A distinction was to be made between intentionally killing an unborn baby and indirectly killing the foetus during treatment of the mother, a medical expert told the all-party Oireachtas Committee on the Constitution.
Dr James Clinch, retired consultant obstetrician/gynaecolo gist, a former master of the Coombe, was chairman of the Ethics Committee of the Medical Council from 1995 to 1999 and was involved in formulating the current wording relating to the care of pregnant women.
Dr Clinch detailed his career, which included working in Aberdeen and Cardiff in the late 1960s when a large number of abortions were carried out.
Answering committee members on how he would like to see the law reformed, Dr Clinch said: "I could work very happily with a law that said you must not directly kill an unborn baby. That would not restrict me in any way in dealing with any of my patients."
He said in formulating the current guidelines of the Medical Council they took about 500 submissions, at the same time the report of the Constitutional Review group had come out.
"A lot of doctors felt this failed to make a clear difference between treating the mother who is pregnant and actually simply killing the baby," he said. When the council guidelines were produced they were short and clear-cut.
Then the Government Green Paper on Abortion appeared a year later and this seemed to cause confusion again. There were various points where, he thought, the writer got it mixed up and thought an abortion was treatment of the woman.
"In fact there is no medical condition which is cured by simply killing the baby or getting rid of the baby," Dr Clinch said.
He wanted to point out that obstetricians thought in terms of two people, the mother and baby. They balanced the care.
Senator Kathleen O'Meara (Lab) said the issue in the Green Paper with regard to how the courts had seen what constituted a "real and substantial" risk to the life of the mother, particularly in the X case and C case, was a risk of suicide because of pregnancy in the case of alleged rape. Did that not conflict with the Medical Council guidelines?
How did one reconcile this problem, as on one hand the courts said suicide constituted a real and substantial risk and allowed abortion, but the Medical Council appeared to take a narrower view. Did suicide constitute a real and substantial risk? she asked.
Dr Clinch said if one looked at the most recent maternal mortality report, it said quite clearly that pregnancy appeared to damp down the tendency towards suicide. He thought they should get a psychiatric opinion from a psychiatrist and not from a barrister.
"Psychiatric opinion, from what I can see, seems to think that pregnancy is almost protective from suicide," he said.
In the previous report, there were two deaths from suicide within weeks after termination following psychiatric disturbance.
Ms Marian McGennis TD (FF) asked whether, if there was an absolute constitutional ban on abortion, he would feel that people in practice might be in a situation where they would feel they could not perform the procedures to save the mother's life which led to the indirect killing of the foetus.
Dr Clinch said: "On the understanding that abortion meant simply killing what was in the uterus, I would not feel that I was spancelled in any way whatsoever."
Senator Denis O'Donovan (FF) asked for Dr Clinch's view on when life began and also about the morning-after pill.
Dr Clinch said until somebody proved life did not begin at the beginning, he had to assume it did. "The morning-after pill, the wording we used [in the council] was the `deliberate and intentional' destruction of the unborn child. If you actually believe there is a child there, I don't think you'll use the morning-after pill," he said.
Mr Jim O'Keeffe TD (FG) asked what the circumstances of an intervention were and the attitude of the Medical Council to this. Dr Clinch said the council guidelines said "direct and intentional killing of the baby" was unethical. There were no circumstances where simply killing the baby cured the mother. There were circumstances where the mother had a lethal or very serious disease where in treating it the baby might die.
Ms Liz McManus TD (Lab) asked about the number of women going to Britain for abortions. Did it concern the profession here?
Dr Clinch said: "There isn't a doctor in this country who wouldn't see someone and discuss what is euphemistically called a `crisis pregnancy' . . . and they would certainly see them afterwards and I can actually show you records of loads of women I've seen post-termination who have ended up in the Coombe and been looked after."