Minister Simon Harris has confirmed that the abortion legislation will allow general practitioners to abstain from providing abortion pills, but a duty to refer patients to pro-choice doctors will stay. This is a plain contradiction because duty to refer involves complicity with wrong, to such a degree as to significantly undermine the provision for conscientious objection.
In countries where abortion is legal, conscientious objection is also generally allowed. This is a balanced solution to the conflict between the ‘right’ to have an abortion and the right to do not participate to an abortion or facilitate it in any way.
Many who have voted Yes in the recent referendum will find it unacceptable to force doctors to perform an abortion, or to cooperate with it, when that goes against their professional or moral conscience.
Assisting a person in an immoral act by providing a means to do it is a form of participation. Imagine someone asking you to kill a woman and you reply: “I wouldn’t do it myself but I can tell you who would”. You would be morally complicit in killing that person.
When a doctor is presented with a pregnant women she is dealing with two patients, not one. She wants to help both. She does not want to be involved in ending the life of either.
There is no doubt that referral is a form of participation when, as it is the case in the Irish health system, it is a necessary link in the chain of actions leading foreseeably to abortion. If a doctor believes that abortion is wrong, how can she consistently advise her patient where to obtain one? How can she provide all the necessary documentation without being complicit in what she considers a grave wrong?
Some have expressed concern that removing the duty of refer would deny women who seek abortion proper ‘care. That is not so.
It is possible for the State to provide information online, or through a dedicated phone line for instance, about who offers abortions in their general practice and who does not. Then, the patients who are not happy with their GP because she is a conscientious objector, could move to a non-objector GP so that in case they request an abortion, there will be ‘continuity of care’ for them. It is a simple solution, and no one will be forced to lose their job or to act against their conscience. As the abortion legislation is not going to be approved for several months, there is plenty of time to organise such alternative routes and prevent now, in advance, any possible conflict rather than resolve it after the legislation comes into effect.
Another possible argument in support of the duty to refer is that too many objectors will severely limit the possibility to access to abortion, particularly in remote areas. It is true that the majority of GPs do not want to provide abortions (70% according to a recent poll).
But it is also true that, as reported by the Irish Times, “Government sources stressed they did not believe this would be an issue in practice as women seeking terminations will consult with organisations such as the Irish Family Planning Association or Well Women, rather than their local GP.“ Abortion pills can be offered by those agencies, so to preserve the moral integrity of the objecting doctors.
There is no reasonable argument supporting the duty to refer, unless one rejects the principle of conscientious objection, which is an internationally recognised human right. In 2010, after a long debate, the Parliamentary Assembly of the Council of Europe approved a resolution stating that “No person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion, the performance of a human miscarriage, or euthanasia or any act which could cause the death of a human foetus or embryo, for any reason.”
It is still not clear if there will be an opt-in or an opt-out system but, in any case, Minister Harris should let the doctors choose and act according to their conscience, otherwise he is not pro-choice but simply pro-abortion.
