Rural women impacted by misuse of Abortion Law Reform Act

Matt Woodley

15/02/2019 10:58:25 AM

A minority of Victorian doctors use conscientious objection laws to obstruct women from accessing legal abortion, a new study has found.

RACGP President Harry Nespolon believes that doctors’ personal views must not adversely affect patient care.
RACGP President Harry Nespolon believes that doctors’ personal views must not adversely affect patient care.

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


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Peter Coleman   19/02/2019 8:26:11 AM

Dear Dr Nespolan , your personal views about abortion ,I believe, are damaging to both the life of the baby , whose life is taken by the doctor who performs the abortion , and also the consequences for the parents who must live with the knowledge that they have ended the life of their own baby.
In our society there is government financial assistance for single parents and also support agencies to help with the pregnancy. It may be harder in country areas but still help is available. We judge no one but give the best medical advice we know to preserve the life of every human being including the baby who has not been born and also to support mothers and fathers as they make the decision for life and not death of their baby. This is not a personal belief but a basic belief of all human beings and a healthy society without prejudice . I suggest you consider changing your personal beliefs for the sake of your patients. Yours faithfully , Peter Coleman

Ian Denness   19/02/2019 12:47:40 PM

Thank you, Dr Nespolon, for bringing up the big social issue of abortion. This is so important, especially for the woman involved, but also the man, and our health profession. Dare I even point out, that it is even more important for the baby at the centre of it all. No-one else but the baby is in imminent danger of being killed for their innocent involvement in the whole affair.
You have reported some less than ideal reactions on the part of some of us who don't want to have any part in abortion. For example, the doctor immediately opening the door to let the patient out would be abhorrent to most of us. At the same time, many of us have seen the door for abortion opened far too readily and far too widely, so as to make it seem that our profession has decided it to be the most humane and only form of 'treatment'. This also is abhorrent.
As doctors, we should be seeking to save life, rather than destroy it. To be compassionate and wise, instead of advancing a social ideology.

Dr T   19/02/2019 9:49:57 PM

This is a poor quality, politically motivated study, relying on what an abortion provider claims that a woman said to them, which lacks any reasonable validity.

Pierre Sands   19/02/2019 10:20:12 PM

It is interesting to note how far we have come as a society in relation to increasing intolerance of minority opinion. And in this case I mean increasing intolerance of the opinion that a life begins at conception.

Doctors are free to refuse to perform cosmetic skin procedures with a “sorry I don’t do that,” or to attend for after hours care, “sorry, feel free to call the home visit service.”

Doctors (who believe abortion is murder) are however required to refer to someone else (who they this consider a murderer) to do a job they find abhorrent.

So please have some ‘tolerance’ for those who view slicing a fully formed human being and suctioning out as murder. They need to live with their decisions to, as do the mothers that make these decisions.