Conscience question still a roadblock on route to accessing abortion care

THE countdown has begun to introducing a far-reaching abortion service that will test not just our doctors but also the wider health system.

It must be safe and it has to be workable.

But as of now there are practical and ethical roadblocks to be overcome.

The Health (Regulation of Termination of Pregnancy) Bill came before the Dáil this week – but there are just 12 weeks of behind-the-scenes groundwork to have it ready for rollout by January.

How ready are GPs, pharmacists and hospitals to deliver a timely and comprehensive service that women can trust?

In a world where some GPs have such workloads they cannot take on new patients and maternity hospitals have huge gynaecological waiting lists, where will women seeking an abortion fit in?

A statement from the Irish Catholic Bishops’ Conference yesterday, asking that doctors, pharmacists and nurses not just be allowed to opt out of being involved in abortion procedures, but also exempted from referring on a woman, has highlighted a major issue that must be circumvented.

There is the potential for some tragic outcome if a woman in a crisis pregnancy finds herself caught in a maze of confusion, unable to find a provider of a medical abortion.

The bishops say the proposed legislation has no provision for pharmacists to refuse to stock medical abortion medicines.

When it comes to an anti-abortion health professional having to refer a woman to another service, it requires them to “co-operate in what he or she sincerely believes is doing harm to one patient and taking the life of another,” they said.

The bishops point to New Zealand, which has an “opt-in” system and doctors are not obliged to refer.

“We believe the Government by following this approach could demonstrate respect for freedom of conscience,” it said.

It is unclear how this would square with current guidelines from the Medical Council, the regulatory body for doctors, which allows for freedom of conscience – but obliges GPs to transfer the patient to a another doctor or service.

A group of about 200 GPs have written to the Irish College of General Practitioners (ICGP) in recent days, to put their case to Health Minister Simon Harris and his officials for a clause to free them from having to refer on a patient seeking abortion.

The ICGP is one of the key groups involved in drawing up guidelines and sorting out the logistics of how the abortion service will work.

At a recent meeting of the Oireachtas Health Commit- tee, GPs and obstetricians proposed setting up a 24-7 phoneline.

This suggestion has been taken up and Mr Harris told the Dáil it would be medically staffed.

Dr Tony Cox of the ICGP said the helpline should help with appointments, provide reassurance, and give information if a woman was concerned about any aspect of her care, such as where to go in the case of a complication.

The extent to which this phoneline will help bridge gaps in service that may arise remains to be seen.

There may be a reluctance among GPs who will provide the service to be on any list that can be given over the phone.

This is due to the fear of being the target for anti-abortion protesters.

The phoneline will be essential, but it may not go far enough and some form of legal exemption of GPs and other professionals may have to be written into the legislation.

The onus is on the Government to ensure that the service on the ground is practical and patient-friendly.

There is potential for women being caught in maze of confusion