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Ireland – Abortion system could collapse, says researcher involved in review of laws
Dr Deirdre Duffy identifies issues around conscientious objection and spread of services and is concerned her findings will not be shared

Elements of Ireland’s abortion system are “not sustainable” in their current form and the service could collapse, according to a researcher involved in a review of the State’s laws on terminations of pregnancy.

Dr Deirdre Duffy, now at Lancaster University, and a team of researchers from Manchester Metropolitan University were appointed by the Government to carry out a study looking at the experience of abortion service providers such as hospital staff and GPs.

Their research has identified issues around guidance on conscientious objection as well shortcomings in the spread of services available around the country and the availability of staff and facilities in hospitals.

Polish health minister ‘appalled’ girl, 14, struggled to get abortion after rape
Doctors at several hospitals cited a conscience clause to avoid treating the teenager who has a mental disability

Poland’s health minister has weighed in on a high-profile rape case, saying it was “unacceptable” that a mentally disabled 14-year-old girl struggled to get a legal abortion.

The case, in which doctors at several hospitals used a conscience clause to avoid carrying out the procedure, has sparked renewed calls to ease the Catholic country’s abortion laws, which are among Europe’s most stringent.

Ireland – Five maternity hospitals will not provide abortions until next year

Ellen Coyne
October 24 2022

Five of the country’s maternity hospitals will not be providing abortion services until next year at the earliest, amid conscientious objection from individual obstetricians and a lack of resources.

Another two maternity hospitals are still in talks with the HSE to try to roll out termination of pregnancy services next year, three years after free access to abortion was first legalised in Ireland.

What Will Happen if Doctors Defy the Law to Provide Abortions?
If lawmakers won’t protect conscientious providers, then judges should

Days after Texas banned most abortions after about six weeks of pregnancy in September 2021, Dr. Alan Braid disclosed that he had “provided an abortion to a woman, who though still in her first trimester, was beyond the state’s new limit.” Dr. Braid wrote in a Washington Post opinion piece that when he was a medical resident before Roe v. Wade, he had seen “teenagers die from illegal abortions. One I will never forget. When she came into the ER, her vaginal cavity was packed with rags. She died a few days later from massive organ failure, caused by a septic infection.” Dr. Braid resolved, “I can’t just sit back and watch us return to 1972.”

Rome (AFP) – For 40 years, gynaecologist Michele Mariano has been the only person performing abortions in Italy’s conservative Molise region. He has delayed retiring twice because no one will replace him, many refusing to terminate pregnancies as conscientious objectors.

It’s an extreme example, but emblematic of a wider issue in Italy, where abortion up to 90 days after conception has been legal since 1978 — but many healthcare providers don’t offer them.

What is ‘conscientious objection’? Here’s why major parties are talking about it

As the campaign for the 2021 federal election continues, one controversial topic looks to be coming right to the forefront — whether health-care professionals are obligated to provide care for service they morally oppose, or at least refer the patient to another doctor.

At issue is what’s known as conscientious objection: when health-care practitioners refuse to do or refer patients for a medical procedure that is against their belief such as abortions, medical assistance in dying or even gender-reassignment surgery.

Australia – Doctors’ conscientious objection to abortion can affect women’s health: study

Some Victorian health professionals who conscientiously object to abortion are breaking the law by not referring patients to another professional who doesn’t object, new Victorian research has found.

Published in BMC Medical Ethics, the University of Melbourne-led study found that in some cases, women had abortions much later than necessary or had the baby, despite seeking a termination.

… The researchers found: …. Doctors directly contravened the law by not referring women or by attempting to make women feel guilty, attempting to delay women’s access, or claiming an objection for reasons other than conscience

Ghana – The battle of values: Health practitioners make medical decisions based on personal values

Women seeking legal abortion care including life-threatening complications due to abortion (post-abortion complication) or after suffering miscarriage may be denied care by some health service providers in Ghana due to their religious or moral beliefs, a research finding has revealed.

According to the study, which looked at Conscience-based Objection to abortion care or Conscientious Objection to abortion (CO) conducted in two regions in Ghana Volta and Eastern Regions by reproductive rights advocacy network Global Doctors for Choice Ghana, a relatively high number of doctors, midwives, nurses and physician assistants who have received training in comprehensive abortion care will rather exercise their right to refuse to provide legal abortion services to women in need due to their religious or moral beliefs.

Let’s call ‘conscientious objection’ by its name: Obstruction of access to care and abortion in South Africa

Satang Nabaneh, Marion Stevens, and Lucia Berro Pizzarossa
24th October 2018

South Africa has one of the most liberal laws on abortion and constitutionally recognizes reproductive rights as human rights. However, data shows important difficulties translating the legal norms into effective access to services. One of the key challenges is physicians’ refusal to perform abortions invoking an “ad hoc, unregulated and at times incorrect” conscientious objection. The Department of Health is now spearheading a reform of the abortion guidelines aiming to bring them in line with human rights standards and reframing the refusal as “obstruction of access to care”.

Read full article: Oxford Human Rights Hub

How ‘conscientious objectors’ threaten women’s newly-won abortion rights in Latin America
From Uruguay to Chile, medical staff are refusing to provide abortion services even after their legalisation.

Diana Cariboni
18 July 2018

Women’s rights to legal abortion have increased in Latin America – but so have campaigns and policies for medical staff to be able to ‘conscientiously object’ and refuse to participate in these procedures.

“We didn’t see it coming,” said feminist activist Lilián Abracinskas in Uruguay, a secular country where abortion, same-sex marriage and the marijuana market were each legalised in the last decade.

Read full article: Open Democracy

United States – An Arizona woman needed a drug to induce a miscarriage. Her pharmacist refused.
Arizona is one of a handful of states that lets pharmacists raise ethical objections to prescriptions.

By Jen Kirby
Jun 25, 2018

An Arizona woman who was having a miscarriage said a pharmacist at a local Walgreens store refused to issue her a prescription on Saturday because of ethical objections — an incident that’s put a spotlight on pharmacists’ ability to refuse to serve patients.

The woman, Nicole Mone Arteaga, detailed the encounter in a Facebook post. Arteaga’s doctor had been monitoring her pregnancy and found her nine-week-old fetus had no heartbeat and that she would miscarry. Her doctor prescribed a medication: misoprostol, an FDA-approved drug that induces an abortion.

Read full article: Washington Post

South Africa – ‘Conscientious objection’: when doctors’ beliefs are a barrier to abortion
As a report highlights the ruinous impact of denying abortion, two medics offer opposing views on the role of personal belief

Hannah Summers
Fri 22 Jun 2018

A rise in the number of healthcare providers who refuse to provide abortion services based on their personal beliefs is having a devastating impact on women and girls around the world, a new study has claimed.

Over the past two decades, at least 30 countries – including, most recently, Ireland, Chile and Argentina – have taken steps to improve access to abortion through legislative changes.

Read full article: The Guardian

Abortion in Italy, a Right Wronged

by Ilaria Maria Sala, Nov. 13, 2017

Late last month, Cosimo Borraccino, a left-wing member of the regional council for Apulia, in southern Italy, proposed passing a local law to require the enforcement of national legislation granting women access to abortion. His opponents on the council, mostly from center-right parties, said the bill was unnecessary and that Mr. Borraccino was “slamming into a wall of self-evidence.”

Yet when it comes to reproductive rights in Italy, respect of the law is anything but self-evident. In fact, 9 out of 10 gynecologists in Apulia refuse to perform abortions, even though the right to obtain one has been legal since 1978. Nationwide statistics are only slightly less staggering: Seven out of 10 gynecologists in Italy won’t terminate a pregnancy.

Read full article: New York Times

Uruguay – The Discussion on Conscientious Objection

August 10, 2017, by Nomtika

All roads led to Uruguay last week, between July 31st and August 4th, as 5 SRJC members took to Montevideo for the International Convention on Conscientious Objection.

The meeting, co-hosted by Mujer y Salud en Uruguay (MYSU) and the International Women’s Health Coalition (IWHC), featured policymakers, academics, health professionals, legal experts, and feminist activists who collectively established that objecting to the provision of voluntary abortion services on religious or moral grounds, is a chief barrier to safe abortion and endangers the lives of women.

Read full article: Sexual and Reproductive Justice Coalition

Sweden – The case of the anti-abortion Swedish midwives – again

by International Campaign for Women’s Right to Safe Abortion, August 8, 2017

On 17 March, 19 April and 31 May, we published three reports from Sweden on the cases of two midwives who sought to keep their jobs in spite of declaring conscientious objection to abortion, which is not recognised under Swedish law, and refusing to provide abortion services, which were a part of their job descriptions. The most recent report said they were considering taking a case to the European Court of Human Rights, as they had failed to win their case in the Swedish courts. It would appear they have done so.

However, on 18 July, we received an e-mail from someone in Sweden which explained that the case the two midwives took to the European Court was not an appeal against the Swedish courts’ rulings, but a new case. The writer said:

“The verdict against Ellinor Grimmark that came out of Sweden’s Labour Court in April cannot be appealed. The other midwife with the same story, Linda Steen, who also sued her county and was ruled against, appealed to the Labour Court, which declined to hear the case. So these cases are, in point of fact, concluded.

“However, the two midwives have sued Sweden before the European Court of Human Rights. This is not an appeal of the verdicts in their respective labour disputes, but a separate suit alleging human rights violations by the Swedish government.

Read full article: International Campaign for Women’s Right to Safe Abortion

Ghana: Provider obstruction: a major threat to critical maternal health services in Northern Ghana

April 17, 2017, Ghana Web, by Mathias Aboba

A study has revealed that access to critical maternal health care service in the three regions of Northern Ghana; Northern, Upper East and Upper West regions is impeded with clinicians refusing to provide some legally prescribed services due to their moral or religious beliefs.
The research known as the Conscientious Objection to Legal Abortion Care was undertaken by reproductive health advocacy network, Global Doctors for Choice-Ghana (GDC, Ghana).

Read full article: Ghana Web

Sweden: Where conscientious objection to abortion is not recognised in law

March 17, 2017, International Campaign for Women’s Right to Safe Abortion

In Sweden, conscientious objection is not recognised in law. A Swedish midwife who refused to participate in abortions or prescribe contraceptives, which are part of the job description for midwives, was turned down for jobs in three clinics in the region of Joenkoeping in 2014.
Her case was tried by Sweden’s discrimination ombudsman and appealed to the district court. Both ruled against her claims of discrimination in 2015. The district court ordered her to pay the authorities’ legal costs. She then appealed to the Labour Court. Her anti-abortion lawyers argue on human rights grounds that her freedom of religion and freedom of conscience have been breached, and that she has been discriminated against.

Read full article: www.safeabortionwomensright.org

Norway: Doctor lost lawsuit after she denied patients UID

February 9, 2017, norwaytoday.info, by Tor Ingar Oesterud

The doctor, Katarzyna Jachimowicz, was fired after refuse to insert the birth control IUD (Intrauterine Device) for women. In the Norwegian GP regulations, from January 2015, states that doctors do not have a right to reserve them against consulting women about abortion or inserting UID.

Read full article: norwaytoday.info

South Africa: Women and girls risk unsafe abortions after being denied legal services

January 31, 2017, Amnesty International

Women and girls risk unsafe abortions that can lead to serious health complications, and even death, due to persistent barriers to legal abortion services, according to research by Amnesty International and the Women’s Health Research Unit of the School of Public Health and Family Medicine at the University of Cape Town.

The briefing published today highlights how despite South Africa having one of the world’s most progressive legal frameworks for abortion, many women and girls – especially those in the poorest and most marginalized communities – struggle to access safe abortion services. A key barrier is the failure of the government to regulate the practice of ‘conscientious objection’ through which health professionals can refuse to provide abortion services.

Read full article: Amnesty International

Doctors Have no Right to Refuse Medical Assistance in Dying, Abortion or Contraception

by Julian Savulescu and Udo Schuklenk
First published: 22 September 2016
https://doi.org/10.1111/bioe.12288

Abstract: In an article in this journal, Christopher Cowley argues that we have ‘misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors’. We have not. It is Cowley who has misunderstood the role of personal values in the profession of medicine. We argue that there should be better protections for patients from doctors’ personal values and there should be more severe restrictions on the right to conscientious objection, particularly in relation to assisted dying. We argue that eligible patients could be guaranteed access to medical services that are subject to conscientious objections by: (1) removing a right to conscientious objection; (2) selecting candidates into relevant medical specialities or general practice who do not have objections; (3) demonopolizing the provision of these services away from the medical profession.

Read full article: Bioethics

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