State hospitals must provide abortion if Catholic clinics will not – report

Patient’s life must take precedence over ethos in emergencies, says report

State-owned hospitals should provide abortions in situations where neighbouring Catholic institutions are unwilling to do so, a new report suggests.

Two of the State's 19 maternity units – the Rotunda and the National Maternity Hospital – have religious involvement but the report by a review group on voluntary hospitals, chaired by former European Commission official Catherine Day, says this does not appear to restrict the range of services they provide.

However, the report says it is clear there will be situations where abortions have to be carried out in acute hospitals, rather than maternity units. There are seven Catholic voluntary hospitals in Dublin, Cork and Limerick.

“In each of these three cities, there are a number of other hospitals and it should therefore be possible for the State to procure or provide the necessary services in the same areas to ensure patient choice and access to all lawful services,” the report states.


All treatment available

In emergency situations, the life and wellbeing of the patient must always take precedence over the ethos of an organisation, it says.

Organisations must therefore ensure that all legally permitted treatment is made available “to the greatest possible extent within the capabilities available to the hospital”.

Any organisation that refuses to provide certain services has an obligation to provide patients with information on the full range of choices available to them in the State and to make available their records, the report says.

The State is entitled to attach conditions to its funding and is free to not provide funding to organisations that on grounds of ethos refuse to provide certain lawful services.

However, such a decision would entail “serious and prolonged disruption” to the health service.

“Although we agree on the State’s right not to fund organisations that opt out of providing lawful services, we recommend avoiding the serious consequences that could ensue from such a decision.”

The report says the issue of refusal to provide services on grounds of ethos or conscientious objection is a clear area of potential difference between faith-based and secular institutions.

Church’s ethical code

The ethos of an organisation could lead it to oblige employees to refuse to provide certain services such as abortion, aspects of end of life care and issues relating to sexual health and reproductive services.

“This issue has come into sharp focus in Ireland following the outcome of the 2018 referendum on the repeal of the Eighth Amendment and the decision to relocate the National Maternity Hospital.”

The Catholic Church’s ethical code instructs hospitals and staff not to refer patients for abortion, it points out, adding this has implications for other services such as contraception, sterilisation and genetic testing.

The report says it did not come across any evidence of difference between voluntary and State hospitals in relation to ethos.

On the issue of chapels, religious icons, logos and posters appearing in hospitals, it says organisation should be cognisant of the impact of décor on patients and should strive to ensure their “personal preferences” are met “to the greatest extent possible”.

Twelve of the State’s 48 hospitals have some form of religious involvement in their ownership or governance.

Between them, they account for one in four beds and receive €1.34 billion in State funding annually.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.