Portugal- Epidemic of Conscientious Objection to Performing Abortion

PORTUGAL: Epidemic of Conscientious Objection to Performing Abortion
By Mario de Queiroz

LISBON, Jul 20 (IPS) -
Pleading "conscientious objection," a significant proportion of doctors in Portugal are preventing women from making use of the law authorising abortions up to 10 weeks of gestation, which entered into force on Sunday.

Voluntary abortion is also legal up to 16 weeks of pregnancy in cases of rape, and up to 24 weeks if the foetus is found to have congenital malformation or an incurable disease.

The new abortion law follows a Feb. 11 referendum in which 59.3 percent of the votes were in favour of decriminalisation of the procedure, and 40.7 percent against. One day after the law came into effect, very few women were availing themselves of their right to terminate pregnancies.

The reasons for this are neither technical nor political. Many public hospitals simply cannot respond to the demand because most of their doctors refuse to perform abortions. The Health Ministry acknowledged this week that doctors' recourse to conscientious objection has left the state with its hands tied, as its only remaining option to provide the abortion services stipulated by the law is to contract doctors from outside its hospital system.

Vasco Freire, the head of Médicos pela Escolha (Doctors for Choice), one of the civil society movements that worked hardest for the referendum "Yes" campaign, told IPS that many of his colleagues refused to perform abortions on moral grounds, "but in many cases, their conscientious objection is limited to state hospitals and does not apply in private medicine."

The same view was expressed by gynaecologist Miguel de Oliveira e Silva, who has written several books about abortion. In many cases, "in the morning, at the National Health Service, they are conscientious objectors, but in the afternoon when they practise privately, they aren't," he said.

The main problem is the mentality of Portuguese doctors, who have a "very conservative code," Oliveira e Silva said. "Neither the referendum nor the law were able to change doctors' attitudes. That's why the Health Ministry recently initiated negotiations to 'privatise abortion,'" he said.

Conscientious objection by doctors is contributing to delays in hospitals all over the country, where women are on waiting lists for mandatory counselling appointments and ultrasound examinations to determine gestational age, before being given a date for the procedure -- which may be another15 days later.

In Madeira, the North Atlantic archipelago which is the most religious and conservative region of Portugal, feelings over the controversy are running high. Madeira's regional secretary for Social Affairs, Francisco Jardim Ramos, said on Sunday that Lisbon "cannot behave like a colonial power and impose on this autonomous region a law that 64 percent of (Madeira's) population rejected in the referendum."

In response, Health Minister António Correia de Campos said that women from Madeira who wanted an abortion could come to the mainland, so long as the autonomous community paid for their travel. Jardim Ramos replied that the central government ought to bear those costs.

On Sunday, several civil society movements opposed to abortion demonstrated in front of hospitals all over the country in "actions symbolising what we defend, and presenting an alternative to a law that is patently bad," said Catarina Almeida, an anti-abortion activist. To comply with the law, the National Health Service estimates it will need to spend some eight million dollars a year, to provide between 17,000 and 18,000 abortions at a unit cost of between 467 and 608 dollars, depending on whether pharmaceutical or surgical methods are used. Cases requiring hospital admissions could cost up to 1,470 dollars.

Portugal's new law on abortion takes it out of the group of the European Union's most conservative countries, comprising Ireland, Malta and Poland. These countries allow termination of pregnancy only in cases where the woman's life is in danger.

Until February, Portugal was the only EU country where women who opted for an abortion could face up to three years in prison, with all the resulting humiliation of public trials and sentencing, and television cameras waiting at the courtroom doors.

In Finland and Luxemburg, abortion may be carried out in cases of rape, or where there are socioeconomic or sociomedical reasons to interrupt the pregnancy.

Twenty out of the 27 members of the bloc have liberal legislation, allowing abortion on demand in "early pregnancy," which is variously defined as between 12 and 24 weeks' gestation.

Spain is a special case in that the law contains a clause to which many women have recourse. Termination of pregnancy is permitted if there is "serious mental or physical risk to the health of the mother," up to 22 weeks' gestation.