Doctors have welcomed new Medical Council ethical guidelines which outline the extent of conscientious objection to abortion.
The Medical Council issued an updated edition of its Guide to Professional Conduct and Ethics for Registered Medical Professionals yesterday, following the enactment of the Health (Regulation of Termination of Pregnancy) Act 2018.
It includes two new key elements, one related to the termination of pregnancy and the other to conscientious objection — with a group of GPs who campaigned for reform of the Eighth Amendment saying they welcomed the new wording as it “provided clarity for both patients and doctors”.
The new guidelines outline how the “Termination of pregnancy is legally permissible within the provisions of the Health (Regulation of Termination of Pregnancy) Act 2018” and that medics “have a duty to provide care, support, and follow-up for women who have had a termination of pregnancy”.
As for conscientious objection, the guidelines tell medics “you may refuse to provide, or to participate in carrying out, a procedure, lawful treatment, or form of care which conflicts with your sincerely held ethical or moral values”.
However, it also stresses that “if you have a conscientious objection to a treatment or form of care, you should inform patients, colleagues, and, where relevant, your employer as soon as possible”.
Anyone with a conscientious objection to a treatment must also inform the patient that they have a right to seek treatment from another doctor, and give the patient enough information to enable them to transfer to another doctor to get the treatment they want.
“When you refer a patient and/or facilitate their transfer of care, you should make sure that this is done in a safe, effective and timely manner,” it states, adding that medics should make it as easy as possible for the patient, including being sensitive and respectful to minimise distress.
There should be no interruption to patient care as a result of any objection and access to care is not to be impeded.
“You should not provide false or misleading information, or wilfully obstruct a patient’s access to treatment based on your conscientious objection,” state the guidelines.
“If the patient cannot arrange their own transfer of care, you should make these arrangements on their behalf.
In an emergency situation, you must provide — as a matter of priority — the care and treatment your patient needs.
Dr Trish Horgan, chair of the Start group which campaigned for abortion, said the new guidelines are “comprehensive”.
“It clarifies the position for patients and for doctors,” she said.
Dr Horgan said the key is the HSE’s 24/7 MyOptions.ie website, the point of referral for any medical practitioner holding a conscientious objection and which ensures the patient is swiftly rerouted to practitioners who would assist.
She said while around 250 GPs are providing those services, the new guidelines should make the situation easier for those with a conscientious objection, as they stress that any objections be made known to the patient at the earlier possible time.
Dr Horgan said the new guidelines are compatible with the law and with the existing guidelines and that “it is important that all [patients] feel safe regardless of what doctor they see”.
The Medical Council had appointed an Ethics Working Group to review and advise the Medical Council on any required edits to the Guide to Professional Conduct and Ethics for Registered Medical Practitioners, which also sought input from doctors and key stakeholder groups, as well as the public.
Chair of the Ethics Working Group, Dr Suzanne Crowe, said: “The majority of the amendments made are to be read from the practising of medicine point of view and not in isolation for any one procedure.”