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She Is Not a Criminal. the Impact of Ireland's Abortion

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She Is Not a Criminal. the Impact of Ireland's Abortion SHE IS NOT A CRIMINAL THE IMPACT OF IRELAND’S ABORTION LAW Amnesty International is a global movement of more than 7 million people who campaign for a world where human rights are enjoyed by all. Our vision is for every person to enjoy all the rights enshrined in the Universal Declaration of Human Rights and other international human rights standards. We are independent of any government, political ideology, economic interest or religion and are funded mainly by our membership and public donations. First published in 2015 by Amnesty International Ltd Peter Benenson House 1 Easton Street London WC1X 0DW United Kingdom © Amnesty International 2015 Index: EUR 29/1597/2015 Original language: English Printed by Amnesty International, International Secretariat, United Kingdom All rights reserved. This publication is copyright, but may be reproduced by any method without fee for advocacy, campaigning and teaching purposes, but not for resale. The copyright holders request that all such use be registered with them for impact assessment purposes. For copying in any other circumstances, or for reuse in other publications, or for translation or adaptation, prior written permission must be obtained from the publishers, and a fee may be payable. To request permission, or for any other inquiries, please contact [email protected] Cover photo: Stock image: Female patient sitting on a hospital bed. © ès/Corbis amnesty.org CONTENTS 1. Executive summary ................................................................................................... 6 2. Methodology ........................................................................................................... 11 3. In context: Abortion in Ireland .................................................................................. 13 International human rights obligations to address gender stereotypes ...................... 13 3.1 The Irish state and religious institutions enforce harmful gender stereotypes and have institutionalised violence against women and girls ....................................................... 14 3.2 A climate of stigma and intimidation ................................................................... 17 4. Ireland’s legal and policy framework governing abortion .............................................. 19 Criminal offences relating to abortion in Ireland ................................................... 19 4.1 Constitutional framework and the X case .............................................................. 20 4.2 The Protection of Life During Pregnancy Act (PLDPA) and accompanying guidance .. 21 4.3 The PLDPA does not protect women and girls ....................................................... 22 Ireland’s burdensome legal requirements contravene human rights standards and World Health Organization guidance on safe abortion services ................................ 25 4.4 The Department of Health’s Guidance Document for health professionals on the implementation of the PLDPA ................................................................................... 27 4.4.1 “Suicidal intent” ......................................................................................... 27 4.4.2 “Early delivery” ........................................................................................... 28 The Human Rights Committee’s Concluding Observations on Ireland (2014) ........... 28 4.5 Health care providers regard the PLDPA and accompanying guidance as retrogressive and dangerous for women ......................................................................................... 29 5. Restricted access to legal, life-saving abortion in Ireland ............................................. 31 5.1 When does risk to health become risk to life? Physical health grounds ..................... 31 International human rights standards on abortion reflect the link between risks to life and health ........................................................................................................ 31 Savita Halappanavar’s case ................................................................................ 32 5.2 Risk to life but not to health: An impossible legal fiction ....................................... 35 5.3 The impact of Savita Halappanavar’s death on women in Ireland ............................ 37 Lupe’s experience ............................................................................................. 38 5.4 A risk to life: The suicide exception ..................................................................... 39 Ms. Y’s case: Denied a lawful abortion ................................................................. 40 6. Impact of the Constitution’s Eighth Amendment protection for the foetus on the quality of health care pregnant women receive ............................................................................. 44 6.1 The impact of the Eighth Amendment on abortion-related care ............................... 45 6.2 The impact of the Eighth Amendment on non-abortion-related maternal health care . 46 Rebecca H.’s story ............................................................................................ 46 6.2.1 Eighth Amendment denies a pregnant woman dignity in death ......................... 48 Right to life protections do not apply before birth ................................................. 49 7. Criminalization of abortion in cases of fatal and severe foetal impairment ..................... 51 Nicola’s story ................................................................................................... 51 International human rights standards: Abortion on grounds of severe and fatal foetal impairment ...................................................................................................... 52 7.1 The impact of carrying a fatal foetal impairment pregnancy to term ........................ 53 7.2 Forced to travel: Cast out from the Irish health care system after a diagnosis of fatal foetal impairment .................................................................................................... 55 7.2.1 No support upon return ............................................................................... 57 7.2.2 Choices around severe foetal impairment ....................................................... 58 Laoise’s mother’s experience ............................................................................. 58 8. Criminalization of abortion in cases of rape ............................................................... 60 8.1 Abortion ban is another layer of trauma for rape survivors ...................................... 60 Asylum-seekers and sexual violence .................................................................... 61 8.2 Limited access to information for rape survivors ................................................... 62 8.3 Travel: Compounding psychological trauma and complicating access to accountability ............................................................................................................................. 63 8.4 Rape as grounds for a lawful abortion .................................................................. 64 Denial of abortion on grounds of rape: Torture and other ill-treatment .................... 64 9. Censorship and silence: Denial of information about abortion ...................................... 66 9.1 The Regulation of Information Act ....................................................................... 66 “Crisis pregnancy counselling” in Ireland ............................................................ 67 9.2 Restrictions on pregnancy counselling services and doctor-patient counselling under the Regulation of Information Act ............................................................................. 67 9.3 Impact of restrictions on women, doctors, and the doctor-patient relationship ......... 69 9.4 Denied critical health information and referrals due to Ireland’s Regulation of Information Act ....................................................................................................... 69 The denial and manipulation of pregnancy-related information violates fundamental human rights .................................................................................................... 72 9.5 Impact on the counsellor-client and doctor-patient relationship .............................. 72 9.5.1 Smear campaigns ....................................................................................... 73 UN Special Rapporteur on human rights defenders calls for protection of women, pregnancy counsellors and health care providers in Ireland ................................... 75 9.6 Restrictions on the provision of information about abortion services abroad to the general public ......................................................................................................... 76 International bodies condemn Ireland’s information restrictions ............................. 76 10. Ireland “exporting” its human rights obligations: Women left to find their own alternatives outside Ireland’s health system ................................................................... 78 10.1 Forced to travel abroad for health care services ................................................... 79 10.1.1 The logistical challenges of travelling abroad ................................................ 80 10.2 Lack of referrals and support from doctors and the impact on access to services .... 81 10.3 Financial barriers to travel
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