Doctors take up opposing sides on abortion debate

The forthcoming abortion referendum had divided medical practitioners into two camps

The forthcoming abortion referendum had divided medical practitioners into two camps. Dr Muiris Houston, Medical Correspondent, examines the competing arguments.

The medical profession sees itself as central to the abortion debate in the run-up to the referendum. There are two formal groups on either side of the debate, with many other doctors active in a non-formalised way in the campaign.

Doctors For Life was set up in 1992 in the aftermath of the X case decision. It has "about 300 members from across the specialities". Its aim is to provide information on medical issues arising in the abortion debate. Doctors for Life advocates a Yes vote.

Doctors for Choice was set up last year and says it has "in the region of 100 active members". It is urging a No vote. Doctors for Choice "strives to create a climate where comprehensive reproductive health services, including abortion and contraception, are an integral and respected part of mainstream medicine in Ireland".

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How do the two groups approach some of the central issues in the referendum campaign?

Both welcome the Crisis Pregnancy Agency, but disagree on other aspects of the referendum.

Suicide: Doctors for Choice say the Bill devalues womens mental health by excluding suicide on grounds for a life-saving abortion. "This failure to recognise mental distress and disorder as a serious concern is a regressive step in healthcare," it says.

Doctors for Life point out that where abortion is available it is not improving suicide rates. "This underlines the point that abortion is not a solution," it says.

Psychiatrists are divided on the issue of suicide. Professors Patricia Casey and Anthony Clare have stated psychiatry has no role in the abortion debate. However, another group, led by Professors Ted Dinan and Tom Fahy, have disputed this.

Approved Places for Abortions: Doctors for Life quote obstetrician Dr James Clinch, who said he did not see any difficulty with the treatment of seriously ill women. "Effectively this is what happens at the moment in the country's maternity hospitals. A seriously ill patient would be moved as soon as possible to a unit appropriately equipped to deal with the illness," he said.

Doctors for Choice says the proposals seriously restrict the number of hospitals authorised to perform life-saving abortions "even in the most extreme circumstances".

Rape/Incest: Doctors for Choice say the referendum offers no compassion or assistance for rape and incest victims. Those in favour of a Yes vote say that psychiatric evidence cannot justify arguments in favour of abortion in these specific cases. Doctors for Life also point to the risk of subsequent depression and suicide following abortion in women already traumatised by rape.

Severe Foetal Anomaly: Doctors for Life argue this should be tackled by the implementation of an effective folic acid supplementation campaign to prevent anacephaly. They say termination of pregnancy where a foetus has a chromosomal abnormality is tantamount to "rejecting people with disability". Doctors for Choice believe denying such women a termination causes psychological and physical suffering and means doctors are forced to act "without compassion".

Travel: Doctors for Choice say Irish women are more likely to have late terminations, using more invasive medical procedures and requiring a general rather than a local anaesthetic, than women in other countries. Doctors for Life say doctors should focus on avoiding termination with its associated risk to the mother's health.

Confidentiality: Doctors for Life are adamant this is a "red herring". They point to the already detailed reports on maternal deaths which are published here and in the UK without breaching patient confidentiality.

Doctors for Choice say that if the referendum is passed it will threaten the privacy of patients' medical records "by giving the Government unprecedented access to the records of any woman who receives a life-threatening abortion".