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WATCH: Senator Rónán Mullen urges against ‘reckless’ extension of telemedicine abortion 

Independent National University Senator Rónán Mullen has urged Minister for Health Stephen Donnelly “not to recklessly make telemedicine abortion permanent”, calling for an investigation into the operation and impact of such abortions in Ireland to date.

In April 2020, telemedicine provision was introduced in Ireland, meaning women could legally access abortion pills for home use without an in-person, physical consultation with a qualified medical professional. 

Speaking in the Senate, Mullen said that at a bare minimum, a conversation needed to be had about something as “far-reaching” as making telemedicine abortion permanent in Ireland. It comes after the UK made the controversial practise permanent – despite safety fears voiced by pro-life campaigners and some politicians. 

“The very least we could do in this House is to have a serious discussion about something so potentially far-reaching,” Senator Mullen said. He was speaking during the Seanad’s Order of Business on Tuesday, where senators expressed their condolences on the death of cervical cancer campaigner Vicky Phelan, who died on Monday. 

“Déanaim comhbhrón le muintir Vicky Phelan freisin agus le muintir an Dr. Éamon Phoenix – go ndéana Dia trócaire orthu. Rinne an Dr. Phoenix sár-obair mar a luaite,” Senator Mullen said. The senator also hit back at calls for assisted suicide to be legalised following the death of the campaigner – who was an outspoken advocate of the practise.

He was referring to comments made moments before by colleague Senator Martin Conway, who pointed to the late Ms Phelan’s campaigning, stating that politicians “could pay tribute” to the mother of two through the setting up of an Oireachtas committee on dying with dignity, an issue she had campaigned for and “had a great interest” in.  

“We have looked at setting up citizens’ assemblies on matters such as biodiversity. While these matters are important, health and dying with dignity are far more important. I cannot for the life of me understand why we would delay setting up a committee to engage in this issue, hear all sides and come back with recommendations on what should happen,” Senator Martin conway said, adding:

“These are the tangible ways that the Oireachtas, the Seanad and society can pay tribute to Vicky’s legacy and the tremendous work she did”.

Responding, Mullen said that “everybody dies with dignity”. He argued that the greatest disrespect to human dignity is someone feeling as though they are a “burden” in life.

“In response to what my friend, Senator Conway, had to say, I will point out that everybody dies with dignity,” Senator Mullen said, calling on Irish lawmakers to “move very carefully”.

“The question always is whether people’s dignity is respected. Nothing disrespects people’s dignity like making them feel as if they are a burden in life. That is one of the single biggest fears people have about euthanasia, assisted suicide, assisted dying or whatever people care to call it. 

“We should move very carefully in that area and not just rush to have another citizens’ assembly discussion that seems, whenever these happen, to be designed to bring about a preordained or pre-desired change”.

He went on to highlight the issue of telemedicine abortion during the Order of Business. His comments on the issue come as at-home abortions without in-person consultation are set to continue on foot of new advice to Health Minister Stephen Donnelly from the State’s chief medical officer and the HSE. The imminent advice is expected to recommend the extension of remote abortion consultation on a long-term basis, The Irish Times reported on Saturday. The measure was due to lapse following the end of Covid travel restrictions.

Ahead of that advice, Mr Donnelly has claimed that telemedicine is now backed by major health organisations, including the Royal College of Obstetricians and Gynaecologists, which is in favour of broad-based abortion rights, and British abortion provider British Pregnancy Advisory Service (BPAS).

Senator Mullen, however, described the move as “misguided”, adding that “it will have negative consequences.

“The matter I want to raise today is a similar human dignity issue. It was reported last Saturday that the Government plans to make telemedicine abortion, so-called, or telephone-based appointments for abortion, a permanent feature of Ireland’s abortion policy,” he said. 

“I think this is misguided and that it will have negative consequences. The HSE confirmed in October last year that no report or analysis into the operation of so-called telemedicine or remote consultations had been carried out in Ireland since the policy was introduced in early 2020 in the context of Covid. 

“We were told by the Secretary General of the Department of Health in March 2021 that telemedicine would lapse when the pandemic was over. In 2018, the then Minister for Health, Deputy Simon Harris, said in the context of the abortion legislation that there would absolutely not be abortions by telemedicine in this country”.

Last year, an investigation revealed that ambulance dispatches and 999 calls dealing with concerns about abortion pills soared by 64% since NHS abortion pills by post were legalised in Britain in 2019. The investigation, using information obtained via FOI requests, revealed 10,000 British women received hospital treatment after obtaining abortion pills.

This was highlighted by the senator Mullen, as he questioned why such unsettling revelations have not informed policy in Ireland.

“Yet here we are, despite the fact we know from England that over 10,000 women there had to receive hospital treatment following the use of at-home medical abortion pills between April 2020 and September 2021. England has also seen a dramatic spike in the number of ambulance call-outs dealing with the adverse effects of the self-administration of abortion pills”.

The Senator also referred to safeguarding issues surrounding the practise – In April in response to a parliamentary question from Carol Nolan,, the HSE admitted that Ireland’s ‘DIY’ abortion pill system makes it harder to identify when women are being coerced or abused by their partners.

“We also have the safeguarding issues associated with the removal of the need for in-person consultations. When we substitute that for a telephone call, we remove the privacy afforded by a GP’s surgery,” the senator said, adding that coercion is also a major issue.

“There is no way for a doctor to verify that a woman requesting an abortion is actually alone and that she is not being pressured by a partner or third party. We had an alarming report in October describing how an underage girl in this country was locked in a room and forced to ingest abortion pills. This is highly disturbing. It would be terrible to think that the Minister and the Department of Health would be enablers of such abuse by their overly lax attitude to telephone appointments for abortion.

“There needs to be a serious discussion about this. I call on the Minister for Health not to recklessly make telemedicine abortion permanent but to immediately instigate a comprehensive investigation into the operation and impact of such abortion appointments in Ireland to date.

“The very least we could do in this House is to have a serious discussion about something so potentially far-reaching,” he said.

Last month, the Irish Examiner reported one case of reproductive coercion in Ireland which recently became public. The Irish newspaper detailed how a child who became pregnant was “locked in a room and forced to take abortion tablets”. The chilling case involving the girl under 18 was detailed by staff at the sexual assault treatment units SATU. 

National director of SATU, Dr Maeve Eogan, said: “As a society, we have become more aware, traditionally we would have considered domestic violence purely as a physical injury”.

“Now, very clearly, there are lots of discussions about the crime of coercive control, but in addition, there is this concept of sexual coercion”.

Some medical professionals have expressed deep concern about how abortion outside of a clinical setting makes coercion and abuse easier because there is no in-person appointment with a nurse, midwife, or doctor to spot any indications and help investigate whether it is taking place. 

In June, a British civil servant was jailed after he was found guilty of spiking his lover’s drink with abortion pills he had obtained with the motive of keeping an affair secret.

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