Good morning, my name is Dr. Marie Therese McKenna. I am a GP and I am voting No.

When a woman presents to a GP, that GP has a duty of care to her. When a pregnant woman presents, the duty of care is to 2 patients, the mother, and the baby. The primary principle governing medical ethics to “first do no harm” therefore applies to patients. The second is to provide care according to best medical evidence.

If the 8th amendment is repealed in the upcoming referendum, the Government will legislate on the termination of pregnancy in this country. Termination is defined as “a medical procedure intended to end the life of a fetus”. By definition, the intentional, direct ending of another human being’s life is not health care.

The legislation goes on to outline the proposal for unrestricted abortion up to 12 weeks. Minister Harris has proposed, without any consultation with GP’s, that this would be a GP led service. This would mean that a healthy woman with a healthy baby could go to her local GP and ask for a lethal drug to be prescribed. The legislation gives her the right to this drug whether or not the doctor thinks it is a good idea for her. In no other area of medicine does the law ask a doctor to suspend clinical judgement and simply do as the patient asks.

These abortion pills are not licensed in other countries beyond 10 weeks. Mr. Varadkar has stated that GPs providing this service would need to confirm the gestation of the pregnancy. This should be done by ultrasound. GPs do not have the expertise or training to correctly assess gestation by ultrasound: it is a specialised area not part of normal GP services.   

Yes, campaigners raise concerns about the number of women ordering illegal abortion pills online. It has been suggested that legalising these pills will be safer for women.  

In the UK, 190,406 abortions were carried out in 2016. The number of abortion pills being obtained illegally in the same year was described by the British Pregnancy Advisory service as staggering. Any medication whose sole purpose is to end a human life is by definition unsafe. Until we offer real support to women with crisis pregnancies, we will never resolve this problem.

If GPs are forced to offer abortion to women up to 12 weeks, it will fundamentally affect the doctor-patient relationship. Legalising abortion normalises it. If you normalise something, it becomes more common. This has been the experience in every other country which has good statistical data.

It is disempowering to women to suggest that rather than encouraging them to give life to their baby, their best option is to end that baby’s life. Abortion is presented as healthcare. Abortion, by its very definition, can never be healthcare. It does not heal, it does not restore. It hurts both the mother and her baby.

Many women who have had an abortion feel deep sadness and regret, maybe not initially but often later in life. We see this in our GP surgeries and are perhaps more aware of it than Obstetricians or other healthcare professionals.

(Many of the countries who have legalised abortion, did so before the advent of ultrasound. At the time it was introduced, parents could not see their babies at the various stages of development and could not appreciate the wonder of the life developing in the womb.)

In this debate, those advocating for abortion speak of the fetus. This distances us from the reality that we are talking about babies and the reality of abortion is that it ends the lives of babies.  

Doctors are being told that if the 8th amendment is repealed, they will have the right to conscientious objection. The heads of bill outlines the terms of this and specifically states that a doctor must refer to a colleague who is willing to perform the abortion.

(“A person who has a conscientious objection referred to in subhead (1) shall, as soon as may be, make such arrangements for the transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the termination of pregnancy concerned”.)

This cannot be described as a true conscientious objection as the doctor is directly involved in organising the abortion.

There is already a serious manpower crisis in General practice. May rural GP posts are vacant or very difficult to fill. Many of our future doctors will self-select out of General practice due to a reluctance to be involved directly or indirectly in abortion. Under the current proposal, many practicing GPs will find it very difficult if not impossible to reconcile their responsibility to first do no harm with the inadequate arrangements for conscientious objection. GPs nearing retirement will feel demoralised and marginalised while younger GPs may move to different specialities. All these factors can only lead to further pressure on an already overstretched, under-resourced general practice and it will be our patients who suffer as a result of this.   

The 8th amendment currently provides the only legal protection to the unborn as confirmed in the recent Supreme Court ruling on March 7th, 2018. We will have no control over what future governments or even our current government will introduce if we repeal the 8th.

General practitioners are on the front line in dealing with crisis pregnancies especially in the first 12 weeks. Women do not choose abortion lightly. It is seen as a last resort. We call on the government to grant adequate resources so we as their doctors can offer women proper support and assistance, assistance that does not involve pitting the rights of the mother against the rights of her baby.

Abortion hurts women, it hurts babies, it hurts families. I urge people to vote NO so that we can find a better way.

Thank you