FPA gets the go-ahead for a Judicial Review

Royal Courts of Justice, Belfast

The FPA has been given the green light to proceed with an application for a judicial review of the health department’s progress on the publication of guidance to the medical profession on Northern Ireland’s abortion law and clinical practice since the SPUC’s legal action forced the withdrawal of dangerously flawed guidelines in 2010.

In Court this morning Mr Tony McGleenan, the FPA’s legal council, tried to minimise the seriousness of the problems highlighted by the SPUC action. There were two main areas of concern, i) counselling for women considering abortion, and ii) the rights of medical personnel not to take part in abortion procedures. But the judge in SPUC’s case took the view that these were cross-cutting issues which held implications for the guidance as a whole and, therefore, ordered the entire document to be withdrawn. 

Since then there has been a change in the post of Minister for Health. Edwin Poots, the new Minister, has taken a more considered approach to how the guidance should reflect the laws which prohibit abortion in Northern Ireland. In a written response to a parliamentary question on the matter from to Anna Lo, a pro-abortion MLA from the Alliance Party, he stated: 

"This is a complex issue and one that requires careful consideration. I must ensure that any guidance produced for health professionals is robust and compatible with criminal law. I will only produce guidance when I am satisfied that this has been achieved."  (AQW 13733/11-15, Hansard  Written Answers, WA 30 14:09:2012)

Also in contrast to his predecessor, Mr Poots has listened to the concerns of pro-life doctors and parliamentarians who had for years been calling for more accurate and detailed records to be collected regarding the circumstances surrounding the abortions carried out in the Province. Supposedly these are lawful abortions but while no detailed records are kept it is simply impossible to say for certain. Strangely, (but predictably) the FPA who are now stamping their feet and demanding the publication of guidance is simultaneously opposed to the collection of data on abortions here. How can any group demand the immediate publication of guidance yet oppose mechanisms needed to ensure compliance with that guidance? The answer of course is that the FPA don’t want guidance that reflects the criminal law but something which medicalises it. Abortion, however, is not healthcare. It remains a criminal offence.  

The FPA application is scheduled to be heard over Monday 21st and Tuesday 22nd January, 2013. The pro-life movement has a dog in this fight but so far hasn’t seen a need to intervene in a case that shouldn’t have any bearing on the contents of the guidance. Nevertheless, we will be keeping a careful eye on developments. 

The role of conscience in medicine

The presentations delivered at the International Symposium on Maternal Health (Dublin, 8th September 2012) have just been made available on the internet. Of the many excellent presentations given at the event one of the most powerful came from Dr John Monaghan, consultant obstetrician and gynaecologist at Portiuncula Hospital in Ballinasloe, Co Galway.

Dr Monaghan began by outlining Ireland’s outstanding record on maternal health. This may be due in part to the pioneering work of Bartholemew Mosse who, in 1757, established the world’s first purpose built maternity hospital, The Rotunda, in Dublin. Since then Ireland has continued to be a leading light in obstetrics and maternal health. United Nations agencies have consistently ranked Ireland as one of the safest places in the world for expectant mothers. It is significantly safer than the US or the UK. 

And the differences between the records of Ireland and the UK was something Dr Monaghan wanted to look at specifically. One possible factor he identified could be the problem of recruitment. In 2007 a report from the Royal College of Obstetricians and Gynaecologists in Britain claimed that, over recent decades, the number of medical graduates choosing to specialise in this branch of medicine had fallen to dangerously low levels. 

“If you look at career choices of medical graduates in the UK” said Dr Monaghan “...the medical school with the most graduates coming into obstetrics and gynaecology is Queens University, Belfast. We take a look at maternal mortality. The figures for 2003-2007 in the different countries in the UK ...Northern Ireland has the lowest maternal mortality, for this five year period. So they seem to get more graduates and more live mothers.”  

He continued, “With its high recruitment and its low maternal mortality, I ask myself what else is different between the North of Ireland and the rest of the UK. There is only one difference that I’m aware of, the Abortion Act doesn’t apply there. And maybe this is why [more] graduates are attracted to work in obstetrics.”

“There have been several stories, especially in the UK, about more young doctors opposing abortion on ethical grounds. ...I’m suggesting that it’s nothing to do with religion or ethics it’s just that the prospect of abortion is sufficient to put many good graduates off practising obstetrics.

“...So we have evidence of increasing conscientious refusal among young doctors for abortion, so what do we think we can do about that? Well,” said Dr Monaghan, “one suggestion is that we should get rid of conscientious objection.” 

He went on to outline the growing threat to freedom of conscience within the medical profession. Anyone unsure of just how serious this threat is needs only to look at the Technical Guidance Document for the Reduction of Maternal Mortality just issued by the United Nations Human Rights Council. But as Dr Monaghan demonstrated, when doctors are no longer guided by the their code of conscience but by political decrees, then the consequences are grave. 

The legislation which prohibits abortion in Northern Ireland and the Republic is the Offences Against the Person Act. It was passed in 1861 but the origins of our law date back to the fifth century before the birth of Christ when the western tradition of medical ethics was founded on the Hippocratic Oath. This oath prohibited doctors from killing their patients through abortion and euthanasia.

These principles were reaffirmed in 1948 by the World Medical Association in the Declaration of Geneva which bound doctors to “maintain the utmost respect for human life from the time of conception, even under threat,” and not to use their medical knowledge contrary to the laws of humanity. 

The publication on the internet of Dr Monaghan’s presentation could not be more timely. Hopefully, the success of the International Symposium on Maternal Health will remind the medical profession, in Ireland and farther afield, that as the judges at Nuremberg warned, doctors cannot deviate from their ethical obligations even if legislation demands it. 

The battle continues Update: FPA’s judicial review

The Family Planning Association (FPA) was originally scheduled to be in Court today, but the leave hearing has now been listed for Monday 24th September 2012. The FPA’s aim in seeking a judicial review could only be to force the Department of Health to issue its guidance on abortion without any further consideration. Ten years after the FPA first went to court over the matter, it's clear that things haven’t gone according to plan and the abortion industry is growing impatient.  

It might seem something of a contradiction that while the FPA is so keen on abortion guidance for doctors in Northern Ireland, it has been so vehemently opposed to the imminent introduction of new requirements on the collection of data on abortions in hospitals here. After all, without accurately recorded figures, how is anyone to say if guidance is even being applied? The answer is, of course, that the abortion industry's idea of guidance is an official document that streamlines access to abortion without actually seeking to ensure that the law is upheld. Whether or not the FPA is granted leave to seek a review and whether or not such a review would be successful, it is extremely unlikely that the FPA will ever get the kind of guidance it would like. The devolution of criminal justice powers and political stability in Northern Ireland has proven to be a big set back for the FPA and its friends in the abortion industry.

A powerful defence of the right to life.

"Abortion is not medically necessary to save the life of a woman"

Last Saturday, 8th September 2012, an International Symposium on Maternal Health took place in Dublin. It was a truly remarkable event. Around 150 people crowded into the Great Hall in King’s Inn (off Henrietta Street) to listen to experts from Europe, Africa and the US speak about maternal health and foetal medicine. 

The organisers of the conference deserve to be congratulated for bringing together such an impressive array of speakers at a single event. Their breadth of research and combined level of experience must surely mean that this conference was unparalleled in recent decades in either Ireland or the UK. 

According to the World Health Organisation, the Irish Republic has consistently been one of the safest countries in the world for pregnant women. And, while each of the speakers was an expert in his or her field, many of them expressed how honoured they were to have the opportunity to address the Irish medical profession which has such an outstanding record on maternal healthcare. 

At its conclusion, the Symposium issued the DUBLIN DECLARATION ON MATERNAL HEALTHCARE which states:

• “As experienced practitioners and researchers in Obstetrics and Gynaecology, we affirm that direct abortion is not medically necessary to save the life of a woman.

• “We uphold that there is a fundamental difference between abortion, and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child.

• “We confirm that the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.”

As the pressure on Ireland to liberalise its abortion legislation is growing, the timing of this event could hardly have been better. Its influence on the abortion debate is likely to be felt for many years to come. 

It would be difficult to report on the full line up of speakers or on the wealth of information they provided. Over the coming days, however, I will try to summarise some of the highlights of the Symposium.

The battle continues

Northern Ireland's new Secretary of State

Arguments of the Abortion Advocates: Part 1 "Need"