LONDON — Is it legal for a British doctor to refuse to perform an abortion? More broadly, in today’s United Kingdom, does conscientious objection still hold for medical practitioners?
Recent U.K. court decisions seem to suggest that the law is unclear. As a result of this trend, there is legislation now before Parliament — the “Conscientious Objection (Medical Activities) Bill” — that seeks not only to clarify the legal position for U.K. medical staff but also safeguard the legal principle of conscientious objection.
The bill’s sponsor is a Catholic member of the House of Lords, Baroness Nuala O’Loan. She told the Register, “[The bill’s] provisions seek to affirm as a matter of statute that no one shall be under any duty to participate in activities they believe involve the taking of human life, either in the withdrawal of life-sustaining treatment or the termination of life before birth.”
O’Loan added that the need for the bill arose because there is “lots of evidence that medical professionals are suffering serious disadvantage and discrimination for their beliefs.”
In particular, she cited the “Glasgow Midwives” case.
In 2014, the U.K. Supreme Court heard the case of Greater Glasgow Health Board v. Doogan and Another, involving two senior midwives who conscientiously objected to having to delegate tasks to or supervise those directly involved in abortion. The Supreme Court decided that indirect roles taken by nurses and midwives were excluded from protection under Section 4 of the Abortion Act 1967. As a result, with no legal right of conscientious objection, the midwives lost their jobs.
Said O’Loan, “I heard many stories of young doctors and nurses contemplating their future who decided that — although they would love to be involved in obstetrics and gynecology, even though they feel vocationally called to the medicine of helping women through conception and childbirth — nevertheless, they cannot do it because they could not, in conscience, kill an unborn child.”
Accounts of Discrimination
In 2016, a parliamentary inquiry examining freedom of conscience in regard to abortion provisions received many accounts from medical professionals who had experienced discrimination in their workplace due to their beliefs.
Speaking of that inquiry, Laurence Wilkinson, legal counsel for Alliance Defending Freedom International in London, told the Register there was “evidence from the British Medical Association confirm[ing] that some doctors had complained of being harassed and discriminated against specifically because of their conscientious objection to abortion.”
Wilkinson added that there had also been evidence presented “on how career progression opportunities, particularly in the field of obstetrics and gynecology, had been limited for those wanting to exercise their conscience.”
There is growing concern that, in addition to abortion, doctors and nurses are being asked to engage in the withdrawal of medication, nutrition and hydration from patients who are terminally ill or those very ill who are seriously disabled.
If made law, the bill would allow medical staff to opt out of participating directly or indirectly in treatments with which they have conscientious objections.
“If one delegates, supervises or supports an activity, it is not unreasonable in concluding that one shares moral responsibility for what happens,” O’Loan said. “I believe that it cannot be consistent with conscience to say, ‘I cannot do this, but I will order you to do it.’”
If the legislation does not succeed, the consequences will be grave for faithful Catholics working in the U.K.’s state-run National Health Service.
Dr. Pravin Thevathasan, editor of the Catholic Medical Quarterly, told the Register, “Freedom of conscience and respect for diversity are values we cherish in liberal society. When such values are rejected … it will be impossible for those holding pro-life views to continue to work in health care.”
The “Conscientious Objection (Medical Activities) Bill” has received support across both Houses of Parliament and from all sections of the political spectrum. O’Loan told the Register, “It is supported by members of many faiths and churches and by people who are not religious but support it for philosophical and social reasons.”
She also cited the bill’s “support from members of the medical profession at all levels, from academics working in the fields of philosophy and ethics” as well as “many ordinary people who recognize that nobody should be forced to be involved in processes which lead to the end of life.”
Given these political moves for legal protection gathered pace after the case of the “Glasgow Midwives,” ironically, if passed, the bill will only take effect in England and Wales.
Anthony Horan, director of the Catholic Parliamentary Office for the Bishops’ Conference of Scotland, said, “While the bill only applies to England and Wales, its progress should be of interest to people in Scotland, where, hopefully, a similar bill could be presented to the Scottish Parliament.”
Added Horan, “Conscientious objection is a widely respected concept, with considerable international and national laws, guidance and conventions protecting the right. A Scottish bill would bring Scotland into line with international norms.”
Elsewhere in Europe
The Council of Europe’s Resolution 1763 explicitly states: ‘”No person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion.”
A number of recent cases from across Europe have demonstrated the need for such legal protections. Swedish midwives have appealed to the European Court of Human Rights, after the Swedish Courts failed to protect their right to conscientious objection. In Norway, a long-serving general practitioner was dismissed after refusing to insert intrauterine devices (IUDs), which can act as abortifacients.
A Norwegian appeal court found the dismissal to be unlawful, but now the case has been appealed and may come before the European Court of Human Rights if the lower court decision is overturned by Norway’s Supreme Court.
In the U.K., given the level of cross-party support for the parliamentary bill there, O’Loan is confident that it will become law. “Our National Health Service (NHS) could accommodate the number of people who cannot, in conscience, engage in procedures which will result in the taking of life,” the Catholic baroness said. “Reasonable accommodation of conscientious objection is a matter of liberty and equality — of individual freedom and social inclusion. That is why this is important and timely legislation.”
Register correspondent K.V. Turley writes from London.