In the Shadow of the Eighth: Dr Boylan, Repeal and the maternity hospital 'scandal'

The most engaging aspects of this new book by the high-profile obstetrician revolve around his influential role in the Repeal vote, writes Martina Devlin.

Peter Boylan is the doctor who let the genie out of the bottle. In the run-up to the abortion referendum, the most controversial public vote in recent times, he told the Irish people explicitly what many knew already but needed to hear spoken aloud: the Eighth Amendment to the Constitution was unfit for purpose.

In giving equal emphasis to the lives of both mother and unborn child, it had the potential to act as a death sentence for women. Dentist Savita Halappanavar discovered that to her cost in 2012 when she was refused the termination she needed until it was too late.

Her death shocked the nation and led to mass demonstrations calling on politicians to “woman up” and do their jobs by legislating for abortion. Finally, a referendum was announced for May 2018 and obstetrician Dr Boylan proved to be one of the campaign’s most visible faces and persuasive voices.

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That divisive time culminated in an unequivocal result: some two in three Irish people who voted ticked the Repeal box. The referendum was significant on various levels beyond the issue at hand. It was a watershed in the evolution of Church-State relations; it spoke to women’s mounting resistance to State control over their autonomy; it spotlighted officialdom’s hypocrisy in failing citizens repeatedly rather than deal with a highly charged matter.

Hypocrisy is a word we encounter often in Dr Boylan’s memoir, In the Shadow of the Eighth. As forthright in print as he is in interviews, he takes the reader through that tumultuous period when the Citizens’ Assembly recommended that abortion rights should be introduced by legislation and politicians grappled with how to proceed.

He makes the point in his book, as he did before an all-party Oireachtas committee chaired by Senator Catherine Noone in 2017, that the legal situation pre-Repeal was “profoundly hypocritical”. The Constitution “effectively enshrined a woman’s right to commit an act that was a serious criminal offence as long as it was committed outside the State”, he observed, and “by any yardstick this was a bizarre situation and an embarrassment to many”.

Dr Boylan, a former Master of the National Maternity Hospital in Dublin’s Holles Street and former chair of the Institute of Obstetricians and Gynaecologists, was among those who positioned the debate in terms people could empathise with. It was about trusting women, he said.

Behind all the anonymous initials associated with the Eighth Amendment, from Miss X to Miss Y and Miss P, he reminds us there were the real women and girls obliged to resort to legal action in the throes of their difficulties.

His book covers his four decades as a doctor working in Ireland, the US and Britain, but its primary interest lies in the chapters on the Eighth. He reminds us how doctors had an appalling judgment call to make: obliged to determine how close to death or how sick a pregnant woman was before a legal termination could take place.

Medics were subject to criminal prosecution if it could be established they had acted in bad faith, even if the patient was satisfied with their care. As Dr Boylan puts it, if they got it wrong, either the mother could die or they’d be guilty of a criminal offence.

He explains here, as he did throughout the campaign, that doctors had no difficulty in obeying clear legislation and medical regulations but were untrained for the complexities of constitutional interpretation. Furthermore, it was a distraction from their role of caring for sick people.

While other doctors spoke out on both sides of the debate, Dr Boylan was the most prominent. He took a courageous stance in working closely with the Together for Yes team, a grassroots, female-led social movement – and was targeted for personal attacks by the No side. In the run-up to the referendum vote, he criss-crossed the country speaking at public events with his wife, Jane, whose contribution to the campaign was also important and should be noted. Many doctors stayed silent, conflating advocacy for Repeal with support for abortion.

Again and again in his book, he contends that Catholic teaching has no place in women’s healthcare. He also takes the reader through the machinations behind plans to relocate the proposed new National Maternity Hospital from Holles Street to the St Vincent’s Hospital site in Dublin 4. Dr Boylan’s was an influential voice here too, ready to articulate inconvenient truths. He emphasised that the State was building this facility and needed unfettered control over it, rather than allow a veto over medical procedures to a religious organisation. His position brought him into public conflict with his sister-in-law and former colleague, Dr Rhona Mahony, Master of the National Maternity Hospital at the time.

In his resignation letter from the board, Dr Boylan said: “To believe that the new National Maternity Hospital will be the only hospital in the world owned by a Catholic congregation to permit sterilisation, IVF, abortion, gender- reassignment surgery and any other procedures prohibited by the Church is naïve and delusional… That approximately €300m of public money will be spent on such a project is a scandal.”

The day he resigned was the saddest of his career, he recalls. His book reveals that the hospital site, owned by the Sisters of Charity, still remains under religious control.

As this memoir shows, Dr Boylan has had a long and distinguished medical career, but his standout legacy is the contribution he made to lobbying for Repeal of the Eighth Amendment. With the advantage of both platform and communication skills, he used them selflessly in the best interests of women.

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