Conscientious objection


Sir, – Section 23 of the Health (Regulation of Termination of Pregnancy) Bill 2018 will allow doctors to refuse to provide abortion care. This includes performing minor surgical procedures and prescribing abortion pills. No nurse, anaesthetist, doctor, pharmacist, or other healthcare professional will be required to assist in performing an abortion. No doctor will be required to examine a woman who seeks an abortion, or sign a form allowing her to access one.

The Bill’s accommodation of doctors’ right to refuse care burdens women who need to access abortion within a strict 12-week time-limit. If doctors can refuse to refer women to willing colleagues, the law will fail those with little practical choice of provider. So, if a woman approaches a doctor seeking an abortion, and he cannot help her for reasons of conscience, section 23 says that he must refer her to someone who can.

This is a modest requirement. The legislation prescribes no punishment for refusal to refer, however severe the consequences for the woman. The duty to refer applies equally to doctors who are religious and those who are not. Doctors are not asked to prove the sincerity of their objections before refusing care.

Our right to freedom of conscience is not absolute. It cannot apply where a woman’s life is at risk or her health at serious risk. It cannot trump the woman’s freedom of conscience by blocking her decision to end a pregnancy. A doctor must co-operate with the woman to ensure that protection of his conscience does not override hers, by referring her to someone who can help. Since work in women’s healthcare is voluntary, a doctor owes a duty of reasonable co-operation with his employer, to ensure accessible abortion services.

None of this diminishes the moral claims of doctors who trained and have practised in a system underpinned by different values to those endorsed in the May 25th referendum. They and their patients deserve dignity. The duty of referral should not be the only support available to women refused abortion care. The Government should ensure that women can avoid any confrontation or conflict with doctors. Willing providers should be available across the country, ensuring equal access for all.

However, the duty to refer must remain in law, for the protection of women’s rights. – Yours, etc,


Senior Lecturer in Law,

Birmingham Law School,