In early March, the Minister for Health Stephen Donnelly confirmed to Cabinet that he had initiated a review of Ireland’s radical abortion law.
It is important to note ,however, that this was less a political choice and more of a legal requirement given that Section 7 of the 2018 Act which legalised abortion clearly states: “The Minister shall, not later than 3 years after the commencement of this section, carry out a review of the operation of this Act.”
The mechanics of the review process were recently outlined in a letter to the Oireachtas Health Committee by the incoming Secretary General of the Department of Health, Robert Watt.
Mr Watt’s letter makes it clear that while the process will be overseen by his department, it is anticipated that it will take a three-part approach to reviewing the operation of the 2018 Act.
These strands will focus on service users, service providers and a public consultation. Research to inform the service users and providers will be carried out ‘independently’ while the Department of Health will manage the public consultation end of things.
The plan is then to collate the findings of all three strands and publish these in the form of a report with “any necessary recommendations” being submitted to the Minister for Health.
So what does all this mean?
Apart from the fact that no indication has yet been provided as to when the public can have their say, there are a number of other significant problems with this process, particularly those surrounding the strands on services users and service providers.
We know, for example, that the term ‘service users’ refers primarily to the women who obtained an abortion under the Act.
But what about the almost 1000 women who approached their GP’s for a first consultation on abortion but never returned for the second consultation? The women who changed their minds and kept their babies because of the 3-day waiting requirement. Will they be included? Will their voices be heard?
Will the perspective of these women – up to one in eight of all women who have used the abortion service – regarding the value of retaining the mandatory 3-day pause find its way into the ‘necessary recommendations’ that Minister Donnelly will be asked to decide upon? Or will he only be hearing from activists who want to scrap that waiting period?
It is crucial that we know this.
Then there are the serious conflict of interest issues involving the so called ‘service providers,’ i.e. those who carry out or facilitate abortions as well as those who oversee the implementation of the service within the HSE.
Take the Irish Family Planning Association for instance. It is one of the largest service providers of abortion in the community while also remaining a prominent abortion advocacy organisation that did not stop campaigning on the abortion law once the referendum passed in 2018.
Are we to seriously believe that an organisation such as the IFPA in its contribution to the review will do anything except call for further liberalisation?
In fact, we know from one of the most recent IFPA reports on the operation of the 2018 Act that it chose to highlight concerns about the impact of the 12-week gestational limit on access to abortion, as well as what it describes as “the range of access barriers that many women experience.”
Or what about the pro-abortion National Women’s Council of Ireland.
Information received in reply to a Parliamentary Question submitted by Carol Nolan TD has shown that the NWCI is a member of the Clinical Advisory Forum that was established within the HSE after the enactment of the 2018 law to “inform and enable the provision of a safe, high quality termination of pregnancy service.”
That PQ Reply also referred to the fact that the Clinical Advisory Forum aims to “develop consensus recommendations” on the provision of abortion services and emerging issues “based on all available sources of evidence.”
Again, here we have a situation where an abortion-promoting NGO, which campaigned to overturn the 8th, and is a leading supporter of extending the abortion law, will be asked to engage critically and objectively to the abortion review.
Who honestly believes that the NWCI or the IFPA for that matter is prepared to examine “all sources of evidence.”
And then there is Dr Aoife Mullaly, who is Chair of the HSE’s Clinical Advisory Forum and who reports directly to the HSE’s National Women and Infants Health Programme (NWIHP).
Only last year, Dr Mullaly co-authored an article with a doctor from START, the GP abortion advocacy group. In that article, Dr Mullaly and her co-authors describe the 3-day waiting period as “presumptive and patronizing.”
They also explicitly state that since the abortion legislation will be reviewed after three years, they will continue to make this “an area for advocacy.”
So, even before the public consultation aspect of this process gets off the ground, we are already likely to have an extremely deficient range of perspectives feeding in to the process at the operational level.
The services providers responses are more a less a foregone conclusion.
All of the evidence suggests that they will argue and push for two major changes; these being an end to the 3-day waiting period – and the retention of the telemedicine ‘model of care’ where a woman can obtain abortion pills without ever having a single physical consultation with a GP.
However, if Minister Donnelly agrees to end the 3-day waiting period after the review he will have to explain why he has backtracked on his support for its inclusion in the 2018 Act because at the time he explicitly accepted that “it clearly formed part of what people voted for.”
It would be easy to take from all of all of this that there is little or no point in engaging with the public consultation process once it does finally begin. That would be a mistake of monumental proportions.
We cannot wait for the scales to be evenly weighted before we decide if the fight is worth continuing. Instead, we must work, even in the face of institutional and political bias and overwhelming odds to tip the balance in favour of life.
Staying silent and allowing the cheerleaders of abortion free reign during this review process is one way to guarantee that this balance will never be achieved.