Being a doctor is about saving life, not taking it, suggests Dr Berry Kiely, who argues that a Yes vote will enhance the current protection for mothers and babies
As a doctor I would say there are many good reasons to vote Yes on Wednesday, and I cannot think of a single good reason to vote No.
The amendment will strengthen and support the current protection for mothers and their babies. It recognises that, in pregnancy, a doctor - almost uniquely - has a simultaneous duty to two patients and obliges the doctor to do everything in his/her power to save the life of both. Thus the amendment enhances protection of both mother and baby.
Some have tried to suggest that the amendment makes an invidious distinction between mothers suffering mental disorders and those suffering from physical disorders. This suggestion is entirely without foundation. The referendum proposal requires all necessary treatment of an ill mother in pregnancy, and thereby avoids putting women's lives at risk.
The treatment may be medical, surgical or psychiatric. A psychiatrically ill pregnant woman will receive the same care that a psychiatrically ill non-pregnant woman would receive.
Those who suggest that abortion is a treatment for suicidal tendencies have failed to produce a single piece of evidence to back up their claim. Indeed the Confidential Report on Maternal Deaths in the UK points to the fact that suicide is responsible for 27 per cent of maternal deaths there - in spite of the ready availability of abortion.
The authors of the report clearly identify improving the standard and availability of psychiatric services as the key factor in reducing maternal suicide.
The issue of rape and sexual assault is one that must be treated with great sensitivity and expertise. The first concern must be not to make an already bad situation worse. We should not add the trauma of abortion to that of the rape.
All the studies on management of rape confirm that overcoming the trauma of the rape experience is the primary concern for the vast majority of the victims. The goal of treatment is: "to regain a sense of safety . . . a sense of self and (to) re-establish sharing . . . relationships with men, women, and society." Studies also confirm that most women do not choose abortion in these circumstances.
Several reasons are given for this. First, many women felt that abortion was another act of violence. Secondly, some saw an intrinsic meaning or purpose to the child. Thirdly, at a subconscious level some victims felt that by continuing the pregnancy they would in some way conquer the rape.
An issue that has received very little coverage in this debate is the negative consequences of abortion for women. Abortion can cause infertility, especially where there is concomitant infection . . . Women can suffer from depression after abortion. A recent study showed that even after early abortions up to a fifth of the women are depressed two years later.
A Finnish study found suicide was seven times more common in women who had had abortions compared to those who carried their babies to term. It is now generally accepted by most doctors that abortion increases a woman's chances of breast cancer and there is currently a case before the courts in Australia where a woman with breast cancer is suing her doctor for not warning her of this when she had an abortion.
Ethical medical practice - which has a tradition going back over 4,000 years - has always prohibited the direct and intentional taking of life. Those seeking to change this tradition risk undermining the whole basis of the trust which is central to the doctor-patient relationship. When doctors start to use their skills to destroy life rather than to save it, something essential has changed in their thinking and practice.
Sadly, it is true that we cannot always preserve life and sometimes a patient dies as a side-effect of necessary medical treatment. This does not mean that the death of the patient was intended. It does not mean that there is any moral or legal blame attached. It is no more than an example of the limitation of human endeavour. This amendment recognises this reality but puts a clear onus on the doctor to do everything possible to save the life of both mother and baby.
The death of a baby as a side-effect of the necessary and proportionate treatment of an ill mother is not, and has never been, unlawful or unethical. That was the situation before the people adopted the Eighth Amendment in 1983. It was the situation after 1983. And, it remains the situation today. About this there was never any ethical doubt. The plain and simple language of the referendum proposal makes it blindingly clear that legally and ethically nothing is being changed in this regard.
The amendment is, at its simplest, incorporating into law the essential principle of ethical medical practice - no more, no less. It prohibits abortion - the intentional destruction of an unborn after implantation in the womb. Here it is worth reminding ourselves that what is being prohibited is induced abortion in its ordinary, clinical meaning. By the time a woman even realises that she might be pregnant, implantation has already occurred! The amendment makes a clear distinction between abortion, on the one hand, and the death of an unborn baby as a side-effect of the treatment of an ill mother. In express terms it reverses the effect of the decision of the Supreme Court in X - and not just in relation to suicide. It requires that both mothers and their unborn babies receive whatever treatment is necessary.
In short, the amendment requires that women and their babies get the best of care and dispels any legal confusion there may have been about the treatment of ill mothers in pregnancy. This is something that doctors should welcome, not reject. And that is why, as a doctor, I will be voting yes next Wednesday.
• Dr Berry Kiely is a paediatrician and medical adviser to the Pro-Life Campaign