There have been several high-profile cases in the last year of women in the UK being prosecuted for allegedly obtaining abortions illegally. In 2022, there were 29 cases of suspected unlawful abortions that were reported to police—almost a two-fold rise on the number reported four years earlier.
In response to this, the Royal College of Obstetrics and Gynecologists (RCOG) has issued guidance that seeks to clarify the legal obligations of health care professionals. The full guideline has not yet been released, but the RCOG insists that professionals “are under no legal obligation to contact the police following an abortion, pregnancy loss or unattended delivery.”
There are different ethical questions that we might ask concerning abortion and the law in the UK. For example, we might ask what the law should be. That is, at what stage of pregnancy and in which circumstances abortion should be legally permitted?
A more radical question would be whether abortion is properly a question for the law.
RCOG and the British Medical Association (the trade union for UK doctors) have long called for reform and decriminalization of abortion, arguing that—where it is provided by a health professional with the woman’s consent—it should be managed and regulated as other forms of health care.
But a different question relates to how health professionals should respond in a situation where abortion is sometimes unlawful and they become aware that a woman has sought an abortion outside the current legal framework. Must they report to the police? May they report to the police (for example, if they have a personal view that abortion is seriously wrong)? Or, if they do report to the police, might the health professional be the one who ends up in trouble?
A question of confidentiality
The central ethical issue at stake here is not, in fact, the morality of abortion. Rather, the key issue is about medical confidentiality and when health professionals are justified in violating their strong obligations to safeguard the patient’s medical details.
Confidentiality has been thought to be vital to the doctor-patient relationship for centuries. For doctors to be able to help patients, they need the patient to provide full details of their symptoms and how they have arisen. That will sometimes include very private details—say, of sexual relationships and function—which the patient will only divulge if they can be assured the doctor will keep them strictly secret.
In more recent decades, confidentiality has also been justified in terms of a more fundamental right of the patient to privacy and autonomy. That right seems particularly vital when it comes to reproductive health care.
Because it is so important, modern codes of practice for health professionals allow confidentiality to be breached only in truly exceptional circumstances. That could include notification of a serious infectious disease or prevention of terrorism. But it does not, in most circumstances, include reporting that a patient has committed a crime.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Should a health professional be disciplined for reporting an illegal abortion? (2024, January 23)
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