Australian Medical Association (Tasmania) Submission to the Tasmanian Government

Re:law governing termination of pregnancy

5 April, 2013

Full Text

From Introduction

. . . AMA Tasmania has grave concerns that the draft legislation has the potential to criminalise members of the profession with conscientious objection to termination of pregnancy. . .

From The AMA Tasmania submission

. . . The AMA Tasmania submission cannot be read as representing the view of all doctors, as medical practitioners’ views on termination of pregnancy vary considerably. . .

From Concerns and comments with the draft new legislation

. . . Conscientious objection

- Importantly, the proposed changes to the termination laws in Tasmania should not deny a doctor opposed to terminations the ability to act according to his or her beliefs. AMA Members are very concerned about conscientious objection. It is noted that Members of Parliament would have a conscience vote on the proposed legislation but that the draft as it stands denies similar consideration to medical practitioners.

. . . Mandating referrals

- Mandating a conscientious objector to make a referral to another doctor could be viewed as denying that doctor the ability to live according to their beliefs (if the person considers providing a referral to be participating in an activity to which they object). The AMA has already informed the minister directly that a referral in medicine is a very formal process. We suggest removing section 7, subsection 2 and replacing it by paraphrasing the Federal AMA position statement on Reproductive Health and Reproductive Technology. “When a personal moral judgement or religious belief prevents doctors from recommending termination of pregnancy, they must so inform their patients. They must also inform patients that this option may be available elsewhere.“

. . . Referral obligations

– The draft legislation information paper states that referral obligations exist under the Tasmanian Charter of Health Rights and Responsibilities, the Australian Medical Association Code of Ethics, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists Code of Ethical Practice. The AMA Code of Ethics does not oblige a doctor to provide a referral in the case of conscientious objection. What the Code says in relation to referral is '19. Recognise your professional limitations and be prepared to refer as appropriate'. Again, this does not impose a duty to refer in relation to conscientious objection.

From Federal AMA policy in relation to abortion (these statements are direct from policy and are appropriate to use in a submission)

. . . A doctor who undertakes research or provides clinical services related to abortion should not be marginalised or stigmatised (not yet in policy but part of review of statement); . . .

. . . A doctor who chooses not to undertake research or provide clinical services related to abortion should not be marginalised or stigmatised (not yet in policy but part of review of statement); . . .

. . . Individual doctors hold differing views on abortion and this should be respected; . . .

Relevant Federal AMA policy on conscientious objection

Below are statements on conscientious objection (and the policies in which they are found). Please note that none of these statements indicate that a doctor with a conscientious objection has a duty to provide a referral to another doctor.

AMA Code of Ethics

16. When a personal moral judgement or religious belief alone prevents you from recommending some form of therapy, inform your patients so that they may seek care elsewhere.

Position Statement on Reproductive Health and Reproductive Technology

2.6 When a personal moral judgement or religious belief prevents doctors from recommending some form of therapy, they should so inform their patients. They should also inform patients that such therapy may be available elsewhere.

Medical Board of Australia Good Medical Practice: A Code of Conduct for Doctors in Australia statements on conscientious objection

2.4.6 Being aware of your right to not provide or directly participate in treatments to which you conscientiously object, informing your patients and, if relevant, colleagues, of your objection, and not using your objection to impede access to treatments that are legal.

2.4.7 Not allowing your moral or religious views to deny patients access to medical care, recognising that you are free to decline to personally provide or participate in that care