The Eighth Amendment and right to conscientious objection

Sir, – Thomas Ryan (April 5th) claims that "Once the so-called "right to choose" is placed on legal footing, it is quickly transformed into the right to force people to pay for abortions and force medical professionals to perform them". While it is common sense to note in answering this that none of us is entitled to opt out of paying taxes that might contribute to something with which we disagree, the second claim requires a little more by means of response.

The right to conscientious objection has been enjoyed by Irish medics, healthcare professionals, and pharmacists for many years. Not only is conscientious objection protected in the Protection of Life During Pregnancy Act 2013 (except in cases of life-threatening emergency), but doctors and pharmacists have always had the right to refuse to prescribe or dispense contraception and emergency contraception.

International human rights law recognises a right to conscientious objection and recognises that medical professionals cannot be compelled to participate directly in the provision of abortion care. Furthermore, this is almost certainly required by Article 44 of the Constitution. The general scheme of the proposed post-repeal law explicitly protects individuals’ right to conscientiously abstain from direct provision of abortion care.

Mr Ryan appears to object to the continuing obligation to refer a patient to another health care professional in a case of conscientious objection; however, in both international best medical practice and international best legal practice that is considered the appropriate way to balance the pregnant person’s right to access appropriate healthcare and the medical professional’s right to opt out of providing healthcare to which s/he has a conscience-based objection. Any other approach would privilege the right of a medic in a way that abandons and does harm to the pregnant person. No system could realistically countenance so unbalanced an approach, and it is difficult to understand how one’s conscience could demand it. While the State is obliged to make sure abortion will be available to all who meet the legal requirements laid down for access, this cannot be done by overriding conscience and must instead be done by the arrangement and distribution of resources and services around the country, as is the case in most states.

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Respecting people’s deeply held beliefs, finding a way to balance that respect against the needs and beliefs of others, and resisting compulsion and domination is the essence of pro-choice thought. Mr Ryan presents a red herring. Individual healthcare professionals have, and will continue to have, a right to opt out of providing abortion care. It is in nobody’s interest for it to be otherwise. – Yours, etc,

Prof FIONA DE LONDRAS,

Birmingham Law School,

University of Birmingham,

United Kingdom.

Sir, – Diarmaid Ferriter's article (March 31st) was headlined "Anti-Abortion front trusts politicians only when it suits them." I would say that most people trust politicians when they find them trustworthy. I was mentioned by name a few times in the article.

The idea of the 1983 amendment may have sprang from small groups but it spread and was endorsed by numerous others. At its launch in 1981, it had on its board school-parents’ associations, a lawyers’ group and various others. Its patrons were the five professors of obstetrics and gynaecology and seven masters of maternity hospitals. Later on more than 1,500 GPs pledged their support.

The aim of the pro-life amendment was to protect the unborn child from the courts and serve as a guide to politicians. In 1971, the US supreme court had imposed abortion by “discovering” a right to privacy. To the alarm of many, the Irish Supreme Court had also used that argument in a case in 1973.

Diarmaid Ferriter claims that there was little national support for Article 40.3.3 as the turnout on voting day was only 55.6 per cent. There was a high turnout in Dublin and a low turnout in rural Ireland, perhaps because of a rural bus strike on polling day. Dr Brendan Mary Walsh of ESRI wrote that if rural Ireland’s turnout was as in the previous general election, the final support for the Amendment would have exceeded 70 per cent. The pro-abortion side gained to an unknown degree from some pro-lifers voting No because they thought it was No to abortion. At least that will not happen in the next referendum.

Regarding trusting politicians, in 1981 when Charlie Haughey was approached to support the amendment he agreed at once, as did Garrett FitzGerald. When in power, Fine Gael did nothing for the amendment, and Fianna Fáil produced the wording just prior to the 1982 election, which Fine Gael endorsed with Garrett FitzGerald exclaiming, “You could not find a better wording.” Then, in power, Fine Gael tried to change the wording. A number of Garrett FitzGerald’s Fine Gael TDs objected and the taoiseach was forced to let it go through. The amendment was supported by TDs from all parties in its passage through both Houses.

Personally I would distrust the then-taoiseach and some of his cohorts but would absolutely trust the Fine Gael members who kept their word and those of Fianna Fáil and Labour who supported it. Trust is something that must be earned.

In 2011, the group I was then with lobbied all parties not to interfere with the right of the unborn and to legislate for the protection of human embryos. It was Yes from Micheál Martin, Enda Kenny, and many others. The then-taoiseach Enda Kenny broke his promise immediately after the election, and Micheál Martin supported the abortion legislation in 2013.

As regards Diarmaid Ferriter’s comments on my address to a small group of Knights of Columbanus in 1988, I had resigned from the Knights a few years previously and was only there at the behest of a very good friend of mine, now deceased. I was never an officer of the organisation dictating policy to its members. It was advice applicable to anyone in any secular organisation: “Do and say what you think is right at all times, use your own arguments without quoting other bodies spiritual or secular of which you might be a member.” – Yours, etc,

JOHN O’REILLY,

Second Look Project,

Merrion Square, Dublin 2.

Sir, – I welcome David Robert Grimes’s call for accuracy and respect for truth in the debate over the Eighth Amendment (“Myths and lies about abortion must be debunked”, April 3rd). Unfortunately, in his rush to castigate pro-lifers for their failures in this area, he ends up making misleading claims himself. His claim that “legal barriers have never dissuaded anyone from seeking terminations, instead only adding emotional and financial obstacles to an already difficult decision” is extraordinarily bold and completely implausible – the idea that not one person, anywhere, has ever changed their mind about having an abortion as a result of the law is ludicrous, especially in light of testimonies from women to the contrary. For example, in qualitative research carried out by O’Connell, Meaney and O’Donoghue in Cork University Maternity hospital, “Preparing for Stillbirth in Cases of Prenatal Lethal Diagnosis”, one mother said, “If abortions had been legal in Ireland, I would have done it, so I am glad that it wasn’t.”

Even if Dr Grimes was using poetic licence and really only meant that the law has had little effect on termination rates, the evidence still doesn’t support him. His claim that “medical evidence suggests that termination rates are approximately equal in countries with and without legal abortion” is hopelessly general: as a scientist he should know that to merely compare average rates between countries with and without legal abortion ignores all the other variables that drive high rates of abortion – poverty chief among them. It would be much more revealing to compare Ireland’s own level of abortion to countries of similar socioeconomic status.

But if Dr Grimes did that he would be forced to confront the inconvenient truth that Ireland’s abortion ratio is approximately one abortion for every 12 live births, while the UK and France have approximately one abortion for every four live births, and Sweden one for every three live births.

These figures of course include the Irish women who travel to the UK, and a generous estimate for the numbers of abortions carried out using abortion pills. “Ireland has the lowest abortion rate in Europe” and “no country in the developed world with liberal abortion laws has a rate lower than Ireland’s” are not claims that help the repeal narrative. But they are true, and if he is interested in truth Dr Grimes would do well to acknowledge them. – Yours, etc,

BEN CONROY,

Oxford,

England.