Abortion by telemedicine in the European Union

March 15, 2019

Congratulations and thanks to Professors Tamara K. Hervey and Sally Sheldon, whose concise article in the International Journal of Gynecology and Obstetrics suggests that, where offered by accredited doctors within the EU, telemedical early medical abortion services are potentially protected by EU free movement laws.      Tamara K. Hervey teaches European Union Law at the University of Sheffield’s School of Law, and Sally Sheldon teaches at Kent University.  We are pleased to circulate the abstract.

Tamara K. Hervey and Sally Sheldon, “Abortion by telemedicine in the European Union,” by International Journal of Gynecology and Obstetrics 145 (2019): 125–128.   PDF at Wiley Online.   Submitted text online.

This paper analyses an important set of legal issues raised by the telemedical provision of abortion pills. Focusing on the case of European Union (EU) law, it suggests that a properly accredited doctor seeking to treat a patient with abortion pills is entitled, in principle, to rely on EU rules of free movement to protect their access to patients in other member states, and women facing unwanted pregnancies likewise have legal rights to access the services thus offered. EU countries seeking to claim an exception to those rules on the basis of public health or the protection of a fundamental public policy interest (here, the protection of fetal life) will face significant barriers.

Keywords: Abortion pills;  Early medical abortion; European Union; EU law; Free movement of services; Mifepristone; Misoprostol; Telemedicine; Trade Law.

Full text of this IJGO article, with access to PDF, is online here.
Submitted text is online here.

RELATED RESOURCES.

90 concise IJGO articles on “Ethical and Legal Issues in Reproductive Healthare online here.  They include:  “Legal and Ethical Issues in Telemedicine and Robotics” by B.M. Dickens and R. J. Cook, International Journal of Gynecology and Obstetrics 94 (2006):73-78.
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Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca    For Program publications and resources, see our website, online here. TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.

Europe: Women’s sexual and reproductive health and rights

January 14, 2019

Congratulations to the Council of Europe’s Commissioner for Human Rights, whose recent Issue Paper contributes to debate and reflection on this important topic:

Women’s sexual and reproductive health and rights in Europe (France: Council of Europe, Dec. 2017).  78-page Issue Paper.

This Issue Paper was prepared by reproductive rights experts Leah Hoctor, Adriana Lamačková and Katrine Thomasen, with assistance from Jessica Boulet, from the Europe Program at the Center for Reproductive Rights.  We are pleased to cite these paragraphs from its 3-page summary and the Table of Contents below:

Excerpt from Summary: Despite considerable progress, women in Europe continue to face widespread denials and infringements of their sexual and reproductive health and rights.  Laws, policies and practices still curtail and undermine women’s sexual and reproductive health, autonomy, dignity, and decision-making and pervasive gender inequality continues to have profound effects on their sexual and reproductive health and rights.  Moreover, in recent years, resurgent threats to these rights have emerged, jeopardising longstanding commitments to gender equality and women’s rights.

This Issue Paper addresses these concerns against the backdrop of the human rights obligations of Council of Europe member states, as enshrined in international and European human rights instruments and as elaborated and interpreted by human rights
mechanisms. It provides an overview of states’ obligations in the field of women’s sexual and reproductive health and rights with a particular focus on comprehensive sexuality education; modern contraception; safe and legal abortion care and quality maternal health care.

Table of Contents:
Summary
The Commissioner’s Recommendations
Introduction
SECTION 1 – Women’s sexual and reproductive health and rights in EuropeConcerns, Challenges, and Deficits
1.1   Retrogression and backlash
1.2   Harmful gender stereotypes, social norms and stigma
1.3   Lack of comprehensive sexuality education
1.4   Deficits in health systems, data collection and financing
1.5   Barriers in access to modern contraception
1.6   Restrictions on access to safe and legal abortion
1.7   Concerns in the field of maternal health care
1.8   Intersectional discrimination
1.9    Shortcomings regarding effective remedies and access to justice
SECTION 2 – International Human Rights standards and women’s sexual and reproductive health and rights
2.1   The right to health, including sexual and reproductive health
2.2   The right to life
2.3   The right to freedom from torture and ill-treatment
2.4   The right to privacy
2.5   Gender equality and freedom from discrimination

SECTION 3 – Specific obligations to ensure women’s sexual and reproductive health and rights
3.1    Guaranteeing the provision of evidence-based information
and comprehensive sexuality education
3.2    Securing the availability and affordability of modern contraceptive services
3.3    Ensuring access to safe and legal abortion services
3.4    Safeguarding access to health care in light of refusals of care
3.5    Respecting women’s rights in childbirth and guaranteeing access
to quality maternal health care
Bibliography and Endnotes

This 78-page Issue Paper, Women’s sexual and reproductive health and rights in Europe  is online here.

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Compiled by
the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca For Program publications and resources, see our website, online here. TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.


Germany: Criminal prohibition of abortion “advertising” restricts information provision

May 31, 2018

Many thanks to Stephanie Schlitt, a consultant researcher with the World Health Organisation’s Global Abortion Policies Database (online here), for commenting about current legal debates in Germany.

In November 2017, general practitioner Dr Kristina Hänel was sentenced under Section 219a of the German Penal Code to pay a fine of 6000 for stating on her office website that she provides abortion services.  Her conviction (against which she is appealing), and cases of other physicians, have prompted a debate on the repeal or reform of Section 219a, one of several remaining Nazi era Penal Code articles.  Entitled “advertisement for termination of pregnancy”, §219a criminalises those who “for material gain or in a grossly inappropriate manner” offer abortion services, irrespective of whether the abortion provided is within the scope of the law.  In Germany, abortion is a crime which is not punishable if undertaken after mandatory conflict pregnancy counselling within twelve weeks of gestation and for specified indications at later stages.  There is no general prohibition against physicians’ websites stating the services they provide.

Those who wish to repeal §219a argue that it stigmatises abortion, violates women’s rights of access to information about a medical procedure which they have decided or may decide to undergo and unjustifiably exposes physicians to criminal prosecution for providing factual information.  Advertisement by physicians can be regulated adequately by laws on the practice of medicine.  Opponents of repeal argue that §219a is a necessary part of the state’s protection of prenatal life, relying on Constitutional Court statements that abortion must not be “normalised” or “commercialised” and therefore should not be treated like other medical procedures.  They say that information about physicians offering abortions could be published online by all state-level Ministries of Health.

The pro-repeal Social Democrat Party is calling for a free parliamentary vote, unless it can reach a law reform agreement with its anti-repeal Christian Democratic partners in Germany’s coalition government by summer of 2018.   . . .  Read more detailed comment.
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Note:  Reprohealthlaw readers who know about relevant legal provisions and law reform discussions in other countries are encouraged to contact the author {stephanieschlitt*at*hotmail .com} who can share such information with German advocates.

See also: 
“German doctor fined for illegally ‘advertising’ abortions”  News article.

Section 219a of the German criminal code available in German. 

UPDATE: Feb. 6, 2019

Germany’s cabinet approves revision to Nazi-era abortion law banning doctor advertising  News article, Feb 6, 2019

 


Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca For Program publications and resources, see our website, online here. TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.


REPROHEALTHLAW Updates – Jan. 2018

January 31, 2018

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates monthly by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

LEGAL DEVELOPMENTS
Africa:  Madagascar – New Family Planning Act enacted Jan. 18, 2018 sweeps away the old colonial-era policy that prohibited any promotion of contraception, and recognizes reproductive health and family planning as basic human rights says Family Planning 2020.   However, planned inclusion of therapeutic abortion “sabotaged” at Senate level.   Summary by Safe Abortion.   News report in French.

 

SCHOLARSHIP:

Abortion by telemedicine in Northern Ireland: patient and professional rights across borders, by Tamara Hervey and Sally Sheldon. Northern Ireland Legal Quarterly (2017) 68.1: 1-33    Article online

[abortion law, conscientious objection, Chile]   “A critical review of conscientious objection and decriminalisation of abortion in Chile,” by Adela Montero and Raúl Villarroel,  Journal of Medical Ethics, preview online Jan. 6, 2018 

[abortion law in Sweden, Norway and Finland]  Dropping the ball or holding the line? Challenges to abortion laws in the Nordic countries, Heli Askola (Faculty of Law, Monash University)  Women’s Studies International Forum 66 (Jan-Feb 2018): 25-32.
Institutional access

[abortion Law, Uruguay]  Legal barriers to access abortion services through a human rights lens: the Uruguayan experience,” by Lucía Berro Pizzarossa, Reproductive Health Matters 26.52 (2018): preview online Jan. 17, 2018

Abortion Law in Transnational Perspective: Cases and Controversies, ed. Rebecca J. Cook, Joanna N. Erdman and Bernard M. Dickens (University of Pennsylvania Press, 2014), now also in Spanish (see next entry) and in paperback, 20% discount code PH70.  English editionTable of Contents with chapter summaries. 
Abortion Decisions Online
El aborto en el derecho transnacional: casos y controversias,  ed. Rebecca J. Cook, Joanna N. Erdman y Bernard M. Dickens (Mexico: FCE/CIDE, 2016)   En espanol, 2016: Fondo de Cultura Económica Libreria CIDE.   Índice con resúmenes de capítulos 1-16
Decisiones Judiciales sobre aborto en línea

[Africa] Legal Grounds III: Reproductive and Sexual Rights in Sub-Saharan African Courts  (Pretoria, Pretoria University Law Press (PULP), 2017).  PDF 228 page bookPrevious volumes PDF online at CRR.      Printed edition from PULP.
Online edition with links to decisions and updates.

FIGO Bioethics Curriculum:  Introduction to Principles and Practice of Bioethics: Case Studies in Women’s Health.  Table of Contents and List of Case Studies    Curriculum in EnglishCurriculum in Spanish    Ahora en Español!

“Freedom of conscience in Europe?  An analysis of three cases of midwives with conscientious objection to abortion,” by Valerie Fleming, Beate Ramsayer, Teja Škodič Zakšek, Journal of Medical Ethics (2018) 44: 104-108  Article online.

Portuguese edition online: Reproductive Health and Human Rights:  Integrating Medicine, Ethics and Law, (Oxford University Press, 2003)  English  (Oxford Scholarship Online)  en Francais    en Portugues, 602 pages\Spanish / Español    Case Studies in Arabic

US-focused news, resources, and legal developments are available on Repro Rights Prof Blog.   View or subscribe.


NEWS:

New “Framework Convention on Global Health Alliance aims to facilitate a coordinated global treaty for the Right to “the highest attainable level of health.”  For an overview, see: “Turning the Right to Health into the Lived Reality for Everyone” by Dr. Martin Hevia (Founding Chair):  Overview online.

Canada:  Court dismisses anti-abortion group’s injunction request about refusal of Canada Summer Jobs funding.  News report.

Germany:  Doctor fined 6000 euros for illegally “advertising” abortions, having listed “abortion” among other medical specialties on her website.   It is illegal to advertise abortion services in a way that is to one’s own economic advantage.  News articleSection 219a of the German criminal code, in German.     See new comment by Stephanie Schlitt, “Criminal prohibition of abortion “advertising” restricts information provision,” Brief comment.     Detailed comment.

Ireland:  Government announces referendum on the 8th Amendment of the Constitution which limits abortion access, following recommendations of the Joint Committee of the Irish Parliament (the Oireachtas).  Jan. 30, 2018 newsComment by Christina Zampas.
Comment by Mercedes Cavallo.

JOBS

Links to employers in the field of Reproductive and Sexual Health Law are online here

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Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca For Program publications and resources, see our website, online here. TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.


REPROHEALTHLAW Updates – Dec. 2017

December 20, 2017

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates monthly by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS

Bolivia:   decriminalized abortion within 8 weeks of pregnancy for “students, adolescents, or girls” presumably under 18 years old.  National Assembly vote was December 6, 2017.  President will sign.  Press release from Ipas Bolivia.

Ireland:  After months of hearings, special parliamentary committee voted to recommend repealing the controversial “eighth amendment” to the Irish constitution which protects “the right to life of the unborn.”  Referendum promised in early summer 2018.  BBC Report.
See also: Christina Zampas, presentation on Ireland’s international human rights obligations: Video (see 2:27-2:45)  Transcript Oct 4, 2017.  Comment by Christina Zampas.

CALL FOR PAPERS

on Reproductive Health in Latin America (Ethical and Legal Issues welcome), for publication in the International Journal of Gynecology and Obstetics (IJGO): Re: the XXII FIGO World Congress of Gynecology and Obstetrics in Rio de Janeiro in October 2018.  Submit by February 28, 2018 for peer review. IJGO guidelines and call for papers on Latin America

Audre Rapoport Prize for Scholarship on Gender and Human Rights is awarded annually to the winner of an interdisciplinary writing competition on international human rights and gender.   $1000 prize honors the work of Audre Rapoport (1923-2016), who advocated for women in the United States and internationally, particularly on issues of reproductive health.  University students eligible.  Submit by July 1, 2018.
Details and papers by past winners online

SCHOLARSHIP:

[Europe]  Council of Europe Commissioner for Human Rights, Women’s Sexual and Reproductive Health and Rights in Europe (France: Council of Europe, Dec 2017), prepared by Leah Hoctor, Adriana Lamačková and Katrine Thomasen, with assistance from Jessica
Boulet, from the Europe Program at the Center for Reproductive Rights.
Overview, Summary and 78-page Issue Paper.

[Slovakia – Discrimination against Roma women in reproductive healthcare]:
Vakeras Zorales – Speaking Out: Roma Women’s Experiences in Reproductive Health Care in Slovakia, by the Center for Reproductive Rights and the [Slovak] Center for Civil and Human Rights (Poradna)  Report online.  Overview.   44-page Report

Abortion Law in Transnational Perspective: Cases and Controversies, ed. Rebecca J. Cook, Joanna N. Erdman and Bernard M. Dickens (University of Pennsylvania Press, 2014), now also in Spanish (see next entry) and in paperback, 20% discount code PH70.  English edition from U Penn PressTable of Contents with chapter summaries. 
Abortion Decisions Online

El aborto en el derecho transnacional: casos y controversias,  ed. Rebecca J. Cook, Joanna N. Erdman y Bernard M. Dickens (Mexico: FCE/CIDE, 2016)   En espanol, 2016: Fondo de Cultura Económica Libreria CIDE.     Índice con resúmenes de capítulos 1-16
Decisiones Judiciales sobre aborto en línea

[Africa] Legal Grounds III: Reproductive and Sexual Rights in Sub-Saharan African Courts  (Pretoria, Pretoria University Law Press (PULP), 2017).  PDF 228 page bookPrevious volumes PDF online at CRR.      Printed edition from PULP.
Online edition with links to decisions and updates.

US-focused news, resources, and legal developments are available on Repro Rights Prof Blog.   View or subscribe.


JOBS

Jobs and Fellowships Women’s Rights and Reproductive Health, in Malawi, Rwanda, Uganda and Zambia.  Global Health Corps.  Apply by Jan 17, 2018  for the 2018-2019 fellowships Details online.

Reproductive Health Matters.  Director and Editor-in-Chief.  2-year renewable contract.   Apply by Jan 8, 2018.  RHM Director and Editor Position details.

Links to other employers in the field of Reproductive and Sexual Health Law are online here

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Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca For Program publications and resources, see our website, online here. TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.


Mandatory Waiting Periods and Biased Abortion Counseling in Central and Eastern Europe

November 30, 2017

Congratulations to Leah Hoctor and Adriana Lamačková of the Centre for Reproductive Rights, whose article has just been published in the Ethical and Legal Issues section of the International Journal of Gynecology and Obstetrics.  The article addresses the recent retrogressive introduction of mandatory waiting periods and biased counseling and information requirements prior to abortion in Central and Eastern Europe.

Leah Hoctor and Adriana Lamačková,  Mandatory Waiting Periods and Biased Abortion Counseling in Central and Eastern Europe (2017). International Journal of Gynecology and Obstetrics, 139 (Nov. 2017): 253–258. 
PDF at Wiley Online Library.    Submitted text online at SSRN.

A number of Central and Eastern European countries have recently enacted retrogressive laws and policies introducing new pre-conditions that women must fulfill before they can obtain legal abortion services. Mandatory waiting periods and biased counseling and information requirements are particularly common examples of these new prerequisites. This article considers these requirements in light of international human rights standards and public health guidelines, and outlines the manner in which, by imposing regressive barriers on women’s access to legal abortion services, these new laws and policies undermine women’s health and well-being, fail to respect women’s human rights, and reinforce harmful gender stereotypes and abortion stigma.

Key words: Abortion; Abortion counseling; Central and Eastern Europe; Discrimination; Human rights; Informed consent; Waiting periods

The published article is online in PDF at Wiley Library.
Full text, as submitted, is online at SSRN.
Ethical and Legal Issues in Reproductive Health: 80 other concise articles.


Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca For Program publications and resources, see our website, online here. TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.


Eslovaquia: “Los derechos de las mujeres en las sentencias sobre aborto” por Adriana Lamačková

August 31, 2017
[For Abstracts of original English edition, click here]

El aborto en el derecho transnacional: Casos y controversias fue publicado en agosto de 2016 por el Fondo de Cultura Económica y el Centro de Investigación y Docencia Económicas.  Los primeros cinco capitulos  exploran “Valores Constitucionales y Regímenes Normativos” ilustrando como las cortes constitucionales europeas abandonaron la presunción de que los derechos de las mujeres están en conflicto con el feto. El capitulo de Reva Siegel “La constitucionalización del aborto” (resumen aqui) provee un panorama de esta tendencia, seguido por dos capítulos de países específicos. A continuación se encuentra el resumen del segundo de ellos.

Adriana Lamačková   “Los derechos de las mujeres en las sentencias sobre aborto del Tribunal Constitucional de Eslovaquia, Capítulo 3 en El aborto en el derecho transnacional: Casos y controversias, editoras/es  Rebecca J. Cook, Joanna N. Erdman, y Bernard M. Dickens (FCE/CIDE, 2016) págs. 82-106. Ahora disponible en español  y en inglés.

En 2007, el Tribunal Constitucional de la República Eslovaca falló que el aborto a petición de la mujer esta en consonancia con la obligación constitucional de proteger la vida humana por nacer.1 La cuestión de la compatibilidad entre una ley de aborto liberal y el derecho a la vida no es nuevo en el derecho constitucional europeo. Una vez terminado el socialismo de Estado, los tribunales constitucionales de Europa Central, incluidas Alemania, Hungría y Polonia, cuestionaron y respondieron esta cuestión.2 Sin embargo, el tribunal eslovaco es el único de la región que validó el aborto a petición haciendo referencia a ambas obligaciones del Estado, tanto de proteger la vida humana por nacer como de respetar el derecho de las mujeres a la autodeterminación reproductiva. Validando nuevamente la congruencia del régimen de consejería con el derecho a la vida del feto, esta sentencia es especialmente significativa en la región puesto que no considera la protección de la vida del feto como el único, o incluso el principal, derecho en las normativas constitucionales sobre el aborto. El derecho de las mujeres a la autodeterminación reproductiva goza de la misma posición plena y equitativa en el orden constitucional. Lamaĉková atribuye este cambio jurisprudencial a que la corte utiliza el equilibrio como marco analítico, según el cual se validan diversos derechos y principios constitucionales, sin que ninguno de ellos anule por completo a los otros, favoreciendo la concesión en vez de la regulación absoluta.  La sección final del capitulo describe brevemente el desarrollo legislativo posterior al fallo, los cambios en el discurso y los argumentos antiaborto relacionados con el fallo en el contexto eslovaco.

El tercer capitulo de El aborto en el derecho transnacional: Casos y controversias ilustra como los valores constitucionales pueden usarse para reformas las leyes de aborto en el mundo. El fallo del tribunal eslovaco, al conceder pleno reconocimiento y efectividad a los derechos de las mujeres, refleja un cambio fundamental en la regulación constitucional europea del aborto, también explorado en capítulos anteriores como “La constitucionalización del aborto,” por Reva Siegel, y “El aborto en Portugal: Nuevas tendencias en el constitucionalismo europeo” por Ruth Rubio-Marín.

El aborto en el derecho transnacional: casos y controversias es disponible en español    en inglés   y dos capítulos en portugués: Capítulo 2.    Capítulo 4
Descargar: Reseña del libro en Andamios, por Diego Garcia Ricci      
Introducción y Prólogo.
Índice con resúmenes de otros capítulos

Tabla de Casos/Jurisprudencia en línea con enlaces a muchas de las decisiones judiciales
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