Can Doctors Refuse to Perform Abortion?

In response to new legislation that would permit health care providers to refuse to perform abortion, medical ethics expert Dr. Muhtar Çokar said this was a universally discussed topic, and that respecting the autonomy of physicians should not be at  the expense of ignoring public heath concerns.

He added that granting this right to health care providers might have the same effect as banning abortion because services to terminate pregnancy are not very common in Turkey.

Details of the Abortion draft law

These are the main points of the abortion draft law, according to Hürriyet newspaper:

* Health care providers have the right to refuse to perform abortion.

* Health care providers will work to dissuade women and couples seeking abortion.

* Those seeking abortion will asked to rethink their decision over four days.

* There will be a 10-week time limit on abortion with an increased fine for those who exceed the limit.

* Counseling services for women and couples seeking abortion will be provided upon request before the termination of pregnacy.

* Population planning law and regulation will be replaced by the Reproductive Health Services Act.

* The creation of an effective hotine for reproductive health.

* "Morning after" pills will be provided for free.

"Public health officials cannot refuse to perform abortion"

Çokar said that a physician's autonomy with regard to performing abortion can only be upheld on the condition that abortion services are provided elsewhere.  He stressed that doctors working in government hospitals should not have the option to refuse a patient services.

"[Abortion] services are not commonly available as it is.  If we have legislation geared toward permitting doctors to refuse this service, then it's possible that people won't be able to access any kind of service and we will see the same negative effects that we foresaw [with the prohibition on abortion]."

"Counseling should offer options such as employment services"

Çokar said that counseling services were offered in other countries, but stressed that the counselling process should not only consist of trying to dissuade women from seeking abortion.

"A woman would benefit from counselling if it presented employment options that would enable her to raise the child herself.  With regards to counselling, it all depends on what kind of options are presented to the patient."

"In some countries, counselling is done by phone or in person.  But we don't have a lot of options in our country.  A counsellor might say, 'Have the child and give it to the SHÇEK (Social Services Child Protection Agency),' we don't know."

In regards to the draft law article on "working to dissuade mothers and couples seeking abortion" (worded as 'working to convince mother and father candidates' in the original Turkish legislation), Çokar said "the Ministry of Health probably did not use the expression 'convince'.  They will probably use language like  'thinking time and options will be presented'. Let's not call this 'convincing' or 'dissuading' but rather 'directing'.

"We cannot fully comment on this issue until the entire text of the draft legislation is published," he said. (RE/ÇT)