Conscientious Objection and the Duty to Refer

Many thanks to Bernard M. Dickens, Professor Emeritus of Health Law and Policy and Co-Director of the International Reproductive and Sexual Health Law Program at the University of Toronto’s Faculty of Law. His article in the International Journal of Gynecology and Obstetrics is now freely available.

Bernard M. Dickens, “Conscientious Objection and the Duty to Refer,” International Journal of Gynecology and Obstetrics 2021; 155: 556-560. PDF at Wiley Online.  Submitted Text at SSRN.

Abstract: Medical associations and leading courts reinforce the duty of physicians who conscientiously object to participate in treatment indicated for their patients to refer them to non-objecting practitioners. Ethical and legal duties require continuity of care when physicians withdraw from patients’ treatment on grounds of conscience. The duty to refer might affect gynecologists when their patients request, e.g., contraceptive means, sterilization, abortion, medically assisted reproductive procedures or gender reassignment. Legislation and leading law courts, notably the UK Supreme Court and Constitutional Court of Colombia, and professional associations such as the College of Physicians and Surgeons of Ontario,  have clarified the duty to refer. Physicians are expected to cater their individual conscience to their professional ethical and legal duties, favoring their patients’ choices over their personal objections. Physicians can object to “hands-on” conduct of procedures they find objectionable, but cannot deny referral on grounds of complicity in what other care providers do.

Keywords: Conscientious objection; Duty to refer; Freedom of conscience; Professionalism; Referral; Religious objection; Therapeutic continuity.

OTHER RELEVANT RESOURCES:

“The Right to Conscience: An Annotated Bibliography,” by the International Reproductive and Sexual Health Law Program, Faculty of Law, University of Toronto, updated Feb 15, 2021; download Conscience bibliography.

Global Map of Norms regarding Conscientious Objection to Abortion (180 countries) by Agustina Ramón Michel (coordinator) and Dana Repka.(CEDES/REDAAS). Updated December 15, 2022: Conscientious Objection Map online.

Ethical and Legal Issues in Reproductive Health – more than 100 other concise articles are online here.

______________________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – Autumn 2020

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

DEVELOPMENTS
Amnesty International’s new institutional policy on abortion, released Sept 28, 2020, has been endorsed by the International Federation of Gynecologists and Obstetricians (FIGO). Amnesty Abortion Policy.
Press release. Explanatory note. Key messages. FAQ.

[Poland] Constitutional Tribunal ruled that abortion on grounds of congenital fetal defects is unconstitutional. Sygn. akt K 1/20, October 22, 2020. Decision in Polish. News report in English.

[The Philippines] PINSAN (network of NGOs and individuals) released proposed text of a “decriminalization bill” and an international petition to decriminalize abortion in the Philippines, September 28, 2020.
Proposed legislation. International petition. Bill launch on Facebook with Q & A.

SCHOLARSHIP
Access to Abortion: An Annotated Bibliography of Reports and Scholarship. (Toronto: International Reproductive and Sexual Health Law Program, 2020) 44 pages. Abortion access bibliography.

[abortion] “Why self-managed abortion is so much more than a provisional solution for times of pandemic,” by Mariana Prandini Assis & Sara Larrea, Sexual and Reproductive Health Matters, 28:1 (2020) Article online.

[Africa] “Adolescent sexual and reproductive health and universal health coverage: a comparative policy and legal analysis of Ethiopia, Malawi and Zambia,” by Godfrey Kangaude, Ernestina Coast & Tamara Fetters (2020) Sexual and Reproductive Health Matters, 28:2, 1-15. Abstract and article. Policy briefs: Ethiopia brief, Malawi brief. Zambia brief.

[Argentina] “A Case for Legal Abortion: The Human Cost of Barriers to Sexual and Reproductive Rights in Argentina,” (Human Rights Watch, 2020) 77-page report in English. Overview in English. Informe en Espanol.

[Australia] “Advancing Reproductive Rights through Legal Reform: The Example of Abortion Clinic Safe Access Zones,” by Ronli Sifris, Tania Penovic and Caroline Henckels, University of New South Wales Law Journal 43.3 (2020): 1078-1097. Abstract and Article.

[Belgium, Ireland] “Abortion law reform in Europe: The 2018 Belgian and Irish Acts on termination of pregnancy,” by Fien De Meyer – Medical Law International 20.1 (2020): 3-30. Abstract and article.

[India-abortion law] “The MTP 2020 Amendment Bill: anti-rights subjectivity,” by Alka Barua, Anubha Rastogi, V. Deepa, Dipika Jain, Manisha Gupte, and Rupsa Mallik. Sexual and Reproductive Health Matters 28.1 (2020). Commentary online.

[India] “Reimagining Reproductive Rights Jurisprudence in India: Reflections on the Recent Decisions on Privacy and Gender Equality from the Supreme Court of India,” by Dipika Jain and Payal K. Shah, Columbia Journal of Gender and Law 39.2 (2020): 1-53. Abstract and PDF access.

[Mexico] “Bioethics training in reproductive health in Mexico,” by Gustavo Ortiz-Millán and Frances Kissling, International Journal of Gynecology and Obstetrics 151.2 (November, 2020): 308-313  PDF free access for 12 months.  Submitted Text. 

[Nigeria] “The Conflict in Northeast Nigeria’s Impact on the Sexual and Reproductive Rights of Women and Girls.” by Onyema Afulukwe and Chinonye Obianwu (Nairobi: Center for Reproductive Rights and Legal Defence and Assistance Project, 2020) 26 page report.

[Philippines] “Reasons Why We Need to Decriminalize Abortion” by Clara Rita A. Padilla (of EnGendeRights and PINSAN).
Seven reasons op-ed, 22 reasons – full report.

[Surrogacy] “Paid surrogacy abroad does not violate public policy: UK Supreme Court,” by Bernard M. Dickens, International Journal of Gynecology and Obstetrics 150.1 (July 2020): 129-133 PDF- Free Access till July 2021.  Submitted Text.

“Transsexuality:  Legal and Ethical challenges,” by Bernard M. Dickens.  International Journal of Gynecology and Obstetrics 151.1 (October, 2020): 163-167 PDF free access for 12 months.   Submitted Text.

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

JOBS
Links to employers in the field of Reproductive and Sexual Health Law are online here.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – Summer 2020

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

DEVELOPMENTS
[Argentina, abortion, conscience]  Argentina Ministry of Health issued a protocol expanding hospital abortion access to pregnancies resulting from rape. Raped girls 13 and over can have abortions without parental consent. The protocol also weakens a doctor’s ability to refuse to perform such abortions due to personal objection. New York Times, Dec 12, 2019.

[IACtHR, Ecuador], First standards for protection from sexual violence in schools: Paola del Rosario Guzmán Albarracín et al. v. Ecuador, Case C No. 405 (June 24, 2020) Sentencia en espanol – 85 paginas. Public Hearing Jan. 28 2020.  Resolución (Asuntos) 7 paginas. Reprohealthlaw blog summary.
Case comment in English (10 pages).

Ugandan Constitutional Court declares maternal health a constitutional right. First African court to do so. The Center for Health Human Rights and Development (CEHURD) and 3 Others v Attorney General [2020], Constitutional Petition No. 16 of 2011 (Constitutional Court of Uganda at Kampala). [Maternal health] Decision of August 19, 2020. Reprohealthlaw blogpost. Longer comment with the Court’s twelve “Declarations.”

[United Kingdom, surrogacy] Whittington Hospital NHS Trust (Appellant) v. XX (Respondent) [2020] UK Supreme Court 14. (April 1, 2020) allows paid surrogacy, where legal, in foreign countries. Decision (24 pages). Article by Prof. Bernard Dickens.

WEBINARS
“Access to medical abortion: Global South perspectives,”, with Panelists Dr. Shilpa Shroff, Prof. Dipika Jain, Dr. Sana Durvesh, and Moderator, Sai Jyothirmai Racheria. Organizers: SARJAI and SAIGE. Friday, Sept. 4, 2020, 14:30 (GMT+8, Kuala Lumpur time). Register here for Sept 4.

“Telemedicine, self-managed abortion and access to abortion in the context of the Covid-19 pandemic,” chaired by Mariana Romero (Argentina). Speakers: Jade Maina (Kenya), Maria Mercedes Vivas (Colombia), Wendy V. Norman (Canada), Rodica Comendant (Moldova), Jasmine Lovely George (India), Kinga Jelinska (The Netherlands), Marge Berer (United Kingdom), to be held: Wednesday, September 23, 2020 (2:00-3:30 p.m. British Summer Time). Register here for Sept 23.

“Telemedicine / self-managed abortion is critical to strengthening women and girls’ reproductive rights and reducing maternal mortality” FIGO webinar, chaired by Prof. Dame Lesley Regan (FIGO), with speakers: Ambassador Dr. Eunice Brookman-Amissah (Ghana), Marge Berer (UK), Christina Zampas (Switzerland), Nelly Munyasia (Kenya), Evelyn Odhiambo (Kenya). Will be available in English, Spanish and French. To be held Thursday Sept. 24, 2020 at 15:00-16:30 (British Summer Time). Register for Sept 24.

SCHOLARSHIP
“Access to Abortion: An Annotated Bibliography of Reports and Scholarship,” prepared by the International Reproductive and Sexual Health Law Program, Faculty of Law, University of Toronto, 2nd edition, 2020, 44 pages, (organized by country, focuses on barriers and recommendations, ) Annotated bibliography.

[abortion] “Abortion,” thematic chapter in Comparative Human Rights Law, by Sandra Fredman (Oxford UP, Nov. 2018). Institutional access through Oxford Scholarship Online. About the book.

[abortion, Argentina, Ireland, US] “Argentina’s path to Legalizing Abortion:  A comparative analysis of Ireland, the United States and Argentina,” by  Andrea F. Noguera, Southwestern Journal of International Law 25.2 (2019): 356-392.    Article online.

[abortion, Brazil, Argentina, Uruguay ] “Challenges and opportunities for access to legal and safe abortion in Latin America based on the scenarios in Brazil, Argentina, and Uruguay,” by Beatriz Galli – Cadernos de Saúde Pública, 2020 – SciELO Public Health

[abortion, Brazil] Understanding the sexual and reproductive health needs in Brazil’s Zika-affected region: placing women at the center of the discussion,” by D. Diniz, L. Brito, I. Ambrogi, AB Tavares, M. Ali. International of Gynaecology and Obstetrics 2019; 147: 17 Institutional access

[abortion, India] “Reimagining Reproductive Rights Jurisprudence in India: Reflections on the Recent Decisions on Privacy and Gender Equality from the Supreme Court of India,” by Dipika Jain and Payal Shah. Columbia Journal of Gender and Law 39.2(2020), 1-53. Article online.

[abortion law, India] “A Womb of One’s Own: Privacy and Reproductive Rights,” Arijeet Ghosh & Nitika Khaitan (2017) 52:42/43 Economic & Political Weekly, [1-9], re landmark Aug 24, 2017 privacy decision (Puttaswamy) already helped decriminalize homosexuality, adultery–potentially abortion. Article online.

Human Rights Quarterly is freely available online during the COVID-19 pandemic.  All issues.

[obstetric violence] “Operationalizing a Human Rights-Based Approach to Address Mistreatment against Women during Childbirth,” by Christina Zampas, Avni Amin, Lucinda O’Hanlon, Alisha Bjerregaard, Hedieh Mehrtash, Rajat Khosla, and Özge Tunçalp, Health and Human Rights Journal, 22(1) 2020: 251-264 Article online.

[surrogacy] “Paid surrogacy abroad does not violate public policy: UK Supreme Court,” by Bernard M. Dickens, International Journal of Gynecology and Obstetrics 150.1 (2020): 129-133. PDF at Wiley Online.    Abstract and Submitted Text.

[U.S. reproductive decisions] Feminist Judgments: Reproductive Justice Rewritten, ed. Kimberly Mutcherson, Cambridge UP, 2020. Book details.

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

Violence Against Women’s Health in International Law, new book by Sara De Vido, Manchester University Press, 2020. Abstract and Table of Contents.

JOBS
Links to employers in the field of Reproductive and Sexual Health Law are online here.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

UK Supreme Court: Paid surrogacy abroad does not violate public policy

Congratulations to Bernard M. Dickens, Professor Emeritus of Health Law and Policy at the University of Toronto’s Faculty of Law, for commenting on a recent United Kingdom Supreme Court decision in Whittington Hospital NHS Trust v. XX [2020]. His concise analysis is now published in the “Ethical and Legal Issues in Reproductive Health” series of FIGO’s International Journal of Gynecology and Obstetrics, and also online. We are pleased to circulate his abstract:

Bernard M. Dickens, “Paid surrogacy abroad does not violate public policy: UK Supreme Court,” International Journal of Gynecology and Obstetrics 2020; 150: 129–133. PDF at Wiley Online. Submitted Text.

Abstract: In April 2020, the United Kingdom Supreme Court upheld compensation for a woman whose negligent medical care had left her dependent on surrogate motherhood (SM) to have a family, even though SM might be by lawful commercial services in California, USA. Paid SM is criminal in the UK. Altruistic SM arrangements are legal, but unenforceable. The trial judge felt bound by precedent to disallow compensation for lawful commercial SM abroad, as contrary to public policy. The Court of Appeal reversed this ruling, since public policy is not immutable, and had changed. The Supreme Court agreed, acknowledging an evolution in popular attitudes concerning what a family is, and how it might be formed. Government policy was observed to accommodate SM in suitable cases. Movement was perceived towards legislative reform, and judicial recognition of paid SM arrangements abroad that are not exploitative or abusive of surrogates, commissioning parents, or resulting children was considered appropriate.

Keywords: Commercial surrogacy; Law reform; Public policy; Surrogate motherhood; UK law reform; UK Supreme Court; Whittington Hospital case

See also:

Whittington Hospital NHS Trust (Appellant) v. XX (Respondent) [2020] UK Supreme Court 14. (April 1, 2020) Decision (24 pages).

Ethical and Legal Issues in Reproductive Health – 95 concise articles online.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – August 2019

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.

COLLOQUIUM:

Overcoming Barriers to Safe Abortion in the African Region, 16-17 January 2020, at the University of Pretoria’s Centre for Human Rights. Details, funding, topics, and Call for Abstracts

DEVELOPMENTS:

El Salvador – Young woman acquitted of aggravated homicide after miscarriage in 2016. Evelyn Hernandez Cruz was released on appeal, July 10, 2019. News report.

Germany: Higher court overturns doctor’s conviction for “advertising” abortion among other health services, in light of recent legal reform. News report, July 3, 2019.

Kenya – Case of “JMM,” a teenager who died in 2015 after botched illegal abortion.  The High Court of Kenya at Nairobi, Constitutional and Human Rights Division, declared that abortion is permitted for rape victims. It also ruled that the Ministry of Health’s 2014 withdrawal of abortion “Standards and Guidelines” and abortion trainings for healthcare professionals, were arbitrary and unlawful. Federation of Women Lawyers (Fida – Kenya) & 3 others v Attorney General & 2 others; East Africa Center for Law & Justice & 6 others (Interested Party) & Women’s Link Worldwide & 2 others (Amicus Curiae) [2019] eKLR, Petition No. 266 of 2015.   Decision of June 11, 2019.   News report.    Press release by Center for Reproductive Rights.

Northern Ireland – U.K. bill to maintain Northern Ireland’s public services during governmental hiatus includes decriminalized abortion and same-sex marriage. Bill was signed into law July 24, 2019, to take effect October 22, 2019. Time Magazine: “After 158 Years.”

United Kingdom: Court of Appeal upholds legality of a buffer zone around a London abortion clinic.  Dulgheriu and Orthova v. the London Borough for Civil Liberties and The National Council for Civil Liberties [2019] EWCA Civ 1490, Case No: C1/2018/1699 Court of Appeal (Civil Division). (Decision of August 21, 2019)  Report by Safe Abortion.

United Nations, International Law Commission, UN 71st session, A/CN.4/L.935 May 15, 2019, adopted new edition of “Crimes against Humanity” treaty, which “removed the outdated definition of gender … [It] affirmed that the rights of women, LGBTIQ persons, and other marginalized groups are protected in international criminal law, which will have ripple effects across national laws and future legal mechanisms for years to come,” according to Jessica Stern et al. New edition of Treaty.

SCHOLARSHIP:

[abortion law, Brazil] “Why is decriminalization necessary?  by the Anis Bioethical Institute (Brasilia, 2019).  The booklet is now available in English, Spanish and Portuguese : scroll down on this webpage.

[abortion law, Chile ] “Criminalisation under scrutiny: how constitutional courts are changing their narrative by using public health evidence in abortion cases,” by Verónica Undurraga, Sexual and Reproductive Health Matters 2019;27(1) DOI: 10.1080/26410397.2019.1620552 Article and abstract

[abortion law, Mexico] “Motherhood or Punishment: The criminalization of abortion in Mexico.” English 57-page report, 2019, English executive summary. Based on “Maternidad o Castigo:  La criminalización del aborto en Mexico,”  (Mexico, GIRE, 2018)  Informe de 72 paginas. 

[abortion law – United Kingdom] “Female Autonomy, Foetal Personhood and the English Legal Stance on Abortion Practice,” by Sahra Paula Thomet, Queen Mary Law Journal 10 (2019): 27-50. Institutional Access.

[abortion pill – Canada] “To Solve Abortion Pill Prescription Problems, We need to Rethink the Prescription Itself” by Professor Joanna Erdman, Dalhousie Law School, July 17, 2019 Newspaper Comment.

[age-of-marriage, Mali] “A commentary on the African Court’s decision in the case APDF and IHRDA v Republic of Mali: why socio-cultural endemic factors of a society could never support arguments based on force majeure” by Giulia Pecorella,  International Law Blog, January 14, 2019.  Comment online. Decision PDF.

“Gender Equality, Norms, and Health” 5-part series in The Lancet Vol. 393 provides new analysis and insights into the impact of gender inequalities and norms on health, and opportunities to transform them. ArticlesGender Equality Norms and Health series.

“Integrating Gender Perspectives  in Gynaecology and Obstetrics: Engaging Medical Colleges in Maharashtra, India,” by Sangeeta Rege,  Padma Bhate-Deosthali, Pravin Shingare, Srinivas Gadappa, Sonali Deshpande, Nandkishore Gaikwad, and Shailesh Vaidya, International Journal of Gynecology and Obstetrics 146 (2019): 132–138    PDF at Wiley Online.  Submitted text at SSRN.

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

JOBS

Links to employers in the field of Reproductive and Sexual Health Law are online here.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – March 2019

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:

[El Salvador] Supreme Court ordered release of another three women serving 30 years for alleged abortions.  News report, March 7, 2019.   Report from Safe Abortion.

[Germany]  In February 2019, the Bundestag revised the Criminal Code provision that prohibits the so-called “advertising” of abortions. Providers can now publicly announce, e.g. on websites, that they provide abortion care. News report, Feb 21, 2019.

[Isle of Man] In January 2019, the Abortion Reform Act 2019 allows abortion on a woman’s request in the first 14 weeks of pregnancy.  Abortion at 15-23 weeks’ gestation in cases of sexual assault, severe fatal impairment, or risk to the woman’s health.  effective May 2019.  Abortion Reform Act 2019.

Kenyan High Court upholds human and constitutional rights to maternal dignity and reproductive healthcare:   J O O (also known as J M) v Attorney General & 6 others [2018] Petition No 5 of 2014, (High Court of Kenya at Bungoma).  March 22, 2017.  Case summary by Naitore Nyamu.     Court decision.    Legal Grounds III online.

Pakistan Court Orders Implementation of Measures to Address Obstetric Fistula
CRR Press Release.

SCHOLARSHIP:

Mahmoud F. Fathalla, “Abortion and Public Health Ethics,” in: The Oxford Handbook of Public Health Ethics, ed.  Anna C. Mastroianni, Jeffrey P. Kahn, and Nancy E. Kass, Oxford Handbooks Online,  February 2019.  Article online.

[abortion law, Argentina]  “Constitutional Dialogues and Abortion Law Reform in Argentina: What’s Next?” by Paola Bergallo, featured on I-CONnect Blog, Feb. 27, 2019.  Article online.

[abortion law, El Salvador] “Restricted abortion law in El Salvador,” by Anibal Faúndes and  Marina Padilla de Gil, International Journal of Gynecology and Obstetrics 145.1(April 2019):136. doi: 10.1002/ijgo.12759. Epub 2019 Feb 1. Article online.

[abortion law, Scotland] “Challenging Home Abortion in Scotland: Society for the Protection of Unborn Children v Scottish Ministers,” by Robert Brett Taylor and Adelyn L M Wilson, Edinburgh Law Review 23.1 (Jan 2019): 103-110   Introduction online.

[abortion law – telemedicine, Europe]  “Abortion by telemedicine in the European Union,” by Tamara K. Hervey and Sally Sheldon,  International Journal of Gynecology and Obstetrics 145 (2019): 125–128.  Abstract.  PDF at Wiley Online.

[abortion law – travel] Abortion across Borders:  Transnational Travel and Access to Abortion Services,  ed. Christabelle Sethna and Gayle Davis, Johns Hopkins University Press, 2019.  360 pages.  Detailed overview, Author bios, Reviews, and Contents.

[abortion law, United Kingdom]  “UK Abortion Law: Reform Proposals, Private Members’ Bills, Devolution and the Role of the Courts,”  by Robert Brett Taylor and Adelyn L.M. Wilson,  Modern Law Review 82(1) (2019): 71–104.   Abstract and article.

[abortion law, United Kingdom] “The Abortion Act (1967): a biography” by Sally Sheldon , Gayle Davis, Jane O’Neill and Clare Parker,  Legal Studies 39.1 (March 2019): 18-35   Abstract and article.

Conscientious objection and access to abortion in the case CGIL v. Italy, decided by the European Committee of Social Rights, by Sara de Vido,  Hitotsubashi Journal of Law and Politics 47 (2019), pp.45-55.  Abstract and article.

[female circumcision]  “Circumcision, Female,” by Mahmoud F. Fathalla,  Encyclopedia of Global Bioethics, ed. Henk ten Have  (Switzerland: Springer International, 2016)  Abstract and article.   Encyclopedia of Global Bioethics.

[HIV transmission, stigma] “Expert Consensus Statement on the Science of HIV in the Context of Criminal Law” by F. Barré-Sinoussi et al.  Journal of the International AIDS Society  21 (2018): e25161  Expert Consensus Statement.      Overview in JIAS editorial.

JOBS

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

______________
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.

 

 

 

 

Abortion Across Borders: Transnational Travel and Access to Abortion Services

Congratulations to the editors and authors of a new book, Abortion across Borders Transnational Travel and Access to Abortion Services, who examine how restrictive policies force women to move both within and across national borders in order to reach abortion providers, often at great expense, over long distances and with significant safety risks.  Taking historical and contemporary perspectives, contributors examine the situation in regions that include Texas, Prince Edward Island, Ireland, Australia, the United Kingdom, and Eastern Europe.  Throughout the book, they take a feminist intersectional approach to transnational travel and access to abortion services that is sensitive to inequalities of gender, race, and class in reproductive health care. This multidisciplinary volume raises challenging logistical, legal, and ethical questions while exploring the gendered aspects of medical tourism.   To request an examination or review copy,  see online here.  We are pleased to circulate the full Table of Contents:

Christabelle Sethna and Gayle Davis, eds., Abortion across Borders:  Transnational Travel and Access to Abortion Services,  Johns Hopkins University Press, 2019.  360 pages.  Detailed overview, Author bios, Reviews, and Contents.

Table Of Contents

Introduction:
Christabelle Sethna

Part I. Flight Risks

1. Sherri Finkbine Flew to Sweden: Abortion and Disability in the Early 1960s
Lena Lennerhed

2. From Heathrow Airport to Harley Street: The ALRA and the Travel of Nonresident Women for Abortion Services in Britain
Christabelle Sethna

3. The Trans-Tasman Abortion Travel Service: Abortion Services for New Zealand Women in the 1970s
Hayley Brown

Part II. Domestic Transgressions

4. All Aboard the “Abortion Express”: Geographic Variability, Domestic Travel, and the 1967 British Abortion Act
Gayle Davis, Jane O’Neill, Clare Parker, and Sally Sheldon

5. A Double Movement: The Politics of Reproductive Mobility in Ireland
Mary Gilmartin and Sinéad Kennedy

6. Tales of Mobility: Women’s Travel and Abortion Services in a Globalized Australia
Barbara Baird

7. Don’t Mess with Texas: Abortion Policy, Texas Style
Lori A. Brown

8. Trials and Trails: The Emergence of Canada’s Abortion Refugees in Prince Edward Island
Cathrine Chambers, Colleen MacQuarrie, and Jo-Ann MacDonald

Part III. Democratic Transitions

9. Abortion Travel and the Cost of Reproductive Choice in Spain
Agata Ignaciuk

10. “The Import Problem”: The Travels of Our Bodies, Ourselves to Eastern Europe
Anna Bogic

11. Abortion and the Catholic Church in Poland
Ewelina Ciaputa

12.  Beyond the Borders of Brexit: Traveling for Abortion Access to a Post-EU Britain
Niklas Barke

Abortion across Borders:  Transnational Travel and Access to Abortion Services, 

Book Overview, Author bios, Reviews, and Contents.

__________________
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.

CEDAW re Northern Ireland abortion laws: grave and systematic violations of women’s rights

Many thanks to Professors Claire Pierson of the University of Liverpool,  Kathryn McNeilly of Queen’s University Belfast and Fiona Bloomer of Ulster University, founding members of the Reproductive Health Law and Policy Advisory Group, online here, who kindly commented on the results of CEDAW’s inquiry into Northern Ireland’s abortion laws, based on their 9-page Briefing Document:

Reproductive Health Law and Policy Advisory Group,  Briefing Document: Report of the inquiry concerning the United Kingdom of Great Britain and Northern Ireland under article 8 of the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women, April 2018.
Briefing on CEDAW’s Northern Ireland inquiry and UK response – (9 pages).

From the late twentieth century onwards, human rights emerged as a significant tool, drawing attention to reproductive health provision for women. In Northern Ireland, however, it is only recently that human rights have stimulated meaningful discussion on local abortion access. The UN CEDAW Committee has become the latest body to engage rights in this way.

In early 2018, the CEDAW Committee completed an Optional Protocol inquiry into Northern Ireland’s abortion laws. CEDAW’s report, online here, found the United Kingdom in violation of several articles of the Convention through maintenance of a criminal framework permitting abortion in Northern Ireland only in circumstances of threat to life or serious and long-term threat to health. These violations were found to be grave and systematic.

The inquiry was undertaken following a 2010 submission by the Family Planning Association for Northern Ireland (FPA), Alliance for Choice and the Northern Ireland Women’s European Platform (NIWEP). In 2014, the UK submitted written observations on the submission to CEDAW.  These denied that violation of rights had occurred and outlined that legislative change was not envisaged.  Upon reviewing the UK response and material received by the FPA, Alliance for Choice and NIWEP, CEDAW determined the allegations were reliable and assigned two delegates to conduct an inquiry in 2016.

In addition to the impact of the region’s restrictive criminal law on women’s health and equality, the report highlights concerns with wider access to reproductive and sexual health services, including: post-abortion care, harassment at reproductive health clinics, and a lack of adequate sexual health education. It particularly notes the disproportionate impact of restrictive abortion access on rural and poorer women.

The Committee made 13 recommendations, including repeal of the current criminal law (sections 58 and 59 of the Offences against the Person Act 1861) and the creation of legislation to allow for abortion under particular grounds.  The UK Government has issued a response outlining that it does not accept that women in Northern Ireland have been subject to grave and systematic violations of rights under the Convention.

A separate legal challenge to the compatibility of Northern Ireland’s law with domestic human rights commitments is being heard by the UK Supreme Court. Pressure is mounting for the UK to seriously consider the rights implications of abortion law in this region.

RELEVANT LINKS:
CEDAW’s Report, see: Committee on the Elimination  of Discrimination against Women,Report of the inquiry concerning the United Kingdom of Great Britain and Northern Ireland under article 8 of the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women, U.N.  Doc, CEDAW/C/OP.8/GBR/1, February 23, 2018.  CEDAW’s report on abortion law in Northern Ireland, 19 pages

Observations of the Government of the United Kingdom of Great Britain and Northern Ireland on the report of the inquiry concerning United Kingdom of Great Britain and Northern Ireland of the Committee on the Elimination of Discrimination against Women under article 8 of the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women*  United Kingdom response, 7 pages

The Reproductive Health Law and Policy Advisory Group, discussed above, has issued a  a Briefing Document summarizing both the CEDAW report and the UK government’s response 9-page briefing.

“How Laws Fail the Promise of Medical Abortion,” by Patty Skuster

Congratulations to Patty Skuster, Senior Policy Advisor at Ipas and an Adjunct Professor at the University of Pennsylvania’s Center for Public Health Initiatives;  her recently published article is now publicly available through SSRN.  We thank her for abstracting this article for Reprohealthlaw subscribers:

Patty Skuster, “How Laws Fail the Promise of Medical Abortion: A Global Look,” Georgetown Journal of Gender and the Law 18.379, 2017.  Article online at SSRN

Abortion law has not kept pace with abortion practice, namely the rising use of abortion with pills. Evidence is growing that women can safely use misoprostol without the involvement of a healthcare professional. And researchers have attributed abortion with pills outside formal health care settings to a worldwide decrease in abortion mortality.

Meanwhile, abortion law globally and nationally remains rooted in outdated abortion methods that do require a healthcare professional.  Global human rights experts recommend governments decriminalize women who seek abortion to meet human rights treaty obligations and reduce unsafe abortion deaths. However, the vast majority of abortion laws—even recently liberalized ones—still require a health-care professional to perform or approve legal abortion. More recent laws have progressed to allow mid-level providers (instead of medical doctors) to provide legal abortion. But even in liberal settings, women who end their abortion with pills and without a provider face imprisonment.

This article includes a summary of treaty body recommendations on abortion and the right to life and health. While treaty bodies call for governments to change laws to make abortion more accessible, treaty bodies have failed to address the nearly universal criminalization of women’s self-abortion with pills. It offers examples of laws that criminalize women’s self-use: newer laws in Uruguay and Uganda, and Zambia which, like many other former British Colonies, follows the model of the United Kingdom and requires provider involvement.

To make real progress toward upholding women’s rights to health and life, human rights authorities and governments must examine provider involvement requirements in abortion laws. We must work toward laws that permit all women to realize the promise of medical abortion.

Related links:

“Access to safe abortion in Uganda: Leveraging Opportunities through the Harm Reduction Model” by Moses Mulumba, Charles Kiggundu, Jacqueline Nassimbwa and Noor Musisi Nakibuuka, International Journal of Gynecology and Obstetrics 138 (August 2017): 231–236. doi:10.1002/ijgo.12190   PDF at Wiley Online.  Submitted text.

“Updated WHO Guidance on Safe Abortion: Health and Human Rights”   by J.N. Erdman, T.  DePiñeres, and E. Kismödi, International Journal of Gynecology and Obstetrics 120 (2013): 200-203. Article online”

“Applying Human Rights to Improve Access to Reproductive Health Services,” by Dorothy Shaw and Rebecca J. Cook,  International Journal of Gynecology and Obstetrics 119 (2012) S55–S59.  Article online,

Ethical and Legal Issues in Reproductive and Sexual Health – 80+ brief articles

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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 – Nov. 2017

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DEVELOPMENTS

Northern Ireland:  Low-income women seeking free abortions will receive government travel grants. Newspaper

 CONFERENCES

“Abortion in the British Isles, France and North America since 1800,”    International Conference organised by the University of Paris-Sorbonne (research group HDEA, EA 4086), in Paris (France), 6-8 November 2018.  Registration fee  Submit 500-word abstract and short CV by Dec 23, 2017.  Conference details.

SCHOLARSHIP:

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 Press.  Table 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 y  Libreria CIDE.     Índice con resúmenes de capítulos 1-11
Decisiones Judiciales sobre aborto en línea

About Abortion: Terminating Pregnancy in Twenty-First Century America,  by Carol Sanger (Harvard UP, 2017)   Book details

“The Abortion Closet (with a Note on Rules and Standards),” by David Pozen, Columbia Journal of Gender and Law, Vol. 35, pp. 161-166, 2017. draws out some implications of Sanger’s arguments concerning abortion secrecy, abortion discourse, and the use of standards in constitutional abortion law.  Abstract and article

 

[Colombia, conscience]  Criminal Scopes of the Doctor Conscientious Objection in the Cases of Lawful Abortion in Colombia; Alcances penales de la objeción de conciencia del médico en el aborto lícito en Colombia; Âmbitos penales da objeção de consciência em o médico, by Juan Francisco Mendoza Perdomo, IUSTA 2:37 (2012) doctoral research, Summary in Spanish, English and Portuguese

[Europe] “Mandatory Waiting Periods and Biased Abortion Counseling in Central and Eastern Europe by Leah Hoctor and Adriana Lamačkova,  Int J Gynecol Obstet, 139 (2017) : 253–258.  Abstract and article

Global Abortion Policies Database, an open-access repository of abortion laws, policies, standards, and guidelines for 197 countries. Designed to strengthen efforts to eliminate unsafe abortion, the database acknowledges and engages law and policy as a social determinant of safe abortion.   Global Abortion Policies Database.

“The global abortion policies database—legal knowledge as a health intervention,” by Joanna Erdman, November 1, 2017  Opinion piece at BMJ.

 

Legal Grounds III: Reproductive and Sexual Rights in Sub-Saharan African Courts  (Pretoria, Pretoria University Law Press (PULP), 2017), and previous volumes.
Printed edition of Legal Grounds III available from PULP.
Previous volumes PDF online at CRR.
Legal Grounds III, online edition with links to decisions and updates.

[United Kingdom, abortion law] British Journal of Obsetrics and Gynaecology (BJOG)  124:13 (Dec. 2017)
BJOG issue on UK abortion law
—“The emancipation of women’s fertility,” by Michael Marsh, BJOG 124:13 (Dec 2017): 1921-22.
—“Abortion care as a key women’s health service,” Lesley Regan, BJOG 124.13 (Dec 2017): 1922.
—“Effectiveness, safety, and acceptability of first‐trimester medical termination of pregnancy performed by non‐doctor providers: a systematic review,” by S Sjöström, M Dragoman, MS Fønhus, B Ganatra, K Gemzell‐Danielsson, BJOG 124.13 (Dec 2017): 1928–1940
—“Reproductive rights: perspectives from a retired American obstetrician‐gynaecologist,” by Stephen S Entman, BJOG 124:13 (Dec 2017): 1941
—“The 50th Anniversary of the Abortion Act,” by David Paintin, BJOG 124:13 (Dec 2017): 1947.

“End criminal sanctions for abortion,” by Richard Hurley, BMJ 2017;359:j5409. 
Comment at BMJ.

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

JOBS

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.