Doctors who refuse to take part in abortions are suffering increasingly from harassment and discrimination at work, the British Medical Association has told MPs.
Healthcare professionals are complaining to the union that they are facing pressure to take part in abortions and confronted with glass ceilings to advancement when they refuse, a new report reveals today.
The BMA highlighted the problem in written evidence submitted to a parliamentary inquiry into the working of the conscience clause of the 1967 Abortion Act.
The BMA said in its evidence that it “supports the right of doctors to have a conscientious objection to termination of pregnancy and believes that such doctors should not be marginalised”.
“Some doctors have complained of being harassed and discriminated against because of their conscientious objection to abortion,” it continues.
“The BMA abhors any instances of harassment or discrimination of doctors on the basis of their views on abortion.”
The inquiry by the All Party Parliamentary Pro-Life Group received evidence from hundreds of individuals and institutions, including abortion providers.
In its report, it concluded that the conscience clause was not being upheld and that medical professionals with a moral objection to abortion were vulnerable to victimisation.
Fiona Bruce, the Conservative MP for Congleton, Cheshire, and the chairman of the group, said action must be taken to protect such healthcare professionals.
“This report reveals concerning evidence of doctors and other healthcare professionals being harassed, abused, and denied career choices, as a result of seeking to exercise their legal right to conscientiously object to being involved in the abortion process,” she said. “This must stop.
“Our All Party Parliamentary Group calls on Government and all those involved in overseeing healthcare provision to take steps to ensure that the conscience clause is fully respected and observed in practice.
“It is now almost 50 years since Parliament enshrined the conscience clause in law – and in an age when diversity is increasingly celebrated and discrimination deplored it is today more relevant than ever.”
The conscience clause states that “no person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by this Act to which he has a conscientious objection”.
But the new report, called “A Report into Freedom of Conscience in Abortion Provision”, found that “inadequate observance” of the law and in some cases a total “disregard of the conscience clause”.
“This means that, in practice, there is inadequate accommodation for healthcare professionals with a conscientious objection to abortion, contrary to the protection which the 1967 Act is intended to provide,” the report says.
“In particular, the treatment of such individuals is far too dependent on the individual attitudes and discretion of their personal line managers or colleagues.”
As a result pressure was increasing on pro-life doctors to refer women who want abortions to colleagues willing to authorise them, which meant they were still culpable.
Promotion is denied to doctors with conscientious objections while access to specialities like obstetrics and gynaecology have been made practically impossible for medical students with objections, the inquiry found.
The Royal College of Obstetricians and Gynaecologists refused to give evidence to the inquiry and was severely criticised in the report for operating a policy which explicitly discriminates against the advancement of students with such objections.
But Ann Furedi, the chief executive of the British Pregnancy Advisory Service, the largest private chain of abortion clinics in the UK, said that even her organisation allowed some doctors to object.
“At BPAS, some doctors feel unable to carry out, or be trained to carry out abortions beyond a particular gestation,” she said in a written submission. “Their view is respected and they are able to treat those clients that they feel they can treat.”
Dr Arianne Shahvisi, lecturer in medical ethics and humanities for the medical school at the University of Sussex, said in her oral submission, however, that students should not go into medicine if they were not willing to participate in abortions.
“If a person finds abortion objectionable, they should not pursue employment in which their only options are to be at one or two removes from abortion provision,” she said.
“In disclosing a moral reservation, doctors risk producing moral distress in the patient or even of deterring the patient from proceeding with the abortion,” she added.
“The disclosure of a moral reservation by a powerful and respected person to a vulnerable person, against the backdrop of a society in which abortion is still stigmatised, seems deeply problematic.”
The report said Dr Shahvisi’s position excluded “those with a conscientious objection to abortion from training in such fields as General Practice, Obstetrics and Gynaecology, nursing, and midwifery”.
“Should assisted dying ever be legalised in the UK, a whole host of other medical fields would also be excluded for the pro-life individual,” the report said.
The report recommended a review of training to ensure that the conscience clause is properly understood and respected and called for an end to any requirements of an objecting doctor to refer abortions elsewhere.
It recommended the establishment of an appeals system to help people who feel victimised because of their objection and the protections offered by the conscience clause to be extended to cover wider numbers of healthcare professionals.
It also called for the 2010 Equality Act to be amended to incorporate the principle of “reasonable accommodation” to encourage employers to avoid flashpoints with employees in the first place.
In her submission, Dr Mary Neal, senior lecturer in law at the University of Strathclyde, said: “We should not expect someone who believes abortion to be seriously morally wrong to be willing to participate in it in any capacity, and conscience provisions should be drafted and interpreted so as to protect health care practitioners against any such expectations.”
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