Chair of the Oireachtas committee on the Eighth Amendment has told members that she will not be reading letters of witnesses into the record of the committee, if they choose not to attend. 

Senator Catherine Noone was returning to an earlier request by Deputy Mattie McGrath of the Rural Independent Group, who requested that letters be those who did not attend today be read by the chair.

Senator Noone said she would only read letters if, for example, they are clarifications and warned that she would not be challenged on the matter. 

Independent Senator Rónán Mullen questioned the source of her authority.

"I've decided that letters from witnesses sent to the committee who can't attend will not be read," said the chairperson.

Following further requests of clarification from Senator Mullen, Senator Noone accused Senator Mullen of trying to undermine her.

He said if she regarded his contribution as undermining her, she did not understand democracy. 

Senator Noone said she was an "extremely patient person" and found the engagement inappropriate.

Social Democrats Leader Catherine Murphy intervened and said the same set of rulings apply to each of the committees and questioned if there was going to be deviation from that practice.

Senator Noone said she had given too much time to the matter and had been generous and patient for allowing tonight's discussion. 

Senator Mullen interrupted her and said: "We don't owe you any gratitude for doing your job."

"I'm not looking for thanks," she replied. 

Sinn Féin TD Jonathan O'Brien warned he was starting to lose his temper and described the exchange as "a joke".

Deputy Mattie McGrath accused Senator Noone of taking umbrage, which she denied and at which point she suspended the committee.

Tension brewed from the outset at today's committee.

It began when Senator Noone expressed disappointment over a decision by another invited witness not to go before the committee. 

Marty McCaffrey, Professor of Paediatrics at University of Carolina declined to appear, while Professor Patricia Casey had also confirmed she would not participate.

It was cited that their concerns centred on a pre-determined outcome, following the committee's vote a number of weeks ago recommending not to keep article 40.3.3 in its current form. 

Senator Noone said a determination had not been made. 

However, Deputy McGrath said the committee had been compromised by the vote and Professor McCaffrey's letter needed to be read into the record. 

The Chairperson asked that the matter be discussed later in the day because there were witnesses waiting to go before the Committee. 

Session One

First up was Gilda Sedgh from the Guttmacher Institute in New York, which she said conducts population-level research on reproductive health globally.

She said regions with the lowest abortion rates are those with countries with the least restrictive abortion laws. 

Women obtaining abortions represent a broad spectrum of all women - young and old, single and either married or co-habiting, childless and with children, she said. 

Gilda Sedgh said restrictive abortion laws lead to more abortions later in pregnancy. 

She was asked by Fine Gael TD Hildegarde Naughton if it was due to a lack of sex education.

Ms Sedgh said it was about comprehensive sex education as well as improving the quality of services available. 

She was also asked if she had any examples of "flood gates" to abortion opening after changes in law in other countries.

When it becomes legal, she said, the numbers increased. However, she said it wasn't known if this was simply because abortions were put on the record. 

The Center for Reproductive Rights representative said the majority of countries do not impose time limits in cases of foetal impairments.

She was responding to Fianna Fáil's Health Spokesperson Billy Kelleher who queried international time limits in relation to fatal foetal impairment. 

Leah Hoctor said some countries distinguish between fatal foetal and severe foetal and impose different limits for both cases. 

However, she said the majority of countries do not distinguish between the two, and the vast majority do not distinguish if the case is fatal.

Ms Hoctor said some of the lowest rates of abortion are in places that have access to abortion on request. 

She also told Deputy Naughton that regulation of abortion in constitutional provisions is very rare - she said Andora was the only other place in Europe with such strict abortion laws. 

Ms Hoctor said Ireland could see other cases go to the UN Human Rights Committee, similar to that of Amanda Mellet and Siobhan Whelan. 

She was responding to Independent4Change deputy Clare Daly who asked what Ireland needed to do to avoid other similar cases coming before the UN committee. 

Ms Hoctor said that the committee's conclusion was that Ireland must amend its law on abortion, including the constitution, and it must make abortion services accessible in a timely manner. 

She said the committee found the rights of both women, who had sought abortions due to fatal fetal abnormality, had been violated because they had to travel. 

Fine Gael TD Peter Fitzpatrick asked if the Center for Reproductive Rights ever criticised any aspect of abortion. 

He asked Ms Hoctor if she was aware that the Marie Stopes Clinic in the UK was giving its staff bonuses to persuade women to have abortions. 

Ms Hoctor said she was not aware of the allegations he was making, however she said there is a regulatory body in the UK which oversees abortion services there. 

Sinn Féin TD Jonathan O'Brien asked if it is in the best interest of a woman's health to have a termination on request. 

Leah Hoctor said when a global perspective is taken into account, the answer is yes. 

She said in countries outside of Europe with highly restrictive laws, there would be higher rates of unsafe abortion and mortality. 

Deputy Fitzpatrick asked Ms Sedgh if she believed lives had been saved due to the Eighth Amendment. 

She said she could not answer that question. 

Deputy Fitzpatrick said he was disappointed with the answer.

"The taxpayer paid for these people to come for the day and they can't give me a yes or no answer," he said. 

Session Two

The next witness before the committee was Dr Ruth Fletcher from the University of London. 

She outlined key issues in legislating for the Citizens' Assembly recommendations and put the draft heads of a bill entitled the Reproductive Health and Access to Abortion Bill 2018 before TDs and senators. 

In her opening statement, Dr Fletcher said a lot of people think foetal life deserves respect and although the "on request" legal pathway would be unacceptable to those against all abortions, it was capable of finding support from those who want the law to accommodate some respect for prenatal life, independent of the pregnant person's investment in that life. 

She said that for many people, a law which has the effect of helping to make earlier abortion more likely than later abortion, is more respectful of prenatal life if it reduces the rate of later abortion. 

The Social Democrats co-leader Catherine Murphy pointed out that the Citizens' Assembly said rape and incest are incredibly difficult to incorporate into law.

Dr Fletcher said in circumstances where someone is pregnant through rape and is distressed and vulnerable in continuing that pregnancy, that could constitute a risk to her psychological health. 

She said that in relation to pregnancy from rape, it could constitute a risk to health grounds. 

The Senior Lecturer in Medical Law suggested that the adjudication of medical practitioners be guided through a public policy document. 

"It can be made more explicit through Department of Health guidlines", she said.

Session Three

In the third session, the National Maternity Hospital's Consultant Psychiatrist Professor Anthony McCarthy told the committee that in an ideal world abortion would never be needed or requested, however, he said that even if medical emergencies and severe life threatening indications were excluded, abortion couldn't be wished away. 

In his opening statement, he said how any woman responds to a pregnancy is so personal to her and how she visualises and imagines what is or is not growing inside of her is unique. 

Addressing the question of the mental health outcomes after induced abortion and the research evidence in this area he said the first key point is that no significant research on this subject has been completed in Ireland.

He said research from the UK, the USA, Australia, etc, may not be applicable here, or may only be in a very limited way.

The second point he noted is that there are many other limitations to most of the research in this area such as  researcher bias, inadequate control for confounding variables and inappropriate control groups, and the failure to control for previous mental health problems. 

"Therefore, my advice is to read any such research in a critical, informed and objective way", he said. 

He concluded by telling the committee that the dilemmas for women in such difficult situations will always be painful and distressing. 

As the evening wore on there was further heated discussion between two Independent senators. 

Senator Lynn Ruane took issue with a comment made by Senator Rónán Mullen when he was questioning Professor Anthony McCarthy.

Senator Mullen put it to the Professor that given the gravity of what was involved, given the culture of informed consent that applies in other forms of medicine and through a duty of care "surely it's not excessive to expect basic investigation to see what type of person is before you". 

When it came to her time to question the Professor, Senator Ruane noted that Senator Mullen questioned "the type of person" was before Professor McCarthy. 

She said it upset her and surmised that if someone has a mental health issue before being pregnant; it undermines their capacity as a person to have autonomy, to have a view of their life and who they are. 

Senator Ruane said she didn't appreciate it as a woman and as a mother who sought help in her second pregnancy, with Professor McCarthy's counterpart in the Rotunda.

Senator Ronan Mullen accused Senator Lynn Ruane of "implying an attitude" that wasn't there. 

He questioned the fairness of the Committee process.

He claimed he was attacked in "a frontal and emotionalising way by a colleague" after he had finished his line of questioning.

Senator Mullen said it was making a farce of the procedure.