Abortion law must accommodate the conscientious objector

Failure to address the concerns of the conscientious objector in abortion legislation will run the risk of losing GPs, says Catherine O’Donoghue.

I had the opportunity in the summer of 1997 to work in an orphanage in Bucharest, Romania, eight years after the Christmas Day executions of the dictator Ceausescu and his wife.

The orphanage was alongside another residential facility, a convent, a priest’s house, and a church, all behind high walls.

After a while there, I met a local GP based about two miles away, whom I introduced to the facility with the aim of organising regular local healthcare involvement.

The GP herself expressed surprise that she was unaware of the facility there, despite having passed it regularly.

Today in Ireland we are acutely conscious of the many ‘walls’ that have been pulled down — including those concerning abuse, homosexuality, institutional services for women and children.

Indeed, it may be that future generations will look back on us and wonder about how we looked after the homeless, the immigrant, and so on.

It is essential that, as a country, we can learn from the past. One thing that our past can teach us is the importance of dialogue and listening, so that the insights and wisdom to be gleaned from experience do not go unheard.

If we can manage to achieve this in our country now, there will be less need for state apologies by future generations.

In the aftermath of the referendum on the Eighth Amendment, one of the tasks now facing our legislators is to address the concerns of conscientious objectors.

This brings us to the question of what conscience is? Alicia Keys, Amnesty International 2017 Ambassador of Conscience has said: “Our conscience is something we are gifted with at birth, no matter who we are.”

One of the definitions of conscience I have come across is “the sense of right and wrong that governs a person’s thoughts and actions”.

Everyone has a conscience, independent of whether he/she is atheist, agnostic, or a member of a faith group. One’s conscience will determine one’s reaction, whether public or private, to what he/she considers unjust.

Conscience will always be present in the search for truth and justice. It has been a motivating force for so many.

Internationally, we can think of Malala Yousafzai — the then-15-year-old schoolgirl and educational activist for women shot by a Taliban gunman in 2012; Robin Cook — the British MP who resigned as Leader of the House in 2003 rather than vote in favour of the Iraq invasion; Nelson Mandela, Rosa Parks, Martin Luther King, and many others.

We have many publicly known figures in Ireland whose actions or advocacy reflects conscience: our annual National Bravery Awards, Louise O’Keefe, Catherine Corless, Tomi Reichenthal, Pavee Point, all those involved in the decriminalisation of homosexuality, NICRA, the Dunnes Stores anti-apartheid strikers, and numerous more.

Then there are the absolutely innumerable acts of conscience on a daily basis — privately, or not reaching the public arena.

Conscience was a motivating factor for many who voted in the referendum, irrespective of the way each person

individually voted.

We saw in 2013 how a number of politicians, including the then minister of European affairs, Lucinda Creighton, were expelled from their party for following their conscience on the Protection of Life During Pregnancy Act, which allowed for abortion where pregnancy put a woman’s life at risk. More recently, Offaly TD Carol Nolan resigned from Sinn Féin over its stance on abortion.

Failure to address the concerns of the conscientious objector in framing the required abortion legislation will run the risk of losing GPs and healthcare workers who would rather pay the price of their job than breach their conscience on this matter.

We have enough problems and disillusionment within the healthcare sector without creating unnecessary problems.

TDs and senators, whether Independent or members of a party, enjoyed freedom of conscience in how they voted during the referendum.

It would be ironic now if that choice was not to be extended to others in their place of work.

Archbishop Diarmuid Martin touched on this in 2015 when he said: “People will say if you are paid by the State, you have to do what the State tells you. That isn’t in the long-term... what democracy is about.”

Both the Minister of Health Simon Harris and Taoiseach Leo Varadkar (a qualified doctor) have been quite clear that, in their view, there will be significant consequences for GPs with a conscientious objection who refuse to directly refer a patient to a colleague, who would then do the onward referral for abortion.

Mr Harris was explicit that this would be a matter for the Medical Council. If the planned legislation facilitates self referral for any woman, with her own GP providing copies of any required medical notes/history, the involvement of the Medical Council would prove an unnecessarily blunt approach.

Are there limits to the rights of the conscientious objector? Yes. It is the responsibility of all persons to ensure that their conscience is informed to the best of their abilities.

We live in a democratic state where we can take it for granted that a clearly articulated mandate from the people, as in this referendum, will be respected and implemented by our political body. This includes provision of requisite services subsequent to legislation being enacted.

Given the landslide majority result, it should prove eminently achievable, in our internationally wealthy and privileged country, to provide abortion services without failing to accommodate the conscientious objector.

It is essential that, in implementing the outcome of the refererendum, care and diligence is not displaced by a rushed process and hence having an increased risk of flaws in the resulting legislation.

Otherwise, the passage of time will confirm the accuracy of the words of Mahatma Gandhi:

“There is a higher court than courts of justice and that is the court of conscience. It supersedes all other courts.”

Dr Catherine O’Donohoe is a single-handed rural GP in Co Wexford. She is a member of NAGP, IMO, and ICGP. She is also on the Doctors for Life WhatsApp group. She has written this article in a personal capacity.