Abortion law in New South Wales a global first

Freedom of conscience conditional upon gestational age

Sean Murphy*

The Abortion Law Reform Act 2019 No. 11 has become law in New South Wales, Australia. It is obviously modelled on Queensland’s Termination of Pregnancy Act 2018.

The law permits abortion up to 22 weeks gestation for any reason; no medical indications are required (Section 5).  Abortion after 22 weeks gestation may be performed for any reason that two specialist practitioners find sufficient, including current and future “social circumstances” (6(3)b).

A provision for conscientious objection requires disclosure of objections to abortion by a practitioner when asked by someone (not necessarily a patient) to perform or assist in the performance of an abortion on someone else, to make a decision about whether an abortion should be provided for someone else who is over 22 weeks pregnant (Section 6), or to advise about the performance of an abortion on someone else.

The law requires disclosure of objections to abortion by a practitioner when asked by someone (not necessarily a patient) to perform or assist in the performance of an abortion on someone else [(9(1)a(i) and (ii)], to make a decision about whether an abortion should be provided for someone else who is over 22 weeks pregnant [(9(1)a(iii)], or to advise about the performance of an abortion on someone else [(9(1)a(iv)].

When a woman up to 22 weeks pregnant wants an abortion or advice about an abortion [i.e., under 9(1)a(i) or (ii)], an objecting practitioner is required to disclose his objection [9(2)] explain how she can contact a non-objecting practitioner [9(3)a], or transfer the care of the patient to a practitioner willing to provide an abortion, or to an agency (health service provider) where an abortion can be provided [9(3)b]. 

However, if the woman is over 22 weeks pregnant, a practitioner is obliged to disclose objections to abortion but, if not convinced that the abortion should be performed, is not obliged to facilitate the abortion by explaining how she can contact a non-objecting practitioner or by a transfer of care to a willing colleague. That is because  section 9(3) makes no reference to 9(1)a(iii).

Practitioners who object to abortion in principle and those who object in particular cases are often unwilling to facilitate the procedure by referral, arranging transfers of care or other means because they believe that this makes them parties to or complicit in an immoral act.  Thus, the provision for conscientious objection in the bill actually suppresses the exercise of freedom of conscience by these practitioners with respect to abortions up to 22 weeks gestation.

On this point Queensland’s Termination of Pregnancy Act, while it also suppresses the exercise of freedom of conscience by physicians who object to referral for abortion, at least does so consistently from conception to birth.

It is possible that the wording of this provision has been been muddled in New South Wales either in an attempt to put an end to the idea that only women can become pregnant, or to avoid the possibility that abortion might not be available to a woman who believes that she is a man, or who believes that she is neither a woman nor a man, but who becomes pregnant.

In any case, New South Wales is the first jurisdiction to make the exercise of freedom of conscience in relation to abortion conditional upon the gestational age of an embryo or foetus.  A physician will be free to fully exercise freedom of conscience at 22 weeks plus one day, but not at 22 weeks minus one day.  The inexact calculation of gestational age contributes further to the arbitrariness of this restriction of fundamental human freedom.

UK High Court defines ‘motherhood’ in controversial transgender case

BioEdge

Michael Cook*

A trans man in the United Kingdom has lost his bid to be deemed a father on his child’s birth certificate – even though he conceived it, gestated it, and gave birth to it.

Astonishingly, it appears to be the first time that English common law has defined the word “mother”.

The would-be father, a natal female multimedia journalist at The Guardian named Freddie McConnell, was deeply disappointed by the decision and said that he plans to appeal. He complained:

“It has serious implications for non-traditional family structures. It upholds the view that only the most traditional forms of family are properly recognised or treated equally. It’s just not fair.”

Full text

‘It should be treated just like every other civil right’: Top Trump health official looks to enshrine religious liberty

Washington Examiner

Kimberly Leonard

The Trump administration official who enforces civil rights protections in healthcare sees his work on religious liberty as his biggest legacy for the Department of Health and Human Services.

“There is a real problem out there of lack of respect for conscience and religious freedom that needs to be addressed and we are taking the concrete steps to finally address it,” said Roger Severino, 44, director of the Office for Civil Rights at HHS. “And I think this is an awakening of sorts that has opened up people’s eyes, both in the healthcare industry and beyond, that this is a right that had been under-enforced, that people were being discriminated against and felt they had nowhere to turn, and now they have somewhere to turn. And it would be a shame if that door ever closed on them again.” . . . [Full text]

‘Assisted suicide is not always a crime’: rules Italian court

The  Guardian

AFP in Rome

Italy’s constitutional court has ruled it was not always a crime to help someone in “intolerable suffering” kill themselves, opening the way for a change of law in the Catholic country.

Parliament is now expected to debate the matter, which was highlighted by the Milan trial of an activist who helped a tetraplegic man die in Switzerland.

Anyone who “facilitates the suicidal intention … of a patient kept alive by life-support treatments and suffering from an irreversible pathology” should not be punished under certain conditions, the top court ruled. . . [Full text]

Nova Scotia hospital forced to provide euthanasia, assisted suicide

Services to be provided in attached building

Arrangement said to preserve Catholic identity

Sean Murphy*

Hospital

St. Martha’s Regional Hospital in Antigonish, Nova Scotia, will begin providing euthanasia and assisted suicide (EAS). The hospital had refused to provide the services because they were considered to be contrary to the Catholic identity of the hospital. The change of policy appears to have been forced by the threat of a lawsuit by EAS advocates. A campaign to force the hospital to permit EAS services had been ongoing for some time [See 958 days without medical assistance in dying policy, Ban on assisted dying at St. Martha’s hospital should end, says law prof].

St. Martha’s was established by a Catholic religious order, the Sisters of St. Martha. However, in 1996 the order transferred ownership of the hospital to the state. The terms of the transfer were set out in a “Mission Assurance Agreement” that required the state to ensure that “the philosophy, mission and values of St. Martha’s Regional Hospital would remain the same and the hospital would keep its faith-based identity.”1

Notwithstanding the terms of the agreement, from 1996 the hospital was not legally a private or Catholic institution, even though it is popularly known as “Nova Scotia’s only Catholic hospital .”2 EAS advocates argued that state ownership of the hospital made it a state actor obliged to provide euthanasia and assisted suicide.1 Logically, this would also apply to abortion, surgical sterilizations, and other procedures contrary to Catholic teaching.

The Nova Scotia Health Authority states that the change of policy is consistent with “the spirit of the Mission Assurance Agreement,”3 which seems to imply that a way has been found for the hospital to “keep its [Catholic] faith-based identify” while providing euthanasia and assisted suicide.

According to NSHA’s Vice President of Health Services and Chief Nursing Executive Tim Guest, euthanasia and assisted suicide will be provided in the Antigonish Health and Wellness Centre, formerly the Martha Center.4

Built in 1961, the Antigonish Health and Wellness Center is attached to St. Martha’s Regional Hospital. In 2009, still known as the Martha Center, it was described as “primarily a professional building” of 92,000 square feet that had undergone major renovations between 2006 and 2009.5

The Sisters of St. Martha have issued a statement:

The Sisters of St Martha were informed that the Nova Scotia Health Authority continues to uphold our Mission Assurance Agreement, while providing access in Antigonish for individuals who request Medical Assistance in Dying (MAID).

The Nova Scotia Health Authority has assured us that Medical Assistance in Dying (MAID) will not take place in St. Martha’s Regional Hospital. We do not own St. Martha’s Regional Hospital, or the building called the Antigonish Health and Wellness Center. . . 6

It is not clear from the statements if assessments and preliminaries for euthanasia/assisted suicide will occur in the hospital building, with actual administration of lethal medication taking place in the Health and Wellness Center.

1. Downie J, GilbertD. Nova Scotia now a leader in medical assistance in dying [Internet]. The Chronicle Herald. 2019 Sep 19.

2. Willick F. Ban on assisted dying at St. Martha’s hospital should end, says law prof [Internet]. CBC News. 2018 Dec 28.

3. Lord R, Quon A. NSHA quietly changes medically assisted dying policy at Catholic hospital [Internet]. Global News. 2019 Sep 18.

4. 989XFM. Nova Scotia Health Authority allows Medically Assisted Death at St. Martha’s Regional Hospital [Internet]. 2019 Sep 19.

5. Guysborough Antigonish Strait Health Authority. Request for Proposal: Radio Frequency (RF) Wireless Site Survey [Internet]. 2009 Apr 17.

6. Boisvert B. Sisters of St. Martha Media Statement [Internet]. 2019 Sep 19.