Mrs Maria Miller, in the Chair
Draft Report (Abortion law in Northern Ireland), proposed by Eddie Hughes, brought up and read, as follows:
1.Abortion is a devolved issue in Northern Ireland. Westminster has not sought to make decisions on abortion in the province since it came into existence in 1921.
2.No member of our Committee represents a Northern Ireland constituency and any suggestion that Westminster should act to change the law on abortion in circumstances of fatal foetal abnormality, has implications for the devolution agreement.
3.We make four points on the nature of devolution in Northern Ireland.
4.Firstly, it is vital that we uphold and respect the devolution settlement.
5.It is indeed regrettable that the Assembly has not been functioning since January 2017. However, for understandable reasons, the Government has up to this point been reticent to introduce Direct Rule in Northern Ireland. The focus of the Government over the past two years has been the restoration of devolved government. As the Northern Ireland Office put it in their submission to our Committee:
The absolute priority of the Government, and indeed the Secretary of State for Northern Ireland, remains the restoration of devolved government in Northern Ireland. In part, so that the people of Northern Ireland, and locally elected representatives, can decide what is right, for Northern Ireland, and have the opportunity to fully discuss and debate sensitive devolved issues, such as abortion.
6.This Committee should not undermine devolution in Northern Ireland given the important contribution devolution has made to peace in Northern Ireland. The position of the Government not to intervene has been repeatedly asserted by the Secretary of State for Northern Ireland who made the following comment in June last year on the floor of the House:
Abortion has been a devolved matter in Northern Ireland since it was created in 1921, and it would not be appropriate for Westminster to seek to impose its will, or to be the arbiter of an issue that has long been devolved to the people of Northern Ireland. The Government believe that the question of any future reform in Northern Ireland must be debated and decided by the people of Northern Ireland and their locally elected, and therefore accountable, politicians.
7.The submission of the Northern Ireland Office makes it clear that abortion is a devolved matter, stating that:
Under the Northern Ireland devolution settlement, the following areas, relevant to the provision of abortion services, are “transferred matters” and therefore devolved in Northern Ireland: health and social services; equal opportunities (including as provided for in equality law); and justice and policing. As a result, any questions of reform or legislative changes to the law or policy in these areas are matters that are within the competence of the Northern Ireland Assembly and Executive.
8.Secondly, the Committee acknowledges that Northern Ireland has held the most recent democratic votes on the issue of whether to reform the law on abortion of any jurisdiction in the UK having debated a detailed series of proposals. In February 2016, the Assembly voted not to change the law. We must respect the decision made at that time by the elected representatives of Northern Ireland.
9.Thirdly, in fulfilling the scope of this inquiry, it seems imperative, that as a Committee of elected representatives, we take into account the large volume of responses we have received from members of the public and organisations who want to maintain the current law as it stands. Indeed, a substantial majority of the published inquiry responses are in favour of maintaining the current law: at the time of writing, this is approximately 85% of submissions.
10.Furthermore, a considerable number of submissions made to our Committee referred to a claim made by the campaign organisation Both Lives Matter that the law on abortion in Northern Ireland has led to 100,000 people being alive today in Northern Ireland who would otherwise not be if the 1967 Abortion Act had been introduced. Notably, no submissions made by organisations or individuals calling for a change in the law on abortion in Northern Ireland sought to substantively challenge this evidence.
11.Following a complaint made about whether this figure could be substantiated, it was investigated by the Advertising Standards Agency who made the following conclusion: “On balance, we concluded that the evidence indicated that there was a reasonable probability that around 100,000 people were alive in Northern Ireland today who would have otherwise been aborted had it been legal to do so.”
12.If we accept the finding of the ASA that this is a reasonable estimate of the number of individuals alive today as a result of Northern Ireland not accepting extension of the 1967 Act to their jurisdiction, it is perhaps understandable why there is such strength of feeling on this issue in Northern Ireland, and offers us an explanation why so many submissions to our Committee advocated for the laws on abortion to remain unchanged.
13.We should also give credence to the views expressed by the people of Northern Ireland. In a poll conducted by ComRes in October 2018, 64% of people (and 66% of women) said they do not want Westminster to interfere in this matter, rather they believe that this is an issue that should be settled in Northern Ireland. This was referenced by the Secretary of State for Northern Ireland on the floor of the House in March 2019.
14.Finally, it has also been asserted by some that human rights matters are not devolved to the Northern Ireland Executive. The situation is more complex. Whilst the UK Government is responsible in international law for its international obligations, the devolved administrations are responsible for ensuring compliance with devolved matters. Under Schedule 2, paragraph 3 of the Northern Ireland Act 1998, observing and implementing international obligations, and obligations under the ECHR, is transferred to the Northern Ireland Assembly. This is also outlined in the same submission from the Northern Ireland Office, which states:
Whilst the UK is the State party to these international treaties, it is for the devolved administrations, here the Northern Ireland Assembly and Executive, to ensure that their domestic laws and actions are compliant. The observance and implementation of international obligations and obligations under the ECHR (so far as they are otherwise within the competence of the Assembly) are matters for the Northern Ireland Assembly.
15.It cannot be asserted that the UK Government is failing to meet its obligations under any international treaty, since this is a devolved competency. Any recommendation that the UK Government legislate to change the law in Northern Ireland due to their responsibility under international obligations is a significant infringement upon these devolved powers. It also misinterprets the nature of these obligations, which are outlined later in this report (see paragraphs 21 to 36 below).
16.Furthermore, the UK Government cannot make any decision to change the law based on assertions that the political landscape has “significantly changed” since the Assembly considered abortion in 2016.The non-binding opinion of the CEDAW Committee and the commentary of the Supreme Court in June 2018 do not offer us any definitive indications that a vote would be significantly different were the Assembly reformed in the immediate future. The views of the Assembly elected in March 2017 on this question cannot be assumed.
17.Our Committee cannot recommend any change to the law on abortion in Northern Ireland as it would undermine the devolution settlement, nor is it mandated that the UK Government act on the basis of international obligations.
18.Aside from the fact that observation of human rights matters is a devolved competency, there is currently no legal imperative for the Northern Ireland Assembly to change the law on abortion arising from current jurisprudence.
19.Firstly, it is crucial to underline that there was no declaration of incompatibility made by the Supreme Court in the Northern Ireland Human Rights Committee (NIHRC) case in June 2018.As there was no standing found for the NIHRC to bring the case, the subsequent substantive judgement issued by the Supreme Court Justices following this finding was entirely non-binding. However, both the NIHRC and other oral and written submissions refer to this case as though it possessed the same binding precedent as if there had indeed been a declaration. , Since there was not, the judgment does not provide a sufficient basis on legal grounds for the Committee to recommend a change in the law. It can be definitively stated that if this question reaches the United Kingdom Supreme Court again a different panel of judges would hear the case and they may come to a different conclusion.
20.Secondly, it must also be asserted that, even if a declaration had been made by the Supreme Court, there would still be no imperative for the Government to change the law in that event. The Human Rights Act 1998 states in s.4(6):
A declaration under this section (“a declaration of incompatibility”)
does not affect the validity, continuing operation or enforcement of the provision in respect of which it is given; and
is not binding on the parties to the proceedings in which it is made.
We cannot and should not make recommendations to change the law without a declaration of incompatibility, and we should also have regard for the options available to the Northern Ireland Assembly under the Human Rights Act 1998 to amend the law as they see fit.
21.Thirdly, we cannot assume how the UK Government would have responded to such a declaration in the absence of the Assembly, had it been made. Although, as the Secretary of State for Northern Ireland commented to our Committee, a future declaration would be “highly persuasive”,the question still stands as to whether the Government would have legislated to rectify that incompatibility when that action is the responsibility of the Assembly.
22.Fourthly, abortion is also a matter that is plainly within the margin of appreciation afforded to States within the ECHR. This was confirmed by Lady Hale in the NIHRC case, who outlined that there was a “do nothing” option for Parliament to take in the event of a declaration of incompatibility, and that, in such an instance, “the democratic will, as expressed through the elected representatives of the people, rules the day”.It falls to the elected representatives, the Northern Ireland Assembly, to amend the law as they see fit if such a declaration is made. If it is the democratic will of the people of Northern Ireland to elect representatives that voted as recently as 2016 not to change the law, then we must respect that will, until such a time as the Assembly votes differently.
23.Fifthly, our Committee is aware of a case currently undergoing judicial review with regard to the law on abortion for fatal foetal abnormality where the person bringing the case has standing to do so. It is therefore premature to recommend a review of the law regarding fatal foetal abnormality in primary legislation when abortion under this ground is already undergoing consideration by the judiciary, who possess the authority under the Human Rights Act 1998 to assess its compatibility with the ECHR.
24.It would be more appropriate for the Committee to await the outcome of such a judgment, by which time the Assembly may be reformed and in a position to change the law if they see fit to do so. This is also the Government’s view. The submission from the Northern Ireland Office states that “it would be a matter for the restored devolved government in Northern Ireland to carefully consider the Supreme Court’s comments in the above matter and any other relevant emerging legal judgments or developments, as appropriate”.
25.There are no immediate human rights judgments that require action by the Government in the absence of the Northern Ireland Assembly.
26.Some witnesses have placed much emphasis on the report by the United Nations Committee on the Elimination of Discrimination Against Women (CEDAW).However, the CEDAW report and its recommendations to the UK do not have a binding effect or incur any legal imperative on the UK to act in response to its findings.
27.Whilst we do not doubt the expertise of CEDAW, we received evidence from a legal opinion by Professor Mark Hill QC regarding the CEDAW report, which was presented to the Committee in a written submission. According to Professor Hill, CEDAW’s:
Invitation to the Home Secretary to treat the content of the Committee’s report as authoritative and determinative of the complex issues involved in the specific case of Northern Ireland is flawed. The report is based upon a misapprehension as to the status of the Committee and its competence to make declaratory determinations, still less juridical rulings regarding CEDAW whist States parties are obliged to follow.
28.There are several reasons why our response to the CEDAW Committee’s recommendations should be far more measured.
29.Firstly, whilst the CEDAW Committee is entitled to hold a position on violations of the Convention, its views are “not binding interpretations of the law, nor do they contribute to customary international law when approaching the interpretation of these rights.” It has no jurisdiction to read abortion in to the text of CEDAW; that is a power reserved for the International Court of Justice.
30.Secondly, aside from the issues with CEDAW’s standing, its interpretation of the text is based on an assumption of a right to abortion. When the UK Government signed CEDAW, they were not signing anything which confers a right to abortion, or indeed even mentions abortion, within its text.The International Court of Justice has not interpreted CEDAW in any way which departs from its plain wording, and it has not read in abortion into the text. Yet the CEDAW Committee says, based on its expertise in interpreting the Convention, that it “recommends that abortion be decriminalised in all cases and asserts that “States parties are obligated not to penalise women resorting to, or those providing such services [abortion]”.
31.The lack of the right to abortion in any international treaties was confirmed in R (A and B) v Secretary of State for Health per Lord Wilson, with whom Lord Reed and Lord Hughes agreed:
The conventions and the covenant to which the UK is a party carefully stop short of calling upon national authorities to make abortion services generally available. Some of the committees go further down that path. But, as a matter of international law, the authority of their recommendations is slight.
32.Thirdly, CEDAW incorrectly interprets the definition of ‘health care’ as including termination of pregnancy. It is only family planning that is brought within this definition and other international agreements have not included abortion in their definition of family planning. Professor Hill QC points out the following:
When the Programme of Action of the International Conference on Population and Development referred to family planning, a significant number of reservations were made which noted that the concept of family planning did not include abortion. The Programme of Action declared that:
Governments should take appropriate steps to help women avoid abortion, which in no case should be promoted as a method of family planning. [7.24]
Any measures or changes related to abortion within the health system can only be determined at the national or local level according to the national legislative process. In circumstances where abortion is not against the law, such abortion should be safe [8.25].
33.Thus, the suggestion in the CEDAW report that States should have considered abortion to be ‘related to family planning’ under Article 12 of the CEDAW text is an overreach.As no mention is made of abortion in the context of family planning in Article 12, CEDAW cannot infer that State parties intended abortion to be treated as healthcare. The fact that States signed up to the CEDAW Treaty who explicitly restrict abortion within their jurisdictions emphasises this fact.
34.The CEDAW Committee advocates abortion law should be decriminalised in all situations. Our Committee has considered the matter of the law in Northern Ireland within the debate about wider reform to abortion law in England and Wales. However, there is no international legal obligation that provides a right to abortion whether through the civil or criminal law. Our Committee therefore notes that the view expressed by the CEDAW Committee is advisory—and in this case without the backing of international law that they are supposed to work within—so to suggest that the Government establish a framework to address the recommendations of the CEDAW report places a disproportionate and misguided degree of authority on its substantive findings and the limited jurisdiction of this unelected UN Committee.
35.We have heard three other reasons frequently cited in support of a change in the law. Firstly, that the recommendations of the Working Group on Fatal Fetal Abnormality, which reported in Northern Ireland Ministers in 2016 (but was only made publically available in 2018), have not yet been implemented. The recommendations included a change to the law on abortion in cases where a pregnancy involved an FFA diagnosis.Secondly, because of evidence put to our Committee that there is a conflict between what medical professionals feel is their “duty of care” towards women with a diagnosis of fatal foetal abnormality and the existing law. Thirdly, concerns that the current law is putting lives at risk.
36.The Committee has already set out why the devolution settlement and upholding the principals of devolution should be of great importance. This Working Group on Fatal Fetal Abnormality was commissioned by Ministers in a devolved legislature to make recommendations on what was recognised to be a controversial subject.
37.It is surely up to that legislature to implement the recommendations of the Working Group, as they see fit, after the Report has been the subject of scrutiny and debate within the Northern Ireland Assembly. This process has not been able to happen and there has been no opportunity for the people and wider medical profession of Northern Ireland to input their views into this process locally through their democratically elected representatives.
38.Given there has not been an opportunity for a wider debate on the recommendations of the Working Group report, there are a number of points for consideration.
39.Firstly, the Working Group Report states that the evidence from medical professionals is that they feel their duty of care towards women in cases of fatal foetal abnormality is in conflict with the law, which offers them little clarity regarding the situations they can offer a woman a termination. This point was repeated by the Chief Medical Officer of Northern Ireland on the basis of the findings of the Working Group. These findings are of concern. However, there is no indication in this report as to who the medical professionals who took part in the Working Group were bar that they were members of relevant professional bodies, nor was any indication given regarding the numbers of professionals practicing in Northern Ireland who feel they cannot carry out their duty of care effectively; nor whether any alternative views were given or sought. If the Report had been debated by the Northern Ireland Assembly, it is likely that this information would have come to light, which would be important before acting on any of its findings.
40.Secondly, while concerns about care are reported, it is worth noting that there have been no complaints made to the GMC by patients experiencing a pregnancy with an FFA diagnosis, about the conduct of doctors in Northern Ireland.
41.Thirdly, the elements of the Report that highlight proposals (yet to be implemented) for improved practical care for women—equal treatment under the Maternity Strategy with other expectant women and the creation of a Regional Centre—have not been as intensively scrutinised during this inquiry as arguments for changing the law. These proposals could make a practical difference to the care of women facing a pregnancy with an FFA diagnosis and it would be premature to recommend that a key aspect of devolution is contradicted - with all the attendant constitutional implications - before these changes are made and the impact of them is measured.
42.The Working Group Report notes regarding the lack of equal treatment for women who receive a diagnosis of an FFA:
It is clear that the health service standards set out in the Department of Health’s Maternity Strategy are not being applied to women who receive a diagnosis of fatal fetal abnormality. These women therefore experience a particularly stark inequality, compared to other expectant women, in relation to communication, locally accessible care, appropriate advice and support at a time when they are at their most vulnerable.
43.The Working Group Report also noted that the Public Health Agency had already proposed a regional team to improve care for women and their families with a diagnosis of a:
The PHA has proposed to the Department of Health the establishment of regional team to help women and their families deal with a diagnosis of fatal fetal abnormality. Obstetric and midwifery care will be provided by the local Trust team, as with any pregnant woman. The new team will aim to provide direct advice and support, signpost and co-ordinate the woman’s journey through the various Health and Social Care services, complementing the local obstetric and midwifery care team, and if the woman avails of termination services outside the jurisdiction, aim to re-establish her care with local systems when she returns.
44.Sadly, the Chief Medical Officer reported that neither of these initiatives have been pursued because of the lack of funding and Ministerial approval.
The Public Health Agency has developed proposals about how we might better co-ordinate that care. We have no steer and have had no steer from Ministers, because the Executive collapsed, and there were clear recommendations within section 5 of the FFA working group as to whether Ministers were minded to support that. That was a priority, that it should be funded to provide the level of care that one would reasonably expect and to reduce the very fundamental issues about variability in the levels of advice and support provided.
45.It was envisaged that the regional team would provide “regionally consistent care, support and information”, which would address one of the concerns presented to our Committee about inconsistent treatment of women between Trusts. A regional centre would allow “a degree of specialism to be developed, resulting in increased awareness of best practice in the care and support of women where a diagnosis of a fatal fetal abnormality has been made.” The regional team would be able to discuss with women the implications of a diagnosis and what it might mean to them, since some conditions have a range of potential outcomes for both parents and children. The team could advise women on the care available to them, including the option raised by some witnesses of access to high quality palliative care services before and after birth. The services are outlined in the Department of Health strategy document, which states in Objective 1 that:
Parents and children will be provided with information on their child’s condition and the care and support options available to them in a clear, open and timely manner to ensure they are fully involved in decision-making. In the case of a pre-birth diagnosis, information and advice on perinatal hospice and palliative care, and support for parents, are to be provided.
46.Fourthly, the Report suggests that a change in the law should be made because there is evidence that there are medical risks of carrying a child with an FFA to term, which could impact future pregnancies. Most of the cases under consideration are diagnosed at a late stage of pregnancy. There has not been the opportunity to explore in depth in our Committee debates the medical risks (physical or mental) of terminations at such a late stage of pregnancy either for the health of the women or future pregnancies, even though evidence suggests they exist. Nor has there been any opportunity to explore whether women have found it beneficial to continue with the pregnancy, even though their child may only have lived a matter of hours. A duty of care should involve making women aware of the risks of a termination as well as the risks of continuing with the pregnancy, as per the 2013 Supreme Court judgment in the Montgomery case.
47.In a context where Westminster has not interfered with abortion law in Northern Ireland since 1921; where the law is part of the devolution settlement which should not be contradicted by a return to direct rule practices and where the current abortion law is thought by some to result in 100,000 people being alive today who would otherwise not have been born; the lack of full scrutiny of the duty of care arguments has led us to conclude that it is premature to recommend that Westminster intervenes to change the law on FFA. The Committee does, however, have a number of recommendations for action.
48.The Department of Health should review the inconsistencies of care for pregnant women with a diagnosis of a fatal foetal abnormality between the Trusts and seek to put in place advice that will address this; just as would occur in England and Wales if there is a postcode lottery of care.
49.The Department should review whether improvements to the maternal health strategy and the implementation of the Regional Centre can be implemented as soon as possible to improve the overall care for women with a diagnosis of a fatal foetal abnormality.
50.The Attorney General for Northern Ireland should provide guidance setting out the extent to which the current law provides a basis on and through which doctors can, and indeed must, provide a duty of care for pregnant women with a diagnosis of a fatal foetal abnormality under the current law, which respects the conscience of doctors in the province.
51.There have been discussions on the “duty of care” of doctors to their patients. This issue has arisen in relation to how doctors support women who have a diagnosis of a fatal fetal abnormality, (see above paragraphs 44 to 53) and on several occasions in oral evidence sessions, there have been references to women’s lives being put at risk in Northern Ireland under the current legal framework and it was repeated by witnesses.
52.If it is indeed the case that women’s lives are being put at risk in Northern Ireland, it is important to note that in these instances medical professionals are misapplying the law. The Guidance on Termination of Pregnancy in Northern Ireland, published by the Department of Health, Social Services and Public Safety in 2016, is clear that the law construes an obligation on health and social care professionals to prioritise the life of the mother:
Health and social care professionals must be clear that the law in Northern Ireland requires the life of the pregnant woman to be the priority. There is no upper gestational age limit as to when a pregnancy may be terminated if a medical practitioner decides in good faith that continuance of the pregnancy threatens the life of the woman, or would adversely affect her physical or mental health in a manner that is ‘real and serious’ and ‘permanent or long term’.
53.This was confirmed by Dr McBride in his oral evidence to our Committee:
We have to be clear that where there is a risk to the life of a woman that is covered within the extant legislation in Northern Ireland and health professionals can act in those circumstances. The guidance is very clear: if there is a risk to the life of a woman, that takes priority over any other consideration. Doctors and other health professionals have an obligation and a duty of care to act in the best interests of women in those circumstances or if there is a serious risk of adverse impact on physical or mental health, that risk is likely to be long term or serious. Where there is a risk to life, there is no impediment to act.
54.It was also confirmed by the representative of the Office of the Attorney General for Northern Ireland:
If a woman’s life is at risk or her health is at risk of severe or serious and long-term impact, then abortion is available to her in Northern Ireland… Our law does allow for people to have abortion when their life is at risk. It should not be that someone’s life is at risk because an abortion is not being offered to them.
55.Both the Guidance and the law are clear that a woman’s life should never be placed at risk. Indeed, in failing to perform a termination on a woman whose life is at risk, a medical professional would be vulnerable to prosecution. The Guidance confirms this:
At all times, health and social care professionals have a duty of care to their patients and failure to act, may lead to prosecution.
56.It is vital that medical professionals are cognisant of existing jurisprudence interpreting the legal duty conferred on them in situations where termination of pregnancy may be performed.
57.The Committee strongly recommends that the Department of Health urgently address the need for greater awareness of the duty of care under both the law and guidance to provide an abortion if a mother’s life is at risk.
1.This inquiry has looked at the legal and practical concerns around abortion in Northern Ireland.
2.Our Committee cannot recommend any change to the law on abortion in Northern Ireland as it would undermine the devolution settlement, nor is it mandated that the UK Government act on the basis of international obligations. (Paragraph 17)
3.There are no immediate human rights judgments that require action by the Government in the absence of the Northern Ireland Assembly. (Paragraph 25)
4.The CEDAW Committee advocates abortion law should be decriminalised in all situations and our Committee has considered the matter of the law in Northern Ireland within the debate about wider reform to abortion law in England and Wales. However, there is no international legal obligation that provides a right to abortion whether through the civil or criminal law. Our Committee therefore notes that the view expressed by the CEDAW Committee is advisory—and in this case without the backing of international law that they are supposed to work within—so for our Committee to suggest that the Government establish a framework to address the recommendations of the CEDAW report places a disproportionate and misguided degree of authority on its substantive findings and the limited jurisdiction of this unelected UN Committee. (Paragraph 34)
5.The duty of care for medical professionals caring for women who have a diagnosis of a fatal fetal abnormality could be improved by action from the Northern Ireland Executive in line with the recommendations of the Working Group Report on Fatal Fetal Abnormality. (Paragraph 45)
6.The Northern Ireland Department of Health should review the inconsistencies of care for pregnant women with a diagnosis of a fatal foetal abnormality between the Trusts and seek to put in place advice that will address this; just as would occur in England and Wales if there is a postcode lottery of care. (Paragraph 48)
7.The Northern Ireland Department of Health should review whether improvements to the maternal health strategy and the implementation of the Regional Centre can be implemented as soon as possible to improve the overall care for women with a diagnosis of a fatal foetal abnormality. (Paragraph 49)
8.The Attorney General of Northern Ireland should provide guidance setting out the extent to which the current law provides a basis on and through which doctors can, and indeed must, provide a duty of care for pregnant women with a diagnosis of a fatal foetal abnormality under the current law, which respects the conscience of doctors in the province. (Paragraph 50)
9.The Northern Ireland Department of Health should urgently address the need for greater awareness of the duty of care under both the law and guidance to provide an abortion if a mother’s life is at risk. (Paragraph 57)
Motion made, and Question proposed, That the Chair’s draft Report be read a second time, paragraph by paragraph.—(The Chair.)
Amendment proposed, to leave out “Chair’s draft Report” and insert “draft Report proposed by Eddie Hughes”.—(Eddie Hughes.)
Question put, That the Amendment be made.
The Committee divided.
Question accordingly negatived.
Main Question put and agreed to.
Ordered, That the Chair’s draft Report be read a second time, paragraph by paragraph.
Paragraphs 1 to 160 read and agreed to.
Summary and Appendix agreed to.
Resolved, That the Report be the Eighth Report of the Committee to the House.
Ordered, That the Chair make the Report to the House.
Ordered, That embargoed copies of the Report be made available (Standing Order No. 134).
[Adjourned till Wednesday 24 April 2019
173 Written Submission from the Northern Ireland Office (), Para 4
174 House of Commons Official Report, ; Vol. 642, c. 220
175 Northern Ireland Office (), para 9
176 This is different from the 23 October 2018 vote in the House of Commons, which was not on legislation that could have the effect of changing the law. It was instead simply agreeing that legislation should be brought before the House. In Northern Ireland specific measures were debated and had the Assembly supported them the law in the province would have changed. These proposals, however, were rejected by a simple majority.
177 Note that not all responses have been published at the time of writing.
179 Northern Ireland Abortion Poll, Comres, 21st October 2018
180 House of Commons Official Report, , Vol 655, c 949
181 Northern Ireland Office (), para 26
182 Northern Ireland Office (), para 17
186 See, for example: ; Written submission from the Northern Ireland Human Rights Commission (); Written submission from Humanists UK (); Written submission from Alliance for Choice ()
188  UKSC 27, 39
189 Northern Ireland Office (), Para 21
190 See, for example: ; Northern Ireland Human Rights Commission (); Written submission from the Northern Ireland Human Rights Commission ()
192 According to Professor Hill, the Committee “does not have the capacity or standing to give a binding adjudication on the United Kingdom’s obligations under CEDAW or on the proper interpretation of CEDAW. The interpretative function under the CEDAW is reserved, not to Committee, but to the International Court of Justice, Legal Opinion, Hill QC, Op Cit, para 4
193 , Op Cit
194 See Appendix to Written Submission from CARE Northern Ireland () which contains the Legal Opinion of Professor Mark Hill QC regarding the CEDAW report
195 Legal Opinion, Hill QC, Op Cit, para 3
196 Legal Opinion, Hill QC, Op Cit, para 5
197 Legal Opinion, Hill QC, Op Cit, para 4
198 “There is nothing in the text of CEDAW which requires a state party to allow abortion on specified grounds and/or decriminalise abortion generally. The absence of such a provision in the formal text gives a clear indication that no such obligation exists.” Legal Opinion, Hill QC, Op Cit, para 7
199 , Op Cit, para 58
200  1 WLR 2492 
201 Legal Opinion, Professor Mark Hill QC, 16 March 2018, para 13
202 Legal Opinion, Hill QC, Op Cit, para 12
203 Legal Opinion, Professor Mark Hill QC, 16 March 2018, para 15
205 , Healthcare and the Law on Termination of Pregnancy for Fatal Fetal Abnormality. Proposals to the Minister of Health and the Minister of Justice, 11 October 2016
207 , Op Cit, Annex C
208 and para 31 GMC Written Evidence, ()
209 , Op Cit, para 5.4
210 , Op Cit, para 5.8.
211 , See also and
212 , Op Cit, para 5.9.
214 , Op Cit, para 5.9
215 , and
216 Page 5, ‘, Department of Health Northern Ireland.
217 , Op Cit, paras 4.5–4.11
218 “Women should be informed that induced abortion is associated with a small increase in the risk of subsequent preterm birth, which increases with the number of abortions. However, there is insufficient evidence to imply causality.” . RCOG 2011, para 5.12 and page 44.
219 For instance, see Cope H, et al, . Prenatal Diagnosis, 2015, 35(8): 33–44. The article concludes, “There appears to be a psychological benefit to women to continue the pregnancy following a lethal fetal diagnosis. Following a lethal fetal diagnosis, the risks and benefits, including psychological effects, of termination and continuation of pregnancy should be discussed in detail with an effort to be as nondirective as possible.”
220  , 109 “An important consequence of this is that it is not possible to consider a particular medical procedure in isolation from its alternatives. Most decisions about medical care are not simple yes/no answers. There are choices to be made, arguments for and against each of the options to be considered, and sufficient information must be given so that this can be done.”
221 , , , ,
222 Written submission from the Royal College of Obstetricians and Gynaecologists (); ;
223 , Department of Health, Social Services and Public Safety, March 2016, p. 8
226 , Op Cit, p. 13
Published: 25 April 2019