Minister Simon Harris has pledged to allow doctors to conscientiously object to providing abortion pill [1]s, in the event of the pro-life amendment going. But how much protection is he willing to allow? For example, will doctors opposed to abortion be forced to refer women who doctors who don’t oppose abortion, which is a form of facilitation?
Minister Harris said the provision would be based on the Protection of Human Life During Pregnancy Act 2013. What protection of conscience does this provide?
Conscientious objection has been variously defined but it is based on the principle that a medical professional should not be forced to participate, directly or indirectly, in procedures to which they object for reasons of conscience. Conscientious objection is a human right internationally acknowledged and its provision is a regular feature of laws regulating abortion.
It could be said that conscience is at the foundation of the medical profession and every action should be inspired by a well-formed moral conscience. Conscience-based refusals are particular instances of the exercise of conscience and require a particular protection. In accommodating them, the State recognises that certain issues are highly divisive both in society at large, and among health care professionals in particular.
The Protection of Life During Pregnancy Act (PLDP) 2013 recognises conscientious objection but only up to a point. Article 17.1 says: “nothing in the Act shall be construed as obliging any to carry out, or to assist in carrying out, any medical procedure …. to which he or she has a conscientious objection.“
So far, so good, but two subsections on, there is the requirement to refer. It says an objector should “make arrangements for a transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the medical procedure concerned.” (17.3)
Let’s consider first the positive elements, with regard to conscientious objection, of the PLDP Act 2013.
The provision is broad in scope and regards anyone who potentially might be involved in an abortion. Let’s recall that the Act permits a termination of pregnancy where the life of the mother is in danger (which was permitted under the 8th amendment anyway), but extends this to include women deemed to be suicidal.
Article 17 doesn’t specify precisely which health professionals exempted but it refers to “any”. Also, “medical procedure” is a broad expression and could include the prescribing of any drug, including lethal ones like the abortion pill.
It is good that it does not limit conscientious objection to doctors, or nurses, but to anyone who might be potentially involved. Medicine, nursing and pharmacy are interdependent in health care, and conscience protection should be extended to as many classes of professionals as possible, including students.
However, there are at least two highly problematic elements in this piece of legislation. Firstly, conscientious objectors are obliged to refer to other doctors, when they don’t want to perform abortions. This is a case of indirect participation in abortion that many would find not acceptable. Secondly, the right of conscientious objection is given only to individuals, and there is no way an institution can opt out, including pro-life hospitals, Catholic or otherwise.
In the unfortunate event that the referendum to repeal the 8th amendment passes, the State should assure that the accommodation of access to abortion does not adversely affect those who don’t want to be directly or indirectly involved. Obliging doctors, or any other professional, to provide information of where the service is performed or, even worse, to make arrangements for a transfer of care, means forcing them into an indirect participation to the procedure. (Should a doctor who will not give a person a lethal injection be forced to refer to a doctor who will, if assisted suicide is ever introduced?)
To those who claim that accommodating health care professionals’ conscience-based refusals should not prevent a patient from receiving the procedure they have requested I answer that it is the State, rather than the conscientious objector, that should be responsible for assuring that this happens.
No matter what happens to the 8th amendment, doctors and other medical professionals must be allowed to practice only medicine that truly heals and which does not result in the death of one patient, in this case the unborn child.