Monday, January 17

Society. IVG: understand everything with the double conscience clause

The National Assembly on Tuesday approved the extension of the legal deadline for performing a voluntary termination of pregnancy to 14 weeks of pregnancy instead of 12 as part of a bill “aimed at strengthening the right to abortion”. MEPs, on the other hand, refused to remove the conscience clause allowing doctors to refuse to perform an abortion. It was, however, one of the flagship provisions of the text.

How does this conscience clause work? And why is it strongly criticized by defenders of the right to abortion? We will explain everything to you.

What is the conscience clause?

According to the Public Health Code, any doctor or midwife has a conscience clause authorizing them to refuse to provide care to a patient because of their personal or ethical convictions. However, this provision does not apply in the event of a vital emergency.

Why do we speak of a double conscience clause for abortion?

Doctors authorized to perform voluntary terminations of pregnancy have a double conscience clause. This clause specific to abortion was introduced by the Veil law, which legalized abortion in France in 1975. At the time, it was a question of making concessions to parliamentarians who were most reluctant to the right to abortion.

The text stipulates that “a doctor or a midwife is never required to perform a voluntary termination of pregnancy and no midwife, nurse or nurse, or medical assistant is required to participate in it”.

A doctor who invokes his conscience clause does not have to justify himself. On the other hand, he must inform the patient without delay and has the obligation to refer her to another practitioner who agrees to perform abortions.

What other acts benefit from a double conscience clause?

The abortion is not the only medical act affected by a double conscience clause. Since 2011, research on the human embryo and stem cells are also concerned. Doctors authorized to carry out sterilizations for contraception have also benefited, since 2001, from a double conscience clause allowing them to refuse to sterilize a man or a woman who requests it.

Why is this conscience clause so widely criticized?

In fact, the removal of the conscience clause specific to abortion which was provided for by the bill would not have forced doctors to perform abortions. The latter would in fact have remained covered by the general conscience clause. For those opposed to the double conscience clause, its abolition would have above all had a symbolic significance.

“The abolition of the specific clause is not the abolition of the general clause”, pleaded during the debate the co-rapporteur of the text, the socialist Marie-NoĆ«lle Battistel. This clause specific to abortion “only has the effect of stigmatizing” women wishing to have an abortion, said Annie Chapelier (Agir group, ally of the majority).

“We are not taking anything away from anyone (…) The deletion of this specific clause will thus make it possible to change mentalities and strengthen voluntary access to the termination of pregnancy”, declared the rapporteur of the text, Albane Gaillot. , To Why doctor. “Abortion is a care given to women, so it is no longer justified for the law to give it a special place as if the legislator sometimes wanted to make women feel guilty.”

“The double conscience clause specific to abortion stigmatizes this act a lot”, also estimated last September Sarah Durocher, co-president of Family Planning:

In the field, it will be postponed appointments, or the doctor will say at the last moment ‘no, I can’t do it’. But we do not manage to estimate the rate of anti-choice doctors at all, unlike Italy where there are 80% of conscientious objectors … The interest is to remove it, especially since anti-choice people raise awareness among student doctors, nurses, midwives … It is one of their strategies and it works.

What do the defenders of the conscience clause say?

Ethical arguments are also put forward by defenders of the conscience clause. At the end of 2020, the National Consultative Ethics Committee (CCNE), “abortion is a unique medical act which justifies maintaining the specific conscience clause”.

Last year, the National Council of the Order of Physicians also went in this direction, considering for its part removing the conscience clause “will not guarantee unhindered access to abortion”. According to him, it is above all necessary “to ensure, at all points of the territory, the provision for women of material and professional means of care of quality”.

As for the National College of Gynecologists and Obstetricians, it says it fears a suppression that would push gynecologists to turn away from the practice of abortion, or even from the profession. According to him, this would decrease the number of practitioners in France, and would help to lengthen the period of recourse to abortion.

Opponents of the double conscience clause think the opposite. According to them, its elimination would make it possible to conceive of the abortion as an innocuous medical act. It would therefore become, in fact, harder for doctors to refuse. According to them, this would limit the situations of hindrance that can sometimes be observed in certain hospitals or certain departments, sometimes without doctors agreeing to perform voluntary terminations of pregnancy.

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