Punishing doctors for following their consciences

The Health (Regulation of Termination of Pregnancy) Bill 2018 is set to return to the Dáil for Report Stage debate next week.

We can be almost certain that before, during and after this debate, the onslaught of deliberate misrepresentations around the 16 ‘pro-life’ amendments will continue apace.

Much of the commentary surrounding those amendments has centred on the apparent wish of the proposers to ‘criminalise’ the pregnant woman and other such absurdities.

What has not been so prominent, however, is a focus on the sanctions that some pro-choice politicians are seeking to impose on doctors who do not sign up to the grossly inadequate conscientious protection provisions that currently exist.

For example, Sinn Fein Deputy, Louise O’Reilly, submitted the following amendment to the abortion bill at Committee Stage:

“A person who has a conscientious objection referred to in subsection (1) but refuses to make arrangements for the transfer of care of the pregnant woman concerned shall be referred to the Medical Council for appropriate sanction.”

During the course of the Committee debate on her amendment Deputy O’Reilly provided the following revealing insight:

“Although I may have had my own views about whether or not a criminal sanction would be appropriate, the amendment does not say that.”

I would suggest that it does not take much to guess from this statement just how far the Deputy might like to go in terms of the nature of any sanctions that might apply.

Concerns around possible criminal sanctions for doctors were also reflected in questions put to Minister Harris by some pro-life TDs when he was asked, “Are their (medical practitioner) licences going to be taken? Are they going to be locked up?”

We need to clear about the kind of sanctions that may actually be applied should the amendment referred to above be accepted at Report Stage next week:

For that we can look to the Guidance on Sanctions Imposed by the Medical Council pursuant to the Medical Practitioners Act 2007 which was published in January 2015.

This document outlines the following sanctions that are available to the Council. They include:

(a) An advice, or admonishment or censure in writing;

(b) A censure in writing and a fine not exceeding €5,000.00;

  1. c) The attachment of conditions to the practitioner’s registration, including restrictions on the practice of medicine that may be engaged in by the practitioner;
  2. d) The transfer of the practitioner’s registration to another division of the register;
  3. e) The suspension of the practitioner’s registration for a specified period;

(f) The cancellation of the practitioner’s registration; and

(g) The prohibition from applying for a specified period for the restoration of the practitioner’s registration.

To be sure, the medical council guidelines clearly state that a proportionality test will first apply before determining what, if any sanctions are to be handed down.

What is deeply troubling however is that to date, neither the Medical Council nor indeed the Irish College of General Practitioners have demonstrated any public willingness to protect the genuine conscientious objection rights of medical practitioners opposed to actively arranging for the death of one of their patients.

We may well ask where is the commitment to proportionality and fairness in this instance?

We might also ask how conscientiously objecting medical practitioners can have any confidence that such ethical principles will come into play at any later point when they are so manifestly absent now?

The manner in which this whole sorry episode has thus far played out is a clear indication to many, that for these representative body’s, the potential loss of hundreds of conscientiously objecting medical practitioners is nowhere near the cause for concern that it should be.

It is also supports the view that something akin to a philosophical and ethical civil war is currently taking place within the practice of medicine in this State.