. If you want to retain the status quo in the X case and allow suicide as a ground for abortion, you must vote No.