Ireland is introducing an abortion bill that would include mental health among factors that could put a woman's life at risk. Opponents say it would open the door to greater liberalization.
When Ireland's Supreme Court ordered the government to pass a law allowing abortion when a pregnant woman's life was at risk, none of the five judges could likely have imagined that its ruling would still be pending more than 20 years later.
This week, Ireland is preparing to announce the draft law, which permits abortions on limited medical grounds, including threat of suicide. Mandated by the Irish Supreme Court in 1992, and finally confirmed in December 2012, the bill has been with the cabinet for several weeks. But the depth of feeling – at least among the political class – about allowing any abortion has been underscored by yet another delay as ministers attempt to bridge a chasm between the two governing parties, conservative Fine Gael and center-left Labor.
The issue took on new urgency this week when The Sunday Independent newspaper published a report based on a "sting" operation by an antiabortion activist. The activist posed as a pro-choice supporter and secretly recorded two Labor lawmakers saying they wanted to go much further in allowing abortion on demand, and that the currently proposed law was merely a steppingstone.
The backlash was immediate, with antiabortion activists online branding the Labor party "liars" and claiming the recordings were proof of an agenda to seek laws allowing abortion on demand.
Caroline Simons, legal adviser to the Pro Life Campaign, says the revelation will come as a surprise to the majority of Irish people.
"It's not something the government has been highlighting, [but] in other countries risk to mental health and suicide opened the door to abortion on demand," she says.
One Fine Gael lawmaker, Brian Walsh, has already signaled his intention to oppose any bill that includes being at risk of suicide as grounds for abortion. His party colleague, junior minister Lucinda Creighton, has become a rallying figure for opponents of abortion within the party. She claims at least six members will rebel against the government, though many observers say more will stake their careers on the question.
Labor senator and attorney Ivana Bacik says the divisions are overstated.
"Some people would like to suggest this is a major rift between Labor and Fine Gael, but that's not true. Most people in Fine Gael would like to see a resolution to this, so we can hope calmer heads will prevail," says Ms. Bacik.
"Clearly it's not going to lead to abortion on demand. It won't change the law. It just restates the existing position [of the Supreme Court]."
Allowing abortion because the mother may be at risk for suicide remains controversial in Ireland. Following the 1992 Supreme Court ruling in the so-called X case,in which a 14-year-old girl became suicidal when denied an abortion after being raped, preoccupation with suicide has been included among the list of immediate threats to a pregnant woman's life that constitute grounds for an abortion. Despite the ruling, successive governments have failed to legislate – until now.
A 2012 poll conducted by research firm Red-C found 85 percent those surveyed said they wanted the government to legislate for "X," supporting the move.
Dubliner Joan O'Connell says she thinks public opinion is often moved by personal experience.
"Although this is a deeply emotional issue, many people in Ireland are generally reasonable and understand the nuances of actual cases – once the discussion is taken out of the abstract. The figures on women who travel for abortion necessarily mean that there are many people in Ireland who know a woman who has had an abortion, even if they are unaware of it," she says.
Still, the inclusion of suicide has angered antiabortion campaigners – but now it's the turn of pro-choice activists and politicians to object.
A leak published in The Sunday Times last week said any woman seeking to procure an abortion would have to submit to assessment by a panel consisting six hospital doctors. The panel would have included two obstetricians, three psychiatrists, one of whom was to be a specialist perinatal psychiatrist, of which there are three in the entire country. One doctor, psychiatrist Anthony McCarthy, compared this to "an inquisition."
The government scotched the six-doctor claim, but opted to delay the publication of the bill for a week. The Christian Science Monitor understands that the bill, due to be published Tuesday, now proposes a two-stage consultation, with women reporting suicidal thoughts required to consult a lower, but as yet unspecified, number of doctors. Suicide remains the sticking point: how to deal with threat to life by non-pyschiatric medical condition is believed to be settled between the two governing parties.
Peadar O'Grady, a child psychiatrist and representative of campaign group Doctors For Choice, says making abortion decisions contingent on medical opinion sidesteps the real question of individual autonomy.
"The political cowardice is about handing over responsibility [to psychiatrists] for an individual case in order to avoid handing the choice over to the woman," he says.
Medical opinion is divided, however – 113 psychiatrists have signed a letter saying abortion as treatment for suicidal thoughts "has no basis in the medical evidence available."
Pro-choice activists dispute the claim that the inclusion of suicide will lead to abortion on demand, citing Ireland's unique constitutional ban on abortion: the eighth amendment to the Constitution effectively forbids abortion by giving equal rights to the pregnant woman and the unborn.
The law follows in the wake of the findings of the inquest into the death of Savita Halappanavar, a 31-year-old Indian-born woman who died from septic shock during childbirth last year. Both Ms. Halappanavar and her husband, Praveen, requested an abortion after being told the fetus was unviable, but were denied, sparking outrage in Ireland and India. The inquest recorded a verdict of death by "medical misadventure."