We have a brand new abortion law in Spain, it is called something like Law on Sexual Health and Voluntary Interruption of Pregnancy and it replaces the previous one, which was already 25 years old. Some people describe it as one of the most liberal of its kind in Europe even when the rest of the world still think of Spain as a very traditional and catholic country.
With this new piece of legislation, Spanish women will be able to request a free abortion up to week 14/40 without needing any excuses and up to week 22 if there is any risk for their health or their lives, and beyond then if there is serious fetal malformation.
In 2008, there were 115,000 abortions according to the Ministry of Health but since the morning after pill became available without prescription on January 2010, there has been a decrease of 9% in the abortion rate.
This law has been approved after a lot of controversy and against the will of the Spanish Conservative Party (Partido Popular) but there is currently a great campaign against it by doctors themselves and led by the Organización Médica Colegial (which is like a mixture of the BMA and GMC).
The reasons for this fight are twofold. First, the new law makes allowances for doctors and other health workers with issues of conscience to be allowed to refuse taking direct part in an abortion but is leaving all those doctors who might need to be involved in an indirect way without any legal cover. For example, a GP who is approached by a patient requesting an abortion will not have the chance from a legal point of view to object getting involved. The second issue that is creating uneasiness is the situation is with 16 and 17 year old girls who want to abort. These young women do not need parental consent but they have to show that at least one parent or legal tutor is informed and they have to attend the abortion clinic with them. However if the girl can prove that informing her parents could cause her a serious conflict it is the doctor who takes the responsibility.
So, now that I have told you where we are at, I’ll get on with my blogging. My personal opinion about abortion and whether it is right or wrong is somehow unclear, I find myself unable to stand up and say either that I am in favour or I am against it in a blank way and for all cases; I guess I can probably understand some of the women that go for it and I can be very judgemental with others. I don’t think I would ever choose to have an abortion myself but I don’t know how I would react if my daughter ever wants to have one. No black or white there.
However when it comes to my medical opinion, I am very certain of what I think. I want to stick to the most basic principles of medicine, the kind of medical ethics that will allow me to look at myself in the mirror every morning and be comfortable with it. I refuse to be involved in abortions on the principle of primum non nocere, I simply don’t want to cause any harm to any human beings born or unborn. It is upsetting to know that if a woman asks me to refer her for an abortion, I’ll have no choice as the law does not to allow me to be a conscientious objector. I do respect the doctors who agree to it, or the women that go for it, but I never want to take any part on it.
It will be interesting to watch what happens from now on, it is unlikely that any other changes will be introduced so it will be outrageous to watch a doctor being penalised for practising the sort of medicine he or she strongly believes on.