Court to rule on midwives who refuse abortions

Southern General Hospital. Picture: John Devlin

A health authority in Scotland is appealing at the Supreme Court in London against a decision of the Court of Session in Edinburgh last year in the case of Mary Doogan and Connie Wood, who are conscientious objectors to the process.The challenge before five justices centres on the scope of the right to conscientious objection under the Abortion Act 1967, which provides that “no person shall be under any duty ... to participate in any treatment authorised by this Act to which he has a conscientious objection”.

The issue to be decided by Lady Hale, Lord Wilson, Lord Reed, Lord Hughes and Lord Hodge is whether the women’s entitlement to conscientious objection includes the entitlement to refuse to supervise staff in the provision of care to patients undergoing terminations.

They will rule on whether the relevant section of the Abortion Act entitles a labour ward co-ordinator “to refuse to delegate to, supervise and/or support midwives providing care to patients undergoing termination procedures”.

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Both Ms Doogan and Ms Wood attended the hearing today. A decision on the appeal will be given by the court at a later date.

The Royal College of Midwives (RCM) and British Pregnancy Advisory Service (bpas) have warned of the implications for services if the Court of Session decision is allowed to stand.

Ann Furedi, bpas chief executive, said: “bpas supports the right of healthcare professionals to conscientious objection, not least because women deserve better than being treated with contempt by those who think they are sinners. But ultimately a balance needs to be struck between that exercise of conscience and women’s access to legal services.

“There may be a small number of healthcare workers who have a conscientious objection to providing abortion care. There are far more who have a conscientious commitment to helping women who need to end a pregnancy.

“It would be grossly unjust if an interpretation of conscientious objection was allowed to stand which would disrupt services to the point that those committed to helping women were unable to do so.”

Support

Gillian Smith, RCM director for Scotland, said: “We absolutely support midwives’ rights to conscientious objection. The RCM position has always been and will remain that we support women’s choice within the law.

“We also want to ensure that women undergoing this procedure, for whatever reason, get the best possible care, which we feel could be compromised if the current laws are changed.

“Whilst recognising the rights of healthcare professionals to conscientious objection as described in the 1967 Abortion Act, we will be encouraging our members to continue to provide professional care to women who require this type of treatment.”

Last April’s appeal victory for the two women followed a ruling against them in 2012 in their action against NHS Greater Glasgow and Clyde.

As conscientious objectors, the women have had no direct role in pregnancy terminations.

But the senior midwifery sisters, who are in their 50s, claim they should also be entitled to refuse to delegate, supervise and support staff involved in the procedures or providing care to patients during the process.

The health board argues that conscientious objection is a right only to refuse to take part in activities that directly bring about the termination of a pregnancy.

In the appeal ruling in favour of the women, Lady Dorrian, with Lords Mackay and McEwan, said: “In our view, the right of conscientious objection extends not only to the actual medical or surgical termination but to the whole process of treatment given for that purpose.”

After that decision, Ms Doogan and Ms Wood voiced their delight and said the ruling affirmed the rights of all midwives to withdraw from a practice that would ‘’violate their conscience’’.

The women were employed as labour ward co-ordinators at Southern General Hospital in Glasgow. At the time of the original ruling, Ms Doogan had been absent from work due to ill health since March 2010 and Ms Wood had been transferred to other work.

Both registered their conscientious objection to participation in pregnancy terminations years ago, under the Abortion Act, but became concerned when medical terminations were moved to the labour ward in 2007.

They said being called upon to supervise and support staff providing care to women having an abortion would amount to ‘’participation in treatment’’ and would breach their rights under the European Convention on Human Rights.

In the original ruling against them, the judge, Lady Smith, found that the women were sufficiently removed from involvement in pregnancy terminations to afford them appropriate respect for their beliefs.

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