DÁIL ÉIREANN AN COMHCHOISTE UM AN OCHTÚ LEASÚ AR AN MBUNREACHT JOINT COMMITTEE ON THE EIGHTH AMENDMENT OF THE CONSTITU- TION Dé Céadaoin, 25 Deireadh Fómhair 2017 Wednesday, 25 October 2017 The Joint Committee met at 1.30 p.m. MEMBERS PRESENT: Deputy James Browne, Senator Paul Gavan, Deputy Lisa Chambers, Senator Rónán Mullen, Deputy Ruth Coppinger, Senator Lynn Ruane. Deputy Clare Daly, Deputy Bernard J. Durkan, Deputy Peter Fitzpatrick, Deputy Billy Kelleher, Deputy Mattie McGrath, Deputy Catherine Murphy, Deputy Hildegarde Naughton, Deputy Jonathan O’Brien, Deputy Kate O’Connell, Deputy Louise O’Reilly, Deputy Jan O’Sullivan, Deputy Anne Rabbitte, SENATOR CATHERINE NOONE IN THE CHAIR. 1 JEAC The joint committee met in private session until 2.15 p.m. Business of Joint Committee Chairman: We are now in public session. I welcome members. I welcome viewers who may be watching our proceedings on Oireachtas television to this meeting in public session of the Oireachtas Joint Committee on the Eighth Amendment of the Constitution. We will be holding three separate sessions this afternoon. The first session will address risk to mental health; the second will address termination arising from rape and the third will look at personal experience of cases of fatal foetal abnormality. We had invited the support group One More Day to that third session, however, they could not make today’s session and the secretariat will accommodate them on a date in November. I welcome Professor Veronica O’Keane to the meeting, but before I introduce her I must attend to some housekeeping matters. There are two items of correspondence that I need to read into the record. The first is a letter from Ms Cora Sherlock dated 18 October 2017 and addressed to me. Dear Senator Noone, I would appreciate the opportunity to set the record straight about comments made by me that were misrepresented by Deputy Ruth Coppinger at last week’s meeting of the Joint Oireachtas Committee on the 8th Amendment. Deputy Coppinger called into question statements I have previously made surrounding the rate of abortion of babies diagnosed with Down Syndrome in the womb in England and Wales, namely that 90% of babies diagnosed with the condition are aborted. As on previous occasions, Deputy Coppinger disputed this figure, claiming instead that the correct rate is 44% and seeking confirmation from Dr. Fergal Malone who indicated that the abortion rate from the Rotunda when babies are diagnosed with Down Syndrome is already around 50% even with the 8th Amendment in place. By means of clarification, I would point to the fact that under Ground E of the Abortion Act 1967, abortion is allowed to birth if the baby in the womb is diagnosed with any disability or foetal anomaly and this includes Down Syndrome. I would refer to the Parliamentary Inquiry into Abortion on the Grounds of Disability (July 2013). Item 21 on page 14/15 of this Report states that “approximately 90% of babies with a definite diagnosis of Down Syndrome are aborted”. This figure has been generally accepted within the wider abortion debate and is regularly referred to by disability rights activists such as the “Don’t Screen Us Out” campaign in the UK which is trying to preserve the right to life of babies diagnosed with Down Syndrome in the womb. I would add that this worrying phenomena was highlighted at the January session of the Citizens’ Assembly when reference was made to a worldwide “trend” of aborting babies on the basis of a diagnosis of Down Syndrome. I ask that you bring this letter to the attention of your fellow colleagues on the Committee and that it be read into the record. 2 25 OCTOBER 2017 With every good wish. Yours Sincerely, __________________ Cora Sherlock Pro Life Campaign The next is an email from Dr. Peter Boylan dated 25 October 2017. Dear Senator Noone, Thank you again for the invitation to last Wednesday’s meeting of the Oireachtas Com- mittee on the Eighth Amendment. I was very impressed with the work of the Committee and thought the session was notable for the most part for its thoughtful and open-minded question- ing and collegial atmosphere. However, although Senator Ronan Mullen was absent for much of the committee on other business, while he was present he made several assertions at odds with the facts regarding what was said at the hearing in respect of my evidence. The next day, he appeared on at least two radio shows, during which he repeated those inaccurate assertions. In particular, he repeatedly claimed that Savita Halappanavar’s treating consultant in Galway did not “hide behind the Eighth Amendment”, i.e. that Dr Astbury was in no way constrained by the Eighth Amendment. This claim was made in direct contradiction of the evidence of both myself and Professor Arulkumaran last week. I am therefore attaching for your attention, and that of the committee, transcripts of the third day of the inquest into Ms Halappanavar’s death, in which it is absolutely apparent that Dr. Astbury, her treating consultant, could not have been clearer about how the eighth amendment prevented her from intervening. The relevant section is on pages 46 and 47, questions 176 to 179, inclusive. I have also attached Professor Arulkumaran’s evidence to the committee last week in re- sponse to Senator Lynn Ruane in which he categorically stated that the eighth amendment contributed to Savita Halappanavar’s death (page 30 of transcript). Both of us reviewed Ms Halappanavar’s full medical case records, and Professor Arulku- maran also had the advantage of interviewing those involved in her care in University Hospital Galway. This point is so fundamental to your hearings that I believe the record should be corrected in respect of Senator Mullen’s inaccurate assertions last Wednesday that the eighth amendment did not constrain Ms Halappanavar’s treating doctor. Yours sincerely, Peter Boylan. For the purposes of clarification, the attachments referred in the email will be available on the website and form part of the record of the committee. Risks to Mental Health of Pregnant Women: Professor Veronica O’Keane 3 JEAC Chairman: Before we begin our first session, members and those in the Visitors Gallery are reminded, at the request of the broadcasting and recording services, to ensure their mobile phones are turned off completely for the duration of the meeting. By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by ab- solute privilege in respect of their evidence to the committee. However, if they are directed by it to cease giving evidence on a particular matter and continue to so do, they are entitled thereafter only to qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person or an entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an of- ficial, either by name or in such a way as to make him or her identifiable. I welcome Professor Veronica O’Keane, professor of psychiatry at Trinity College Dublin and consultant psychiatrist at Tallaght hospital, and invite her to make her presentation. Professor Veronica O’Keane: I thank the Chairman and members of the committee for inviting me. I hope I can be of help to them in their task of interpreting the findings of the Citi- zens’ Assembly. I have been asked specifically to give my opinion as an expert in the field of mental health. My current role is a joint academic and clinical one, as consultant psychiatrist in the service of the HSE at Tallaght hospital and professor of clinical psychiatry at Trinity College Dublin where I lead a research programme in perinatal psychiatry. My previous expe- rience includes leading a national perinatal psychiatry service in London for five years at the Maudsley Hospital which covered all of the United Kingdom. Concurrently with that position, I was head of the perinatal psychiatry section at King’s College GKT School of Medical Educa- tion where I led a research programme in perinatal depression. I have had papers published in the scientific literature on the subject of perinatal depression and written a book on the topic. I co-authored the standard clinical assessment tool for perinatal psychiatry disorder in the United Kingdom and served as an expert for the National Institute for Clinical Excellence in devis- ing guidelines for clinicians on the management of perinatal depression. I set up two hospital psychiatry services, including the suicide prevention service in Beaumont Hospital. I was an expert witness at the two Oireachtas hearings which led to the introduction of the Protection of Life During Pregnancy Act and was also privileged to serve as an expert witness at the Citizens’ Assembly. Last March I co-hosted, with the National Women’s Council of Ireland, the World Congress on Women’s Mental Health at the RDS in Dublin. I begin by thanking the members of the Citizens’ Assembly for their work. The process and governance of the assembly in its consideration of the eighth amendment were an example of the best of democratic principles in action. Its conclusions were solution-focused and not ideo- logically driven. Most of the recommendations made are relevant to mental health, but they have been spelled out in a very helpful way that leaves no room for ambiguity.