Individual conscience may make implementing abortion reform as controversial as deciding on the principle

From the Asher’s case to abortion, individual conscience and the prerogatives of devolution greatly complicate reform beyond a straightforward appeal to human rights. Secretary of state Karen Bradley has been attacked for hypocrisy over personally supporting abortion reform while resting on her belief that the Northern Ireland public overwhelmingly support action by a Stormont that is non-sitting and in which there probably isn’t a majority in favour of reform anyway. She knows resting on constitutional propriety gets her off even a hypothetical hook.

Stella Creasy’s reform strategy subtly shifted from a doomed attempt for Westminster to legislate directly on NI abortion to reforming the abortion laws for the whole UK. But this swaps one form of complication for another and it is hard to imagine action in any from any time soon.

Even after the overwhelming vote in the Article 8 referendum, translating the result into practical implementation is no easy task.  In a review of how abortion is being handled in all three jurisdictions, Newton Emerson argues forcefully for a denial of individual conscience for doctors in the North as well as the Republic. Will this divide opinion even more than the principle of allowing abortion in set circumstances? The law may offer no easy answers.  The Supreme Court’s next ruling, on the Asher’s case. will be keenly watched. If a baker is allowed not to decorate a cake in a particular cause, can a doctor be compelled to treat for abortion? Newton makes a spirited case.

The UK Supreme Court sat for the first time in Belfast last month, hearing an appeal into the “gay cake” case, among others.

“People will of course not expect an answer any time soon,” the president of the court said upon reserving judgment.

Another thing nobody expects is for the court to let bakers opt into a register of those willing to ice gay cakes, comprising only a handful of bakers in the country, with people obliged to travel to find them.

Yet that is exactly what Taoiseach Leo Varadkar is proposing for GP-led access to medical abortion, in response to lobbying from the National Association of GPs.

If this seems like a false equivalence because abortion is a far more serious matter than cake, that is all the more reason why women should not have to traipse around looking for a doctor who will deign to treat them.

The  extraordinarily low number of GPs the Taoiseach foresees as needing to opt in – he cited “50 or 60” out of 4,000 in the State – may be enough in practical terms to cater for the national average of six patients per day. However, it sends an unmistakable signal of continued shame and marginalisation.

The main flaw in the {GB} 1967 Act is that it has facilitated abortion on demand in the guise of protecting maternal health. So much denial and dishonesty surrounds this that it has become an enormous ethical mess.

 

The 1967 Act does not extend to Northern Ireland, meaning there is no statutory right to conscientious objection in any case.

Yet, in 2004, the BBC discovered that 13 of the North’s 15 emergency departments would not dispense the morning-after pill because some staff considered it a form of abortion, to which they felt entitled to object.

The report alleged a number of GPs and pharmacists were doing likewise. In a 1997 academic study in Northern Ireland, 6 per cent of GPs self-reported denying the morning-after pill and some forms of contraception on the same vague and erroneous grounds. The report’s authors noted how remarkable it was for any doctor to admit such a clear contractual breach of their duty to patients, and concluded the real figure must be much higher.

This is the inevitable consequence of letting medical professionals believe their religious views are more important than lawful, universal healthcare.

Better to follow the Scandinavian example and leave them in no doubt to the contrary.

 

Former BBC journalist and manager in Belfast, Manchester and London, Editor Spolight; Political Editor BBC NI; Current Affairs Commissioning editor BBC Radio 4; Editor Political and Parliamentary Programmes, BBC Westminster; former London Editor Belfast Telegraph. Hon Senior Research Fellow, The Constitution Unit, Univ Coll. London

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