Health (regulation of Termination of Pregnancy)Bill 2018

1. Health (regulation of Termination of Pregnancy)Bill 2018 Bill No. 105 of 2018

2. 8th Repealed-What Has Changed? • Abortion now considered within ordinary medical decision-making • “Reasonable opinion formed in good faith” • Primary Legislation- Abortion Regulated and legal ONLY under the provisions of the ACT • Does NOT criminalise a mistake • 3 year review

3. Section 9 • TOP permitted where 2 medical practitioners, having examined the pregnant woman, certify that, in their opinion: • 1. There is a risk to the life or a risk of serious harm to the health, of the woman • 2. The foetus has not yet reached viability • 3. The termination is appropriate to avert the risk

4. Section 10 • Provides for situations where there is a risk to the life or a risk of serious harm to the health of a pregnant woman inan emergency • One Medical practitioner • There is immediate risk to the life or serious harm to the health, of the woman • It is immediately necessary to carry out a termination of pregnancy in order to avert that risk

5. Section 11 • Allows TOP in cases where a condition has been diagnosed which is likely to lead to the death of the foetus either before, or within 28 days , of birth • 2 Medical Practitioners

6. Section12 • TOP may be carried out where a medical practitioner certifies that, having examined the pregnant woman, the pregnancy concerned has not exceeded 12 weeks in their reasonable opinion formed in good faith. • Termination cannot be carried out until a period of 3 days has elapsed from the FIRST date of certification. • Certification: Medical practitioner is satisfied that in their reasonable opinion formed in good faith that the pregnancy has not exceeded 12 weeks.

7. SCHEDULE 4 Health (Regulation of Termination of Pregnancy) Act 2018 Certificate to be completed in relation to a termination of pregnancy referred to in section 12 (Early pregnancy) of the Act of 2018. Please complete this form in BLOCK CAPITALS. ........................................................................................................................................... (Full name of pregnant woman) of ........................................................................................................................................... …………………………………………………………………………………………………………………………. ........................................................................................................................................... ........................................................................................................................................... (Address) Date of birth of above named pregnant woman .................... (DD/MM/YYYY) Estimated weeks of pregnancy: ................................................................................... I, the undersigned, in accordance with section 12 of the Act of 2018, hereby certify that I am of the reasonable opinion formed in good faith that the preg- nancy of the above named pregnant woman has not exceeded 12 weeks. Medical Practitioner ........................................................................................................................................... Full name of medical practitioner ........................................................................................................................................... Medical Council Registration No. Signed: ............................................................................................................................. Date of signature: ..........................................................................................................

8. Notification • Doctor carrying out TOP will be legally obliged to notify the Minister for Health of the following information: • 1. The medical council registration number of the doctor who carried out the termination of pregnancy • 2. Whether the termination of pregnancy was pursuant to section 10-13 certification and the Medical Council registration numbers of the doctors who made the certification • 3. The country of residence (or place of residence if outside the Republic of Ireland) of the pregnancy person • 4. The date on which the termination of pregnancy was carried out. • Notification to be forwarded to the Minister of Health within 28 days of the termination being carried out

9. SCHEDULEHealth (Regulation of Termination of Pregnancy) Act 2018 Record to be kept of the carrying out of a termination of pregnancy in accordance with section 9, 10, 11 or 12 of the Act of 2018 Please complete this form in BLOCK CAPITALS. INFORMATION RELATING TO THE TERMINATION OF PREGNANCY 3 1. Medical Council registration number of the medical practitioner who carried out the termination of pregnancy: ................................................................................................................................. Medical Council registration number of medical practitioner 2. Please indicate whether the termination of pregnancy was carried out in respect of the pregnant woman pursuant to a section 9 certification, section 10 certification, section 11 certification or section 12 certification (tick as appropriate): ❒ Risk to life or health (section 9)❒ Risk to life or health in emergency (section 10)❒ Condition likely to lead to death of foetus (section 11) ❒ Early pregnancy (section 12) 3(a). If the termination of pregnancy was carried out pursuant to a section 9 certification, the Medical Council registration numbers of the medical practitioners who made the certification concerned: ................................................................................................................................ Medical Council registration number of Medical Practitioner 1 — Obstetrician ................................................................................................................................ Medical Council registration number of Medical Practitioner 2 — Appropriate Medical Practitioner 4 3(b). If the termination of pregnancy was carried out pursuant to a section 10 certification (whether made before or after the termination of pregnancy was carried out), the Medical Council registration number of the medical practitioner who made the certification concerned: ................................................................................................................................ Medical Council registration number of Medical Practitioner 3(c). If the termination of pregnancy was carried out pursuant to a section 11 certification, the Medical Council registration numbers of the medical practitioners who made the certification concerned: ................................................................................................................................ Medical Council registration number of Medical Practitioner 1 — Obstetrician ................................................................................................................................ Medical Council registration number of Medical Practitioner 2 — Relevant Specialty 3(d). If the termination of pregnancy was carried out pursuant to a section 12 certification, the Medical Council registration number of the medical practitioner who made the certification concerned: ................................................................................................................................ Medical Council registration number of Medical Practitioner 4. The county of residence, or where the woman resides outside the State, the place of residence, of the pregnant woman in respect of whom the termination of pregnancy was carried out: ................................................................................................................................ County of residence, or place of residence (if residing outside the State), of pregnant woman 5. Date on which the termination of pregnancy was carried out: ................................................................................................................................ (DD/MM/YYYY) 5 GIVEN under my Official Seal, 2018. SIMON HARRIS, Minister for Health.

10. REVIEW OF MEDICAL DECISIONS UNDER THE ACT • Where medical practitioner opinion does not allow for termination under section 11 or section13, he/she must inform the pregnant woman in writing that she may apply to HSE for review fo the decision. • HSE must establish and maintain a panel of medical practitioners for the purposes of establishing a review committee in relation to a decision under review. • Review committee must be convened within 3 days of HSE receiving application for review • Review must be completed no later than 7 days after the review committee is established and convened. • Review committee must examine the pregnant woman.

11. HSE must report to the Minister on an annual basis • The number of applications of review • The number of reviews carried out • The reason why each review was sought • The outcome of review • The HSE must exclude any information which identifies or could reasonably lead to identification of the woman or the medical practitioner.

12. Areas of Ongoing Concern in Current Legislation • 1. Abortion not fully decriminalised • 2. Mandatory 3-day wait • 3. Absolute limit at 12 weeks • 4.No funding for contraception

13. CONSCIENTIOUS OBJECTION • Nothing in the Act will be constructed as obliging any medical practitioner, nurse or midwife to carry out or to participate in carrying out, a termination of pregnancy in accordance with sections 10,12 or 13. • An exception is provided for in cases under the circumstances outlined in section 11, where there is a risk to the life or health of a woman in an emergency. • A person who has a conscientious objection must, as soon as may be, make arrangements for the transfer of care of the pregnant woman to enable her to obtain a termination of pregnancy. • Medical Council Guidelines: “ conscientious objectors must inform the patient that they have a right to seek treatment from another doctor and given them enough information to enable them to transfer to another doctor to get the treatment they want. If the patient is unable to arrange their own transfer of care, the conscientious objector should make arrangements on their behalf.In an emergency, the patient’s care must be the priority and treatment must be given”

14. LEGISLATION AWAITED • SAFE ACCESS ZONES • CONTRACEPTION