Ten ways redefining marriage would damage civil liberty

Freedom to disagree and the right to private conscience are fundamental liberties in any truly open society. Yet, the Government has utterly failed to consider the impact on civil liberty of its plans to redefine marriage (See their proposals here).

The Coalition for Marriage has just released a new leaflet outlining ten ways redefining marriage would damage civil liberty.

If the meaning of marriage changes in law, they argue, based on expert legal opinion that:

1.Teachers in state schools will be forced to endorse the new definition of marriage. Those that refuse could be disciplined or even dismissed. Such action would be legal.

2.Parents will ultimately have no legal right to withdraw their children from lessons which endorse the new definition of marriage across the curriculum.

3.NHS/University/Armed forces chaplains could be lawfully fired by their employers if they express, even outside work time, the belief that marriage is between one man and one woman.

4.Foster carers could be legally rejected by local authorities on the basis that they fail to embrace the new definition of marriage.

5.Public sector workers could be demoted or dismissed for expressing support for marriage between one man and one woman.

6.Registrars who have a conscientious objection to the new definition of marriage will be dismissed unless they are prepared to act against their beliefs.

7.Churches/mosques/synagogues could ultimately be forced to perform same-sex weddings if a Government ban on such weddings in religious premises is overturned by the European courts.

8.The Church of England may have to disestablish or face the prospect of court action because, as the established church, it must provide a wedding to any person who is legally eligible to get married.

9.Faith-based charities could be banned from hiring public facilities if they refuse to endorse the new definition of marriage.

10.Clergy who disagree with same-sex marriage, but who are in a denomination which has no such objection, could be taken to court if the Government allows religious same sex weddings.

The scenarios above are based upon a legal opinion written by Aidan O’Neill QC, a leading human rights lawyer. A summary of the legal opinion is available from the C4M website

See also (on this blog site) - Same-sex marriage - 24 articles on all aspects of the UK debate

I'm happy to publish links to longer responses to this post on this page on request:

Responses

1. Dan Abrahmsen

Health professionals and organisations misusing LCP should be reported to regulators, says CQC

The Liverpool Care Pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice to relieve suffering in dying patients, setting out principles for their treatment in their final days and hours.

But it has been dogged by controversy with claims that patients who were not imminently dying have been placed on it and that patients’ families were not fully consulted and informed.

Health Minister Norman Lamb is currently heading up an investigation into its use but in the meantime there are moves to counter its inappropriate use.

The Care Quality Commission (CQC) has this week agreed a statement with other health and care regulators about each organisation’s role and responsibilities in relation to the Liverpool Care Pathway (LCP).

The CQC regulates all health and adult social care services in England, including those provided by the NHS, local authorities, private companies or voluntary organisations.

The statement has had surprisingly little coverage in the media with only the Daily Telegraph noting it.

It says that ‘it is the duty of those professionals involved in the care of the dying to work together as a team to determine, in association with the person and those close to them, when it is appropriate to implement the LCP. The relevant regulators need to be informed if any person believes the implementation of the LCP to be inappropriate.’

The statement also makes it clear that clinical and other staff working in regulated services have a responsibility to bring it ‘to the attention of the relevant professional regulator’ should they ‘witness malpractice or unprofessional conduct in their work place’.

Nurses and midwives should be reported to the Nursing and Midwifery Council and other health professionals to the Health and Care Professions Council. Organisations should be reported directly to the CQC itself.

The Liverpool Care Pathway is a useful clinical tool that has helped many thousands of people experience better care in the last hours or days of life but like any tool must be used with the proper indications and by properly trained staff.

There have been disturbing case reports in the media about it being used inappropriately with patients who are not imminently dying and it is right that these cases are properly investigated by the appropriate authorities.

This clarification by the CQC about the proper procedures to be followed by clinical and other staff if they witness malpractice or unprofessional conduct in their work place is most welcome.

Meanwhile the people behind the pathway have recently spoken out in its defence and the CMF has published an excellent review article looking at it from a Christian perspective. It concludes:

‘The LCP represents a pragmatic and effective response to some of the suffering experienced by many in the last days of life. It remains, however, a tool and it is only as good as those who use it. There is always potential for misuse and abuse and there are undoubtedly instances where this occurs. Where these arise by intention then those involved should be held to account, but more often they occur through poor understanding and inadequate training. Successful roll out of the LCP needs much education, both initial and ongoing, and this may sometimes be underestimated or under-resourced. We owe it to patients to not only furnish the means to better care, but also to equip adequately those who provide it.’

I have previously outlined a list of issues that need to be addressed in the enquiry.

Christian Medical Comment – 500,000 page views

Christian Medical Comment (CMC) was launched in December 2009 (so is three years old this month) but I started blogging regularly in September 2010.

Overall there have been 556 individual posts and just over 500,000 page-views – at an average of about 900 views per post.

CMC has been ranked in the 20 top UK blogs in the Religion and Belief category in the e-buzzing rankings for all but one of the last 18 months. It peaked at 3rd in March 2012 and currently stands at 13th. It ranks 397th overall amongst e-buzzing’s over 210,000 registered blogs.

CMC is a specialist blog majoring on issues at the interface of Christianity and Medicine with specific focus on the beginning and end of life. But my broader aim is to bring issues to the attention of Christians that I believe they should be informed and concerned about.

I write mainly for a Christian readership but many of my readers hold strongly opposing views and frequently take issue with what I say.

50% of readers come from the UK, 22% from the US and 9% from Canada, Australia, Germany, Russia, France and Ireland combined with the remaining 19% coming from other countries around the world.

CMC was runner up in the People’s Choice category at the Christian New Media Awards in London this year. Last year it was a finalist in the Best Christian Blog category and in 2010 it was listed in Jubilee Centre's seven best blogs giving a Christian perspective on social and political issues.

I’m particularly grateful to those other blogs which republish some of my posts giving them wider distribution (especially Euthanasia Prevention Coalition, Mercatornet, Anglican Mainstream, Care Not Killing, LifeSite News, National Right to Life News and the Official CMF blog) and also to the Christian Institute, Westminster2010 and Christian Concern which frequently link to or quote from them.

My ten most viewed all time posts are as follows:

1. Twenty questions atheists struggle to answer
2. Hospital kills ‘wrong’ twin in selective abortion – both babies now dead
3. Ten reasons not to legalise same-sex marriage in Britain
4. Response to Daily Mail article on abortion of IVF babies for Down’s syndrome reveals frightening attitudes to disability
5. Twenty questions atheists struggle to answer: How theism does better on the first six
6. Fantastic interview! Rev Cooper, chaplain to Chile’s president, gives glory to God on Radio Five Live about God’s hand in rescue of Chilean miners
7. Twenty facts we did not learn from Terry Pratchett’s BBC ‘documentary’ on assisted suicide in Europe
8. Do you object to being labelled 'homophobic' when you are actually just 'homosceptic'?
9. Ireland victory makes North-South rugby world cup final look a near certainty
10. Powerful arguments advanced in UK parliament for a change in the law to ensure properly informed consent for abortion

New study shows free emergency contraception increases rates of sexually transmitted infections

A new American study published this week has shown that making emergency contraception available free over the counter without prescription leads to an increase in rates of sexually transmitted infections and does not decrease pregnancy or abortion rates.

The FDA recently approved access to emergency contraception, or Plan B, through US pharmacies without a prescription. While this change is only now occurring nationally, several states had previously allowed pharmacy access to emergency contraception. In particular, Washington State was the first state to implement such a program in 1998.

In the new study, Christine Durrance, Assistant Professor of Public Policy at the University of North Carolina, Chapel Hill, used county-level data as well as specific timing of changes in pharmacy access to consider the intended and unintended consequences of pharmacy access to emergency contraception in Washington.

The results indicated that while county-level access to emergency contraception was unrelated to trends in STIs and abortions before access changed, access afterwards caused a statistically significant increase in STI rates (specifically gonorrhea rates), both overall and for females, and statistically significant decreases in abortion rates for some ages. These results were robust to several specification tests and falsification tests.

The results are almost identical to those of a British study published in the Journal of Health Economics (full text) in December 2010 and reported in the Daily Telegraph in January 2011.

This research, by professors Sourafel Girma and David Paton of Nottingham University, compared areas of England where the scheme was introduced with others that declined to provide emergency contraception free from chemists (See my previous blogs on this here and here).

The academics found that rates of pregnancy among girls under 16 remained the same, but that rates of sexually transmitted infections increased by 12%.

In fact, in a systematic review published in 2007, twenty-three studies published between 1998 and 2006, and analyzed by James Trussell’s team at Princeton University, measured the effect of increased EC access on EC use, unintended pregnancy, and abortion. Not a single study among the 23 found a reduction in unintended pregnancies or abortions following increased access to emergency contraception (see also fact sheet here).

The phenomenon whereby applying a prevention measure results in an increase in the very thing it is trying to prevent is known as ‘risk compensation’.

The term has been applied to the fact that the wearing of seatbelts does not decrease the level of some forms of road traffic injuries since drivers are thereby encouraged to drive more recklessly.

In the same way it has been argued that making condoms readily available actually increases rather than decreases rates of pregnancy and sexually transmitted infections because condoms encourage teenagers to take more sexual risks in the false belief that they will not suffer harm.

Whilst condoms offer some protection against sexually transmitted infections the morning-after pill offers none.

Britain has the highest rate of teenage pregnancy in Western Europe. In 2008, the latest year for which figures are available, more than 7,500 girls in England and Wales became pregnant. Nearly two thirds of these pregnancies ended in abortion.

Rates of sexually transmitted diseases are also rising. In 2009 there were 12,000 more cases than the previous year, when 470,701 cases were reported. The number of infections in 16-to 19 year-olds seen at genito-urinary medicine clinics rose from 46,856 in 2003 to 58,133 in 2007.

International research has consistently failed to find any evidence that emergency birth control schemes achieve a reduction in teenage conception and abortion rates. But now there is growing evidence showing that not only are such schemes failing to do any good, but they may in fact be doing harm.

Making the emergency contraceptive pill available over the counter free, without prescription, is sadly an ill-conceived knee-jerk response to Britain’s spiralling epidemic of unplanned pregnancy, abortion and sexually transmitted disease amongst teenagers. It is also not evidence-based.

The best way to counter the epidemic of unplanned pregnancy and sexually transmitted disease is to promote real behaviour change. The government would be well advised to enter into dialogue with leaders of communities in Britain where rates of sexually transmitted diseases and unplanned pregnancy are low, especially Christian faith communities, to learn about what actually works.

Church-based programmes such as Love for Life (Northern Ireland), Love2last (Sheffield), Challenge Team, Romance Academy or Lovewise (Newcastle) are getting great results and have much wisdom to pass on. How about financing some serious research into examining them in more depth?

Euthanasia is out of control in Belgium – new ten year review

Belgium has already often been in the news over euthanasia.

I have previously drawn attention on this blog to the fact that using organs from euthanasia victims for transplant is now an established procedure there.

In a previous post, 'Twenty things Terry Pratchett did not tell us about euthanasia in Europe', I also drew attention (with links) to the following facts:

1. Almost half of Belgium’s euthanasia nurses have admitted to killing without consent, despite the fact that involuntary euthanasia is illegal in Belgium and that nurses are not allowed to perform even voluntary euthanasia.

2. In Belgium, nearly half of all cases of euthanasia are not reported to the Federal Control and Evaluation Committee. Legal requirements were more frequently not met in unreported cases than in reported cases and a written request for euthanasia was absent in 88%.

3. A recent study found that in the Flemish part of Belgium, 66 of 208 cases of ‘euthanasia’ (32%) occurred in the absence of request or consent.

But to build on all this Bioedge and Life News have both run stories in the last week about a recent report into the first ten years of legalised euthanasia in Belgium.

Belgium legalised euthanasia in 2002, with a law containing strict controls to protect the vulnerable. (Here is a review of events and the text of the law in English )

The Belgium-based European Institute of Bioethics has just released a study (link to English and Dutch translations) of the experience of ten years of euthanasia. It claims that the results are far from encouraging.

Michael Cook at Bioedge gives his assessment as follows:

‘The central theme of the reportis the ineffectiveness and bias of the body established by the legislation to allay the misgivings of the public by monitoring and controlling euthanasia. After 10 years and about 5,500 cases, not one case has ever been referred to the police. It is illusory, says the IEB, to expect doctors to denounce their own failings.

Furthermore, nearly half of the statutory 16-member Commission for Control and Assessment are members or associates of the leading Belgian right-to-die society. This is sufficient to explain, according to the IEB, ‘the absence of any effective control and the ever‐widening interpretation which the Commission intends to give the law’.

A law which permits euthanasia is bad enough, the IEB suggests, but the government is not even enforcing its application.

‘As is the case in all penal laws, this law has to be strictly interpreted lest it be of seeing it stripped of any substance. It is not for the Commission, appointed to control and assess the law, to provide an ever‐widening interpretation of its terms, with this going so far as to negate the initial spirit of the text and of doing away with the control of decisive legal criteria.’

As a result, there are on-going abuses in several areas. Here are a few of those which the EIB singles out for criticism:

•A written declaration of a desire for euthanasia is required, either by the patient or a surrogate. However, the Commission often waives this obligation.

•Initially patients had to have a life‐threatening and incurable illness. Nowadays, the illness need only be serious and debilitating.

•The pain is supposed to be unbearable, unremitting and unrelievable. However, a patient can refuse medication to relieve the pain. The Commission, says the IEB, has ‘decided not to carry out its mission ‐ so central to the law ‐ of verifying the unbearable and unrelievable nature of the suffering’.

•The ambit of ‘psychological suffering’ is ever-expanding.

•Doctor-assisted suicide is not authorised by 2002 legislation. However, the Commission has ignored this and regularly signs off on such cases.

•If a patient is to be euthanised at home, the doctor himself is supposed to fetch the lethal medications at a pharmacy from a registered pharmacist and to return left-over drugs. In practice, family members often get the drugs; unqualified personnel hand them over; and no checks have ever been made about surplus drugs.’

Wesley Smith at Life News makes the point that once doctor-administered death is legal, any assurances about so-called ‘safeguards’ become inoperative. Instead the categories of the killable continually expand. He quotes from the report as follows:

'Initially legalized under very strict conditions, euthanasia has gradually become a very normal and even ordinary act to which patients are deemed ‘to have a right’. In the face of certain high profile cases, the evident relaxation of the very strict conditions has caused many reactions but also a total absence of any sanctions on the part of the Commission and a very conciliatory silence from the political establishment has given rise to a feeling of impunity on the part of some concerned medical practitioners, and to a feeling of powerlessness in those worried about where things are leading.'

He then argues that things are looking to get worse, with Belgium poised to follow the Netherlands into infanticide and quotes a further chilling section of the report:

'Several neonatologists have drawn up a procedure which enables euthanasia of premature newborn infants or those presenting a handicap in one of the three following instances: either the infant has no chance of survival, or it is deemed to only have a very mediocre quality of life, or the outlook is poor and it is felt that the infant will suffer unbearable pain.

The Groningen Protocol [Dutch infanticide protocol] caused quite a stir in Belgium and a great many medical practitioners are of the opinion that since a ‘therapeutic’ abortion is possible right up to the day before birth in the event of the child being handicapped, euthanasia of newborns ought also to be allowed under the same conditions.'

I have never been convinced by the term ‘slippery slope’ which implies passive change over time. What we are seeing in Belgium is more accurately termed 'incremental extension', the steady intentional escalation of numbers with a gradual widening of the categories of patients to be included.

Documented cases of euthanasia in Belgium have increased 500% since 2003. since I recently described the similar steep increase of cases of assisted suicide in Oregon (450% since 1998) and Switzerland (700% over the same period). In the Netherlands since 2006 the number of official cases of (lethal injection) euthanasia has doubled since 2006, although many other people (possibly up to 12.3% of all deaths) are having their lives actively ended through the process of ‘continuous deep sedation’ whereby doctors deeply sedate patients and then withhold fluids with the explicit intention that they will die.

The lessons are clear. Once you relax the law on euthanasia or assisted suicide steady extension will follow as night follows day.

More on Guttmacher’s gross distortion of worldwide abortion statistics

I have recently reviewed a landmark paper by Koch and colleagues critically examining the methodology used by the Alan Guttmacher Institute (AGI) to estimate abortions in Mexico.

The AGI has long been looked to by decision-makers to provide statistics on abortion and by pro-abortion activists to argue that making abortion ‘legal and safe' all over the world will actually reduce the overall number of abortions.

It is now evident, however, that their methodology is profoundly flawed.

It may well be that there are not 42 million abortions worldwide annually, as AGI claims, but much closer to half this number.

As William Johnston has convincingly argued (see my previous review) whilst there is little dispute about abortion numbers from developed countries, AGI has misled the international community for years about abortion numbers in developing countries.

The upshot of this is that their estimates of abortion in developing countries are astonishingly wayward and a major plank of their argument for legalisation is thereby kicked away (I have previously exposed the way in which inaccurate figures about deaths from illegal abortion have been similarly distorted by pro-abortion activists).

Here is the full press release of 6 December from Koch and Colleagues about their recent paper.

MEXICAN PARADOX: WHILE SURVEYS OVERESTIMATE ABORTIONS 10-FOLD, ABORTION MORTALITY CLEARLY DECREASES

Abortion figures estimated through opinion surveys in Mexico are inconsistent with the significant decrease in abortion mortality in the country, study finds

Summary: There seems to be a paradox between estimated abortion figures and the significant decrease in abortion deaths in Mexico. A multinational collaborative study shows up to 10-fold overestimation of the actual induced abortion figures in Mexico DF when opinion surveys were used. Moreover, the report shows that 98% of maternal death causes are unrelated to induced abortion, highlighting the importance of increasing emergency and specialized obstetric care in Mexico to improve maternal health.

A collaborative study conducted in Mexico by researchers from the West Virginia University-Charleston (US), Universidad Popular Autónoma del Estado de Puebla (México), Universidad de Chile and the Institute of Molecular Epidemiology of the Universidad Católica de la Santísima Concepción (Chile), revealed that opinion surveys used by researchers from the Guttmacher Institute overestimated figures of induced abortion in the Federal District of Mexico (Mexico DF) up to 10-fold. The research recently published in the International Journal of Women’s Health highlights that the actual figure of induced abortion in Mexico DF has not surpassed 15,000 per year according to the official registry. “During 2009, the number of induced abortions in Mexico DF was 12,221, which directly contradicts the figure of 122,355 induced abortions estimated by opinion surveys for the same year, resulting in a 1000% overestimation” pointed out Elard Koch, the Chilean epidemiologist leading the research.

The research group directly compared the estimations of induced abortion reported by the Guttmacher Institute and the actual figures reported by the GIRE (from the Spanish acronym Grupo de Información en Reproducción Electiva), institution that maintains epidemiological surveillance of abortion in Mexico DF since its decriminalization in 2007. The researchers detected that discrepancies found between estimated and actual figures are likely due to the subjective and potentially biased nature of opinion surveys, which have estimated figures as large as 1,024,424 induced abortions per year for the entire Mexican country. “This is a perfect example demonstrating that methodologies used for estimating figures of induced abortion and related indicators, such as abortion mortality rates, need constant re-evaluation and scrutiny by the scientific community in order to provide the best epidemiological data to be used for public policies of any region” explained Byron Calhoun, specialist in Obstetrics and Gynecology from the West Virginia University-Charleston and co-author of the study.

Paradoxically, the study also shows that abortion mortality in the whole Mexican country has decreased to the point that approximately 98% of total maternal deaths are related to hemorrhage during childbirth, hypertension and eclampsia, indirect causes and other pathological conditions. Koch explained that “given the low figures of abortion deaths observed in Mexico and previous results observed in the Chilean natural experiment published in May of this year in PLoS ONE, it is very improbable that changes in the legal status of abortion can elicit significant effects to decrease maternal mortality in these Latin American countries.” For instance, out of the 1207 total maternal deaths registered in Mexico during 2009, only 25 could be attributable to induced abortion, resulting in a mortality rate of 0.97 per 100,000 live births. In the case of Chile, out of a total 43 maternal deaths observed during 2009, only 1 could be attributable to induced abortion, with a mortality rate of 0.39 per 100,000 live births. “To evaluate what are the main causes of maternal death is crucial to promote adequate Public Health policies and allocation of resources in developing countries.” Koch and Calhoun agreed.

A fact that concerned the researchers is that part of maternal deaths due to induced abortion in Mexico may be related to violence against women during pregnancy, whose prevalence has increased alarmingly in the country. Surveys of violence against women (Encuesta Nacional sobre Violencia contra las Mujeres, ENVIM) conducted in 2003 and 2006 show an increase in the prevalence of intimate partner violence from 9.8% to 33.3% and of physical violence during pregnancy from 5.3% to 9.4%. “In addition to some deaths due to spontaneous miscarriages rapidly complicated by sepsis, membrane rupture and subsequent abortion are often observed in pregnant women suffering episodes of excessive physical violence, falls or accidents. If these women do not receive prompt medical attention, they may die from clinical complications. It is important to remark, that any of these deaths cannot be avoided by promoting changes in abortion legislations simply because they are the result of other causes, especially septic shock resistant to antibiotic treatment” said Koch.

The researchers stated that implementation of emergency obstetric units and timely access to specialized medical care for high-risk pregnancies, especially in the most vulnerable regions, are key to further reduce maternal mortality in Mexico. “Hundreds of Mexican women continue to die due to hemorrhage, eclampsia and indirect causes; this suggests very concrete strategies that clearly are unrelated to the legal status of abortion” Koch and Calhoun concluded.

Koch E, Aracena P, Gatica S, Bravo M, Huerta-Zepeda A, Calchoun BC (2012) Fundamental discrepancies in abortion estimates and abortion related mortality: A reevaluation of recent studies in Mexico with special reference to the International Classification of Diseases. Int J Women Health 4: 613-623. Available here.

Koch E, Thorp J, Bravo M, Gatica S, Romero CX, et al. (2012) Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007. PLoS ONE 7(5): e36613. doi:10.1371/journal.pone.0036613. Available here.

See also 'Evidence on abortion figures overestimated in Mexico fuels scientific debate in medical journal'

Ireland and abortion – a review of recent events and the current legislative predicament

The international spotlight is now on Ireland in the wake of the case of Savita Halappanavar who, it is alleged, died after being denied an abortion (the facts of the case are still subject to an investigation and are hotly disputed).

Abortion remains illegal in Ireland under statute law but two court cases have established precedent which has to some extent led to loss of clarity.

The ‘X case’ (in 1992) (Attorney General v. X, [1992] IESC 1; [1992] 1 IR 1) was a landmark Irish Supreme Court case which established the right of Irish women to an abortion if a pregnant woman's life was at risk because of pregnancy, including the risk of suicide.

The ‘ABC case’ ( A, B and C v Ireland [2010] ECHR 2032) was a landmark case of the European Court of Human Rights on the right to privacy under article 8 ECHR. It held there is no right for women to an abortion, although it also found that Ireland had violated the Convention by failing to provide an accessible and effective procedure by which a woman can have established whether she qualifies for a legal abortion under current Irish law.

An ‘expert group’ has now produced a report on the Judgement in A, B and C v Ireland which has put forward four options for the Irish government to consider. The Irish government is not obliged by the judgement of the European Court of Human Rights to legislate for abortion. However there is a lot of international pressure for it to do so.

Pat Buckley (pictured) of the European Life network has put up some very useful posts on the current dilemma faced by the Irish government.

Buckley draws attention to a report from the European Life network (ELN) on the expert recommendations and links to the full critique.

ELN essentially questions the entire basis on which the report is premised and rejects many of the assertions set out in it.

It concludes as follows:

By defining abortion as necessary medical treatment, and by undermining the absolute prohibition on abortion in the Irish Constitution and Irish statute law, the expert report sets the scene for legislation which will lead to ever-wider permissions for abortion.

The history of abortion law in Great Britain shows that, over time, court judgments, new statutes, regulations and professional guidelines form a trend towards de facto abortion on demand.

The Oireachtas must reject the expert group if it wishes to avoid this scenario. It must find a way to overturn the X case judgment and any other element of law or public policy in Ireland which fails to apply Ireland’s constitutional and statutory ban on intentionally ending the lives of unborn children from the point of conception onwards. This will also protect the lives and dignity of women, in a country whose maternal health record is one of the best in the world.

In another post Buckley reports on the statement of the Irish Catholic Bishops' Conference on 4 December who have issued their initial response to the Report of the Expert Group on the Judgement in A,B and C v Ireland.

I have quoted some key excerpts below but a fuller summary is available on Patrick Buckley’s blog.

A society that believes the right to life is the most fundamental of all rights cannot ignore the fact that abortion is first and foremost a moral issue.

As a society we have a particular responsibility to ensure this right is upheld on behalf of those who are defenceless, voiceless or vulnerable. This includes our duty as a society to defend and promote the equal right to life of a pregnant mother and the innocent and defenceless child in her womb when the life of either of these persons is at risk.

By virtue of their common humanity the life of a mother and her unborn baby are both sacred. They have an equal right to life. The Catholic Church has never taught that the life of a child in the womb should be preferred to that of a mother. Where a seriously ill pregnant woman needs medical treatment which may put the life of her baby at risk, such treatments are morally permissible provided every effort has been made to save the life of both the mother and her baby.

Abortion, understood as the direct and intentional destruction of an unborn baby, is gravely immoral in all circumstances. This is different from medical treatments which do not directly and intentionally seek to end the life of the unborn baby.

Current law and medical guidelines in Ireland allow nurses and doctors in Irish hospitals to apply this vital distinction in practice. This has been an important factor in ensuring that Irish hospitals are among the safest and best in the world in terms of medical care for both a mother and her unborn baby during pregnancy. As a country this is something we should cherish, promote and protect.

The Report of the Expert Group on the Judgement in A, B and C v Ireland has put forward options that could end the practice of making this vital ethical distinction in Irish hospitals. Of the four options presented by the Report, three involve abortion – the direct and intentional killing of an unborn child. This can never be morally justified. The judgement of the European Court of Human Rights does not oblige the Irish Government to legislate for abortion.

The Report takes no account of the risks involved in trying to legislate for so-called ‘limited abortion’ within the context of the ‘X-case’ judgement. The ‘X-case’ judgement includes the threat of suicide as grounds for an abortion. International experience shows that allowing abortion on the grounds of mental health effectively opens the floodgates for abortion.

The Report also identifies Guidelines as an option. It notes that Guidelines can help to ensure consistency in the delivery of medical treatment. If Guidelines can provide greater clarity as to when life-saving treatment may be provided to a pregnant mother or her unborn child within the existing legislative framework, and where the direct and intentional killing of either person continues to be excluded, then such ethically sound Guidelines may offer a way forward.

A matter of this importance deserves sufficient time for a calm, rational and informed debate to take place before any decision about the options offered by the Expert Group Report are taken.

I have previously argued, with reference to the Savita case, that Ireland should not be changing its law on abortion.

However, I agree with the Irish Bishops that ethically sound guidelines which clarify when life-saving treatment may be provided to a pregnant mother or her unborn child within the existing legislative framework may offer a way forward.

I have written more on the subject of abortion to save the life of the mother both here and here.

I would also urge medical professionals to sign the Dublin Declaration.

The point of this declaration is to make clear that there is a vast difference between

1.Separating the mother and fetus for purposes of saving the life of the mother, and
2.Intentional destruction of the life of the fetus for the purpose of producing a dead fetus

It is essential that we as medical professionals communicate now that pre-viable delivery to save the life of the mother is not the same as direct abortion, even if the preterm fetus cannot survive the process.

And direct abortion (a procedure performed with the primary intent to produce a dead fetus) is never medically indicated.

In this connection the Association of American Prolife Obstetricians and Gynaecologists (AAPLOG) statement on ‘Maternal mortality in Ireland’ is also well worthy of study.