Sir, - This debate has seen a lot of scaremongering from the mutually antagonistic forces that make up the No campaign. On one hand, the Alliance For Life claims that the Abortion Bill will lead to widespread legalised abortion in Ireland. On the other hand, the Alliance For A No Vote claim that the introduction of the Bill will restrict medical services and put women's lives at risk. Let's face it: they can't both be right.
The Alliance For Life and other similar groupings have to face the fact that we are now living in the 21st century and that Catholic Ireland as they knew it is dead and gone, and with it all the moral certainties that it encapsulated. If they are truly serious about keeping abortion out of Ireland, they will have to overcome their quasi-theological misgivings about the Abortion Bill and engage in some realpolitik.
The stark reality is that if this referendum is defeated, there will not be another one. They have a choice between voting with their hearts - in effect ensuring that the 1992 Supreme Court judgment will be legislated for (with all its implications) - or voting with their heads, and ensuring that social abortion remains illegal in Ireland.
The Alliance for A No Vote, on the other hand, clearly realising that they were faced with a reasonable set of proposals, have (like their unlikely comrades-in-arms) resorted to sensationalism and scaremongering.
The removal of a suicide threat as grounds for an abortion does not deprive women of a vital medical right (as the ANV would have it), but rather rejects a clinically and morally unsustainable solution in favour of appropriate psychotherapeutic or psychiatric treatment and counselling, which is surely a much more appropriate intervention for both the mother and unborn child.
It is also wrong to claim that this amendment will put women's lives at risk - the whole point of having "approved centres" is not to restrict the availability of medical termination services, but rather to ensure that only those centres with the necessary expertise, resources and equipment can provide them. Surely this saves women's lives, rather than putting them at risk? At least the ANV is open as to its underlying agenda: "We want to win this campaign so that we can win a broader campaign later on abortion rights," to quote a spokesperson recently. Perhaps the Alliance For Life should take note.
I believe the Alliance For Life and its allies want abortion laws that strictly reflect to the letter the finer points of Catholic teaching. I believe the Alliance For A No Vote (or at least many of the groups affiliated to it) want the introduction of social abortion. I don't want either of these, and neither, I believe, do the broad mass of Irish people.
I believe it would be a tragedy if this proposal weren't passed; that's why I am voting Yes on March 6th, and why I'm urging others to do the same. - Yours, etc.,
D.J.MOORE,
Green Road,
Carlow.
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Sir, - A comment: many of us find ourselves between poles; we do not want careless abortion on demand, but neither do we want to rule it out it altogether, mindful of tragic cases and human frailty. We can neither fully shut nor fully open the door, yet are fearful to leave it ajar.
To say Yes in the referendum does not answer our dilemma, because its proposals are too narrow for our broad and complex concerns. So we prefer to hold opposite viewpoints in tension and edge towards rightness.
The parable of the Good Samaritan (Luke 10: 25-37) poses well this dilemma for those of us who want to uphold one set of moral principles without losing others. Yet in doing so it warns of hypocrisy and shows how religious scruples may make us blind or indifferent to the plight of fellow human beings at our feet.
Addressed to an expert lawyer, Jesus's story moves away from definitions and takes the question to a particular situation - and the level of compassion and personal conscience. He teaches us to beware of letting national or even religious preoccupations specify an absolute moral code; it may not be merciful enough to meet the wounded agony of others on the ground, however caused.
My neighbour is the one to whom I can be neighbour, and that cannot be defined constitutionally. - Yours etc.,
Rt Rev RICHARD
HENDERSON,
Bishop of Tuam,
Knockglass,
Crossmolina,
Co Mayo.
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Sir, - We, the undersigned, are all members of the medical profession and wish on a personal level to make some comments on the forthcoming referendum. Firstly, we note that in the past several years there have been extensive efforts at political level to address the issue of abortion. These have included the establishment of a Cabinet sub-committee and interdepartmental working group which published the Green Paper on Abortion in September 1999, and the subsequent All-Party Oireachtas Committee which carried out wide consultation and published its report in November 2000.
Following from this report, the proposed constitutional amendment as outlined in the Protection of Human Life in Pregnancy Bill has defined abortion as the intentional destruction of unborn human life after implantation in the womb of the woman. Abortion so defined will not be permitted in Ireland if the referendum is passed. Medical intervention to save the life of the pregnant mother which is at real and substantial risk for reasons other than self-destruction will, however, be allowed, even if it indirectly leads to the loss of life of the unborn child. This is entirely in accordance with the ethical principles used by doctors in Ireland for many decades.
This Bill is designed to overturn the effects of the Supreme Court ruling in the X case which allowed for abortion in, among other cases, threatened suicide. We understand that suicide in pregnancy is extremely rare. The real issue, however, is not the rare occurrence of suicide in pregnancy but rather the difficulty that exists in predicting suicide. In one study reported from the United States, using the best available prediction techniques, correct prediction of suicide was achieved in fewer than 3 per cent of cases. This means that if abortion is to be permitted in every case of predicted suicide in Ireland, then in 97 per cent of cases the unborn child's life would have been destroyed unnecessarily.
Clearly this raises questions about the ability of a court in any jurisdiction to come to a valid adjudication about a case of predicted maternal suicide in which abortion is being considered. Undoubtedly, the pregnant mother who threatens suicide requires urgent psychiatric assessment and treatment, including, if necessary, hospitalisation. We consider, however, that the uncertainty regarding suicide prediction raises serious doubt regarding the appropriateness of abortion in the management of these patients. Indeed, we are concerned from evidence presented to the All-Party Oireachtas committee that women who undergo abortion for any reason have a significantly increased risk of subsequent suicide.
We welcome the unanimous agreement among the members of the All-Party Committee that there was an urgent need to reduce the number of crisis pregnancies in Ireland and that women in crisis pregnancies must be offered real and positive alternatives to abortion. We fully support this approach and we welcome the recent establishment by the Government of the Crisis Pregnancy Agency to deal with these issues. We hope this will help to bring about a better environment for women with crisis pregnancy, so that the rate of abortion will diminish.
The Irish medical profession has always placed the highest possible value on both the mother and the child in utero. This is reflected in low maternal and perinatal mortality in Ireland. This has been achieved by placing the emphasis on providing high quality care and treatment to the pregnant mother and her baby and not by direct and intentional destruction of the life of the unborn. This referendum is designed to further enhance the safety of the mother and child in pregnancy. We call on the Irish people to vote Yes.. - Yours, etc.,
HUGH C. BREDIN,
(Consultant Urologist),
Moneymore, Co Galway;
J. BRENDAN HEALY,
(Consultant Orthopaedic
Surgeon),
Glenard, Co Sligo;
MIRIAM HOGAN,
(General Practitioner),
Newpark, Kilkenny;
EAMONN McGUINNESS,
(Consultant Obstetrician),
Haddington Road, Dublin 4;
MARTIN MAHON,
(Non-Consultant
Hospital Doctor),
Cregg, Co Galway;
HELENA STOKES,
(General Practitioner),
Tullamore, Co Offaly;
ROSEMARY O'CONNOR,
(Public Health Doctor),
Foxrock, Dublin 18.
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Sir, - I wish to respond to Breda O Brien's article,"A better way for women than abortion" (Opinion, February 23rd), which criticises Doctors for Choice.
Doctors for Choice represents a broad spectrum of Irish medical practitioners. We work to create a climate whereby comprehensive reproductive health services are an integral and respected part of mainstream medicine. This includes promoting impartial counselling, which the Mahon report and others recommend as a way of reducing abortion numbers.
Although abortion is illegal in Ireland, up to 7,000 of our patients choose abortion abroad each year. Most of these patients feel they cannot consult a doctor, either before or after their abortions. They receive no medical attention in Ireland, and are more likely to have second-trimester abortions which are problematic medically, ethically and psychologically.
Most could have had first- trimester, medically induced abortion, or safe early abortions without the known risks of general anaesthetic, if such treatment were legal at home. Instead, Irish women who are ill, suicidal or having abortions due to fatal foetal malformation have to travel, and are therefore more likely to have delayed, invasive operations, under general anaesthetic.
In addition, it is important to note that the ban on abortion here does affect mainstream obstetric practice in many ways which are undesirable for both doctors and patients. Patients are not always told about foetal malformations diagnosed on ultrasound and are not offered routine ante-natal screening for malformations; ante-natal cervical cancer screening is not performed, and patients who have hydroencephalic foetuses are delivered by Caesarean section. None of these would be acceptable obstetric practice in other countries.
For those women in crisis who nonetheless continue their pregnancies, with our support, many standard psychotropic drugs are contra-indicated because of danger to the foetus, especially in the first trimester. Women with psychiatric illness are frequently among the most marginalised and impoverished members of society. It is for these reasons that the medical management of crisis pregnancy, whatever its outcome, and in particular in the case of psychiatric illness, is more appropriate in the country of origin.
We believe the referendum represents a deliberate attempt to criminalise medical practice because it also proposes to imprison abortion patients for 12 years, and to imprison doctors and nurses who help them.
It is a shame that columnists such as Breda O'Brien continue to reduce this important health care issue to the level of sound-bite politics. As doctors we are concerned to bring medical and scientific expertise to public policy deliberations and media debate, in an independent and unprejudiced manner. - Yours, etc.,
Dr JULIET BRESSAN,
Doctors For Choice
in Ireland,
Dublin 2.
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Sir, - I have very great sympathy with the agonising situation faced by Deirdre de Barra (February 24th). Some years ago, I too went through a deeply traumatic experience when our fourth child was born with an untreatable chromosomal defect, with attendant physical and mental handicap, affecting every cell in his body. Medical opinion was that he might live for only three days.
These days his physical health is good, and because of the high quality of care he receives with the St John or God organisation he is able to have a happy life, enriching those who look after him. This has motivated his three elder siblings to enter caring professions.
Our experience with our son has made us realise the supreme value of all human life, from conception to natural death. It is indeed a tragic irony that the procedure of amniocentesis, pioneered by Sir William Liley to open up the possibility of treating abnormalities before birth, is now routinely used as a "search and destroy" technique for eliminating those whom society considers incapable of a meaningful existence.
Moreover, experience in other countries has shown that any procedure detrimental to the value society puts on the lives of our handicapped children in the womb is inevitably followed by a downgrading in the quality of care accorded to to the disabled already born. I saw this at first hand when working as a midwife and children's nurse in Britain. - Yours, etc.,
MARY E. LOWRY,
SRN, RSCN, SCM,
Villaréa Park,
Dún Laoghaire,
Co Dublin.
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Sir, - I despair at how cruelly women such as Deirdre de Barra are treated by the Irish State. To compound this treatment, the Taoiseach, the Tánaiste and the Attorney General decline to respond to Ms de Barra on the grounds they don't comment on a "specific case"(The Irish Times, February 26th).
How dare they put a question to the Irish people that affects thousands of "cases" every year, and themselves refuse to comment on just one?
Don't they know what the referendum is about? - Yours, etc.,
FIDELMA O'REILLY,
Stockholm,
Sweden.
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A chara, - May I propose we add a second amendment in the upcoming referendum that will criminalise pointless, uninformative and confusing poster campaigns that will be as annoying on the ground after the polls as they are on the poles before it?
Should it not pass, I further suggest we re-run it with however many Nice referendums it takes. - Is mise,
JERRY TWOMEY,
Woodlawn Court,
Dublin 9.
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Sir, - Why such an interest in conflicting Yes/No referendum posters? Who cares about the party line? I would prefer to make my own informed decision on this vital issue. My concern is: how can such an aspiration be realised? - Yours, etc,
JACQUELINE FACTOR,
Shrewsbury Park,
Dublin 4.