Forcing a woman to ‘prove’ that she is suicidal is a ridiculous proposal

Friday, April 26, 2013

By Matt Cooper

HOW does a person “prove” themselves to be suicidal? By killing herself or himself?

A failed attempt might not suffice: if a person was “serious” about dying by suicide surely she or he would succeed? Failing to complete the act might even “prove” so that a person was not “really” suicidal.

Unpleasant stuff to contemplate, isn’t it, ugly to read? The Government is required to introduce legislation to allow for abortion — the termination of a pregnancy — in the event where the life of the expectant mother is at risk of being lost if the termination does not take place. The legislation is expected to allow for the inclusion of suicide as a threat, to take account of Supreme Court and European Court of Justice findings, and the outcome of two referenda of the people. The need to act accordingly is seemingly clear. It is also a very limited introduction of abortion, to cope with specific circumstances, where a woman might otherwise die.

Yet a vocal group, most likely representing a relatively small minority, is determined to ensure that the threat of suicide is not included as a reason for allowing the termination of a pregnancy. The implication of their argument, their insinuation, is that women will lie about feeling suicidal, in order to procure an abortion they would not otherwise get in Ireland. Loads of women would do this apparently; abortion “on demand” would become part of Irish life. (Or rather, abortions will take place in Ireland, instead of in Britain where 4,000 to 6,000 women go each year to do what is prohibited in Ireland.)

The experts on the mental health of women during pregnancy are horrified by this cynicism on the part of the scaremongers. There are three experts worth listening to in Ireland, who have direct experience of dealing with women who suffer depression during pregnancy, being employed by hospitals to do so. (That there are only three perinatal psychiatrists working in Ireland, and that all are based in Dublin, is another scandal for another day).

I’ve spoken to two of them this week live on radio and they were horrified by the idea that they would be called upon to act as part of an interrogation, one that would almost certainly make the pressures upon a suicidal woman worse, potentially increasing the chances of self-harm.

Dr Anthony McCarthy was particularly scathing of other qualified psychiatrists, who do not care for suicidal pregnant women, declaring as fact that pregnant women do not kill themselves. He acts as a national assessor of the situation and comes into possession of plenty of confidential information. He said that, out of respect to grieving families and so as not to distress them further, such suicides do happen but are described as “accidental deaths” or are given “open” verdicts at inquests.

Dr McCarthy is furious at the idea that women would be asked to “prove” that they are suicidal, as seems to be the intention of Health Minister’s James Reilly initial proposals to Government at Tuesday’s cabinet meeting. The idea is that he (or one of his two colleagues) and up to 11 other doctors, in the event of an appeal of an original decision, would determine whether a woman is to be believed and trusted in what she says.

Not surprisingly, Dr McCarthy is determined not to be turned into some kind of social police, although, unfortunately, I can imagine some doctors who would be more than happy to volunteer for such a task. He put it well when he said that compelling psychiatrists to take part in such a system was an abuse of their profession, when they were supposed to offer comfort, compassion and support to those in vulnerable situations. He said it is up to the Government to legislate to protect the life of the pregnant mother and not to do so in a way to pass social control onto a panel of psychiatrists. They are not judges.

All of this raises the political question of what Mr Reilly was playing at. Did he really think that requiring up to six doctors to test women’s suicidal intentions would really find approval from either doctors or the anti-abortion lobby? What about the invidious position he was going to put the three perinatal psychiatrists into, as their identity would become known leaving them vulnerable to the opposition of anti-abortion activists?

It is all turning very ugly as well as difficult, just as each abortion debate has over the last 30 years. It is causing problems for radio and television debate too, as there are calls for balance of views. Is the public evenly divided on the issue? I doubt it, but that is not necessarily the point. As abortion is a very sensitive issue, broadcasters have a responsibility to hear both sides, whatever their personal beliefs might be. It is a regular complaint from anti-abortion activists that they are not being heard or that the media is being biased against them, but I regard this more as a tactic designed to mislead the audience than a truth.

We hear them anyway. But that does not mean that deliberate lies and smears should be tolerated. I also prefer to provide a platform for the voices of those who have some relevant expertise, who can inform the debate properly with medical and scientific expertise. That is why I didn’t put somebody up against either Dr McCarthy or his colleague Dr Joanne Fenton this week. Anyone who would have debated does not have their level of expertise or experience. Better to have them explain the factual situation without interference in the name of balance. People can make up their own minds after hearing them.

REMEMBER too just how distasteful some of the tactics engaged in by the anti-abortion lobby have been. Late last year mobile advertising hoardings were driven around Dublin with a picture of Taoiseach Enda Kenny opening a door, with a caption along the lines of “Don’t let him open the door to abortion”. Kenny has complained too about receiving threats of an unspecified nature. Other TDs have received menacing calls from those who self-righteousness believes confers them with the right to do as they please.

It remains to be seen how strong Kenny will be in the face of such pressure – and the behaviour of many of his own party TDs. Kenny has never seemed enthusiastic about being responsible for introducing legislation, even in the most limited form being proposed.

Back in 2007 Kenny, when travelling in a car with the journalist Vincent Browne and in the presence of others, apparently insisted that he would not introduce legislation to allow abortion if he ever came into power, not even to give long overdue effect to the findings of the Supreme Court in the X Case of 1992. Nothing he said until the tragic death of Savita Halappanavar in Galway University Hospital late last year suggested that he had any interest in changing his mind on this.

The legislation he may bring in probably won’t deal with the issues of pregnancies arising from rape and incest directly, for example. Nor will it deal with the tragic cases of women who want to have a medical termination because their baby will not live after delivery. You would need a heart of stone not to empathise with their needs, as expressed so movingly in a series of interviews during the year, although some anti-abortion activists are so entrenched as to be unmoved.

– The Last Word with Matt Cooper is broadcast on 100-102 Today FM, Monday to Friday, 4.30pm to 7pm.