Authors: Joan McCarthy, Katherine O’Donnell, Louise Campbell, Dolores Dooley

Paper: Ethical arguments for access to abortion services in the Republic of Ireland: recent developments in the public discourse

Some people argue that abortion is immoral, yet others don’t think so. Some think that abortion is immoral in general, and in the abstract, and yet judge that women and girls may need to choose abortion for many complex reasons. Moral disagreement about abortion is further complicated by different perspectives on the extent to which legislation should be used to enforce moral values (for example, societies tend to view cheating on a partner as immoral yet adultery is relatively rarely criminalised). Over the past five decades, most of the liberal democratic countries around the world, such as the US, the UK and other European countries, have debated the moral rights and wrongs of abortion but they have not reached a moral consensus about it. Instead, most of them have arrived at a political compromise that tries to meet at least some of the deeply felt concerns of those who disagree about the ethical nature of the problem of abortion: they recognize the right of a pregnant woman or girl to have a legal abortion in the early stages of pregnancy but limit access to abortion thereafter.

The Republic of Ireland has also debated the issue of abortion. However, the parameters of the debate were set at a time in Ireland when the Catholic church was a governing presence in every aspect of Irish social and political life. In 1983, after a bitter and sectarian referendum campaign, an alliance of largely Roman Catholic groups persuaded two-thirds of the Irish citizens who voted (54% of the electorate), to agree to the insertion of Article 40.3.3 (known as the Eighth Amendment) into the Irish Constitution. The Eighth Amendment does not represent a compromise among competing perspectives on the morality of abortion; rather, it reflects a highly contested and one-sided account of the moral standing of the embryo or foetus, i.e., that it has an equal right to life to that of the pregnant woman (the Amendment refers to the pregnancy as the ‘unborn’ and the pregnant woman or girl as ‘the mother’). In the thirty-five years since its insertion into the Constitution, the Eighth Amendment has led to an abortion regime that is among the world’s most restrictive and punitive. The case law and legislation that has followed from it prescribes that health professionals can only terminate a pregnancy if there is a “real and substantial risk” to the life of the pregnant woman (when her life is clearly and substantially threatened or when a serious risk of suicide exists), a risk which can only be averted by the termination of the pregnancy. Even the most restrictive of grounds, such as fatal-foetal abnormality or pregnancy resulting from rape or incest, or serious health issues that are not immediately life threatening, are not considered sufficient warrant for abortion. The reach of the Eighth Amendment has had a profoundly negative and dangerous impact on the lives, health and well-being of Irish women and girls who want to continue with their pregnancies, as well as for women and girls who do not.

This article outlines recent developments in the public discourse on abortion in Ireland and explains the particular cultural and religious context that informs the debate. We describe the establishment of An Tionól Saoránach/The Citizens’ Assembly in July 2016 as an exercise in deliberative democracy and, in particular, we report on its processes regarding the Eighth Amendment. In the course of its deliberations, the Citizens’ Assembly heard from a range of experts (medical, legal and ethical), as well as advocacy groups and invited submissions from the general public.  In addition to creating such a very broad and inclusive forum for the presentation and exchange of views on these topics, the Citizens’ Assembly also radically transformed the tone and parameters of the dialogue around women’s autonomy and abortion when it invited individual women to share their personal experiences of having to travel for an abortion to the UK or elsewhere.

The eventual recommendations of the Citizens’ Assembly surprised many on all sides of the political spectrum, as they included repealing the eighth amendment and legislating for the regulation of abortion services along lines that are consistent with most other European countries. A Joint Committee of both houses of the Irish parliament or Oireachtas was convened to discuss the Citizens’ Assembly report, and that Committee concurred with the Assembly that the Irish people should be asked by referendum to consider repealing the Eighth Amendment. Following from the conclusions of the Joint Committee, the majority of Irish politicians in both governing  and the opposition parties  announced that they had changed their long-standing anti-choice position (established for many decades) after  careful  consideration of the respective reports of the Citizens’ Assembly and the Joint Committee. As a result, the Irish electorate will be asked to to vote to repeal the Eighth Amendment in a referendum that will be held on the 25^th of May 2018.

This recent national conversation on abortion reflects a growing appetite for change.  We  argue that the operationalization of the Eighth Amendment in legislation and clinical practice poses serious risks to the lives, health and well-being of pregnant women and girls, ignores their moral agency and requires of them a self-sacrifice that is unreasonable and unjust. In light of this, we believe that it should be repealed and that the rights of pregnant women and girls to make a judgement as to the moral and responsible thing to do in their circumstances should be respected and supported.

Affiliations

Joan McCarthy, School of Nursing and Midwifery, University College Cork, Cork, Ireland