more_vert
AUSTRALIA’S patchwork of abortion laws is leading to “abortion tourism”, according to experts who are calling for nationally uniform legislation.
In an MJA editorial published today, Professor Caroline de Costa, of the College of Medicine and Dentistry at James Cook University, and Professor Heather Douglas, of the School of Law at the University of Queensland, said laws governing abortion had failed to keep pace with developments in prenatal testing which meant increasing demand for safe terminations. (1)
“In 2015, there is an urgent need for legislative uniformity across Australia so that the law is in step with modern medical practice, and so that women, regardless of where they live, have equal access to abortion services”, they wrote.
They noted that only Victoria and the ACT had decriminalised abortion, while health regulations restricted access to late abortion in other states.
The authors called for the rest of Australia to adopt Victoria’s model, where a woman can access a termination up to 24 weeks with the agreement of one doctor, and after 24 weeks if two doctors agree.
Doctors in Victoria have the right to conscientiously object to abortion, but are obliged to refer women with unwanted pregnancies to a doctor with no such objection.
The editorial authors said the Victorian law placed the responsibility for decision making with the woman, or the woman and her doctor, thus “regulating abortion in the same way as other medical procedures”.
They also claimed there was extensive abortion “tourism” from all Australian states to Victoria, and overseas.
Associate Professor Kirsten Black, a spokesperson for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said around 80 000 abortions were performed in Australia each year, with one study she was involved with suggesting only 30% of women accessing abortion were from the two lowest socioeconomic groups. (2)
“The figures in our study of women attending a private abortion service suggested that poorer women may have less access to abortion”, said Professor Black, from the Discipline of Obstetrics, Gynaecology and Neonatology at the University of Sydney.
She told MJA InSight that as well as law reform, more abortions should be provided in public hospitals.
Professor Black said it was “not an uncommon story” to hear of women who could not get an abortion after 20 weeks through either the public or private services in Queensland and NSW having to travel to Victoria at great personal and financial cost.
She also supported the Victorian provisions on conscientious objectors, saying the law needed to “protect women against individuals whose religious or personal convictions might stop them from putting the patients’ best interests first”.
One conscientious objector, Dr John Wenham, director of the Clinical Medical Stream at Broken Hill Department of Rural Health, Sydney Medical School, told MJA InSight the Victorian rules on the issue were consistent with his current practice.
“I won’t sign off on the form to authorise an abortion, but I will refer a patient on to a non-objector, usually a gynaecologist, to ask for a second opinion”, he said.
However, Dr Wenham said he also made time to discuss the situation with the patient, exploring all the options, so they could make a decision with fully informed consent.
“The most important thing is to treat each woman with respect and show her compassion, remembering that she has found herself in a distressing situation she really hadn’t planned on”, he said.
Dr Wenham said his main reasons for objecting to abortion were his medical calling to “first do no harm” and his Christian belief in the sanctity of human life.
“We recognise that in an antenatal appointment we have two patients — one visible to the naked eye, and the other unseen. We have a responsibility to treat them both equally with regard to their human dignity. How can this be so different in a consultation where the pregnancy is unwanted?” he said.
The RACGP refused to comment for this story.
(Photo: bikeriderlondon / shutterstock)
The use of the word “tourism” in this article is in the same context as “medical tourism” – where people travel to have procedures or treatment that are not accessible to them locally – either due to availability or cost. The term does not intend to trivialise the treatment, but to describe the act of travelling.
We can respect individual views about pregnancy termination while also accepting that our society generally favours its legal availability. In that context, it makes sense for a country like Australia, with a small but widespread population, to have uniform laws and facilities for an important procedure which our community generally believes should be accessible to those who seek it.
Is there a reason why half of this article about a widely accepted medical procedure (https://www.mja.com.au/journal/2010/193/1/australian-attitudes-early-and…) is from the perspective of someone who does not fulfil their professional duties as a qualified medical practitioner?
Till the RACGP is prepared to make real comments on real now life situations, their credibility must be brought into question. Though really, their star in the sky is falling quickly, so what does it matter, anyway.
Prof Caroline de Costa is a long-term, consistent and articulate advocate for a woman’s choice, I am in dissent with her conviction here, though always and honestly impressed with the vigor with which she pursues her case. I argue for consistency in caring for life as it presents to us as healthcarers every day. The issue of ‘rights’ and whose rights isn’t simple. It is commonly multi-faceted and can involve other people apart from the person in primary need – the patient in front of us – who justifiably attracts a major share of our concern. She is however not our only ‘patient’ and I would argue the case to see the full picture and other relationsips involved so as to arrive at ‘best care’ for the mother.
Beyond this, I’m aware of the perceived gap in the care I can offer if, as is the case, I will not perform an abortion. Furthermore, sending someone off to a doctor whom I know will perform termination seems the same as doing it myself so this, to me, is not an option either.
My beliefs here underpin my basic approach to healthcare and why I’ve continued in medicine, successfully I feel, with these beliefs now for 43 years. I have been guided by such beliefs in family life as well – this has, as Caroline may recall, called on me to live in the life-changing relationship of being father for my Down Syndrome daughter. As all fathers may agree, parenthood changes one’s focus a bit. I don’t regret my growing experiences with my daughter, she enriches my life – we grow with challenges, eh?
I work in Victoria and am always concerned about the welfare and rights of both mother and baby when a woman with an unwanted pregnancy presents.It happens to me very rarely now as I get older.
Unless the mother’s viability is in real danger and there therefore exists the mother’s right to act in self defence of her life,I will not be part of killing anyone.Therefore ,I refuse to be involved in a referral for abortion to someone who is not of the same moral belief.i.e. I will break the law in Victoria where my right as a citizen to act according to my conscience has been legislated away as a result of the unfortunate alliance of left wing Victorian Labor politicians of the early 2000s.Emily’s List is a very powerful lobby group in the Labor Party who have engineered legislation which allows the legal killing of babies while in utero until birth.What barbarity!
If only Professor da Costa used her intellect, heart, and energies to protect the innocent lives of those unfortunate children whose time has not yet come. This holocaust may be diminished, or even ended.
‘Tourism’.???
Really? ???
I find this both an inflammatory and demeaning term to be used in the exploration of a significant health issue.
It would be too sensible to rationalize the law to make it consistent across Australia so unfortunately it won’t happen