This is the 12th session in our series of meetings on the heads of the protection of life during pregnancy Bill 2013. I remind everyone to switch off their mobile telephones. I will call the Minister of State at the Department of Health, Deputy Alex White, to be followed by contributions from Members, Senator Rónán Mullan on behalf of the non-Members of the committee and the Minister of State will close the session. Is that agreed? Agreed.

I am pleased to be here today at the closing session of these public hearings on the general scheme of the protection of life during pregnancy Bill 2013.

First, I wish to commend the Chairman, Deputy Jerry Buttimer, all the members of the committee, those Members of the Oireachtas who participated in these hearings, and all the invited guests for the balanced and respectful approach that we have witnessed over the past three days. Second, I have been following the hearings as closely as I could manage, and have noted that there is a high level of consensus on most of the provisions contained in the General Scheme. There are also, of course, diverging opinions on some of the provisions - both within and between the legal and medical professions represented before the committee.

I assure you Chairman, and the members of the committee, that we will examine these issues from a policy and legal perspective with a view, where possible, to improving the operation of the Bill. I am confident that all of the submissions, and the report that this committee will produce on its deliberations will greatly assist me, the Minister for Health, and officials in examining and refining the issues involved in the drafting of this Bill.

The aim of the Bill is to regulate access to lawful termination of pregnancy in accordance with the Supreme Court judgment in the X case and the A, B and C v. Ireland judgment of the European Court of Human Rights. The purpose of the legislation is to clarify in statute what is currently already lawful as a consequence of the judgement in the X case, and to set out clearly defined and specific circumstances in which this treatment may lawfully be provided.

I would like to address some of the issues that have been raised by contributors during the debate, to allay, if possible, some of the concerns involved. I am aware, for example, that there has been considerable debate about head 4 and the inclusion in the legislation of the risk of loss of life by way of suicide. The Supreme Court in the X case specifically recognised a risk to life arising from suicidal intent, which it referred to as a risk of self-destruction, as a legitimate basis for permitting termination of pregnancy - but only in circumstances where there was a real and substantial risk to the life of the mother, and where this risk could only be averted by the termination of her pregnancy.

Ireland, as a signatory to the European Convention on Human Rights, is under a legal obligation to implement the judgment of the European Court of Human Rights in A, B and C v. Ireland, and must put in place a legislative or regulatory regime providing effective and accessible procedures whereby pregnant women can establish whether or not they are entitled to a lawful abortion in accordance with Article 40.3.3° of the Constitution as interpreted by the Supreme Court in the X case. The Bill has taken account of the fact that assessment of self-destruction is more subjective and, therefore, requires more safeguards to be put in place. It specifies that three doctors are required to form an opinion and jointly certify that a termination of pregnancy may take place if it is necessary to save the woman's life. This provision is made in the Bill in recognition of the clinical challenges associated with accurately assessing suicidal intent, and the absence of objective clinical markers. The legislation specifies that one of the doctors involved must be an obstetrician-gynaecologist and the other two must be psychiatrists. It also allows that it may be appropriate that the pregnant woman's GP is consulted during the process of assessment, where practicable.

I am also aware that the lack of a gestational time limit in the Bill has been raised, and that concerns have been expressed in respect of where a termination of pregnancy is deemed necessary, and the pregnancy has reached a stage of gestation at which the foetus is or may be viable. In such situations, it must be stressed that the wording of Article 40.3.3° and the judgment in the X case make it crystal clear that the life of the unborn must be protected and vindicated where practicable. This means that where a woman has a pregnancy that places her life at risk, and her foetus is or may be viable, she may have a right to have the pregnancy brought to an end but not a right to insist that the life of the foetus be deliberately ended.

In circumstances where the unborn may potentially be viable outside the womb, doctors must make all efforts to sustain its life after delivery in accordance with existing medical practice with early deliveries. In this regard, I note that this aspect was referred to at some length by a number of the obstetrics experts who appeared before the committee.

It should be noted, however, that this requirement does not go so far as to oblige a medical practitioner to disregard a real and substantial risk to the life of the woman on the basis that it will result in the death of the unborn. Essentially, the decision to be reached is not so much a balancing of the competing rights, rather it is a clinical assessment as to whether the mother's life, as distinct from her health, is threatened by a real and substantial risk that can only be averted by a termination of pregnancy.

Concerns were raised about ensuring that the monitoring systems provided for under head 11 would incorporate appropriate requirements to preserve the confidentiality of the patient and the certifying practitioners. The provisions with respect to monitoring have been included in the Bill because there is a need to keep records on the terminations carried out, and the medical reasons that gave rise to same. Information is also required to inform policy, as well as to ensure that the various statutory principles and requirements are being upheld. However, although the Bill provides for the collection of this data, it is not the intention that personal or identifying information will be published. I think it is clear in the explanatory notes to the Bill that it is not proposed that the Freedom of Information Act 1997 will apply to the records collected as part of the monitoring systems.

In closing, the main objective of the legislation, if I may reiterate again, is to clarify what is lawfully permissible in cases where there is a real and substantial threat to the life of a pregnant woman, and to set out clearly defined and specific circumstances in which a termination may lawfully be carried out. As the committee will be aware, a very significant amount of work was involved in producing the heads of this legislation. More than 50 drafts were composed as we moved to produce what we believe to be balanced proposals that meet our obligations. Of course, as the committee is fully aware, the next phase is the drafting and publication of the Bill. Following publication the Bill will go through the Houses of the Oireachtas, where there will be further opportunity for parliamentary engagement and input. I look forward to working closely with colleagues in both Chambers as we consider the Bill.

I thank the Chairman, his officials and all of those who have participated in any way in these public hearings for the invaluable contribution they have made to this issue both now and at the public hearings in January, and for the assistance they have provided to me, the Minister for Health, and our officials in this work.

I welcome the Minister of State. We had the three days of hearings and preliminary discussions about legislation in January and there is no doubt they were beneficial in terms of Members being able to ask questions of experts. The Minister of State said he was following the debate closely and noted a high level of consensus. I can assure the Minister of State there was a high level of consensus in the areas where Members agree and where experts agree but there was a high level of non-consensual discussion as well in the sensitive area of head 4.

Go raibh maith agat. I thank all who participated over the past three days of hearings. I do not exaggerate when I say that this has been an intense and sometimes gruelling engagement. In particular, I commend the Chairman and members of the Oireachtas joint committee who very responsibly faced the task that was set. The process has been and will continue to be challenging for many of us. It has been a necessary engagement and, as described by one of the participants, an exercise in democracy.

The hearings have helped to tease out and clarify a number of issues related to the heads of the Bill. This has not been about trying to get some Members of the Oireachtas across the line, as portrayed by some sections of the media. The media's focus, and I mean no disrespect to any of them, on Oireachtas voices who hold strong rejectionist views of the Bill, many of whom are not members of the committee, has overshadowed the hard work and dedication of committee members from all parties. Real questions and deep concerns have been addressed here, and that is positive. No one should be surprised that consensus has not emerged among all of the medical and legal voices. Among them, as much as any section of society, there are diverse views on the question of abortion.

That said, I believe there is now a very widely held view, and I would say it is a majority view, in society that legislation along the lines set out in the heads of the Bill is not only necessary but long overdue. Implementation of the X case judgment and legislation in compliance with the A, B and C case judgment are required as soon as possible. We must safeguard the lives of women. We must provide legal clarity. We must ensure there are clear guidelines for clinicians. Some have argued that these conditions already exist. I would argue, and Sinn Féin has long argued, that is not the case and, hence, we need the legislation.

Much of the focus of these hearings, and public discussion generally, has been on the inclusion in the heads of the Bill of the threat to the woman's life through suicide. That is understandable. All aspects of that question have been thoroughly explored. Varying views have been given but the time for decision is approaching. While the anticipated incidence of its employment is thankfully very low, it is our view that it must remain in the Bill. It is a pity the suicide aspect has dominated discussion. It has tended to obscure the other vital and important elements of the Bill and other much more prevalent, commonplace and likely threats to the lives of women in pregnancy. Do the heads of the Bill go far enough to protect women in that regard? That is a question we must all, individually and collectively, address.

We must move on. The Government needs to publish the Bill. It needs to be progressed through the Oireachtas. Sinn Féin will assess the published Bill in light of its party policy and the questions, answers and issues raised during the hearings and in the wider debate. We will engage on each Stage of the Bill's passage. We are committed to ensuring the strongest possible protections are in place.

I welcome the Minister of State, Deputy White, to the final session and thank Deputy Buttimer for chairing the committee. I thank all the various witnesses who presented over the past three days. I thank each and every member of the committee and other Members of the Oireachtas who contributed. I also thank the committee secretariat for its excellent work.

The process has been ongoing for quite some time. We have debated the issue on three occasions in the Dáil Chamber, two to discuss the Bills published by Deputy Clare Daly and one to discuss the Sinn Féin Private Members' motion. The committee held a hearing that lasted three days in January and we have had another three days now. With so much discussion and all of the presentations, it can be difficult to see the wood for the trees, to some extent. Therefore, it is important to restate the parameters within which the legislation is being brought forward. They are restrictive. Article 40.3.3° of the Constitution protects the life of the woman and the unborn. The X case concerns a real and substantial threat to the life as distinct from the health of the mother. In a situation where the threat to a woman's life can only be averted by termination, the woman will have the final say.

The past three days have been very helpful and necessary. We have heard varying degrees of views right across the spectrum, which are sincerely held views that were well thought out and put forward. The Minister and his Department will have to examine, give further consideration to and allow discussion on the many areas that have been highlighted, such as an appropriate location, the very significant criminal sanction in the Bill, the timeframe for review, consent regarding people who are under age, particularly children, monitoring of the Bill and various other areas that were highlighted over the course of the hearings.

These three days were helpful and necessary. I look forward to the completion of the committee's report and the presentation of that report to the Department, as the Chairman stated, by the 30th of this month, and the Minister publishing the Bill at an early date.

I thank the Chairman for his chairing of the past couple of days and his direction on breathing exercises, which have been most useful for some Members from time to time. I thank the clerk to the committee and his team for their support in preparing the past couple of days.

Following on from what Deputy Seamus Healy spoke about, that there have been three Private Members' Bills on this issue and the committee held three days of hearings in January. I would go further and say there have been six successive Governments which have spoken about this and which have done nothing. I, for one, am glad to be a member of the Government that has decided to legislate for this issue and it is incumbent upon us to ensure that happens now because we have talked and talked about it. We now need to see the Bill published on this important issue for so many women and to see it pass through both Houses of the Oireachtas.

There is only one issue which I want to bring to the attention of the Minister of State, namely, head 19 on the criminalisation of women. We have heard, most interestingly, from psychiatrists on both sides of the argument who agree that this is a difficult area, that they do not want to see criminalised women who may purport to take medication that would be, in essence, a medical abortion. The head is drafted broadly. Today Mr. Callanan even spoke about the fact that it is drafted so broadly that it could be interpreted that somebody who is advocating for a pro-choice regime could be liable to criminal sanctions. That is something that should not be part of the heads of the Bill. I would ask the Minister of State to bring that back to the Department and the drafters and that we would refocus our energies around head 19, taking reference and looking at the Criminal Law (Suicide) Act 1993 which similarly imposes a penalty of 14 years but does not criminalise the person who attempts suicide. We could use this as a basis for us having similar sanctions for those in relation to abortion.

I thank everybody. I thank my colleagues and fellow members of the committee for their contributions over the past number of days. As they say, it has been emotional.

The 2002 referendum was my first referendum vote. I worked in the private sector for 15 years and then headed up different children and youth NGOs, both in a voluntary and professional capacity. In these roles, I have always listened to the debate but I have never had to actively formulate a position. I am a little nervous now because this is the first time I am publicly stating how I feel on this issue.

The hearings we held, both in January and over the past three days, have given me an opportunity to form a definitive position. I want to begin by thanking all of the experts, both in January and over the past three days, for their informative and sometimes contradictory testimonies. All have been extremely useful. I thank my colleagues, the secretariat and, in particular, the Chairman, Deputy Buttimer.

I can now say in confidence that I support the Government's decision to legislate. These heads of the Bill only deal with difficult, rare and complex circumstances.

Of course, I would add some caveats. I am concerned about us separating out physical and mental health. In the wider public debate, it will be a step back for us. Therefore, I believe that heads 2 and 4 should be merged. I have not heard legal reasoning - obviously, I have heard contradictory reasoning - but from what I have taken, I do not believe that they should be distinguished. As noted by the expert group, differentiated treatment does not appear to be required for medical or practical reasons. Dr. McCarthy stated that suicide in pregnancy is a real risk; it does happen. There is no distinction in Article 40.3.3° and, therefore, to exclude it in these heads of the Bill would be to change the law. I do not believe that we should have any differentiated treatments.

I am concerned about the scope of head 19. It is extremely broad, in fact, too broad. It covers a wide range of activities, including and beyond those previously covered by sections 58 and 59 of the Offences Against the Person Act 1861. Some of the scope is unclear about what exactly is covered and the penalties are disproportionate.

I have concerns over the appeals process timelines and conscientious objection. We need a further discussion exploring this issue.

I am concerned about the silence in relation to children, specifically young girls. I believe we need specific legislation to address many of the issues raised over the past few days. I am troubled that we will compound the situation of voiceless children who are in the care of the State in this legislation. The hearings have also highlighted the importance of the assisted decision-making (capacity) Bill, which is urgently needed.

I found any association, actual or implied, between abortion in Europe and the Holocaust to be distasteful in the extreme. Besmirching the memory of millions of murdered Jews by turning them into a pawn in the abortion debate displays a woeful ignorance of the Holocaust and a woeful disrespect to the memory of the victims. Whatever one's opinion on the abortion issue and the debate between well-intentioned persons on both sides of the argument, there are no two sides of the Holocaust. I would respectfully encourage my colleagues to desist from making this highly offensive connection during the continuing debate. We must not allow the 6 million victims of a diabolical premeditated attempt to eradicate an entire people to be dragged into this abortion debate.

I was appointed by the Taoiseach, particularly in recognition of my work on children's rights. Advocacy on children's rights has not been an easy road to travel. Therefore, on this decision and in talking about child protection, I had to consider my position, but I stand here in confidence and I will continue to constructively engage with care, conviction and compassion.

I thank the Minister of State for making it clear this evening in his closing statement what these heads of Bill are about.

The time is right for this Bill. We have seen it over the past three days. It has been a privilege to be here. I have been proud to be in the Chamber with Members, those on the committee and those who are not.

I have been moved and touched by many statements that have been made. Most of all, I want to express how proud I am of the experts who have been here from all walks of life, whether doctors, medical experts, lawyers or whoever. It shows the considerable expertise in this country and the pride we should have in our systems, whether medical or legal.

Our role of the past three days was to listen and learn - that was my role anyway and I am sure it was that of the members of the committee as well - because we can only learn if we listen to each other. We learn wisdom, we learn understanding and, above all, we learn compassion.

As I stated, the heads of the Bill are about having compassion for those who find themselves in a very difficult place. Whether in the Dáil, in the community or at home, now and again, we all must have a bit of compassion.

My focus over the past few days was on saving women's lives as well as the life of the unborn. It was made very clear by doctors here that their job is to save lives, whether it is the mother or the unborn. That came across clearly to me.

On whether the heads of the Bill go too far or go far enough, one aspect that stood out which is not in the heads of the Bill was that foetal abnormality was raised on a number of occasions by many in the Chamber. Many of the calls I received have been about that issue. As to whether it deserves consideration at this time, I am not too sure.

The role of GPs, which was referred to by many Members here, is most important. The GP, for anybody, whether a mother, a father or a child, is the first port of call. We need to rely on the expertise of the GPs. In my view, that is honest and open.

I still believe in good faith. It is important in everyone's life to believe that when one puts one's life in the hands of someone else, they will look after one and do the best they can. That is what we do as committee members, as Members of the Dáil and as legislators; we do our best. We may not always be right but we do our best and, consequently, the people decide to elect us on good faith.

I found the arguments on both sides to be at times interesting, at times offensive but above all, genuine. I mean this with the greatest of respect. No one in this room, regardless of what side of the fence he or she is on, wishes to see people losing their children at any stage or time and there is general concern about the mother and the child. One must consider all these viewpoints because I know I have. As I stated, members have listened to the experts, including the masters of the maternity hospitals, and others. I believe that on a daily basis, they will be the people who will make the decisions. It will not be those who are sitting in this Chamber and nor will it be a piece of paper. However, it will be what actually is done when someone arrives into their accident and emergency units.

I was filled with great pride to see people appear before the joint commitment but above all, by Mrs. Justice Catherine McGuinness. She is a woman of wisdom and great presence who has done this country a huge service even through her presence here, which I greatly appreciate. I will finish by thanking the Chair. While it is difficult to chair any kind of meeting, it is especially difficult when there are widely differing views. However, I believe he handled this task with care. I also thank the Oireachtas staff and my other colleagues on the joint committee, as well as those who were not on the joint committee and those who have just arrived on the committee. They have all done a wonderful job, even though they sometimes took over my time. I also thank the witnesses, the people in the Visitors' Gallery, all the former Members of the Oireachtas who attended and especially, the people at home.

I will start by thanking the Chairman for accommodating me as a substitute member of the joint committee, for his engagement prior to the hearings with regard to people coming in and for his subsequent chairing of the joint committee, which was good. That said, the process was very rushed. While that was not the Chairman's fault, it was rushed both for members and for those presenting, as some of the latter have noted subsequently. Despite this, however, it has been quite productive.

The question all members will ask themselves is what they have learned from these hearings. Before the proceedings began, for example, members knew the A, B and C v. Ireland case in the European Court of Human Rights did not involve suicide. They learned that the circumstances of the C case were covered adequately by current medical practice on the treatment of cancer patients and this point was stated here emphatically. They also learned, which they probably knew, that the European Court of Human Rights required not legislation but clarity surrounding the treatment to which Miss C was entitled. They learned an interesting point today in respect of the X case, which is that where an argument in the Supreme Court or any court is conceded, it loses its evidential value and therefore, it only binds the parties in that particular case. This was the incontrovertible evidence presented to members today.

A number of those who presented today stated we are not required to legislate in this instance. I took particular note of the comments of the eminent former Supreme Court judge, Mrs. Justice McGuinness, who stated that over the past 21 years, Governments did not act unconstitutionally by not legislating. Members also learned, although they probably knew it from the previous hearings, that it is not possible to predict suicide. A British study demonstrated that it is only correct in 3% of cases, with 97% being false positives. Emphatically, members learned from all psychiatrists appearing before the joint committee, be they pro-choice or pro-life, that abortion is not a treatment for suicide. I believe that was a unanimous view.

Members did learn something that presents a challenge to the Government, namely, that where a woman presents with a crisis pregnancy and in distress seeking an abortion and is not mentally ill, she is entitled to refuse other treatments such as psychotherapy or home visits that might be offered to her. If she still refuses, she then will be entitled to a certification to allow her to have an abortion. Because of her distress, she will perceive her only solution to be a termination of the life of the baby. This presents a significant challenge and from what I have heard in recent days, I believe that what the Bill is most likely to deal with under head 4 are cases of suicidal intent not associated with mental illness. I believe, as stated by a number of witnesses, that both in law and in practice, this is a highly significant change from the current position.

Members also learned, which certainly has concerned me and I expect most members of the joint committee, the psychiatric profession is divided and more or less polarised on the issue. If, as has been suggested, pro-life psychiatrists do not participate or the selection process is skewed or both, my honest opinion is that Ireland will have a liberal abortion regime within a short period. As the debate progresses, I genuinely hope the Government will pay attention to and act on the evidence presented generously to the joint committee over the past three days by those who appeared before it. This did not happen on foot of the hearings last January and in this instance, I appeal to the Government to pay close attention to the points made, which summarise much of the evidence that came before members.

I thank the Chair for the very good job he did over the past few days. I also say well done to his staff at the top table. The Chairman kept everyone under control and a very good exercise was conducted. I actually learned a lot over the past three days.

In his statement to the joint committee, the Minister of State stated, for the benefit of the public, "Of course as the committee is fully aware the next phase is the drafting and publication of the Bill". Can he provide a timescale of when that publication will take place? From the first page of his statement, I understand he intends to take into account the submissions that have been made during the past three days. Again, he should elaborate a little in order that people, including me, are assured these submissions will be taken into account.

Three areas really stood out for me. The first was the area in respect of children highlighted by Senator Jillian van Turnhout. Many questions have been asked about young girls in care in particular and on how precisely that cohort of people will be dealt with. I am sorry to bring it up but I have concerns in respect of head 19 and the reference to 14-year sentences. One thing I learned in the course of these meetings is that women are importing abortifacient drugs to have abortions. Were a girl or young minor to import some kind of drug, would such a person face criminal charges associated with that provision? I do not believe the issue of people importing such abortifacient drugs was really discussed.

The final issue pertains to the issue of conscientious objection, which was brought up today. I seek assurance that there will be a balance between what will be the law of the land and the conscientious objections of the medics. While I understand it fully, I also wish to ensure that a woman who enters the hospital will be assured of the best treatment. Dr. Simon Mills today brought up the provision that no institution, organisation or third party shall refuse to provide a lawful termination of pregnancy to a woman on grounds of conscientious objection. However, if, in respect of a board of management or whoever runs a hospital, this is not the case, how shall one ensure that this woman will get the treatment she expects?

I thank the Chair for the impeccable way in which he has run the proceedings over the past three days. I also thank the clerk and the secretariat for running the proceedings so well. I feel privileged to have taken part and to have been enabled to take part as a substitute member, that is, as someone who has just come to the committee.

I welcome the Minister of State and thank him for his clarity in addressing some of the issues that have arisen over the past three days. All members are mindful of his comments that they are scrutinising the heads of the Bill to ascertain in what way they can improve the operation of the Bill, bearing in mind their obligation as legislators to ensure an effective and accessible procedure is available for women who seek to access the lawful abortions to which they are entitled where their right to life is threatened by the continuance of a pregnancy.

Like Deputy Conway, I am very proud to be a Labour Party Senator and to be part of a Government that is at last facing up to its responsibilities as legislators in this regard. There has been a compelling need to legislate for the past 21 years, made more stark by the A, B and C judgment in December 2010.

I have a fundamental objection to the wording of Article 40.3.3°, the eighth amendment. Like Mrs. Justice McGuinness, I believe it would be preferable if abortion could be dealt with outside of the constitutional framework altogether, through legislation, but I accept that Article 40.3.3° is the law of the land, as interpreted by the Supreme Court and as upheld by the people in 1992 and 2002. Within that framework the Bill represents a reasonable if conservative attempt to ensure we have an accessible and effective procedure in place for women to access their constitutional rights.

In engaging constructively with the Bill, it has been very useful to hear the comments of the legal and medical experts we have heard in the past three days who have identified specific issues, to which other members have referred, where the operation of the Bill could be improved. I refer in particular to the definition of “appropriate location”, which should be reviewed to cover generally approved hospitals. The definition of “unborn” in head 1 was also raised. The merging of heads 2 and 4 was raised by many of the professional bodies. The requirement that psychiatrists have to be attached to particular institutions in head 4(1)(b) was a concern, in particular of the psychiatrists in the College of Psychiatrists of Ireland, on the basis that it was unduly restrictive and that too few psychiatrists would be able to fulfil the condition. Others pointed out in heads 6, 7 and 8 that the timeframe is too long and it should be shorter, for example, 72 hours for each stage of the review procedure to ensure it is accessible. In head 12 there is a need to ensure a woman has access in a timely manner to another doctor where a doctor exercises his or her right to conscientious objection.

Other speakers referred to head 19. Three specific problems arise with the head as currently drafted. First, the language is too broad. The framing of the offence is too broad. Second, the penalty is too onerous and, third, we must look carefully at whether we need to criminalise the woman - or in most cases the young girl - who might be at risk of prosecution under the provision. Dr. Ruth Fletcher’s submission was particularly useful in that regard.

Thank you, Chairman, for the way you have managed the public hearings. They have been extremely well organised and conducted. I thank you and the staff for the work done. I welcome the Minister of State, Deputy Alex White, and thank him for his contribution this evening.

I came to the hearings with reservations concerning two issues. I felt we had not done all of our homework on the heads of the Bill. The same two issues emerged as being of general concern. The first was head 4 and how the decision is arrived at by the two psychiatrists and the obstetrician making the decision. The proposals from the Medical Council and the College of Psychiatrists of Ireland should be taken on board. It is interesting to see that they are both coming out with the same view. The heads of the Bill do not adequately deal with cases where an expectant mother is under 18 years of age. The issue must be examined carefully.

It is interesting that it is our role to be legislators and that it is not the role of the courts. It is important to remind ourselves again of the words used by Mr. Justice McCarthy on page 82 of the judgment in the X case: "The failure by the Legislature to enact the appropriate legislation is no longer just unfortunate; it is inexcusable." That comment was made on 5 March 1992, more than 21 years ago, yet nothing has changed in the intervening period. We have a role to play as legislators and that is what we have done over the past three days. We have examined all of the angles on the preparation of the legislation we so urgently need to deal with the issue, and also to provide clarity to those who work in the medical profession.

I pay tribute to all of the experts who came before the committee, who gave of their time and who also put a lot of work into preparing the submissions. No one came before us without having carried out a detailed examination of what they had to say. They spent a long period putting their submissions together. No matter what angle they took – even if I disagreed with their views – everyone who came before the committee was extremely constructive.

On the completion of the hearings it is important to say to those in the medical profession that we are fortunate to have the lowest perinatal mortality rate in Europe. We should never forget that. It is the reason we must put supporting legislation in place to give clarity to those who provide the service on a daily basis, regardless of the time of the day or night they are required to provide the service. I thank the leaders of all of the groups for their constructive contributions throughout the three days.

I welcome the Minister of State, Deputy Alex White. I also pay tribute to your job, Chairman. There is a phrase in academic medicine that sometimes trying to chair meetings of academic doctors is like herding cats. The hearings were a bit like trying to herd cats when they had been taking crystal meth and possibly had rabies.

We should be temperate with our language.

I am very sorry. I regret any offence to the cat community for the latter remark of drawing an analogy between cats and Irish parliamentarians.

There can truly be few situations where the will of the people and the voice of the Constitution have spoken as clearly as they have on the narrowly defined necessity for abortion in very narrow circumstances, ones which entirely relate to the life of the mother, the termination of which life would also by necessity result in the termination of the life of the child. People who are pro-life need to understand what the Bill is about. It is about saving life; it is not about ending life. Those who allege that they have a superior pro-life position to others in that the position of those who support the Bill is somehow less purely pro-life than theirs are working on an assumption which has been tacit, and in some cases explicit in recent days, that a large number of citizens are plotting in advance to game the law, to cheat, to lie and to collude in the death of an unborn child for some secondary gain other than their own health. There is no other way to cut this up. That is the only interpretation that can be put on the suggestion by some that somehow the Bill will give wide access to abortion. I just do not think it is true. We must follow the Constitution.

We all have positions on abortion. It will surprise many of those present to know that I was the recipient of a scathing editorial by Doctors for Choice Ireland who pointed out that I was an anti-choice person. I have to say I am; if choice means having the right to choose to kill someone else, I am anti-choice. I do not support that right. I have a very nuanced position on abortion, which is one that would not make people on either side of this House particularly happy, but it is irrelevant today, as are the considerations of evidence-based psychiatry. We are here to defend the Constitution and in this regard let me remind the committee of the Garda oath:

I will faithfully discharge the duties of a member of the Garda Síochána with fairness, integrity, regard for human rights, diligence and impartiality, upholding the Constitution and the laws and according equal respect to all people.

We have the privilege of sitting in these Chambers without having to swear such an oath and not having to declare our loyalty to the Constitution, something which I hope will be fixed. That is all we are doing today; one Supreme Court verdict, Article 34.4.6° – the decision of the Supreme Court shall in all cases be final and definitive. It is not a case of ignoring it if we do not like it or think it is flawed. There is stuff in the Constitution I do not like but I will live by it and if I want to agitate to change it within the law, I will do it.

It is regrettable that the Minister, the CEO and the-----

Senator Crown’s time is up.

I am very sorry. I will finish on this point. It is regrettable that the Minister, the CEO and the chief medical officer have not been able to be present for the three days of hearings. They were present for the first session. The Minister left and we were under the impression that the CEO and the CMO of the Department of Health would be present, but they were not. I cancelled an international cancer meeting – not just my attendance but the meeting itself – of international speakers coming to this country. I cancelled clinics and got colleagues to cover ward rounds. It is regrettable we did not have a higher level ministerial presence.

I thank Senator Crown. He is way over time. He will find that Members of the Houses of the Oireachtas cancelled clinics as well. I call Senator Healy Eames to speak on behalf of the non-members of the committee and then I will take the final two speakers. In fairness, she has been present since the commencement of proceedings. She has four minutes.

This has been a most insightful opportunity to listen and to learn.

I start by thanking the Chairman and staff of the House, and especially the expert witnesses that came before us. We can stand proud in this country to have such fine people serving the people and our patients.

It is important we say that but my key remarks will be addressed to the Minister of State. I represent non-members; we are a disparate group from all parties and both genders. We want to see the key learnings and findings from these three days taken on board and integrated into the drafting of the legislation. Regrettably, we did not see the key learnings from January built into the heads of the Bill - that would be acknowledged by some of the members of the committee - even though they were recommended.

We are linked by our underpinning concern, namely, compassion for both the pregnant woman and the children. We are coming from the two-patient principle. We believe if the Government does one thing, if it acts on the best medical practice available, it will achieve the right outcome for both. If I have learned one thing in the last few days, it is that not acting on best medical practice will lead to serious problems and will be unsafe. We have learned today that it will lead to ethical considerations that the Supreme Court judgment has been deemed not ethical and can leave the State open to liability, as was confirmed today by Dr. Craven. This is a serious issue. We also learned that we are not obliged, although it is the wish of the Government, to legislate for the X case since it is not based on best medical practice and that is our duty as legislators. I am making a call, therefore, to the Government and the Taoiseach to seriously reconsider meeting the clarity required by the European Court of Human Rights while not legislating for X.

We are also concerned about term limits and I share the concerns of many about the criminalisation of women who have been in a dark and vulnerable place. It is too stringent.

Finally, I acknowledge those women who have had abortions, the women who have been hurt by abortion in particular, who did their best to come before the committee. In their absence, I acknowledge them.

I welcome the Minister of State to the House and thank the Chairman for the way he has chaired the hearings in such a calm and fair manner. I also thank all the witnesses that came before the committee, members, non-members and the staff.

We heard many expert witnesses in their professional capacities, with conflicting views, and at times personal views. The debate became intense at times and I have the utmost respect for people and their views. For me this debate is about women, pregnant women. The reality is no one knows more about pregnancy than women themselves. I do not want to insult any of my male colleagues and I know men play their part but they do not become pregnant. I agree with Deputy Catherine Byrne that there were times I found the debate here offensive.

As a woman, a mother and the mother of a teenager, I support this legislation for the X case. I know personally it is not always possible to save both mother and baby. I believe we must protect our doctors in the rare event that the mother's life is at risk and a termination is required. Where a woman with serious heart disease is pregnant and needs a termination to save her life, I would like to think she could have the termination in this country and would be able to avoid the distress of travelling.

As I asked in January, what about the parents who have a 14 year old daughter who was raped and made pregnant and may be suicidal? Parents along with that daughter must make a decision. I know not all but most parents would do one thing. I have concerns for children in care who are in that position and that position must be clarified.

There must be some changes to the Bill and I look forward to further debate as the Bill goes through the Houses. I am proud to be part of the Fine Gael parliamentary party and I am proud of the Taoiseach, the Minister for Health and the Government for bringing forward this Bill to protect women in the future during pregnancy and for saving lives, not killing babies, saving women's lives.

I thank the Chairman for his professionalism during the last three days and the entire team for the way the hearings have been carried out. It has been a pleasure to be here. To have had access to the level of expertise we have had for the last three days has been humbling for someone like me. To hear their opinions, expert and personal, has been hugely informative and I have been struck by the things I have learned in the last three days that I have not considered before.

I never thought I would be an expert in anything but I have decided I am an expert, I am expert on me. I am a woman who has been pregnant five times and I have four truly great children. I do not want there to be any legal doubt whatsoever for any of the doctors who made a presentation before us, or any of the wonderful people who deliver babies in this country and provide medical treatment to women, or any legal doubt, pause or cause for concern in how they would offer treatment because of a lack of clarity in the law. On that basis, I am very pleased we will bring clarity to the law.

On the suicidality element of the legislation, I have thought about this long and hard, particularly thinking of my own children, and such an awful thing happening to anyone I care about deeply as happened to the young girl in the X case. I have come full circle and decided I would want clarity not just in the assessment of eligibility but in the speed and swiftness of the action if anything like that ever happened to someone I love.

I am glad that the last three days have provided clarity for many people, not just in these Houses, but in the wider population. I am proud to have been part of this process and I urge speed in enacting this legislation before the summer recess.

What has been learned in the last three days must be incorporated into the Bill when it is published. Many issues have been raised on elements of the Bill and it is clear there are many areas where it must be strengthened.

There is no doubt that the one contentious issue is that of head 4 and suicide. Over the last three days of hearings, we have spoken in abstract on the issue of suicide and mental health but the reality is that suicide occurs in this society on a daily basis. The real issue of mental health and suicide should be a focus, with the necessary resources made available.

All of the expert witnesses who appeared before the joint committee on Friday and Monday referred to the need to provide adequate resources for maternity services. Investment is needed both in this area and in the provision of perinatal and psychiatric support for women who are pregnant. The concerns that have been raised in these hearings need to be addressed in the legislation. I hope that the one outcome of these proceedings will be that the Department of Health and the Oireachtas address the need to provide adequate resources to support women in pregnancy, irrespective of the decisions they or their clinicians must make.

I thank all Members for their contributions in the past three days, specifically during the closing session of this extremely important process of pre-legislative scrutiny of the heads of the Bill, for which I have the privilege of being present. I thank the main speakers of the main Opposition parties for their initial contributions, in particular Deputy Billy Kelleher for his extremely helpful insights.

When I stated my belief that there was a large measure of agreement throughout the three days of hearings, I was not oblivious to the considerable discussion that had taken place on head 4. I was simply pointing out that I believed there was a reasonable measure of agreement, a conclusion I reached primarily on the basis of the relative silence on many aspects of the heads of the Bill.

While I accept that Senator Walsh would have preferred the debate to have lasted longer, three days of discussion would be considered reasonably lengthy in anybody's book. I am sure all the concerns people have about aspects of the heads of the Bill were given some airing during the course of the hearings. From my observation of the deliberations, I share Deputy Kelleher's view that head 4 is the area of greatest concern. This was evident in the discussion.

Deputy Ó Caoláin is correct that the hearings were a very useful exercise in democracy. I was a Member of the Seanad, the House which normally sits in this Chamber, before my election to the Dáil and appointment as Minister of State. Parliamentarians on all sides may sometimes wish to have an opportunity for greater scrutiny of legislation. The scrutiny of the legislation before us has provided important insights which will be extremely helpful to the Government. Irrespective of which side of the argument one is on, all of us will agree that this has been an extremely positive exercise from the point of view of public elucidation, elaboration and questioning of issues.

Deputy Catherine Byrne stated she was proud to have been involved in this process and noted the level of expertise that was made available to the committee. Her point is well made. We should be thankful that such a high level of expertise is available to us and independent experts are willing to come before the committee, give evidence and subject themselves to what is essentially a cross-examination by Members.

I thank Deputy Seamus Healy for his contribution. The Deputy commented on a number of specific aspects of the heads of the Bill that he and others wish to have addressed in the period ahead. He referred, for example, to the definition of the term "appropriate location" and alluded to the stringency and extent of the criminal sanction provided, the periods to be allowed for review and the issues of consent and monitoring. I emphasise that all issues raised by Deputies and Senators in the course of the debates will be considered. I want to give people the comfort, respect, courtesy and assurance that everything that has been raised here will be considered and addressed in the preparation and publication of the Bill.

Deputy Ciara Conway made a fair point that, at least on one view, society, the country and Parliament are somewhat overdue in addressing this issue. Those of us who argued in the past that it was taking too long to address this issue can now cease doing so. Let us get on with the process that is required. While I agree with the tenor of the Deputy's remarks, I am glad, as she is, to be part of a deliberative process that is finally bringing forward legislation. I also accept the point made by Deputy Conway, Senator Bacik and others in respect of head 19 that the offence or restated offences has been cast, at least in one view, in relatively broad terms. We will consider this matter. The chief medical officer, Dr. Holohan, also made this point on the first day of the committee's hearings.

I thank Senator van Turnhout for her most insightful contribution. She and others raised a concern about the differential treatment of a risk to life based on physical risk as opposed to a risk to life from suicide. As colleagues will be aware, the expert group addressed this issue. The language that has been used and is reflected in the Bill comes at least to some extent from the expert group report, which stated the following:

Finally, the role of the psychiatrist is key where a termination of pregnancy is prescribed as appropriate treatment in case of suicidal ideation/intent. There are recognised clinical challenges in correctly diagnosing expressed suicide intent, for instance, the absence of recognised clinical markers.

The issue was, therefore, addressed by the expert group. I thank the members of the expert group, including Mr. Justice Ryan. While I accept there has been some debate about the group, on any reading, its report is a rigorous treatment of the issue which provides an extremely helpful background and foundation for the work we are doing.

I listened to the comments of Senator van Turnhout and others on penalties, sanctions and appeal times. On the two periods of seven days provided for in the heads, it is important to emphasise that these periods are maxima as opposed to prescribed periods. If the persons who are to consider the review have been empanelled within two or three days, the clock stops and the second seven days within which they must make their determination begins. The periods are maxima which arise from genuine concern in respect of the practicality and pragmatic requirements of bringing together professionals in the field in one place to do this work. The periods were set down as a result of a practical consideration and have certainly not been born of any other motivation.

I appreciated Deputy Catherine Byrne's comment that the time was right for the Bill. She and other speakers also raised the issue of foetal abnormalities. I believe it would be fair to describe her view as one of regret that it has not been possible to address this issue in the legislation. It is regrettable that this is the case. The issue may be revisited either by the Houses or the people at some future time. If I may express a view, I would support such a course of action although it is not something that can be addressed in the context of this legislation.

Senator Jim Walsh makes a reasonable point, albeit one with which I do not agree, in asking what was the requirement of the European Court of Human Rights. The decision in the A, B and C v. Ireland case required clarity, as the Senator acknowledged. The Government decided that the best way to ensure this clarity was by means of primary legislation to be followed by regulations. The Oireachtas makes the law and it is necessary to provide clarity to medical professionals.

It seems to me, if I may say so, entirely appropriate that legal clarity should be provided in laws passed by the Houses of Parliament. That is where it should be done. It is the decision of the Government that it should be done and we will respectfully introduce legislation in these Houses in the hope of winning the support of a majority for its passage. That is what the Government has decided and intends to do.

Senator Walsh posited a scenario - I hope I am not misrepresenting him but rather paraphrasing what he said - where a woman might present in a stressful situation, refuse treatment on offer to her and go on to seek and obtain certification for a termination, in accordance with the provisions of the Bill. This can only occur where there is a real and substantial risk to her life that can only be averted by a termination. We have to keep reminding ourselves of what is provided for here. It can only occur in circumstances where there is a real and substantial risk to her life which can only be averted by a termination. It is worth pausing and reflecting on the nature of that test, which is a very onerous one in my view.

There has been much debate between members of the medical profession, particularly the psychiatrists, echoed throughout these hearings, on the question of abortion never being a treatment for suicide or suicidality. I will not revisit this issue now except to repeat what Dr. Holohan said on Friday because his comments put the issue in the clearest terms. He said that we simply cannot say the circumstance of a real and substantial risk to a woman's life could never occur as a consequence of suicidal ideation. I agree with Dr. Holohan on this point. We simply cannot make the assertion that it would never occur, that a real and substantial risk to a woman's life could never occur as a consequence of suicidal ideation. I do not think anybody could make that statement.

The Deputy has spoken for 11 minutes.

Really? How much time was I allotted?

Five minutes.

I did not realise I was only given five minutes. I am sorry, Chairman.

That is very unfair on the rest of us.

To be fair, there was no time limit.

I did not think there was a limit and I wanted to mention everybody who spoke.

Had I known there was that much time available I would have insisted on having another word myself.

Deputy White is the most impressive witness so far.

He is not a witness.

Deputy Mitchell O'Connor urged me and the Government to make sure that all of the submissions were taken into account and I assure her that they will be. All submissions will be carefully considered and taken into account. She also raised the issue of the breadth of head 19 and expressed concern about the importation of abortifacients. All of those issues and concerns will be addressed. The Deputy also raised the issue of conscientious objection. She spoke about the fact that conscientious objection can be invoked by a practitioner but not by an institution. That is very important. An institution cannot invoke the protection of conscientious objection. Only an individual can do that. There is a further provision in the draft legislation that where an individual practitioner invokes conscientious objection, steps must be taken to ensure that the care is given, nevertheless, by a colleague or someone other than the person exercising that objection.

Senator Bacik asked that we look again at a number of specific issues. She raised the "appropriate location" question and I understand her point in that regard. I also understand her point about the requirement for a psychiatrist to be attached to a particular institution. Indeed, I would make the same point to her in respect of the time limit. These are maxima but still, I take the point that she raises.

I thank Senator Burke for his contribution and his reflections on head 4, particularly his concentration on the issue of minors. He raised particular concerns in this regard in the course of these hearings, as did others, and those concerns will be addressed. I agree with Senator Crown's ringing invocation of the Constitution and the importance of the Constitution as the foundation of our laws. I absolutely agree with him in that regard.

I am sorry if the impression was given that the Minister, the chief medical officer or the Secretary General of the Department would be present throughout the course of these hearings. It was never my understanding that it would be so. There was no discourtesy intended to the committee.

That was not communicated to members of the committee either, to be fair.

I know, from speaking to the chief medical officer and the Secretary General, that serious attention is being paid to what is happening here. The proceedings are being monitored and will be considered carefully.

Senator Healy Eames asked us to take on board key learnings and best medical practice. I say again, at the risk of repetition, that everything that has been said here will be considered. I must say, however, that the Government will introduce this legislation to the Houses. The Government will do that. The Government will introduce this legislation and it will certainly be based, in large part, on what has been before this committee in recent days, namely, the heads of the Bill. There is always scope for addressing technical questions, amendments arising from technical issues that have been raised, drafting issues that have been raised and so forth. Sometimes unintended consequences emerge in the course of debates and these issues can be addressed too. That is why these deliberations were so useful because they will help us to improve the Bill as we go forward, but a Bill there will be. A Bill there will be, I must say that.

One speaker, please.

I was asked about the timing and I wish I could give the committee a precise date for the publication of the Bill but, regrettably, I cannot do so. However, it remains the clear intention of the Government that this legislation will be enacted, subject to the agreement of the Houses, by the summer recess, which is the end of July. We are getting pretty close to that in terms of parliamentary schedules and so on. If members work back from the end of July, they will see that it will be necessary to publish the Bill in the coming weeks.

Senator Henry is absolutely right and I agree that this debate is about women's lives. While public and parliamentary deliberations are not confined to one gender, the Senator is right when she says that this is about women, their rights and their lives. I agree with her on that. I thank Deputy Regina Doherty for her contribution on the necessity to bring clarity, which is what we are doing with this legislation. I understand the points made by Deputy Naughten and heard his contributions over the course the three-day hearings. He referred to head 4 and expressed concern about some of the issues that arise there.

I thank the Chairman, the committee secretariat, the members of the committee and all of the Members of the Oireachtas who took part in this debate. It is important that they did so. The Government has introduced a very useful pre-legislative scrutiny process, not just in regard to this Bill but others too. I thank everyone for their contributions and look forward to further co-operation and close work on this Bill, which will be required over the coming weeks.

As Chairman of the committee, I have probably spoken the least in the last few days. We have had almost 30 hours of hearings, 40 expert witnesses appeared before us and on average, between 18 and 20 Members of the Oireachtas have participated in the discussion on the heads of the protection of life during pregnancy Bill. I wish to address my remarks to two audiences, if I may. First, to the people who are watching and listening at home, whether on Twitter, journal.ie or the Oireachtas website, what we have been doing over the course of three days is discussing the draft heads of a Bill. This is a draft document which sets out the objectives and the main provisions of that proposed Bill. It provides a framework, but not the detail. It is not the final Bill, as the Minister of State has said. It is not the new law but rather a preliminary document which is to be used to facilitate discussion and consideration before producing the Bill. It is part of a pre-legislative consultative process. I am very heartened by the number of people who have listened to and followed this debate through a variety of media and I wish to thank them for that.

In reforming the Houses of the Oireachtas, this Government has referred heads of Bills to committee. Indeed, this is not the first time our committee has considered a Bill on this basis.

It is and can be seen to be a democratisation of the legislative process, allowing stakeholders, us as members, and other experts and outsiders to have a real input into the preparation of proposed legislation. The entire purpose of this pre-legislative consultative process has been, I hope, to facilitate further consideration of the drafting of the Bill, which will ultimately be presented to the Oireachtas.

At the request of Government, this committee agreed to hold a series of hearings to examine the heads of the protection of life during pregnancy Bill. In carrying out this task the committee decided, as a group, to concentrate on the legal and medical issues which arise from the outline document. In doing this we have been greatly assisted by many experts who have voluntarily given of their time so that they could share their knowledge, experience and views.

Our expert witnesses have highlighted many issues, some which need further consideration, others which will require further clarification and more that are viewed as positive contributions to the law in this difficult and sensitive area. I know that all of the contributions made at our hearings and the detail obtained during questioning will be of valuable assistance when the committee is preparing its report for Government.

Our three days of hearings have been another example of how our Parliament can function. Members of the Oireachtas are capable of holding detailed hearings on sensitive social and political matters. Members of both Houses are capable of doing so in a way that is respectful and tolerant. In particular I hope that this has helped to portray the constructive way the Houses of the Oireachtas operate, especially at committee level.

I pay tribute to all Members and expert witnesses who have contributed over the past three days. The way they have conducted themselves, being considerate and respectful, has allowed the committee to do its work. This approach has allowed Members to gather information, to ask questions, and to probe on particular issues in the absence of tension or unnecessary and unhelpful rancour. I thank all those who appeared before the committee for their time and very helpful contributions. It really is appreciated by me and all members, and we are genuinely grateful for their assistance.

I thank my colleagues in the Oireachtas, who are not members of the Joint Committee on Health and Children, for the way they have all discussed the issues and raised their own concerns. Their contributions have been appreciated by their colleagues who are members of the committee. In particular I thank Senators Mullen and Walsh for their assistance in the lead up to the committee meetings and in helping to organise our hearings. I say that most genuinely to them.

I thank my colleagues on the Oireachtas Joint Committee on Health and Children for their dedication and commitment over the past three days. Also, I appreciate the role they have played in the lead up to these hearings. The way these hearings have been conducted reflects the professional approach which is consistently demonstrated at all of our committee meetings.

I hope we have also shown that different political parties and groups can constructively work together. I thank Deputies Kelleher, Ó Caoláin and Conway - Vice Chairman of the committee - as representatives of their respective political parties, along with my Fine Gael colleagues, and Deputy Healy and Senator van Turnhout for the Technical Group and Independent Members. I appreciate the support they have given to the Chair, not just in the past three days, but in the lead-up to the hearings.

A considerable team has helped the Oireachtas Members in preparing these hearings. It has been dedicated, working weekends, including bank-holiday weekends and working long into the night, including past midnight. I thank the clerk, Mr. Paul Kelly, and his team, Ms Paula Cowan, Ms Mary Lindsay and Mr. Colm Duffy, for their efforts and work in the past few weeks and the long days they have had to put in. We very much appreciate that. I also thank the staff from the committee secretariat of the Houses of the Oireachtas, who are not assigned directly to our committee yet gave immense support to the clerk and his team during and in advance of these hearings.

I thank the Superintendent, Captain of the Guard and their ushers for their tremendous co-operation and assistance not just to Members of the House but also to our expert witnesses. I thank the staff in the Editor of Debates office, broadcasting and communications units, our sound engineers and the staff of the Library & Research Service for their support. I also thank our consultant, Mr. Michael O' Sullivan, who has been working with us and will continue to do so next week when we go through the written submissions. I also thank the members of the parliamentary legal service for their support and members of the media, who have been here in large numbers for the past three days and have broadcast our proceedings. I thank the Seanad office, the Seanad Committee on Procedure and Privileges, the Cathaoirleach and the Leader for allowing us to use this august Chamber as a fitting venue for what we have been doing over the past three days. I thank all of our witnesses and Members for their exemplary conduct, and the thoughtful and respectful way they have made their contributions.

The committee will now compile a report on our hearings and the many written submissions we have received. When this report is completed it will then be presented to Government for its consideration. I hope and I trust that these hearings will provide much assistance in the final drafting the Bill which will be presented to the Oireachtas. I thank the Minister, Deputy Reilly, the Minister of State, Deputy White, and officials from the Department of Health.

I again thank everybody for their participation and their continued work in our committee.