The essay below was written by my sister, Lara Cassidy. She came to me for editing help, we worked on it together and then I offered to publish it here, because I stand by it and I want as many people as possible to read it. I admire her clear-headed approach to this issue and I think it may be helpful to voters who are still undecided on how will they will cast their ballot on Friday.

– Marianne

Dear friends, family and acquaintances. Maybe you already know how you’re voting on Friday. Maybe you’re undecided or maybe you don’t intend to vote at all. Wherever you stand, I wanted to ask you one last time to consider what this vote means for us, both as individuals and as a nation.

First off, I want to acknowledge that this referendum is not just a medical or legal dilemma. Emotions are running high, no matter where you stand on abortion. And that’s ok. Birth, life, death: these are emotional issues, and it’s important to acknowledge that. The debate around this referendum has asked us to interrogate our core values. It has asked us what guides the decisions we make and what decisions we would allow others to make. It asks what we believe we owe each other and the society we live in. It has asked many of us to question what we believe to be our own inalienable rights and freedoms.  

This is the question at the heart of the debate: does one human’s right to life trump another’s right to bodily autonomy?

I believe the majority of people on both sides of the debate would agree that both rights – the right to bodily autonomy and the right to life – are sacrosanct and central to human dignity. In the vast majority of cases, people are contentedly both pro-life (do no harm to your fellow humans either directly or indirectly) and pro-choice (my body is mine to do with as I wish).

Pregnancy is a unique physical relationship between two humans. Only fifty percent of the human population have the potential to experience it, and there is no easy analogy to explain it to those who can’t. Pregnancy is also one of the only spheres where these two basic human rights regularly come into direct conflict: when one human life cannot sustain itself without the body of another, which right takes precedence?  And more importantly, should that precedence vary on a situational basis or be subject to a blanket rule?

At present, in Ireland, we live under a blanket rule: an unborn human’s right to life trumps its mother’s right to her body in almost all circumstances. The only exception is the “real and substantial” risk that pregnancy will kill her. This is the status quo under the Eighth Amendment. While mother and unborn do technically have an equal right to life, the unborn has an additional right to sustain itself using its mother’s body, to the point that her health and wellbeing can be severely compromised as long as she is not at risk of death. In general, Irish citizens do not have the right to use another’s body to sustain their own. Even the (non-pregnant) deceased must give consent, in the form of an organ donor card, to have their body used to save living people. But, as stated above, pregnancy is unique physical state and many people believe this warrants a unique legal relationship.

Unfortunately, simple blanket rules do not work well in complex medical scenarios. The Eighth Amendment can and has led to avoidable deaths, either through denial of cancer treatments or failure to catch sepsis in a woman whose prolonged miscarriage left her cervix vulnerable to infection. There is no medical definition of “real and substantial risk of loss of life” and this makes it very difficult for doctors and nurses to make a call on whether a termination is necessary or not, requiring them to constantly monitor women who are teetering on a knife-edge, waiting for their patients to become sick enough to warrant intervention.

This is reality. But perhaps this is the price our society is willing to pay to maintain a blanket preference for the life of the unborn over the health and wellbeing of its mother. As a society, we get to collectively decide what we owe to one another and what each individual owes the state. That is the beauty and the horror of democracy. We all owe taxes and, currently, pregnant women owe their bodies and potentially their lives to the unborn life inside them.

If you are happy with the above blanket rule, vote No. If you believe some women, even one woman, must die so we can protect unborn life, then vote No.

But if you vote No, please acknowledge the logical conclusion of your vote. Stripping a person of their right to bodily autonomy is an ugly thing, even in service of the right to life. The logical conclusion of the Eighth Amendment – the logical conclusion of forcing someone to remain pregnant when they don’t want to be – involves imprisonment, physical restraint, sedation and force-feeding, measures which legally can and have been visited on pregnant women in Ireland since the introduction of the Eighth in 1983. This is why the Eighth Amendment was brought up as a point of key concern during Ireland’s appearance before the United Nations Committee Against Torture in 2017.

You may not think that forcing someone to remain pregnant against their will is akin to torture. You may feel uncomfortable with the scenarios mentioned above, but ultimately believe that they are a price we need to pay to protect the unborn. However, if women, or even one woman, is going to die for the sake of preserving the Eighth Amendment, it is important to ask if the Eighth Amendment is actually achieving its stated goals. Currently, thousands of Irish women travel to terminate the lives of potential Irish citizens every year, while unconfirmed numbers take abortion pills on Irish soil to the same end. In this sense, our blanket rule has utterly failed to protect the right to life of the unborn in the majority of cases, while still creating nightmare scenarios that occur from loss of bodily autonomy. At the moment, our blanket rule is unfairly enforced, imposed on only the poorest and most vulnerable members of our society: the low-income women, the victims of domestic abuse, the immigrants and the asylum seekers, those too young to travel alone and those too sick to travel at all.

If this doesn’t sit well, maybe consider voting Yes.

Alternatively, vote No, but then be sure to go on and campaign to remove the Thirteenth and Fourteenth amendments from our Constitution, which respectively guarantee the right to travel for abortion and the right to information about abortion. Removing these amendments is the only way to ensure that our blanket rule applies to everyone and the right to life of the unborn is protected in all circumstances.

Of course, we would need a system to make sure that pregnant women are monitored, so they can’t return home from an abortion without prosecution. Women who present as pregnant in clinics or hospitals should be registered and monitored to ensure the safety of the unborn, and miscarriages should be open to medical and potentially criminal investigation. Mandatory pregnancy tests for all Irish women of childbearing age at airport security could also be a workable solution. Our current criminal sentence of 14 years for using abortion pills would also need to be enforced. Unfortunately, criminalization and surveillance of pregnant people is the only way to ensure every unborn human receives an equal chance at life, regardless of its mother’s health, family or financial situation.

If this sounds extreme to you, maybe consider voting Yes.

However, if you are happy for our society to use criminalization, confinement and surveillance to protect the right to life, vote No. But maybe also consider expanding your horizons to mandatory blood and organ donations for all healthy adults. Both breach the right to bodily autonomy, but both save lives. Furthermore, if you view the right to life as the most scared of all human rights, you may consider exploring socialism as a potential societal model, if you haven’t already done so. Socialist societies do involve the loss of many personal freedoms (although never loss of control of your own body), including wealth and property, and involves submitting individual choices to state control. However, this is done to ensure that all individuals have equal access to food, shelter and healthcare: basic needs that we cannot live without.

If you do not believe that the right to life trumps bodily autonomy in all but near-death circumstances, then of course you should vote Yes on Friday. This is the only way we can move forward from the status quo. As long as the Eighth Amendment is in our Constitution, the blanket rule holds and we cannot legislate in any case, complex or otherwise. However, you may still have massive reservations about the termination of healthy and viable unborn humans. You may struggle, as many of us do, with the question of gestation: at what point does a fetus become a person with all the same rights as the human who carries it? It’s a difficult question. However, please be assured that our government is not replacing the current blanket rule with another one. We are not enshrining a woman’s right to choose into the constitution. Far from it. We are going legislate for the myriad of complex scenarios where the right to bodily autonomy comes in to conflict with right to life.

If the Eighth is repealed, women will be granted full bodily autonomy up to 12 weeks. This will allow for abortion in cases where the woman becomes pregnant against her will, either through rape or failure of contraception. This is the only workable way to give rape victims, both women and children, control over their own bodies again. There is a possibility that women who have consensual sex without contraception will also avail of abortion during this 12 week period. The potential existence of such women may worry you, but you cannot punish them for their choice without punishing all the women who didn’t have one.

After 12 weeks, the right to life of the unborn will again take precedence. This first trimester cut-off point has been chosen on the basis of a number of medical criteria, such as stage of fetal development, viability outside the womb and rates of spontaneous miscarriage during this period. The only exception will be when there is a risk of “serious harm” to the mother’s health (a slight relaxation of the Protection of Life During Pregnancy Act 2013). However, in these cases terminations will still not be permitted beyond viability, which currently stands at 24 weeks. Abortion beyond viability will only be an option in cases of fatal fetal abnormality.

There is fear that legislating for such circumstances could lead to an abortion regime in Ireland similar to that of Britain, the country which currently regulates the majority of Irish abortions. In Britain, it must only be established that the continuation of pregnancy poses greater risk to mental health than termination for access to a 2nd trimester abortion. This is a very liberal position relative to other EU countries and our politicians have continuously stressed that our criteria for access to 2nd trimester abortions on mental health grounds will be much stricter. The language of the proposed legislation – “serious harm” – is intended to reflect this. However, the inclusion of mental health grounds still be a step too far for many people and you may chose to vote No for this reason, even if you are generally in favour of removing the 8th. If you are conflicted in this regard, I would ask you to again reflect on the fact that the majority of Irish women already have access to abortion in the UK, unregulated by our own laws and medical practitioners. Also, since 2013 this country has accepted risk of suicide as reasonable grounds for abortion, leading to 1-2 terminations for such cases occurring in Ireland annually. It also must be stressed that, despite its liberal laws, 92% of terminations in the UK occur before 13 weeks.*

A 12 week cut off may still feel too late a point for some people. If this worries you, please bear in mind that voting Yes will allow women to access abortion services earlier into their pregnancy. Furthermore, reducing the time spent planning to travel abroad frees up headspace to allow the pregnant person to reflect on what they want, instead of switching to full-blown panic mode. It’s hard to change your mind by yourself in the clinic in England. It’s easier to do it at home, with support from friends, family and local mental health services, when you know that you still have time to come back. The proposed legislation to replace the Eighth also includes a 72-hour pause period after an abortion is requested to make sure women have fully considered all their options.

Finally, regardless of whether you vote Yes or No, if you are determined to reduce Irish abortion rates, there are many tried and tested health and educational policies that could use your support. Firstly, consider campaigning for factual and comprehensive sex education as a mandatory subject in Irish schools. Secondly, we need free and accessible contraception for people of all ages, accompanied by awareness campaigns that emphasise the fact that contraception is everyone’s responsibility. Lastly, we are urgently in need of extended social protection for women and children, and particularly for single mothers. We need you to support free pre- and post-natal care, generous mandatory paid maternity and paternity leave, heavily state-subsidized childcare, the expansion of family planning facilities nationwide and innovative schemes to ease the difficulties and financial strain faced by new parents. We also all have a duty to challenge the persistent social stigma that still dogs people who fall pregnant outside committed relationships, a hangover from an darker Ireland, where both mothers and children were subject to atrocious human rights violations by the Catholic Church and the complicit State. If nothing else, I think we can all agree: the further away we move from that Ireland, the better.

*This paragraph was added on 24/05/2018 at Lara’s request, to reflect concerns raised during the referendum debate on The Pat Kenny Show on TV3 on 23/05/2018.