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Response to the Consultation of the Women and Equalities Committee on Northern Ireland and Abortion

An unjustified interference

Abortion is a devolved matter for the Northern Ireland Assembly which  voted on the issue in February 2016, shortly before it last sat.[1] The NI Assembly rejected a liberalisation of our law on abortion. It is totally inappropriate for MPs from other jurisdictions, in a committee which does not include one NI MP, to instruct or dictate how Northern Ireland should conduct its own affairs. It is an internal matter for Northern Ireland, which requires the input of people from Northern Ireland.

Democracy

The Abortion Act 1967 does not apply in Northern Ireland because the democratically elected Members of the Legislative Assembly have not voted in favour of its extension. Indeed the SDLP, which is a sister party of the Labour party still describes itself as a pro-life party and its members continue to state that it has no desire to extend the Abortion Act to Northern Ireland.[2] Other political parties including the two with the largest mandate in Northern Ireland  i.e. the DUP and Sinn Fein, have, to date, stood for election to the Northern Ireland Assembly and Parliament on the basis of being against the extension of the Abortion Act to Northern Ireland. However since the last Westminster elections, Sinn Fein has officially altered its view on abortion, to supporting abortion in the first trimester of pregnancy.[3] The pro-abortion policy has not been universally welcomed by many Sinn Fein members. Two Sinn Fein TDs in the Republic of Ireland’s Dail were recently disciplined by Sinn Fein because of their pro-life stance. Both have now resigned from Sinn Fein and one of them, Peadar Toibin TD and other dissenting pro-life Republicans throughout Ireland are in the process of setting up a new pro-life republican party which is already attracting significant interest both North and South of the border. The grass roots group Cherish all the Children Equally has been instrumental in highlighting the rights of the unborn child and its mother in the Republican community. It was set up by Anne Brolly, a former Sinn Fein mayor and her husband a former Sinn Fein MLA along with GP Dr Anne McCloskey who has more than thirty years of experience of delivering positive health care to her community in Derry.

It is disappointing for women in Northern Ireland who support life at every stage, to see the UK  Labour party which does not operate in Northern Ireland and the Conservative party which has an almost negligible level of support, attempting to change our protective laws which value the lives of women and babies and seek to do the best for both. It is arrogant in the extreme for either of these party groupings to presume or predetermine what is “best for Northern Ireland women” or citizens more generally.

Effect of the Abortion Act 1967

Since abortion was legalised in England and Wales, just over 50 years ago,  there have been over 8.8 million abortions – the equivalent of the entire population of  London. This translates to 1 in 5 pregnancies ending in abortion[4] and an abortion every three minutes.[5] Abortion is no longer an exceptional response to a crisis, as is evidenced by the fact that 39%(**) of lawful abortions in England and Wales in 2017 were repeat abortions.[6] Surely there must be a better, kinder, way for women, babies and families in crisis than a default assumption that abortion solves the problem.

Repercussions from the Repeal of the 8th Amendment in the Republic of Ireland

This year we in Northern Ireland have watched the repercussions from the repeal of the 8th amendment. Many in Northern Ireland were supportive of that amendment. We were aware that in a jurisdiction where both lives matter, there is a corresponding beneficial effect on the standard of care for both mother and baby. It should be noted that the Republic of Ireland has a much better maternal mortality rate than 86% of countries investigated by WHO.[7] Significantly it outperforms the US and the UK, which each have very permissive abortion regimes. In the UK 1 in 5 pregnancies result in abortion- almost 200 000 annually,[8] 98% of which are under Ground C[9] (specifically, the mental health ground) which permits abortion where the continuation of the pregnancy would pose greater risk to the woman’s mental health than abortion. These are not the exceptional or “difficult” cases which the public are constantly confronted with as grounds for change. Furthermore the exceptional or “difficult” cases all involve a human life which can be cherished by affording proper perinatal hospice care or additional medical and practical assistance to a distressed mother who has been the victim of sexual crime.

Frequently those supporting relaxation of the law on abortion and in particular the repeal of the 8th amendment suggested that only a small change is proposed. Even  Lord Steele who introduced the Abortion Bill in 1967 did not anticipate the level of abortion that would result in his change in the law.[10] During the campaign for the repeal of the 8th amendment in the Republic of Ireland emphasis was laid on allowing abortion in cases where the baby was diagnosed with a life limiting condition (cruelly described as “fatal foetal abnormality”) or had been conceived as a result of rape or incest. The bill which has just been debated and passed by the Dail is much more far-reaching than this. It allows abortion for any reason in the first trimester and up until birth for disability or emergency situations.[11] It is fair to claim that this was not what the general populace who voted Yes to repeal anticipated.[12]

Abortion and mental health

Women from organisations such as Women Hurt by Abortion speak eloquently of the devastating long-term effect of abortion on the mental health of women. What research has been done in this area to avoid a legacy of mental health problems among an ever-increasing number of women? Why do so many women in Great Britain in the age group 16-24 have significant mental health concerns?[13] If the Women and Equalities Commission were truly interested in finding out how to improve the lives of women they would seek to examine the effect of abortion on the lives of generations of UK women who now resort to abortion as  the first solution to an unwanted pregnancy as is evidenced by the 39%(**) repeat abortions last year.

Conclusion

Ideas have consequences, and liberalising our abortion law will inevitably result in unintended consequences with irreversible and damaging social repercussions. Why should very ill or disabled babies in utero, or those whose father is a rapist  have a lesser chance at life than any other unborn baby? Surely this is discrimination against the most vulnerable?

Many women and mothers in Northern Ireland have worked tirelessly to support the right to life of the most vulnerable from womb to tomb. These women believe that mothers’ lives matter too. We know that it is the natural instinct of mothers to want nothing but the best for their children, born and unborn. Mothers need support and assistance during pregnancy, not abortion as the first solution in a crisis. The consciences of many in Great Britain have been dulled and inured to abortion. Listen to those who still value life at every stage. Maybe you will come to realise that we are offering a more progressive solution than what is currently offered in Great Britain. Our voices deserve to be heard too and we are grateful to be able to contribute to this consultation.

(**) This figure was correct at the time of submission (10 December 2018). The following day 11th December 2018, the UK Government revised the figure downwards when it released Abortion Statistics for England and Wales 2017 (June 2018 (revised December 2018), page 4. See: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/763174/2017-abortion-statistics-for-england-and-wales-revised.pdf).

MARY J LEWIS BL

[1] https://www.theguardian.com/uk-news/2016/feb/11/northern-ireland-abortion-laws-easing-voted-down

[2] https://www.irishtimes.com/news/social-affairs/abortion-in-northern-ireland-where-do-the-parties-stand-1.3522879

[3] https://www.bbc.co.uk/news/uk-northern-ireland-44507054

[4] 190406 abortions were carried out in England and Wales in 2016 as reported in https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/679028/Abortions_stats_England_Wales_2016.pdf  Of these , 185 596 were on residents of England and Wales. There were 696271 live births in England and Wales in 2016 see https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsummarytablesenglandandwales/2016#main-points

[5] As reported by Lord David Alton in a speech given at St Bride’s Hall, Belfast on January 25th 2018

[6] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/714183/2017_Abortion_Statistics_Commentary.pdf, p4

[7] http://data.unicef.org/topic/maternal-health/maternal-mortality/

[8] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/570040/Updated_Abortion_Statistics_2015.pdf

[9] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/570040/Updated_Abortion_Statistics_2015.pdf paras  2.13-2.17

[10] https://www.theguardian.com/uk/2007/oct/24/politics.topstories: “…he never anticipated “anything like” the current number of terminations when leading the campaign for reform.”

[11] http://www.thelifeinstitute.net/latest-news/what-you-need-to-know-about-the-abortion-bill/

[12] https://www.facebook.com/lifeinstitute/videos/499658587209751/

[13] https://www.bbc.co.uk/news/entertainment-arts-37504679

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Abortions for NI Women in Wales

In January-February this year the Welsh government set up a consultation on the issue of funding abortions in Wales for women resident in NI. Of the 802 responses to that consultation, only 14 were in support, and not a single one of those came from any NI woman. On the contrary, the majority were against the proposal. That means that 98.254% of respondents opposed the proposal for the Welsh Government to fund abortions for women travelling from Northern Ireland while only 1.746% were in favour. As a result of the consultation the Welsh government decided to ignore the majority of the responses and press ahead with abortion provision for women normally resident in NI. Their reason for rejecting the 98.254% was that they all came from the pro-life sector such that the objections were the same, thus they treated the opposition en masse.

Aside from the fact that the government should not have been surprised that pro-life responses would in fact be uniformly pro-life, the government ought not to dismiss the individuality of those who did engage with the consultation. Indeed, what is the point of such a consultation if the government intends on doing what it wants in spite of majority opposition?

As an indication that all the pro-life responses should not be treated en masse, but that individuals took time and care to construct reasonable opposition to the proposal, we here publish a submission made by Mary Lewis BL to the consultation. Hers is just one of a number of such submissions which the Welsh government has chosen to ignore. This submission was made in early 2018, and so some of the details pertaining to the SDLP’s position on abortion have changed since then, nevertheless they were true at the time the submission was made.

Response to the consultation on funding abortions for non resident women from Northern Ireland

An unjustified interference

Abortion is not a devolved matter for the Welsh Assembly yet it is a devolved matter for the Northern Ireland Assembly which has voted on the issue a mere two years ago[1] and rejected a liberalisation of our law on abortion. It is totally inappropriate for the Welsh Assembly to act in any way regarding abortion or any other internal Northern Irish matter.

Terminology

The consultation document insists on using the euphemism “Termination of Pregnancy,” tritely abbreviated further to TOP, to lessen the reality of the horror of the process, otherwise known as abortion. It should not be forgotten that this procedure ends the life of the most vulnerable human beings – in certain cases up to full term, e.g. where the baby has a disability.[2]

Numbers of Northern Ireland Women who undergo a lawful abortion in Wales.

It is our understanding anecdotally that very few women from Northern Ireland actually avail of lawful abortion in Wales. The Welsh Government will be aware of precisely how low this figure is. This raises the question:  why does the Welsh Government consider it necessary to take action on this issue? How much did this consultation cost?  If there is virtually no demand by Northern Ireland women for abortion in Wales why should scarce  resources, which could be spent in other multiple ways, not be used  to fund the  health of Welsh citizens who are already suffering long waiting lists for essential medical treatment because of  existing NHS constraints.

Democracy

The Abortion Act 1967 does not apply in Northern Ireland because the democratically elected Members of the Legislative Assembly have not voted in favour of its extension. Indeed the SDLP, which is a sister party of the Labour party has a mandate not to extend the Abortion Act to Northern Ireland.[3] Other political parties including the two with the largest mandate ie the DUP and Sinn Fein equally have stood for election on the basis of being against the extension of the Abortion Act to Northern Ireland. The proposal to fund Northern Ireland women to have abortions in Wales brings the Abortion Act to Northern Ireland by the back door.

The Labour party does not operate in Northern Ireland and the Conservative party has an almost negligible level of support. It is arrogant in the extreme for either of these party groupings to presume or predetermine what is “best for Northern Ireland women” or citizens more generally.

Effect of the Abortion Act 1967

Since abortion was legalised in England and Wales just over 50 years ago,  there have been 8.8 million abortions – the equivalent of the entire population of  London. This translates to 1 in 5 pregnancies ending in abortion[4]  and an abortion every three minutes.[5] Abortion is no longer an exceptional response to a crisis, as is evidenced by the fact that 38% of lawful abortions in England and Wales last year were repeat abortions. [6] Surely there must be a better, kinder  way for women, babies and families in crisis than a default assumption that abortion solves the problem.

Appetite of Welsh taxpayers for this proposal

The residents and taxpayers of Wales have not been asked prior to this consultation whether they wish to have pre-existing stretched NHS resources redistributed to facilitate Northern Ireland women to have abortions in Wales. The public is constantly advised that the NHS is at breaking point, yet resources are to be found to pay for medical procedures for non-residents of Wales. The consultation document is unclear whether this funding will emanate from the Government Equalities Office (as in England) or whether the Welsh Government will have to find the funds from its own budget.

Conclusion

The proposals outlined in this consultation lack evidence of economic, equality, or any other justification and  I respectfully submit  that they should not be pursued further. I note that the Welsh Government proposes to review the position “six months after they come into force” which suggests that this consultation is a fait accompli. In any event, if the proposal is passed, there  will be many in Northern Ireland who will also closely monitor the situation through Freedom of Information channels and any other appropriate manner.

MARY J LEWIS BL

[1] https://www.theguardian.com/uk-news/2016/feb/11/northern-ireland-abortion-laws-easing-voted-down.

[2] S 1 (1) d  of the Abortion Act 1967 as amended by the Human Fertilization and Embryology Act 1990.

[3] A policy which has persisted since 1984.

[4] 190406 abortions were carried out in England and Wales in 2016 as reported in https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/679028/Abortions_stats_England_Wales_2016.pdf  Of these , 185 596 were on residents of England and Wales. There were 696271 live births in England and Wales in 2016 see https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsummarytablesenglandandwales/2016#main-points.

[5] As reported by Lord David Alton in a speech given at St Bride’s Hall, Belfast on January 25th 2018.

[6] https://www.gov.uk/government/statistics/report-on-abortion-statistics-in-england-and-wales-for-2016, p 6.

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After Birth Abortion

In 2012 Alberto Giubilini and Francesca Minerva published a paper in the Journal of Medical Ethics arguing that given the same moral status or lack thereof between a foetus and a new born baby, the same conditions that would justify the killing of the foetus also justify the killing of the new born. Their argument is structured around what they take to be the fact that neither the new born nor the foetus is a person (a highly disputable assumption), in which case it is not subject to a moral right to life in which case the rights and interests of actual persons, such as the mother, people in society etc, ought to take priority. They consider the potentiality objection to the effect that both the foetus and the new born are potential persons and so should be afforded the rights that all persons have; they reject this objection arguing that no harm is done to a potential person by not allowing such an entity to develop into a person. They also reject the adoption objection to the effect that adoption would be a better option than abortion or after birth abortion since they do not believe that it is straightforwardly true that the mental health of the mother would be better in the adoption case than in the abortion/after birth abortion case; and if in this case the interests of what they take to be an actual person (the mother) should prevail, then after birth abortion should be a valid alternative to adoption.

After birth abortion is a real issue and not just an academic matter; this is because when abortions are carried out post-viability sometimes they are not successful and the doctor along with supporters of abortion are left with a conundrum. On the one hand the mother has approached the doctor for an abortion, and in the majority of cases what this entails is a termination of the pregnancy and the death of the child. But in cases where the abortion is unsuccessful, the pregnancy is only terminated but the child is not dead.

Given that the mother has requested an abortion, does this extend only to the termination of pregnancy or should it extend to the death of the child?

If one holds that an abortion is unsuccessful unless the child’s life is ended, then one is left with the uncomfortable conclusion that the infant born alive should have its life ended; and if one does not recognise the right to life of this infant then one cannot recognise the right to life of any other infant. Hence Giubilini and Minerva’s conclusion follows and abortion, on this view, can be justifiably extended post-birth.

On the other hand, if one holds that in requesting an abortion a termination of pregnancy is sufficient but not termination of life (presumably because the infant born as a result of a failed abortion has a right to life), then one can query why the infant has a right to life only after being born but not whilst in utero. Indeed, the birth of the child is a rather arbitrary limit on the right to life such that an infant born alive after an unsuccessful abortion is no different from the same child in utero just prior to the abortion.

All of this goes to highlight a central feature of Giubilini and Minerva’s argument, and this is that if the right to life is only extended to individuals of a certain maturity or a gestational limit, then any limit to that right is arbitrary and the goal posts can be moved from 12 weeks to 26 week to full term to after birth and beyond. Indeed, once the limitation to the right to life comes to depend on some arbitrary point, the being in question ceases to have any right to life, but merely enjoys the privilege and benignity of those in power over him or her. In reality, the only limit to the right to life is not being the kind of thing subject to such a right. So, human beings are the kinds of things subject to a right to life, and so the limit on that right is that of not being a human. But this entails that the right to life cannot be based on any gestational limit or beyond, in which case the unborn child has as much a right to life as the newborn and beyond.

Dr Gaven Kerr

Media

Repugnant abortion drugs should not be legalised or normalised in Northern Ireland

Today’s abortion pill judicial review backed by Amnesty international and other pro-choice lobby groups is part of an ongoing and relentless campaign to undermine Northern Ireland’s abortion law. This case being heard in the High Court today involves a challenge to the decision by Northern Ireland’s public prosecution service to prosecute a mother for procuring illegal abortion pills for her 15 year old daughter. The focus of this court case should not be Northern Ireland’s life-saving abortion laws, but the technical details surrounding the PPS decision to prosecute.

This is a deeply saddening case. It is well known that these powerful and potent drugs designed to end the life of a newly developing baby up until twelve weeks gestation (WHO guidelines) present serious physical and mental health risks to pregnant women. There is a host of known serious side-effects for use of the abortion pill drugs: misoprostol, mifepristone, and methotrexate including ruptured uterus, haemorrhaging, hepatotoxicity (liver damage) for the mothers, and cardiovascular and neurodegenerative disease and malformation for their babies if the baby survives.

The French National Agency for medicines and Health Products Safety [ANSM] issued warnings about the gynaecological risks of Cytotec [misoprostol] in 2001 and 2013.The French national authority for health issued recommendations along similar lines in 2008 and 2015. French doctors continued to ignore these warnings and in March this year the drug was eventually banned in France.

In the United States the Federal drug agency states no data is yet available on the safety and efficacy of mifepristone in women with chronic medical conditions, and states women who are more than 35 years of age and who also smoke 10 or more cigarettes per day should be treated with caution because such patients were generally excluded from clinical trials of mifepristone.

The pro-choice lobby in their crusade to undermine Northern Ireland’s abortion law by legalising and normalising the use of these abortion drugs at home are doing women a great disservice. Not only do they ignore the new human life that is ended but also the trauma involved for women in delivering and then disposing off the remains of this new human life.

The repugnant reality of these drugs is that often the recognisable developing baby that is delivered is  disposed of along with other waste materials eventually ending up in the sewage system. The fact that a fifteen year old girl supported by her mother has undergone this tragic course of action is incredibly disturbing. How on earth can this ever be described as compassionate and progressive care?

Women in Northern Ireland facing unplanned pregnancies deserve genuinely life affirming quality support and care. In 2018 no woman should ever feel forced to take this drastic course of action. Our laws here in Northern Ireland should continue to carefully uphold the life health, dignity and well-being of both mothers and unborn babies.

Tracy Harkin

Blog

Conscientious Objection: Individual or Institutional?

In the aftermath of the abortion referendum, a lot of commentary has now focussed on the right to conscientious objection. This right is typically associated with article 9 of the ECHR and it is to the effect that one has freedom of conscience so long as the exercise of such freedom does not conflict with public order, health and morals, or the rights and freedoms of others. Accordingly, there are a number of activities that individuals, especially those working in healthcare, can object to and refuse to carry out, and abortion is one of them.

So far so good; health minister Simon Harris has guaranteed the right to conscientious objection to individuals. However, a rather thorny issue has emerged and that is whether or not the right to such objection extends not only to individuals but also to institutions.  Harris has stated that it only applies to individuals, whereas Baroness Nuala O’Loan has argued that it applies to institutions as well (https://www.irishcatholic.com/baroness-oloan-rejects-simon-harris-conscientious-objection-definition/). In Ireland there are a number of Catholic hospitals committed to a Catholic ethos and culture which is clearly inconsistent with the provision of abortion. Hence, the issue over whether or not an institution can conscientiously object is a pressing one.

A rather simplistic view would be to say that insofar as an institution is not a person, it does not have a conscience, and so cannot avail of conscientious objection. Indeed, one may argue that the notion that an institution can exercise a right that only applies to individuals is absurd. But this is a somewhat simplistic view for the following reason.

Many public institutions adopt a charter which signifies their philosophy and thereby seals that institution with that identity. We don’t have to look too far in the UK to see this to be the case. The NHS was set up with the ideal that the care for the sick and vulnerable is the responsibility of all of society and so should be paid for by society; access to good healthcare should be based on clinical need and not wealth. Hence, UK citizens can avail of health care in any NHS hospital and facility given their needs. If NHS hospitals only provided medical treatment, they would be no different from private hospitals which provide the same. Rather, NHS hospitals provide medical treatment without distinction of material riches, and so they judge that each member of society has as much a right to such treatment as any other. This is a philosophy that many in the medical profession find attractive and indeed will pursue employment in the NHS rather than seek work in the more lucrative private sector. Indeed, such health professionals see a nice accommodation between their paid employment and their general outlook, so that the one tallies with the other.

The free medical care provided by the NHS permits many health professionals to live according to their conscience. And this is not just the case for health professionals; there are many public bodies and institutions which enable the individual members to live in accord with their conscience, e.g. universities, local government, charities etc.  The philosophy characteristic of an institution thereby enables its members to live in accord with their conscience. Accordingly, it is not only important that an institution have a particular philosophy which signifies the culture in the place, but that that philosophy be protected so that the conscience rights of the people working there be protected.

We turn then to the right of conscientious objection, and given that the ethos of an institution is necessary to protect the conscience rights of those who work at that institution, that institution then ought to be able to object to any command contrary to that ethos, and this so as to protect the conscience rights of the individuals who work there. So to go back to the NHS example, the heroic doctor/nurse/midwife who opts for NHS work instead of the more lucrative private work would rightly object to the demand that NHS facilities give preferential treatment to those better off. And the NHS facility as a whole has a right to resist such a mandate in order to protect the rights of those staff who work there because of their belief that when it comes to health material riches should not determine preferential treatment.

In the case of Catholic hospitals then, we have a Catholic ethos which is a pro-life ethos, such that all human life, from conception to natural death, is worthy of respect and to be protected in a medical sense. Medical professionals who have trained in order to uphold that ethos and in turn take on work at such a hospital are exercising their freedom of conscience to pursue good work consistent with pro-life attitudes. The Catholic ethos of the hospital enables them to do that. Hence, if the Catholic ethos of the hospital is threatened, or indeed, if the pro-life value of the hospital is threatened, then the conscience rights of those who hold a pro-life view at that hospital are threatened. It follows that if the Catholic hospital cannot object to a command which undermines its pro-life ethos, then the conscience rights of the medical professionals working there are not being seriously upheld. And indeed this is often the case, since whilst one medical professional can object to direct participation in an abortion, he or she is often required to make a referral or arrangement within the same facility so that the abortion may occur, thereby becoming complicit in the abortion itself. Therefore, it is necessary to allow for institutional conscientious objection so as to enable the conscientious objection of individuals.

Dr Gaven Kerr