Abortion and ‘refusal to provide’


Sir, – The Abortion Rights Campaign’s annual March for Choice takes place in Dublin on Saturday.

Some people wonder why we are still marching when Ireland voted overwhelmingly to legalise abortion last year. Sadly, our imperfect legislation means abortion is still inaccessible to many people in Ireland, and an inaccessible right is a right denied.

One hurdle that makes abortion inaccessible is conscientious objection. There are many reasons why conscientious objection remains enshrined in medical ethics, but recently updated Medical Council ethical guidelines make it clear that doctors have continuing responsibilities to patients, even if the doctor objects to providing the procedure him or herself.

Recent developments at one general hospital show that our legislation on conscientious objection leaves pregnant people unacceptably vulnerable to sudden losses of vital services. It would appear that the objections of some doctors can effectively remove an entire local service. This is unacceptable and undermines the principle of equal access to healthcare for all.

In addition, victims of rape and sexual assault need to feel safe that, should they attend a sexual assault treatment unit, they will be able to discuss options for ending an unwanted pregnancy with trained staff. This would not be so in cases of conscientious objection.

In the Abortion Rights Campaign, we speak about “refusal to provide” which, in the case of abortion, is a more accurate description of what pregnant people in need experience on a day-to-day basis.

Healthcare professionals have a duty of care to their patients, and a duty to practice within the laws as agreed upon by the people.

When refusal to provide interferes so completely with a person’s ability to access services, then that is not an ethical position to hold.

Moreover, some senior GPs in shared practices may not only refuse to provide abortion-related care to their patients, but also pressure junior colleagues in their practices into not providing. This results in the failure of a local GP provision service.

An inaccessible right is a right denied, and we will continue our campaign until everyone can access the rights enthusiastically endorsed by two-thirds of voters in May 2018. – Yours, etc,