DUBLIN, May 24, 2013 ( – Legalizing abortion would increase the risk of suicide for at-risk women, according to testimony offered in hearings this week on the Irish abortion bill.

John Sheehan, a top perinatal psychiatrist at the Rotunda Hospital, the country’s leading maternity hospital, said that legalizing for suicide threats would reduce psychiatrists to “gatekeepers to abortion” and increased the risk of “false positives.”

“In practice, it would be impossible for any psychiatrist to accurately predict which woman will die by suicide in pregnancy,” Sheehan told the Health Committee on Tuesday. “Being unable to predict who will die by suicide is likely to lead to multiple ‘false positives.’ As psychiatrists, we are trained to assess and treat, not to predict the future.”

The coalition government’s Protection of Life during Pregnancy Bill 2013, proposes to legalize direct abortion “where there is a real and substantial risk to the life of the mother, including the threat of suicide.” It includes no gestational age limits on when the abortion can be committed, and pro-life advocates have pointed to admissions by Labor Party TDs that the bill is only the start, and that total legalisation on the UK model is the ultimate goal.

Sheehan added legal abortion for threats of suicide are unnecessary.

As one of only three perinatal psychiatrists in the country, with a combined experience of 40 years, none had ever had a case of suicidal intent during pregnancy.


The actual incidence of suicide in pregnancy, he said, was between one in 250,000 and one in 500,000.

Should it pass, the bill could create an entirely new role for psychiatrists, not as “medical practitioners.”

This follows comments last week by Dr. Sam Coulter Smith, Master of the Rotunda Hospital, who told the Irish Examiner committee that the suicide provisions will pose a “moral dilemma” for physicians.

“Currently I haven’t seen evidence that the termination of a pregnancy is an appropriate treatment for somebody who is suicidal, neither suicidal ideation nor suicide intent,” he said. “So, asking obstetricians to get involved in the termination of a pregnancy when there is little evidence to show that it is an appropriate intervention, I think creates a moral and ethical dilemma for doctors.”

Among the few voices from the psychiatric community supporting the bill was that of Dr. Anthony McCarthy, president of the College of Psychiatrists of Ireland, who said, “If some woman comes to me and she has refused all other alternatives, then my question will be why, and why is she sitting in front of me?”

“If her only option is termination of pregnancy, why hasn’t she gone to England?” he asked. “We’re not fools. That’s going to be a very complex discussion. We’re used to dealing with people who would put us under all sorts of stress to make a decision.”

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McCarthy acknowledged the wide range of opinions in the psychiatric profession on abortion that reflects “deep divisions” in society as a whole.

He called the bill a measure to address the “very small but real possibility” that a woman might take her own life if refused an abortion.

Prof. Kevin Malone of University College Dublin warned, however, that there could be serious repercussions with the bill’s suicide provisions, which would “normalize suicide” for women and other high-risk groups.

Senator Fidelma Healy Eames agreed with Malone that legislating for suicide for abortion would risk “legitimizing” it and described abortion as “a medieval solution to crisis pregnancy.”

Dublin TD Peter Mathews said that the government was attempting to “rush” the bill forward, and lamented that neither the president not the prime minister were present for the hearings. “This is their bill and they should be here, not just the Minister for Health. They’re over there in America but here is where the focus is for this country,” Matthews said.

The prime minister and the health minister have insisted that the government are obliged to legislate for abortion, but Barrister Paul Brady told the committee that the claim is false. The risk of suicide, he said, was only “conceded” by the Supreme Court in the 1992 X case, but never fully argued. He told legislators that they should not feel constrained by an “artificial straightjacket.”

“It is clear that head four marks a change in the law and I don't think it’s accurate to say otherwise,” Brady said.

Prime Minister Enda Kenny and has said the bill makes no substantial change to existing law, merely clarifying existing laws and providing doctors with a “legal framework.” Health Minister James Reilly claimed on Friday that the legislation clarifies what is already “lawfully available.”

But Brady said the bill “creates for the first time a statutory basis in Irish law for what may be a direct and intentional termination of an unborn child’s life.”

Under the suicide provision, Brady said, “it will be statutorily provided for that the aim of the procedure can be to bring about the death of the unborn child.”

“That will be the desired aim of the procedure – not some other form of treatment, not some form of relocation, not some form of therapy to the mother which has that consequence,” Brady said. “But that it’s the actual goal of that procedure. That’s a new departure.”

The Health Committee also heard from Prof. William Binchy, the Regius Professor of Laws at Trinity College, Dublin and legal adviser to Pro-Life Campaign, who said that the bill is unnecessary in the light of the European Court of Human Rights decision on the A, B, & C case that had required merely “clarity” in the law and a review procedure. Legalised abortion, he said, is incompatible with the core values of human rights, since it legislates for the taking of innocent human life.