Northern Ireland's health department published instructions to doctors Friday that for the first time explain the rare circumstances under which they can perform a legal abortion.
Abortion rights activists in Northern Ireland welcomed the move, even though the document reaffirmed that almost all abortions will remain outlawed in the religiously conservative British territory.
Abortion opponents, however, warned that the rules would give doctors new encouragement to begin performing abortions under false pretenses.
Friday's government document said an abortion is permitted in Northern Ireland under two circumstances — to "preserve the life of the woman," or if a doctor determines the continuing pregnancy would impose "a risk of real and serious adverse effect on her physical or mental health which is either long-term or permanent."
This means a suicide threat, if deemed credible by one or more doctors, would be grounds for granting an abortion.
Publication of the Department of Health's 24-page "Guidance on the Termination of Pregnancy: The Law and Clinical Practice in Northern Ireland" capped eight years of legal disputes with the British Family Planning Association.
"Before today guidance for clinical practice simply didn't exist, and health care professionals operated in a void. This new document gives much-needed structure and direction to abortion services," said Audrey Simpson, director of the Family Planning Association in Northern Ireland — the only part of the United Kingdom where the 1967 law legalizing abortion has never come into force.
That anomaly means an estimated 1,400 to 2,000 Northern Ireland women travel annually to England or other European Union nations, chiefly the Netherlands, to end their pregnancies.
Unlike women in Britain, they cannot use their British national health coverage to pay for the cost.
Expanded scope?
Even in countries that officially ban abortion, however, judges have defined at least one exception: abortions deemed medically necessary to preserve the life of the pregnant woman.
A series of court judgments further defined this right in Northern Ireland, most recently in 2004. But until now, the government's health authorities refused to make any guidelines based on those rulings, reflecting widespread opposition within both the British Protestant majority and Irish Catholic minority. Doctors in turn refused to provide abortions under any circumstances, fearing lawsuits from right-to-life activists if they did.
Northern Ireland's main anti-abortion group, Precious Life, said the new rules offered too much scope for doctors to grant abortions.
"These guidelines grossly exaggerate this exception of 'saving the mother's life' — for example, implying abortion is legal on the grounds of mental health," said the Precious Life group, which regularly pickets the Family Planning Association office in Belfast.
In the neighboring Republic of Ireland, a predominantly Roman Catholic nation where abortion is outlawed in a constitutional amendment, a similar gray area in the law exists.
A 1992 Irish Supreme Court ruling found that abortions should be granted in cases where pregnant women were threatening to kill themselves if denied one. But Ireland's lawmakers have refused to pass a law along those lines. As in Northern Ireland, Irish hospitals refer abortion-seekers across the Irish Sea to England.