Thread: This is a list of the challenges and problems with @SimonHarrisTD's abortion bill. #legisl8 data.oireachtas.ie/ie/oireachtas/…
1) It never uses the word 'abortion'.
2) It applies to 'women', when intersex, non-binary and trans people will also need abortions.
3) It does not full decriminalise abortion. It starts by listing offences (and creates a new offence in s. 5(a) of helping another person to have an illegal abortion - which has been prosecuted in NI - see the recent judicial review).
4) It retains a 14 year prison sentence for performing an abortion, so that doctors may still worry about prosecution, and interpret the legislation conservatively. Implementation guidelines should clarify how references to 'good faith' and 'reasonableness' generate defences.
5) It contains no guarantees of access to care, and prescribes no remedies where care is wrongfully delayed or denied.
6) There is no provision for nurses and midwives to certify/provide abortion care in early pregnancy, even though this would help access and they are perfectly capable of performing these functions, with training.
7) At no point does the legislation require doctors to take account of the pregnant person's own assessment of risks to her life/health. (Maybe this will be covered in implementation guidelines).
8) s. 10 - what does 'serious harm to health' mean? Presumably this will be fleshed out in implementation guidelines.
9) s. 12 - 'condition likely to lead to the death of the foetus'...within 28 days. 28 days was not part of the draft legislation put to the people in March-May. Implementation guidelines need to ensure that uncertainty about how long dying baby might live does not prevent access.
10) s. 13 - up to 12 weeks. Delay is the big issue here. Will this provision be genuinely accessible to everyone who needs it? @disabled_choice and @RCNIreland already raising questions.
10 a) @Startdoctors have outlined a likely path to care. Pre-9 wks - Appointment 1 with GP + Appointment 2 (pill 1) + 24-48 hours (pill 2, preferably at home) + Appointment 3 (aftercare)
10 b) But Appointment 1 can be delayed if your GP has a conscientious objection, referring you for a new Appointment 1. Or it can be delayed if your GP sends you for a scan to date the pregnancy (he can't certify you until he can say in good faith that the pregnancy < 12wks
10 c) Or if the GP who saw you at Appointment 1 gets sick or is bereaved or goes on holidays, the legislation suggests that you need to start the process again (because the same dr must certify and arrange treatment)
10 d) Or @SimonHarrisTD has suggested that after 9 wks, you would be referred to hospital, to be placed under the care of a consultant obstetrician. Take home point on 10) = DELAY.
11) - s. 13 also contains a 72 hour waiting period. Depending on when the clock starts (from Appointment 1, or from first contact with the health service e.g. by ringing the designated helpline) this could be a further source of delay.
12) Even assuming everything goes well, 12 weeks (9 weeks in practice) won't be enough time for lots of people. Is this time limit workable? Will we see continued travel or continued (still criminalised) reliance on pills?
13) The Bill maintains the same review process as under the PLDPA. We don't know an awful lot about how that operates or about what is done in practice to ensure the pregnant person has a voice in the process (especially important for vulnerable people).
13 contd) Reviews under the PLDPA are very rare, but we know that most have been carried out under the 'suicide' ground.
14) s. 21 - as @IrishFPA point out, the notification/reporting provisions here are very slender. We need proper public health data collection, so that we know the system is working. And we need to review the operation of the law after 3 years.
15) s. 22 - consent. How will this law interact with the law on capacity to consent (vulnerable people), the law on children's consent to medical treatment? And can we assume repeal of the 8th means pregnant people will now have the ordinary right to refuse medical treatment?
16) s. 23 - CO - this cannot be weakened. Think especially of teenagers, or adults with intellectual disabilities living in congregated settings or in the care of family members. Lots of people don't have a meaningful choice of GP. The first dr they approach must help.
17) s. 24 - the only purpose of this section is to stigmatise providers and it should be removed.
18) s. 62A - does this mean that women travelling from NI to access services must pay for them? (They don't have to pay anymore if they access in Britain on the NHS).
19) No provision has yet been made for exclusion zones outside hospitals/places where abortion care is provided. We know that current legislation cannot adequately regulate the kinds of protest/imagery seen during the referendum.
The position paper here covers some of the above in more detail (please note the numbers of Heads in the General Scheme differ from the numbers of sections in the current Bill) lawyers4choice.files.wordpress.com/2018/08/positi…
Not all of these points require amendments to the Bill to resolve. Some can be dealt with by clear implementation guidance (part of @drboylan's new role).
.@fletcher_ruth at @Startdoctors conference now making key point we forgot that the offences in the legislation are overbroad - should be confined to coercion/unscrupulous providers. And they are unlikely to be enforced.
Notes in practice that DPP will not prosecute unless in public interest, maximum sentence unlikely to be applied, and anyway doctors working honestly in good faith are not at risk of prosecution.
Good question from the audience for @fletcher_ruth about whether 'examined' denotes physical examination, and whether this rules out any form of telemedicine, requires physical examination.
.@fletcher_ruth notes that 'examination' requirement was not part of the first draft of the legislation 'put to the people' in March-May.
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