Conscientious Objection: A Modest Proposal

19 Nov

physician-refusal

What is conscientious objection in medicine? It’s where the law permits doctors, nurses, and pharmacists to refuse to perform lawful services that are part of their specialty without penalty. It is a privilege very few working people enjoy.

Conscientious objection calls to mind courageous soldiers of WWI who refused to kill the enemy on moral grounds. For that, army authorities persecuted them without mercy. They paid a high price for their courage.

Medical conscientious objection is different. It is not a courageous moral stance. Objecting health care providers ARE the persons in authority. It is patients who are forced to make sacrifices for their doctor’s conscience, using their own time, money, and effort. The doctors themselves face no personal disadvantage.

Before 2010 the Medical Council of New Zealand required objectors refer their patients to other doctors who would give them the care they needed. But in 2010 a group of anti-choice doctors in New Zealand tested the limits of conscientious objection by seeking judicial review of the Medical Council’s requirements around abortion referral.[1] The court found that objecting doctors should not be required to refer abortion patients to a doctor who could help them – they only had to inform them that abortion was available elsewhere. The Medical Council considered appealing this decision, then dropped their appeal.

The current situation is unfair to patients. The patients are not doing anything wrong, and yet the law places the burden of their doctors’ conscience on them to navigate the system, and endure humiliation, expense, and delays in receiving care, all without redress.

Why shouldn’t the cost be borne by the person with the objecting conscience? The providers, not the patients, are deviating from the norm in refusing services that would normally be considered part of their job. Only the existence of s 46 of the Contraception, Sterilisation, and Abortion Act 1977 shields them from the consequences of their refusal.

The way the current system apportions the cost of conscience implies patients are doing something wrong by seeking contraception or abortion. Surely our country has moved beyond judging people for having sex.

Some have suggested providers should be compelled to provide the services associated with their specialties, or find another job. But would you REALLY want to get a vasectomy or an abortion from someone who does not want to perform one?

Moreover, compulsion is a blunt instrument that does not take note of nuance among objectors. Some will perform abortions up to the 12th week, some to the 24th week, and others have other idiosyncrasies. Are they all equally culpable?

It would be fairer to require providers to alleviate the harm they have caused. Providers should be required to compensate the patients to whom they deny service. This should take the form of automatic monetary compensation for each instance of refusal, directly to the person who was refused service.

Compensation should take into account efforts the providers make to alleviate the harm they cause. Compensation should be reduced for doctors who refer their patients to a doctor who will provide service. If the provider makes a genuine effort to notify patients and potential patients what services they will or will not provide, compensation should be reduced accordingly.

The purpose of monetary compensation is two-fold. First, it compensates patients for trouble, inconvenience, hurt feelings, and injury to their dignity. Second, it penalises providers who selected specialties they cannot completely honour.

It restores the expectation of reasonable behaviour on the part of health care providers, and defines that behaviour as providing services to patients, rather than passing judgment on them.

[1] Hallagan v Medical Council of NZ HC Wellington CIV-2010-485-222, 2 December 2010.

 

Media Release: Thames Council Urged to Take Action

20 Oct

Nearly a thousand New Zealanders have signed a petition calling for an end to anti-abortion protests outside Thames Hospital, after increasing intimidation of women accessing services there.

The Abortion Law Reform Association of New Zealand (ALRANZ) has submitted a petition to Thames Coromandel District Council, the Police and Waikato District Health Board.

“We’re asking the Council to withdraw permits for Voice for Life, and for ALRANZ too – because we believe that’s only fair,” ALRANZ President Terry Bellamak says.

“Alternatively, we’ve asked for the permitted days to be changed to any day but Friday, which is the only day of the week abortion services are offered at Thames Hospital.

“This would allow protesters their full rights to express their opinion, while allowing patients their rights to be left alone on the street, and access health services without distress and intimidation.”

Voice for Life has staged protests outside the hospital for many years, and the Council permits them to do so as long as they are peaceful and do not intrude on passers-by.

But ALRANZ believes that line has been crossed, with video being released of a Voice for Life protester behaving aggressively towards a pro-choice protester.

Thames Coromandel District Council has so far refused to withdraw Voice for Life’s permit.

“We believe the local community in Thames supports our position, and wants an end to the protests,” Ms Bellamak says.

“Voice for Life are intimidating not only women accessing abortion services, but others attending the hospital, who may have had abortions in the past.

“We hope the Council will consider this option carefully – and whatever its decision, explain it to New Zealanders.”

Dangerous behaviour in Thames

6 Oct

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For several years in Thames, the busybodies from Voice for Life have intruded on the privacy of patients of the Thames Hospital abortion service. Every week, they showed patients of the service how they judged them and found them wanting, by waving gory signs and passing around plastic foeti.

Since August, supporters of women and pregnant people’s right to be left alone when seeking abortion in Thames have counter protested.

On 11 August 2016, Thames Coromandel District Council granted both ALRANZ and VFL permits to hold demonstrations each week. The permits allow holders to “peacefully demonstrate” at the specified time and place, provided the demonstration is at all times “non-violent and non-intrusive”. If those conditions are not met, TCDC has the right to withdraw the permit at any time.

ALRANZ has honoured the conditions of its permit.

In the past few weeks, the protests and counter protests have taken a disturbing turn. A pro-choice protester writes:

Here’s what happened to me 2 weeks ago:

I spent 2 hours standing beside one of the men, who is about 6 foot tall, and much bigger than I am, while he spent most of the 2 hours trying to push me off the footpath onto the road, by consistently leaning his body against mine. I asked him several times to move out of my personal space, he responded by closing his eyes, speaking to Jesus, and leaning harder. I had to be supported by another woman to not fall from the footpath onto the road.

At one point, when I stumbled a little, he moved his foot over to where mine had been and ended up with his leg between mine at the back, still pushing trying to unseat me. He only stopped doing that when one of our people filmed him in action (which we have if you want to see it.) Most of the 2 hours his whole body was pressed firmly against mine, while he either muttered in prayer, talked about how “the worst guards at Auschwitz were the women guards and how cruel women can be” or talked about how he’s talked with “abortionists” who told him how they “rip the arms and the legs off, and then they mush up the torso and sell the body parts to science.”

The following week, another man of their group paraded around in front of us with a little zip lock bag with 4 tiny baby doll heads in it saying “they rip the heads off their babies…..with heads or without heads…”

Follow the LINK to our Facebook page to see the video taken at the tail end of the incident.

The Crimes Act 1961 defines assault as “…the act of intentionally applying or attempting to apply force to the person of another”.

The video evidence shows the VFL protester appears to violate the terms of its demonstration permit. His actions appear to breach the requirements that the protest be non-violent and non-intrusive, and follow all applicable laws.

Allowing VFL’s behaviour to continue or escalate would be a danger to ALRANZ protesters and members of the public.

ALRANZ has written to TCDC, asking them to do their duty and enforce the conditions of VFL’s demonstration permit by withdrawing VFL’s permit. We are waiting to hear from TCDC.

Tribute to Valerie Scott QSM JP 10/8/1928 – 7/9/2016

29 Sep

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by Dame Margaret Sparrow

Valerie Scott (88), journalist, artist, interior decorator, Samaritan, was a long standing member of ALRANZ.

I first met Valerie in 1970 but before that I already knew of her through her regular columns as the “Dulux” lady. I then got to know her much better as a volunteer for the Family Planning Association and as a Director of Samaritans. In her weekly shopping column for the Evening Post, which she compiled for 25 years, she always managed to promote one good cause or another. I will just mention three topics that I shared with her – emergency contraception, abortion and sex education.

In 1972 I was one of the first doctors in New Zealand to prescribe an early method of the “morning-after” pill to prevent an unplanned pregnancy. Valerie appreciated the benefits of this well before many of my medical colleagues did. She introduced me to her long time friend and journalist Cherry Raymond who interviewed me for one of her “Speaking Frankly” articles in the Woman’s Weekly. It was published on 13 November 1972 with the arresting headline “The Morning-After Pill is Not Illegal”. Not used to publicity at that stage of my career I was mortified to see the story advertised not only on the cover of the magazine but also on large billboards!

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Valerie also ensured that those who came her way via Samaritans were given “morning-after” pills when needed. (That was before the name was changed in 1995 to “emergency contraception”.) In a number of cases to save embarrassment and preserve confidentiality she would use her own name and address to meet the legal requirements for a prescription drug. Valerie often laughed that if anyone had audited the records she would have had a lot of explaining to do. Her willingness to do this was in sharp contrast to her very respectable and gracious public image.

In the early 1970s Valerie was equally helpful over abortion an unmentionable topic in polite circles and even among medical colleagues. Through her work in Samaritans she knew of young women who had committed suicide rather than face the stigma of an unplanned pregnancy. Until the Auckland Medical Aid Centre opened in May 1974 women had to travel to Australia for a legal abortion, either to Melbourne or Sydney. Valerie and I decided that instead of being given a number to ring on a scruffy piece of paper women should have the dignity of carrying a letter of referral as in any other case where professional services were sought. Through her Samaritan network Valerie had excellent contacts with the law and police and using them she ascertained that this would be regarded as legitimate. However I was still very apprehensive when I was rung late one evening by a disapproving doctor telling me that one of my letters had been intercepted and was in the hands of the police. Valerie however was reassuring and it was a relief to me that nothing eventuated. We continued to improve our abortion referrals.

For six and a half years Valerie dispensed sensible advice as a panellist on the TV weekday show “Beauty and The Beast” with Selwyn Toogood, (which started in 1976 and ran through to 1985.) In 1982 her experiences as an agony aunt and also her work through Samaritans and Family Planning, led to a six-part series on sex education for parents published in the NZ Times newspaper entitled “What do I tell my daughter?” The articles were very popular and reprinted by the newspaper as a booklet. In 1984 there was a sequel “What do I tell my son?” and in 1985 the two series were published as “What do I tell my children?” Six years later, in 1991 the advice was updated, expanded, illustrated and published as “Telling It: How, when and what to tell your children.” Single and childless, although a favourite aunt of her many nieces and nephews, Valerie was always generous in acknowledging the help of others in preparing these eminently reassuring booklets.

In the New Years Honours 1998 Valerie received the Queen Service Medal for Community Service a tribute to the many years of service to various community groups. As a JP and marriage celebrant she touched many lives. She was a Patron of the Multiple Sclerosis Society and in recent years supported Action on Elder Abuse, an organisation to protect the rights of the elderly. She will be remembered for her compassion for those in need, for her sense of fairness and justice, her dignity and style and permeating all her relationships a delightful sense of humour.

28 September 2016 (International Safe Abortion Day)

TRAPPED Screening

14 Sep

imagesIn honour of International Safe Abortion Day, Wednesday, 28 September 2016, ALRANZ Abortion Rights Aotearoa is screening the award-winning documentary, TRAPPED.

TRAPPED tells the story of how clinics in the states are responding to new abortion restrictions that anti-choice legislators pretend are designed to protect patients from abortion providers, but in fact, exist to make abortion more expensive and harder for patients to access.

New Zealanders who have accessed abortion (that would be one in four people with uteri of childbearing age) are familiar with restrictions that lack any scientific or medical basis, but rather exist solely to make abortion more time-consuming and unpleasant. Restrictions like:

  • requiring the approval of two certifying consultants
  • requiring patients to allege grounds specified in 187A of the Crimes Act to access the procedure, usually that their mental health would be affected, even if they just don’t want to be pregnant
  • requiring patients to get ultrasounds that are not medically indicated, and counselling above and beyond what the patient wants or needs
  • requiring patients to spend weeks running around getting all the necessary bureaucratic approvals, while enduring the physical discomforts of early pregnancy like morning sickness

There is one difference between the situation in the USA and in New Zealand. In the USA these TRAP laws are a new phenomenon. But pregnant New Zealanders have been dealing with the same pointless restrictions, and getting the same pointless runaround, for almost 40 years.

Back when the Contraception, Sterilisation and Abortion Act was passed, Parliament was openly trying to discourage abortion, giving patients as little control and freedom as they could get away with while still providing an alternative to unsafe, illegal abortion. Now, most people have worked out that it is not the government’s place to force people to bear children they don’t want.

When will Parliament come to the same conclusion?

 

Join us at the Lighthouse Cinema in Wellington at 6pm for TRAPPED, and stay for an informal panel discussion afterwards. If you live outside Wellington and you are interested in seeing TRAPPED in your town, contact ALRANZ Abortion Rights Aotearoa at info@alranz.org.

0800 ABORTION Service Closes

14 Sep

The 0800 ABORTION service has closed due to lacking of funding. This is a great loss and a sad day for New Zealanders who believe people own their own bodies, and ought to be able to decide what happens to those bodies.

The 0800 ABORTION service helped pregnant people navigate New Zealand’s arcane, overly-complicated abortion bureaucracy. For a while, desperate people with unwanted pregnancies could talk to a person who could give them medical information based on scientific fact, and solid logistical information to help them through New Zealand’s Rube Goldberg abortion system. The service would help pregnant patients set up the many appointments needed to get all the bureaucratic boxes ticked, and help make sure they did not jeopardise their chance to get their lives back to normal by leaving anything out.

The service ended up a victim, both of its own success, and of government’s failure.

Nurses had to spend more time than expected with patients, sorting out the complicated logistics required. In the end, there was more need than the service could fulfil.

Having created this complicated maze of an abortion provision system and perpetuated it through 40 years of neglect, government should have recognised the need for a service like this. Failing that, when such a service was actually created and doing good work for the pregnant people of Aotearoa, government should have recognised its usefulness and funded it through the health service.

Instead, pregnant people continue to be ignored by both the government and the opposition.

On abortion stigma, and Thames

16 Aug

by Terry Bellamak

 

Last weekend Stuff published an excellent article on abortion stigma. If you haven’t read Michelle Duff’s piece yet, go read it – very insightful and full of good historical information.

It’s also timely, coming a week after pro-choice locals and ALRANZ supporters in Thames took back the corner near the hospital where for years radical anti-choice busybodies have been harassing patients accessing the Thames abortion service. The Thames community had grown used to gritting their teeth and pretending not to see them. They seemed relieved to see us on the corner instead.

A study from 2013 showed how effective anti-choice protesters outside clinics are at getting patients to change their minds about abortion: not effective at all. It showed patients may have found the protesters upsetting, but patients’ reasons for getting an abortion were so compelling that nothing the protesters said could have changed their minds. Some anti-choicers acknowledge this fact themselves.

Another study from 2015 shows patients trying to access abortion find protesters intrusive and intimidating even when they stand silently. It isn’t hard to see why. Most people who access abortion in Aotearoa New Zealand have been raised as women in Western culture, so they are all too familiar with street harassment. How did you feel the last time you walked by the local dairy and the guys on the corner silently watched you walk on by? Did you feel judged? Annoyed? Threatened? How is it any different if they are older and carrying gory signs?

I find it impossible to credit the idea that the anti-choice busybodies with gory signs aren’t fully aware that their presence makes patients feel unsafe. That’s why they are there. Their presence, their judgmental silence, their scaremongering signs, may be the only punishment a patient having an abortion ever experiences.

Punishing women for behaving like the sexual beings they are is crucial to the perpetuation of abortion stigma. Abortion stigma, the vague sense that someone getting an abortion is doing something wrong, is the only weapon in the anti-choicers’ arsenal. Apart from real weapons, of course. Once you reject abortion stigma, there is no viable argument against abortion.

Abortion stigma keeps women silent about their abortions, but more and more women are owning their choices without fear. As time goes on, the circle of people unafraid to talk about their abortions grows, and the reach of abortion stigma shrinks.

Anti-choicers can never let go of abortion stigma. It’s all they’ve got.

Media Release: Thames Takes Action

5 Aug

MEDIA RELEASE

5 August 2016

Thames Community Takes Action Against Abortion Harassment

A community meeting in Thames on anti-abortion harassment was followed on Friday morning by a peaceful demonstration in support of Thames hospital abortion patients.

More than 40 people attended the Thursday night meeting to discuss the on-going harassment of abortion patients  in Thames, and resolved to take action to counter the anti-choice protests.

Speakers included Jan Logie, Green MP, who told the meeting of the need to decriminalise abortion, which is still regulated as a crime. Ms. Logie said the criminalised law reinforced abortion stigma, which anti-choice protesters appeal to with their actions.

“Both the current law and the anti-abortion protests are based on a lack of trust for women,” Ms. Logie said. 

ALRANZ President, Terry Bellamak, also spoke at the meeting, saying “women experience harassment as intrusive and intimidating, even if protesters are silent.”  She said that anti-abortion harassment is another form of the street harassment all women experience. 

Rachel Harrison a longtime sexual violence prevention worker in Thames made links between the abuse and control of women at the hands of violent partners and what women feel when they pass anti-abortion protests. “Both are about trying to control women,” she said.

IMG_1220Scott Summerfield, an ALRANZ member and local organiser, said it was really positive that the Thames community, which has looked at the harassment and intimidation for so many years, has decided to take action towards supporting women in Thames and informing the community about the challenges facing women seeking abortion services in New Zealand.

Anti-abortion protesters gather outside Thames Hospital every Friday when abortion services take place. Because the Bay of Plenty District Health Board does not provide a surgical abortion service, many Bay of Plenty women must travel to Thames for care, along with women from Waikato DHB.

Last year, 180 abortions were performed in Thames out of a national total of 13,155. Waikato District Health Board says it has received complaints that the protests are distressing to patients and their families, but pro-choice advocates say little action has been taken and the protests continue.

The meeting resolved to continue with on-going action to ensure Thames is a safe place for women needing abortion care.

For more information: info@alranz.org

This links to a flier for the event, with some Facts and Figures about abortion in Aotearoa and the Thames service.

And here’s some media coverage by Stuff and NewsHub.

ENDS

Dispatches From the U.S.: Fear, Loathing, Racism & Violence

15 Jul

Fear, loathing, racism and violence in the US

Morgan-with-pounamu-pendant_WebThis is the 11th in the blog series by Morgan Healey, immediate past President of ALRANZ, who has recently returned to the US. It aims to bring to life the uniquely absurd state of reproductive rights and justice in the US.

It has been another brutal, violent week in the US — the vicious police killings of Alton Sterling and Philando Castile followed by the mass shooting in Dallas, Texas. I have read the stories and heard the calls for more and better gun restrictions, the need to end racial police profiling and killings, and the need for criminal justice reform. And to all of that, I say yes — quickly before more blood is shed.

Perhaps it is because I have never owned a gun, never handled one and never wanted to that I do not understand, nor support a reading of the Second Amendment that asserts it as a right. I have lived in countries with histories of colonization, war, and violence, which in many ways mirror the pain and suffering, the segregation, and the loss of cultural and spiritual identity seen in the US. But in those contexts, police do not as a rule carry guns, gun violence happens but it is rare, and mass shootings do not dominate the evening news. That does not mean that racism has ceased to exist, or high rates of mass incarceration do not disproportionately affect non-white people. Statistics highlight the extent of racial inequality in both the US and New Zealand. However, racism in New Zealand does not appear to lead to dead brown bodies in the streets, gunned down by the people who are supposed to protect society from harm.

Why?

Why are the two so inextricably linked in the US?

Unfortunately, I do not have the answer.

But I will say that to my mind gun violence and racism will never be solved unless we understand them as interconnected, two sides of the same coin. We are a nation born of violence and bloodshed, built on the inhumane enslavement of non-white bodies. And yet we assert this has little import in modern society. Instead our national creation myth has always focused on throwing off the chains of British colonization, never the trail of tears it left in its wake. Even the liberal philosophies and tenets that we triumph, like life, liberty and the pursuit of happiness, are flawed. Designed and perfected with white, male, property-owning bodies in mind, they remain the reserve of white, heterosexual, economically well-off, cisgender men. So while we hold dear the ability to own and ‘defend’ one’s body and home, we simultaneously and systematically deny safety and autonomy to certain bodies. A black person holding a gun is understood as a threat, a white person holding a gun is a token of liberty. We are a nation of contradictions and inequalities.

Continue reading

Media Release: Right Decision on Under-16s Petition

10 Jul

Abortion Law Reform Association of New Zealand

MEDIA RELEASE

 7 July 2016

MPs MAKE THE RIGHT DECISION: UNDER 16s WON’T BE FORCED TO TELL PARENTS ABOUT ABORTIONS 

Young people in New Zealand will not be obliged to tell their parents if they are having an abortion – and the Abortion Law Reform Association of New Zealand says that’s the right decision. 

The Justice and Electoral Select Committee considered a petition from Hillary Kieft, who asked for mandatory parental notification for people under 16 seeking abortions. (The committee’s report is available here.)

MPs considered a range of submissions and chose to focus on the needs of young people confronting an unwanted pregnancy.

“We are relieved the year-long, drawn-out process the Select Committee has engaged in has resulted in a decision that does not punish the most vulnerable teens,” ALRANZ president Terry Bellamak says.

“Any young person having an abortion should ideally have the full support of their parents – but in some cases, that can put them at risk.

“Mandatory reporting would increase the fear and stress on young people who are already in a vulnerable position.”

The committee noted the current presumption that health agencies will make the information available to parents, unless the young person asks them not to do so.

They also noted that only about 60 abortions a year are performed on people under 16 – and of those, fewer than 10 choose not to tell their parents.

“It is important to make sure support is available to these young people, and we welcome the Committee’s recommendations around offering counselling, strengthening oversight and guidelines,” Ms Bellamak says.

“We agree there is a need for best-practice guidelines to be drawn up, and that young people who choose not to inform their parents should be treated with special care.

“But we also believe those best-practice guidelines should be prepared for all people seeking abortions, because New Zealand’s abortion laws are still outdated and treat abortion as a crime – not a health issue.”

For more information, contact:

 info@alranz.org

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