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Scanned Document SECRETARIAT GENERAL SECRETARIAT OF THE COMMITTEE OF MINISTERS SECRETARIAT DU COMITE DES MINISTRES Contact: Anna Austin Tel: 03 88 41 22 29 Date: 22/10/2014 DH-DD(2014)1283 Documents distributed at the request of a Representative shall be under the sole responsibility of the said Representative, without prejudice to the legal or political position of the Committee of Ministers. Meeting: 1214 meeting (2-4 December 2014) (DH) Item reference: Communication from the authorities (17/10/14) concerning the case of A, B & C against Ireland (Application No. 25579/05) Information made available under Rule 8.2.a of the Rules of the Committee of Ministers for the supervision of the execution of judgments and of the terms of friendly settlements. * * * * * * * * * * * Les documents distribués à la demande d’un/e Représentant/e le sont sous la seule responsabilité dudit/de ladite Représentant/e, sans préjuger de la position juridique ou politique du Comité des Ministres. Réunion : 1214 réunion (2-4 décembre 2014) (DH) Référence du point : Communication des autorités (17/10/2014) concernant l’affaire de l’A, B & C contre Irlande (requête n° 25579/05) (anglais uniquement). Informations mises à disposition en vertu de la Règle 8.2.a des Règles du Comité des Ministres pour la surveillance de l’exécution des arrêts et des termes des règlements amiables. Hu<.m to n a<lafociH J><' rtll cllH' rH He p rc S<' ll I d I i Oil n<l hl~ i rc<mn of Irclancl c iHJig Colllfwirlc na llEorpd 10 IIH' Council of Europ<' Ms Genevieve Mayer Head of Department Department of the Execution of Judgments of the Eu ropean Court of Human Rights DGI : Directorate General Human Rights and Rule of Law DGI 16 October 20 14 1 7 OCT. 2014 SERVICE DE L'EXECUTION DES ARRETS DE LA CEDH Dear Ms. Mayer, I refer to Mr. Frank Power's letter to you of 28 August 2014 and the additional information provided therewith with respect to the implementation of the ABC v Ireland judgement. The information provided at that time referred to the Guidance Document for Health Professionals on the Implementation of the Protection of Human Life During Pregnancy Act 2013. This document has now been published, and a copy is attached herewith. 1 would be grateful if you could arrange for this document to be circulated to Member States, for their information, in line with normal practice. Yours sincerely, ~k')-~ PeterGunning v U Permanent Representative of Ireland to the Counctl of Europe HEPHI~SE;"\;T,\TIO~ PLH~I \\:E\:TE DE t:IHI \"\,1>1 ~ .\l"PHI::S IH' < <>'-._,l ~ II . I>E L"El"J{()J>J ~ II l>olll('\ clr<l <Ill Pr(·sr<l<'lll 1.<1\\ ctr<ls . ()7000 Stfii~I>Olllg Tt~l ~ · ~ ~ 101 "UU~ 1-L d<l >o · F;n; · +T~ 101 \HH I · ~ ~!l :!:> · l:·llldil Slld~l><>liH.!Cl'(a cll<l 1<" Implementation of the Protection of Life During Pregnancy Act 2013 Guidance Document for Health Professionals 2014 Table of Contents 1. Introduction ....................................................................................................................... 4 1.1 Background to the Act ................................................................................... 4 1.2 The Protection of Life During Pregnancy Act 2013 ..................................... 4 1.3 For whom the Guidance Document is intended .......................................... 5 2. Referral Pathways ............................................................................................................. 7 2.1 Role of Obstetrician & Gynaecologists ........................................................ 7 2.2 Role of Psychiatrists ...................................................................................... 7 2.3 Role of Relevant Specialities ......................................................................... 8 2.4 Role of Nurses/Midwives ................................................................................ 8 2.5 Role of GPs/Other Primary Care Physicians and Referral Sources ........... 8 2.6 Referral to crisis pregnancy services ........................................................... 9 3. Clinical Assessment and Certification Process ........................................................... 11 3.1 Risk to life from Physical Illness – Section 7 of the Act ........................... 11 3.2 Risk to life from Physical Illness in Emergency – Section 8 of the Act ... 15 3.3 Risk to life from Suicide Intent – Section 9 of the Act ............................... 17 4. Certification ..................................................................................................................... 22 4.1 Certification for Non-emergency Physical Health Risk & Suicide Intent . 22 4.2 Certification for Emergency Physical Health Risk ..................................... 25 5. Non-Certification ............................................................................................................. 26 6. Medical Procedure .......................................................................................................... 27 6.1 Medical Procedure – Non Emergencies ...................................................... 27 6.2 Medical Procedure – Emergencies .............................................................. 29 6.3 Appropriate Institutions ............................................................................... 31 6.4 Gestational Age ............................................................................................. 31 6.5 Data Collection .............................................................................................. 32 7. Review Process ............................................................................................................... 33 7.1 Clinical Assessment and Certification Process for the Review ............... 34 7.2 Certification ................................................................................................... 35 7.3 Non-Certification ........................................................................................... 35 7.4 Professional Indemnity ................................................................................ 36 7.5 Payment / Expenses ..................................................................................... 36 8. Notification ...................................................................................................................... 37 9. Professional Issues……………………………………………………………….......……….38 9.1 Consent.......................................................................................................... 38 2 9.2 Freedom of Information and Confidentiality .............................................. 38 9.3 Child Protection Issues ................................................................................ 39 9.4 Conscientious Objections ............................................................................ 40 10. List of Appendices .......................................................................................................... 41 Appendix 1 Terms of Reference of the Committee and Objectives Appendix 2 Protection of Life During Pregnancy Act 2013 Appendix 3 Protection of Life During Pregnancy Act 2013 (Certification) Regulations 2013 Appendix 5 Protection of Life During Pregnancy Act 2013 (Section 20) (Notifications) Regulations 2013 Appendix 6 List of Appropriate Institutions Appendix 7 List of Approved Centres by the Mental Health Commission Appendix 8 List of Executive Clinical Directors (Mental Health) Appendix 9 Protection of Life During Pregnancy Act Review Committee Process Appendix 10 Capacity and Consent Appendix 11 Excerpts from Freedom of Information Acts 1997 and 2013 Appendix 12 List of Useful Contacts 3 1. Introduction 1.1 Background to the Act1 Article 40.3.3° of the Irish Constitution states that ‘The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.’ The interpretation of Article 40.3.3° was considered by the Supreme Court in Attorney General v X (the X case2). The Supreme Court held that if it were established as a matter of probability that there was a real and substantial risk to the life, as distinct from the health, of the mother and that the real and substantial risk could only be averted by the termination of the pregnancy, such a termination is lawful. Further, in December 2009, the European Court of Human Rights heard a case brought by three women in respect of the alleged breach of their rights under the European Convention on Human Rights in regard to abortion in Ireland (the A, B and C v Ireland case3). Ireland was found to be in violation of the right of Applicant C to private and family life, contrary to Article 8 of the Convention. This is because Ireland had failed to provide an accessible and effective procedure to the applicant to enable her establish whether she qualified for a lawful termination in accordance to Article 40.3.3° or not. 1.2 The Protection of Life During Pregnancy Act 2013 The Protection of Life During Pregnancy Act 2013 was enacted in July 2013 and commenced in January 2014. The purpose of this Act is to restate the general prohibition on abortion in Ireland while regulating access to lawful termination of pregnancy in accordance with the X case and the judgment in the European Court of Human Right in the A, B and C v Ireland case. The Act achieves this objective in the following ways: - by providing a clear criminal prohibition on abortion;
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