Abortion – an argument for more liberal laws

Welcome everyone to another GradReady blog on the legal/ethical side of medicine. As I haven’t posted for a little while, my name is Elliot and I am an intern at the Prince Charles Hospital, final year law student, and current PhD candidate. The following discussion is relating to a highly topical area of medicolegal interest: abortion. This topic usually polarises individuals, and we have just had a recent inquiry into liberalising termination laws here in Queensland. The purpose of this article is to give a reasonably one-sided view on the ‘abortion debate’, as I will be arguing for a ‘pro-choice’ view on this issue – due to my medical/legal/research (majoring in feminist studies) background, I am strongly on the side of permitting maximum autonomy for women. I also hope that in the near future, we can get a writer to do a counter-article, which will generate some interesting discussion! The purpose of this article is to also get you thinking about ethical scenarios that may come up in a medical school interview situation.
 
Laws regulating abortion vary in each State across Australia, from liberal laws – such as the ACT and Victoria, which generally allows abortion whatever gestational age (pending additional medical input in Victoria) – to more constrictive laws in Western Australia (requires medical panel to permit abortions of over ~14 week gestation) and Queensland (abortion is criminalised, and only permitted in serious circumstances). As some of you may be aware, Australia is a signatory to fairly important international legal devices, such as the Convention to Eliminate Discrimination Against Women (CEDAW) and the International Covenant on Economic, Social and Cultural Rights (ICESCR). Both the CEDAW and ICESCR demand that women both have full autonomy when it comes to their reproductive health, and that women are permitted to attain the highest standard of physical and mental health. Some of the laws in place in conservative States of Australia currently infringe these rights, and I will explain why.

Over 80,000 abortions are performed in Australia per year (56.3 million worldwide), and we don’t have any reliable statistics that demonstrate how many of these are unsafe procedures – i.e. self-procured by the woman, or with the help of individuals who are unqualified and unregulated. However, there is ample evidence that significant number of unsafe abortions occur wherever laws are present that create barriers to this practice. Indeed, deaths from perilous termination procedures make up 20% of the total death burden worldwide from pregnancy and childbirth. When abortion is restricted, or illegal (such as in QLD), women will either seek unsafe methods, or travel interstate to perform the procedure. This latter option takes women away from referral pathways into supportive care and counselling, and is a highly expensive and mentally distressing process.
 
The current legislation that is in place in States such as QLD, NSW and WA puts significant roadblocks for safe terminations of pregnancy and are founded in antiquated, traditionally-created ideas of womanhood that places responsibility for sex on women, and construes all women as maternalistic and without the right to end a potential life. The UN Committee overlooking the implementation of CEDAW have strongly criticised such laws for being flagrant examples of gender discrimination. Doctors are also fearful of helping women with abortions in States that have ambiguous laws, and often refuse to take part.
 
The European Court of Human Rights have ruled that an unborn child isn’t regarded as a ‘person’ attracting a right to life under the European Convention on Human Rights, and that the women’s rights and interests are implicitly given hegemony above that of the foetus. To align Australia’s abortion practices with the international human rights’ instruments mentioned above, women should not have their reproductive health determined at the behest of additional doctors, committees, partners or family members, and should be able to make this hard choice with full autonomy and support available to them.
 
This has been a very (very!) quick rush through some of the arguments that give weight to permitting women to have more choice in the care of their bodies. We are very keen to hear what you think, and please don’t hesitate to comment on the related social media post!