If a patient requests an abortion or advice on having an
abortion, should a doctor be punished for refusing to refer that patient to
another doctor who will provide the advice, or indeed, the abortion?
Victorian GP, Dr. Mark Hobart is being pursued by the state’s Medical Practitioners’ Board for precisely
this reason.
Doctors in Australia
who are qualified to perform surgery are generally only required by law to perform
an abortion in cases when it is necessary to preserve the life of the mother. However,
S8 of Victoria’s Abortion Law Reform Act (2008) requires that in other circumstances, a doctor having
a conscientious objection to abortion must refer a patient “to another
registered health practitioner in the same regulated health profession who the
practitioner knows does not have a conscientious objection to abortion”.
There’s a hole in that last clause: the practitioner can
claim they do not know another qualified doctor who will perform or advise on
the requested abortion. This is Mark Hobart’s defence. In this particular case,
an Indian couple wanted to abort a 19 week old foetus because it was female. Dr Hobart claims that
he does not know of any doctor who would perform an abortion for reasons of sex
selection. He may be right: Victoria’s
largest abortion provider, the Fertility Control Clinic states:
“It is extremely rare for us to
receive requests for gender-selection abortion and we do not acquiesce to such
requests.”
It would be simple enough for a woman or couple to get
around this by claiming depression and / or extreme anxiety due to not being
able to cope with having a baby at this time of their life. It would also be a
simple matter for the couple to just go to another GP, or look on the internet.
I typed “Victoria
abortion clinics” into Google. Here
is what came up first.
Yet the Victorian Medical Practitioners’ Board is pursuing
Mark Hobart under S8(1) on an “own motion”. That’s right … Board members have
brought the complaint themselves. One might well ask how the Board can credibly
act as both prosecution and judge.
In a twisted irony, Dr Hobart’s persecution ensued from his
own contact with the Board: when he discovered another doctor had subsequently
performed the abortion, he filed a complaint on the grounds that it was
knowingly performed for the reason of sex selection, without there being a
heritable, gender related condition. In response, some Board members decided to
anonymously bring the “own motion” against Dr Hobart. They had no problem pandering
to third world cultural practices, however.
One might also ask why the doctor’s accusers on the Board
have not been forced to identify themselves. This is not how things work in an
open society. A person should always have the right to know his or her accusers
and the face them openly. How much weight should we place on charges when those
bringing them so lack the courage of their convictions that they seek to hide
behind a bureaucratic cloak of anonymity?
The lefties at Crikey have sought to make an issue of the fact that Dr Hobart is a Catholic and a member of
the DLP. But so what? It is not necessary for him to detail the set of his
political and religious beliefs and affiliations in order to make a
philosophical argument. Should everyone commenting publicly on same sex marriage be required to state their sexual
preferences?
That the writer (and editor) of one particular story did not
uncover these facts is sloppy journalism. The Herald Sun made the connection. Regardless of us explicitly knowing Dr Hobart’s political
and religious perspective, the motivations behind such stances are generally
not difficult to guess. However, they are not the point.
If a doctor refuses to provide or even give advice on how to
obtain a medical procedure which he or she deems unnecessary (or destructive)
and moreover, does not seek reimbursement for the consultation, why should they
face censure? This is not a case of harm to a patient ensuing from refusal of
treatment. Nor is it a negligent diagnosis stemming from perverse beliefs: the
doctors at the Fertility Control Clinic probably hold a substantially different
set of beliefs, yet stated that neither would they perform an abortion under
such circumstances.
I think Catholicism contains a plethora of perverse beliefs.
However, that is not the issue in this matter. What is at issue is a professional’s
right to abstain from actions which are contrary to their philosophical principles,
where such abstention does no material harm.
It does not matter whether you or I agree with Mark Hobart’s
principles. He is not required to agree with us either. What he is required to
do, as a licenced doctor, is competently treat patients. He is not required to
perform what many doctors would agree is an unnecessary surgical procedure. Nor
should he be required to scout around for a doctor who would be prepared to
perform such a procedure. The patient should do that for themselves.
This matter makes a good case study in the difference in
approach between genuine Liberals and the left, who are not Liberal in any true
sense.
The attitude of both the conservatives and (in this case)
the left is: if you do not buy into our world view, you must be punished and
excluded. That is how people whose positions derive from ideology rather than
evidence and reason tend to react to dissent. You see the same thing with both
the secular left and the religious right. Because neither can refute the
dissenter with argument, they use their illegitimate power to concoct rules and
procedures and use these to stifle opposing views.
The purpose of the draconian S8(1) is not to formalise a
woman’s right to an abortion. The remainder of the Act achieves that. S8(1)’s
purpose is to force acquiescence to the ideology of those who drafted the Act,
under threat of loss of career. That is its evil.
There already exist provisions for censuring doctors who
fail in their duty of care. If a patient presents with symptoms of
psychological distress about their pregnancy and requests an abortion, any
doctor who does not provide abortions is negligent in their duty of care if
they do not properly refer the patient. This scenario is already covered under
general negligence. It does not need reinforcement with S8(1).
If a patient requests an abortion for the reason of gender
selection, some doctors would perform it and some would refuse on the grounds
the procedure is unnecessary. Those who refuse in such circumstances should be
free to do so, regardless of whether you or I agree with the underlying
philosophical motivation. If the patient is not in genuine distress, there is
no failure of care. The patient can go and find a doctor who will perform the
abortion. Additionally, they can pay for it themselves. I have no problem with
my taxes being spent on providing abortions for women who need them, but there
is no way I want to fund medical procedures for “lifestyle” reasons.
