Rural women impacted by misuse of Abortion Law Reform Act

The research, based on qualitative interviews with 19 selected Victorian abortion experts in 2015, covers the impact of abortion law reform on service provision. While abortion has been legal in Victoria since 2008, Section 8 of the Abortion Law Reform Act allows doctors who conscientiously object to the procedure and refer women to another provider.
 
The 19 interviewees, which included five GPs, held a strong belief that most doctors did not let moral or religious beliefs impact on their patients; however, all could detail negative experiences related to Section 8.
 
According to the study, in some cases doctors had directly contravened the law by not referring patients to a willing health professional, attempted to make women feel guilty, attempted to delay access, or claimed an objection for reasons other than conscience.
 
In addition, some experts reported the use or misuse of conscientious objection by government phone staff, pharmacists, institutions and political groups.
 
‘The abortion experts we interviewed are often in the position of managing the fallout when a doctor misuses Section 8, so they are well aware of the impact that failure to refer can have on women,’ study lead Associate Professor Louise Keogh, of the Melbourne School of Population and Global Health, said.
 
Negative consequences of Section 8 arose from it not being followed, or being followed inappropriately, the study reported, while some participants working in rural areas said refusal to refer is a ‘common practice’.
 
‘Women come to me having had doctors be very rude to them and not necessarily refer them on anywhere,’ one participant said.
 
‘There are quite a few conscientious objectors in our town and they’re not nice to the girls particularly at all.
 
‘Things such as, “No, I don’t do that”, and then just standing up and opening the door for the patients to leave. That’s very, very common here certainly.’
 
Participants were also aware of incorrect advice that had – in rare cases – resulted in women being forced to continue a pregnancy they were otherwise seeking to terminate.
 
In response to the research, RACGP President Dr Harry Nespolon underlined the law in Victoria that doctors’ personal views must not adversely affect patient care.
 
‘All doctors’ decisions about a patient’s access to medical care, including abortion, are required by law in Victoria to be free from bias and discrimination,’ Dr Nespolon said.
 
‘Although GPs are not required to provide treatment in which they conscientiously object, they cannot allow their objection to impede access to legally available treatments.
 
‘If a GP conscientiously objects to a particular treatment, ideally they should communicate this with their patient prior to the consultation with a sign in the waiting room or advice from the practice’s receptionist. This patient should be referred to another GP within the same practice or in a nearby practice in a timely and effective manner, who can provide this treatment.’
 
While the study was limited to Victorian legislation and health professionals, South Australia, Queensland, Tasmania and the Northern Territory have similar conscientious objection laws.
 
Abortion is generally regarded as lawful in New South Wales if it is performed to prevent serious danger to the woman’s mental and physical health – including economic and social pressures – but the state has not enacted legislation to decriminalise the procedure and unlawful abortions are punishable by up to 10 years’ imprisonment. As such, it does not have conscientious objection laws.
 
The ACT is the only state or territory to completely remove abortion from criminal law, but doctors have a right to refuse carrying out or assisting in carrying out a pregnancy termination without referring on. Meanwhile, Western Australia is the sole jurisdiction to recognise a hospital or institution’s right to conscientious objection, in addition to individual doctors.
 
In Victoria, entire institutions have also used Section 8 to justify a refusal to provide abortion services; however, the research considered that such a practice is legally questionable and can disproportionately affect women in rural areas.
 
‘There is currently no obligation on hospitals to provide abortions for the populations they serve, and there was a sense among the study participants that Section 8 was used to justify institutional opting-out,’ Associate Professor Keogh said.
 
‘Particularly in rural and regional areas, where there might only be one health network, this raises serious access challenges to what is a legal, safe and necessary service, especially when these facilities are publicly funded.’
 
The study authors plan to undertake further research to better understand the views and practices of conscientious objectors, while they have also suggested a study that is able to quantify the scope of the issue.
 
 

abortion laws conscientious objection termination