Will psychiatrists who follow the medical evidence be banned from new abortion panels?

Last week, the Irish Times reported that the Irish College of Psychiatrists had advised its members not to take part in review panels on abortion until clinical guidelines were in place. The professional body for psychiatrists in Ireland said that the enactment of the abortion act on January 1st 2014 without clinical guidelines was “very haphazard and unsatisfactory”.

The Irish Times quoted Dr Anthony McCarthy, perinatal psychiatrist at the National Maternity Hospital as saying that there should be a 'process whereby a GP in a particular area could "by-pass" the local HSE psychiatrist if they were concerned about that psychiatrist's ideological stance on abortion.'

This is an astonishing comment since it seems to suggest that psychiatrists would not follow the evidence in making their professional judgment, and that Dr McCarthy would favour discriminating against medical professionals whose professional judgment falls out of favour with the local GP.

Last year, during the Oireachtas Committee hearings, it was established that the medical evidence showed abortion was not a treatment for suicidality.

Dr Seán O Domhnaill, a consultant psychiatrist responded to Dr McCarthy with this piece to the Irish Times

Dear Madam,

I have to admit to having been astonished by the remarks attributed to Dr. Anthony McCarthy, ex-President of the College of Psychiatrists in Ireland, in Kitty Holland's article (I.T. 03.01.14). According to Ms. Holland, Dr. McCarthy "said there should be a process whereby a GP in a particular area could "by-pass" the local HSE psychiatrist if they were concerned about that psychiatrist's ideological stance on abortion." If this quote is accurate and in context, Dr. McCarthy is displaying a professional attitude which is entirely in contrast to the presumed spirit of mutual respect that we seek to preserve between medical professionals. It is very worrying that he seems to be seeking to advocate for General Practitioners to be able to obtain only the psychiatric opinion that they wish to hear, rather than an independent professional appraisal of the suicidality, or otherwise, of their patient.

Apart from anything else, this approach is entirely contrary to the spirit of the Protection of Human Life in Pregnancy Act (2014). Perhaps Dr. McCarthy thinks that some professionals will not act in accordance with their ethical obligation to serve their patients' best interests and to apply the standards of best evidence when making their appraisals of suicidality and best treatment options.

If this is the case, he should speak plainly instead of making insinuations about his unnamed colleagues. Perhaps he wishes to make a list of the Consultant Psychiatrists whom he feels should be the subject of G.P. "by-pass". I would be most interested to read such a list, but it would probably be considered libellous to suggest that the named psychiatrists would act in anything other than a professional and sympathetic manner, as I believe is generally the case, consistent with my own experience of mental health professionals.