Safe Abortion: Technical and Policy Guidance for Health Systems, a newly revised publication of the World Health Organization, claims that objecting health care workers have an ethical responsibility to refer patients for abortion, or to provide abortions if referral is not possible. (Sec. 3.3.6, p. 69, Box 3.2,p. 73). It also claims that conscientious objection without referral is a barrier to health care and that referral is a legal obligation under human rights law. Chapter 4 of the text, which is the basis for these demands, was revised under the guidance of the Programme on International Reproductive and Sexual Health Law in the Faculty of Law at the University of Toronto, Toronto, Canada (p. 11). Two professors from this faculty, Rebecca Cook and Bernard Dickens, have been making such claims for years. They have, in the past, seriously misrepresented the law on this point in an effort to make referral for abortion mandatory. (See Postscript for the Journal of Obstetrics and Gynaecology Canada: Morgentaler vs. Professors Cook and Dickens, and Conscientious Objection as a Crime Against Humanity.) The WHO document has been reviewed and criticized by Susan Yoshihara of the Catholic Family and Human Rights Institute, but awaits a critique by medical and legal professionals.
The U.N. Population Fund’s annual report claims that access to birth control is a human right. The report has no legal significance, but activists like the American based Center for Reproductive Rights have pursued a strategy of seeking such declarations, or “soft norms,” in the hope that they will eventually lead to binding “harde norms” that can be enforced against governments and objecting health care workers. (See Secret Memos Reveal Worldwide Pro-Abortion Legal Strategy)
The death of a 31 year old woman at the Galway University Hospital last month is generating enormous controversy in Ireland. Savita Halappanavar was 17 weeks pregnant when she presented with back pain on 21 October. Reports indicate that she was miscarrying, but that the foetus was still alive. She requested an abortion several times but was refused. The foetus was removed surgically once its heart stopped two days later. She developed septicaemia and died on 29 October. Several investigations are underway. [Irish Times]
Tests of a patient diagnosed as having been in a “persistent vegetative state” for twelve years following a car crash have demonstrated that he is self-aware and capable of mentally responding to communication from caregivers. The tests were performed using an fMRI machine. Medical staff had refused to accept his parents’ assertions to the same effect. Observations since the scan have continued to support the diagnosis of “persistent vegetative state,” so it appears that current diagnostic standards are in question. [BBC]
The European Court of Human Rights has issued a judgement adverse to freedom of conscience and ordered Poland to pay two complainants, a mother and daughter, a total of 61,000 Euros in damages and costs. Subject to the possibility that the English translation of the judgement is faulty, the use of the term “anti-choice activist” by the judges brings their impartiality into question. However, the facts of the case outlined in the judgement suggest that the conduct of Polish health care personnel, anti-abortion activists, clergy and state authorities effectively guaranteed an adverse outcome.
A 14 year old girl, P. supported by her mother, S., sought an abortion for a pregnancy alleged to have been the result of a rape. While she obtained the necessary prosecutor’s certificate for the procedure, mother and daughter received contradictory information from two public hospitals in Lublin. Further, health care personnel clearly violated principles of patient confidentiality and informed consent in an effort to dissuade the girl from having an abortion. These violations included clearly coercive and manipulative tactics. P and S experienced
- the intervention of a priest and anti-abortion activists, unsolicited and unwanted,
- importuning by anti-abortion activists that included confrontations in public,
- national media attention, including a press release issued by a hospital concerning P,
- detention and six hours of questioning by the police,
- apprehension of the girl by state authorities, apparently for the express purpose of preventing the abortion,
- posting on internet by the Catholic News Agency of the girl’s travel to Gdansk for an abortion,
- the filing of criminal charges against the girl for having had unlawful sexual intercourse with a minor (i.e., the rape that resulted in pregnancy)
While the court found that objecting physicians had a legal obligation to refer patients for abortion, the source of that legal obligation was Polish law. Article 39 of Poland’s Doctor and Dentist Professions Act imposes a legal obligation of referral. The imposition is objectionable in principle, but the European Court of Human Rights can hardly be criticized for applying Polish law to Polish citizens.