A Melbourne doctor is being investigated by the medical professional standards body for refusing to refer a woman to another GP after she sought an abortion.
The case raises important questions about doctors’ duties of care, particularly when they have a conscientious objection to a requested procedure, as well as about abortion itself.
Abortion is legal in Victoria. The 2008 Victorian Abortion Law Reform Act repealed provisions on the procedure in the 1958 Crimes Act, and abolished common law offences related to it.
The Act is very precise on the responsibilities of practitioners who object to abortion, saying they’re obliged to inform the woman of their position and refer her to another practitioner who is known to not share their views.
Dr Mark Hobart is being investigated for the alleged offence of failing to refer after he went public with his story; the couple involved have not made a complaint against him.
The importance of choice
Access to safe and legal abortion is a critical element of women’s health; involuntary continuation of unplanned pregnancies causes harm.
There are many different reasons why women may feel unable to take on the responsibilities of giving birth to and caring for children. And lack of access to safe and legal abortion hampers gender equity as women do the bulk of caring for children, which can diminish their educational, employment, and other opportunities.
Legislation such as the Victorian Abortion Law Reform promotes gender equity by offering women the choice of whether or not to continue a pregnancy. And this is one reason why the Hobart case is troubling – the woman allegedly requested an abortion on the grounds that the 19-week foetus was female but she and her husband wanted a son.
A law enacted to promote gender equity and protect women’s rights appears to have become the vehicle for sex-selective abortion because the female foetus was unwanted.
Aborting a foetus just because of its sex seems repugnant to most of us because it’s based on the notion that sex or gender is so important that it should determine whether a pregnancy is continued. Linking the worth of the future child to gender reflects deeply held stereotypes about what a girl or boy will be like.
It’s important to note that stereotyping and gender discrimination are not limited to cultures with strong son-preferences; it is equally discriminatory to want a female foetus on the grounds that boys are too difficult to raise or that girls are more likely to look after their ageing parents.
Even “family balancing” – selecting a child of the opposite sex from an existing child or children – is based on stereotypical beliefs about the nature and importance of differences between the sexes.
But should abortion based on foetal sex be banned? This is a complex and difficult issue with no quick or easy solution.
Make it illegal?
Criminalising sex-selective abortion sends a strong message that society doesn’t condone this kind of discrimination. Laws against sex selection have been passed in various countries where it is widely practised against female foetuses. But laws alone have not proven to be effective due to limited cooperation from women, their families, and practitioners.
In Australia, where abortion is legally available, it would be extremely difficult to enforce a law against sex selection. It would be virtually impossible to prove that a request for abortion was based upon foetal sex rather than any other reason.
Such a law would undermine women’s access to abortion and curtail their right to make choices about childbearing. It would potentially lead to discrimination against some women based on cultural stereotyping, although as noted above, desires for sex selection are not limited to a culturally-based son preference.
Rather than seek a legal solution, we should challenge stereotyping and discrimination based on sex.
We should reject the view that chromosomal sex is the most important feature of a child, and that sex chromosomes predict how a child will turn out or what kind of a person they will be – that boys will be boisterous and difficult; girls empathic and caring.
Penalising individual patients and doctors will not achieve this. We need to chip away at sex discrimination, support gender equity through frank and fearless public debate, relevant policy, and fair representation of women in government, the media, and other parts of society.
This case challenges our views about reproductive freedom. We should abhor sex-selective abortion and work to eliminate it, but legislation is not the best way to achieve this.
In the meantime, GPs and other doctors should provide care for women within the legal framework for abortion. Those like Hobart who do not, fail their patients and expose themselves to disciplinary action.