World Medical Association
Revision of WMA
Declaration of Oslo on Therapeutic
Abortion (2006)
Appendix "B"
National Association Responses to the Secretariat Revision
B1.1 15 of 116 members responded to the Secretariat Revision, which was, in effect, identical to the 2006
Declaration. Of these, five offered comments only.
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Canadian Medical Association
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The CMA supports this proposed revision. [i.e.,
the Secretariat Revision]
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Danish Medical Association
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The DMA would suggest adding a definition of "Therapeutic
Abortion" to this document. [i.e.,
the Secretariat Revision]
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Japanese Medical Association
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JMA supports this version. [i.e.,
the Secretariat Revision]
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Korean Medical Association
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Need to protect both patients' and doctors' rights in the
matter of therapeutic and inevitable abortion.
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Vatican Medical Association
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Abortion is a very controversial topic and different views
can be found in the society. Nevertheless, Medical
establishment should try to protect and promote every human life
(born and unborn). Therefore we don't consider that the
problem can be settle around the concept of "interest" as the
Preamble affirms. Even if there are difficult cases in which
medical provision could involuntarily finish with the fetus life
to save the mother's life, we as doctors should frame all this
problem from the "two patients" perspective and not only from
one.
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- supported the Secretariat Revision "with two minor revisions";
- change "SR Introduction" to "Preamble";
- change "minimal medical standards" to "fundamental medical standards
(SR Recommendation 4).
- accepted the Secretariat Revision, proposed "two clarifying
amendments";
- begin SR Recommendation 2 with the phrase, "The attitude towards
abortion in general . . ."
- change "minimal medical standards" to "required
medical
standards" (SR Recommendation 4).
- supported the Secretariat Revision; recommended two additions;
- SR Recommendation 1 - add the phrase, "including both mothers and
unborn children, and balanced with respect for human dignity and patient
autonomy."
- Add a specific requirement for medical indication and informed
consent of the mother in the case of therapeutic abortion.
B2.3.1 The Associate Members
discussed deleting the word "Therapeutic." Some thought the document was
meant to apply to all abortions, "but others felt that would be a major
change, and that there should be a separate document on legal abortion (for
countries where it is legal.)"
- supported the Secretariat Revision "with some. . . amendments";
- replace the phrase "the diversity of attitudes toward the life of
the unborn child" with "attitudes to women's rights, cultural and
religious tradition and national legislation" (SR Introduction);
- add a statement that women who terminate pregnancies should not be
punished, urging national associations and physicians to "speak out
against legislation and practices that are in opposition to this
fundamental right."
B2.4.1 The NMA explained:
"Diversity of responses is not only due to diversity of attitudes. Women's
right to elective abortion is more important than attitudes. If women's
right to elective abortion is perceived as controversial and is not
accepted, we suggest that the original sentence is deleted."
B2.4.2 The statement that a woman's right to elective
abortion is more important than "attitudes" - apparently to the life of the
unborn child - is significant. First, it implies recognition of a
distinction between therapeutic and elective abortion. Second, Norway, like
Sweden, asserts an absolute right to abortion for any reason.
- delete reference to conflict between the interests of a mother and
her unborn child
- replace with "A pregnant woman may consider terminating her
pregnancy for medical or other reasons." (SR Introduction)
- change "minimal medical standards" to "at least minimal medical
standards." (Recommendation 4);
B2.5.1 It appears that the RDMA wanted reference
to a potential conflict between mother and unborn child deleted because it
did not understand the latter to have any "interests" that could give rise
to a conflict. ("The question is, what are those interests of an unborn
child and for whom [is this] a dilemma?")
B2.5.2 The Dutch made a comment that clearly
articulated an important point:
The Royal Dutch Medical Association
agrees that physicians can't be forced to perform an abortion. There are
little situations in which abortion is therapeutic and those situations are
mostly not controversial. Therefore we suggest to speak about elective
abortion instead of therapeutic abortion.
B2.5.3 This reflected the Dutch statement that a
woman may consider abortion "for medical or other reasons" (emphasis added).
This issue was touched upon only indirectly by others (Denmark,
comment; Associate Members, B2.3.1;
France, B2.8.4; Norway, B2.4.1)
- To SR Recommendation 2, add, "The doctor will respect the
convictions of the patients and will refrain from imposing his/her own."
B2.6.1 By this the Spanish clearly did not mean
that physicians who refuse to participate in abortion for reasons of
conscience were "imposing their values" on patients, because they later
stated that physicians could "legitimately" conscientiously object to
abortion and were "entitled" to do so.
B2.6.2 Spain suggested the addition of a passage
asserting a duty to provide complete and accurate information "about the
evolution of pregnancy and fetal outcome" and a duty of non-abandonment. It
appears that this refers to an obligation to help a woman who has had an
abortion with "medical problems that the abortion or its consequences might
arise."
- delete "create a dilemma" from the passage referring to a conflict
between the interests of a mother and her unborn child (SR
Introduction);
- change "attitudes toward the life of the unborn child" to "attitudes
toward the life of the unborn fetus" (SR Introduction).
B2.7.1 The first recommendation indicates that
the British did not believe that a conflict between the interests of a
mother and her unborn child created a dilemma.
B2.7.2 The BMA suggested that the policy
acknowledge that qualified healthcare workers could provide abortions (SR
Recommendation 4).
B2.7.3 The Association stated that it supported
the right of conscientious objection concerning abortion, adding, "such
doctors should not be marginalised because of their beliefs."
B2.7.4 However, it also recommended the addition
of a requirement that an objector "must perform whatever procedure is
necessary to preserve the life of the woman."(SR Recommendation 5). This was
supplemented by a broader comment, which seems to more accurately state
their position:
We support healthcare workers' right to
conscientiously object, except in circumstances where no other doctor is
available and an abortion is necessary to save the life or prevent grave
permanent injury to a pregnant woman. (Emphasis added)
B2.7.5 Since this may include abortion, such an
expectation would require every physician to be trained and practised in
performing abortions, notwithstanding conscientious convictions to the
contrary.
B2.7.6 Finally, the BMA suggested
the addition of a new paragraph:
- Physicians must work with society to seek to ensure that no woman
loses her life because therapeutic abortion services are unavailable,
even in extreme circumstances.
B2.8.1 France insisted that the Declaration must
be understood to refer exclusively to "Therapeutic Interruption of Pregnancy
or Interruption of Pregnancy on Medical Grounds," and, further, that every
procedure required prior "consultation with a group of experts."
B2.8.2 For these reasons, France stated that
abortion "is a medical act for which there are no grounds for invoking the
conscience clause."
B2.8.3 Nonetheless, it left Recommendation 5 of
the Secretariat Revision largely intact, allowing a physician to withdraw if
his "convictions" precluded participation. Consistent with its position
(B2.7.1) France replaced "abortion" in this paragraph with "Interruption of
Pregnancy on Medical Grounds," so it appears that the French understood "convictions" to mean convictions based on clinical rather than moral
grounds.
B2.8.4 The emphatic
insistence upon the therapeutic and medical nature of the act, together with
reference to a mandatory consultation with experts, indicates that the
French did not believe the Declaration on Therapeutic Abortion
refers to
elective abortions.
B2.9.1 The AMA suggested the most extensive
changes to the Secretariat Revision, but most were editorial, not
substantive.
- move the first three recommendations to the Introduction;
- add the following paragraph to the Introduction:
Abortion is a medical matter between the patient and
the physician subject to the physician's clinical judgement, the patient's
informed consent, and the availability of appropriate facilities. Attitudes
toward abortion are a matter of individual conviction and conscience that
must be respected.
- revise the reference to "minimal medical standards" in SR
Recommendation 4 by stating that abortions should be performed "in
accordance with good medical practice in an approved facility that meets
necessary medical standards."
B2.9.2 If the WMA document summarizing the
returns is accurate, it seems that the reference to the need to
respect "individual conviction and conscience" would appear twice in the
American version of the SR Introduction: once with respect to human life,
and once with respect to attitudes to abortion.
B2.9.3 The AMA suggested only slight revisions to
the protection of conscience provision (SR Recommendation 5).
- change "convictions" to "personal convictions";
- change "may withdraw while ensuring the continuity of medical care
by a qualified colleague" to "may withdraw from the case as long as the
continuity of medical care by a qualified colleague is secured."
B2.9.4 The addition of "personal" may have been
intended to distinguish moral from clinical convictions. The other
modifications more clearly made withdrawal conditional upon maintaining
continuity of medical care, but did not imply that referral was required.
On the contrary: the change made it less likely that the passage could be
understood to imply an obligation to refer, since "while ensuring" implies
action by an objecting physician, but the revised formulation does not. In
any event, the American Medical Association has a carefully considered
policy on referral in cases of conflicts of conscience. While it recommends
referral, it does not require it.23
- delete reference to respecting individual conviction and conscience
(SR Recommendation 2);
- delete WMA duty "to safeguard the rights of the physician within
society" (SR Recommendation 3);
- change "where the law allows therapeutic abortion to be performed"
to "when therapeutic abortion is to be performed" (SR Recommendation 4);
- change "minimal medical standards" to "good medical standards
approved by the appropriate authority" (SR Recommendation 4);
- delete provision allowing physicians to withdraw because of their
convictions (SR Recommendation 5).
B2.10.1 The recommendations were consistent with
Sweden's long-standing hostility to physician freedom of conscience in
relation to abortion.24
B3.1 Among the fifteen responding members, 12
left the protection of conscience clause (SR Recommendation 5) intact, and
one (the AMA) recommended only minor clarifications of the text. It seems
obvious that neither the French nor the British intended to suppress
physician freedom of conscience in relation to elective abortions. Only one
medical association in the world - Sweden - clearly sought the suppression
of physician freedom of freedom of conscience in relation to all abortions.
B3.2 the requirement
introduced by the Working Group that objecting physicians be compelled to
refer patients for all abortions was not recommended by any of the fifteen responding members.
Secretariat Revision (Oct. 2016)
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American Medical Association (April, 2017)
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INTRODUCTION
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INTRODUCTION
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The WMA requires the physician to maintain respect for human
life.
This is a matter of individual conviction and conscience that
must be respected.
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Abortion is a medical matter between the
patient and the physician subject to the physician's clinical
judgement, the patient's informed consent, and the availability
of appropriate facilities. Attitudes toward abortion are a
matter of individual conviction and conscience that must be
respected.
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Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
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Circumstances that bring the
interests of a mother into conflict with the interests of her
unborn child may create a
dilemma as to whether or not the pregnancy should be
deliberately terminated. The diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
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|
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It is not the role of the medical profession to determine the
attitudes and rules of any particular sate or community in this
matter, but it is our duty to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
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RECOMMENDATIONS
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1. The WMA requires the physician to maintain respect
for human life.
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(Moved to introduction)
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2. This is a matter of individual conviction and
conscience that must be respected.
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(Moved to introduction)
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3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
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(Moved to introduction)
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4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
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4. Where the law allows
therapeutic abortion to be performed, the procedure should be
performed by a competent physician in
accordance with good medical practice in an
approved facility that meets necessary
medical standards. |
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5. If the physician's
convictions do not allow him or her to advise or
perform an abortion, he or she may withdraw
while ensuring the
continuity of medical care by a qualified colleague.
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5. If the physician's personal
convictions do not allow him or her to advise or perform
an abortion, he or she may withdraw
from the case as long as
the continuity of medical care by a qualified colleague
is secured. |
Secretariat Revision (Oct. 2016)
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British Medical Association (April, 2017)
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INTRODUCTION
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INTRODUCTION
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Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
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Circumstances bringing the interests of a mother into conflict
with the interests of her unborn child
raise the question as to
whether or not the pregnancy should be deliberately terminated.
Diversity of responses to such situations is due in part to the
diversity of attitudes towards the life of the
fetus.
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RECOMMENDATIONS
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RECOMMENDATIONS
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1. The WMA requires the physician to maintain respect
for human life.
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1. No change suggested.
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2. This is a matter of individual conviction and
conscience that must be respected.
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2. No change suggested.
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3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
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3. No change suggested.
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4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be
performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
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4. Therefore, where the law allows therapeutic abortion to be
performed, the procedure should be
administered by a competent
health worker in an environment conforming to minimal
medical standards and approved by the appropriate authority.
The health worker should be
appropriately trained to administer or perform the necessary
techniques.
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5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
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5. If the physician's convictions do not allow him or
her to advise or perform an abortion, he or she may withdraw
while ensuring the continuity of medical care by a qualified
colleague. If no other qualified
health worker is available s/he must perform whatever procedure
is necessary to preserve the life of the woman.1
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Physicians must work with society to seek
to ensure that no woman loses her life because therapeutic
abortion services are unavailable, even in extreme
circumstances.
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1. We support the right of doctors to have a conscientious objection to
termination of pregnancy and believe that such doctors should not be
marginalised because of their beliefs. We support healthcare workers' right
to conscientiously object, except in circumstances where no other doctor is
available and an abortion is necessary to save the life or prevent grave
permanent injury to a pregnant woman.
Secretariat Revision (Oct. 2016)
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Royal Dutch Medical Ass. (April, 2017)
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INTRODUCTION
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INTRODUCTION
|
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Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child1 create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
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A pregnant woman may consider
terminating her pregnancy for medical or other reasons. This
raises the question as to whether or not the pregnancy
should be deliberately terminated. Diversity of responses to
such situations is due in part to the diversity of attitudes
towards the life of the unborn child.
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RECOMMENDATIONS
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RECOMMENDATIONS
|
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1. The WMA requires the physician to maintain respect
for human life.
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1. No change suggested.
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2. This is a matter of individual conviction and
conscience that must be respected.
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2. Question: "This is a matter" — where is this
referring to?
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3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
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3. No change suggested.
|
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be
performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
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4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be performed by a
competent physician in an environment conforming to
at least minimal medical
standards and approved by the appropriate authority.
|
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5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
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5. No change suggested.2 |
1. The question is, what are those interests
of an unborn child and for whom [is this] a dilemma?
2. The Royal Dutch Medical Association agrees
that physicians can't be forced to perform an abortion. There are little
situations in which abortion is therapeutic and those situations are mostly
not controversial. Therefore we suggest to speak about elective abortion
instead of therapeutic abortion.
Secretariat Revision (Oct. 2016)
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Finnish Medical Association (April, 2017)
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INTRODUCTION
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INTRODUCTION
|
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Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
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No change suggested.
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RECOMMENDATIONS
|
RECOMMENDATIONS
|
|
1. The WMA requires the physician to maintain respect
for human life.
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1. No change suggested.
|
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2. This is a matter of individual conviction and
conscience that must be respected.
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2. The attitude towards
abortion in general is a matter of individual conviction
and conscience that must be respected.
|
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3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
|
3. No change suggested.
|
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be
performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be performed by a
competent physician in an environment conforming to
required medical standards and
approved by the appropriate authority.
|
|
5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
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5. No change suggested.
|
Secretariat Revision (Oct. 2016)
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French National Medical Council (April, 2017)
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INTRODUCTION
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INTRODUCTION
|
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Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
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Delete the paragraph. It must be made clear from the outset
that this refers to Therapeutic Interruption of Pregnancy or
Interruption of Pregnancy on Medical Grounds (rather than . .
.abortion). Question: Can a pathological pregnancy be terminated
deliberately?
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RECOMMENDATIONS
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RECOMMENDATIONS
|
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1. The WMA requires the physician to maintain respect
for human life.
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1. No change suggested.
|
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2. This is a matter of individual conviction and
conscience that must be respected.
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2. Individual conviction must be respected.
The decision to proceed with an
Interruption of Pregnancy on Medical Grounds should be taken
after consultation with a group of experts. It is a medical act
for which there are no grounds for invoking the conscience
clause.
|
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3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
|
3. No change suggested. |
|
4. Therefore, where the law allows
therapeutic abortion
to be performed, the procedure should be performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
|
4. Therefore, where the law allows Therapeutic Interruption of Pregnancy
or Interruption of Pregnancy on Medical Grounds to be
performed, the procedure should be performed by a competent
physician in an environment conforming to minimal medical
standards and approved by the appropriate authority.
|
|
5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
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If the physician's convictions do not allow him or her to
advise or perform an Interruption of
Pregnancy on Medical Grounds, he or she may withdraw
while ensuring the continuity of medical care by a qualified
colleague.
|
Secretariat Revision (Oct. 2016)
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German Medical Association (April, 2017)
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INTRODUCTION
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PREAMBLE
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Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
|
No change suggested.
|
RECOMMENDATIONS
|
RECOMMENDATIONS
|
|
1. The WMA requires the physician to maintain respect
for human life.
|
1. No change suggested.
|
|
2. This is a matter of individual conviction and
conscience that must be respected.
|
2. No change suggested.
|
|
3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
|
3. No change suggested.
|
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be
performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be performed by a
competent physician in an environment conforming to
fundamental1
medical standards and approved by the appropriate authority.
|
|
5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
|
5. No change suggested.
|
1. It is suggested that the term "minimal" be
replaced with "fundamental", as "minimal" could also be interpreted to mean
"the lowest possible" medical standards.
Secretariat Revision (Oct. 2016)
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Norwegian Medical Association (April, 2017)
|
INTRODUCTION
|
INTRODUCTION
|
|
Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to
the diversity
of attitudes towards the life of the unborn child.
|
Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity of responses to such
situations is due in part to attitudes
to women's rights, cultural and religious tradition and national
legislation.1
|
RECOMMENDATIONS
|
RECOMMENDATIONS
|
|
1. The WMA requires the physician to maintain respect
for human life.
|
1. No change suggested.
|
|
2. This is a matter of individual conviction and
conscience that must be respected.
|
2. No change suggested.
|
|
3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
|
3. No change suggested.
|
|
|
Women who decide to terminate
pregnancy should not be punished. National Medical Associations
and physicians should speak out against legislation and
practices that are in opposition to this fundamental right.2
|
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be
performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
|
4. No change suggested.
|
|
5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
|
5. No change suggested.
|
1. Diversity of responses
is not ony due to diversity of attitudes. Women's right to elective
abortion is more important than attitudes. If women's right to
elective abortion is perceived as controversial and is not accepted, we
suggest that the original sentence is deleted.
2. It is important that
women are not punished if they decide to terminate pregnancy.
Secretariat Revision (Oct. 2016)
|
Spanish Medical Association (April, 2017)
|
INTRODUCTION
|
INTRODUCTION
|
|
Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
|
No change suggested. |
RECOMMENDATIONS
|
RECOMMENDATIONS
|
|
1. The WMA requires the physician to maintain respect
for human life.
|
1. No change suggested. |
|
2. This is a matter of individual conviction and
conscience that must be respected.
|
2. This is a matter of individual conviction and
conscience that must be respected. The
doctor will respect the convictions of the patients and will
refrain from imposing his/her own.
|
|
3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
|
3. No change suggested.
|
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be
performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
|
4. No change suggested.
|
|
5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
|
5. No change suggested. |
|
|
The physician who legitimately opts for
conscientious objection, to which he is entitled, is not
exempted from informing the woman of her social rights, or of
solving for himself or with the help of another physician, the
medical problems that the abortion or its consequences might
arise. The physician cannot and should not abandon the person in
need of help and advice and must provide the pregnant woman with
adequate, reliable and complete information on the evolution of
pregnancy and fetal outcome. It is contrary to medical ethics to
deny, hide or manipulate information to influence the mother's
decision about the continuity of her pregnancy.
|
Secretariat Revision (Oct. 2016)
|
Swedish Medical Association (April, 2017)
|
INTRODUCTION
|
INTRODUCTION
|
|
Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
|
No change suggested.
|
RECOMMENDATIONS
|
RECOMMENDATIONS
|
|
1. The WMA requires the physician to maintain respect
for human life.
|
1. No change suggested.
|
|
2. This is a matter of individual conviction and
conscience that must be respected.
|
2. Delete paragraph.
|
|
3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
|
3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community on the matter of
therapeutic abortion, but it is
our duty to attempt to ensure the protection of our patients.
|
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
|
4. Therefore, when
therapeutic abortion is to be performed, the procedure should be
performed by a competent physician in an environment conforming
to good medical standards
approved by the appropriate authority.
|
|
5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
|
5. Delete paragraph. |
|
|
|
Secretariat Revision (Oct. 2016)
|
WMA Associate Members (April, 2017)
|
INTRODUCTION
|
INTRODUCTION
|
|
Circumstances bringing the interests of a mother into
conflict with the interests of her unborn child
create a dilemma
and raise the question as to whether or not the pregnancy should
be deliberately terminated. Diversity
of responses to such situations is due in part to the diversity
of attitudes towards the life of the unborn child.
|
No change suggested.1
|
|
RECOMMENDATIONS
|
RECOMMENDATIONS
|
|
1. The WMA requires the physician to maintain respect
for human life.
|
1. The WMA requires the physician to maintain respect
for human life, including both mothers
and unborn children, and balanced with respect for human dignity
and patient autonomy.2
|
|
2. This is a matter of individual conviction and
conscience that must be respected.
|
2. No change suggested.
|
|
3. It is not the role of the medical profession to
determine the attitudes and rules of any particular sate or
community in this matter, but it is our duty
to attempt to ensure both the
protection of our patients and to safeguard the rights of the
physician within society.
|
3.
No change suggested.
|
|
4. Therefore, where the law allows therapeutic abortion
to be performed, the procedure should be
performed by a
competent physician in
an environment conforming to minimal
medical standards and approved by the appropriate
authority.
|
4.
No change suggested.
|
|
5. If the physician's convictions do not allow him
or her to advise or perform an abortion, he or she may
withdraw while ensuring the continuity of medical care by a
qualified colleague.
|
5.
No change suggested.
|
|
|
In the case of a therapeutic
abortion (as opposed to an elective legal abortion), there
should be a medical indication for the procedure with the
understanding and consent of the mother.3
|
1. . . . We had a discussion about changing the
title to remove the word, "Therapeutic" because some of us felt the document
covers all abortions, but others felt that would be a major change, and that
there should be a separate document on legal abortion (for countries where
it is legal.)
2. We felt the first statement about respect
for human life should be modified because the statement alone may be
interpreted as code for opposition to abortion in some countries.
3. . . . A document on therapeutic abortion
should have more safeguards for the mother to be certain the abortion is not
done against her will and that it is medically indicated.