The Freedom to Make Hard Choices

Recap on Film Screening of Abandoned on 16 January 2020
Andrea Das-Wieczorek (2L) 

For many couples, the news that they are expecting a child is a joyous occasion, filled with many dreams for the future. While most pregnancies involve countless doctor appointments and endless testing to ensure that the baby is developing normally, many women submit to this gladly to fulfill their hopes of having a healthy child. There is an implicit trust between the mother-to-be and her doctor that she is being told all information she requires for her to make the decisions for the best care for her and her unborn child. Abandoned, a documentary by filmmaker Patricia Josefine Marchart in conjunction with the Initiative for Reproductive Health Information, examines how doctors’ and other medical practitioners’ right by law to conscientiously object to performing abortions on religious and other grounds prevents women from receiving sometimes lifesaving treatments or exercising their choice to bodily autonomy when it involves the termination of an ongoing pregnancy.

Screening discussion between Ashley Major and Joyce Arthur (Photo Credit: Andrea Das-Wieczorek)

The documentary sheds light on how conscientious objection clauses, which were first included in abortion laws to allow doctors to refuse to perform otherwise legal abortions in order to placate opposition of such legislation by certain groups in society, have been increasingly invoked by doctors, causing what can only be described as a medical crisis in certain regions of the world. However, the documentary’s power in understanding the impact and magnitude of how conscientious objection to these procedures affects women is through its presentation of the stories of women who were denied abortions because of their doctor’s personal beliefs. Each of the women included in the documentary were excited to become mothers. For some, they were repeatedly told by their doctors that they had nothing to be concerned about in continuing the pregnancy even after they noticed signs that there may be complications. It was only upon further investigation, often involving travelling to hospitals hundreds of kilometers away from their home, to discover that their child was at risk of being born with extensive disabilities or with deformities so severe that the child would not survive long after birth. It was clear in these cases that conscientiously objecting doctors had intentionally hid information about the pregnancy in order to prevent the woman from making an informed choice about whether or not to seek an abortion; however, forcing the mother to give birth to the child may cause extensive physical and psychological damage to the woman and her family which could otherwise have been avoided. 

Other cases presented in the documentary highlight that conscientious objection can be tantamount to medical negligence in instances where a woman is denied a therapeutic abortion where the continuation of the pregnancy is life-threatening to the mother. For some doctors, even where the mother’s life is at risk due to sepsis and other medical conditions associated with the pregnancy, he or she may refuse to terminate a pregnancy if the fetus’s heart is beating, often resulting in the woman’s death.

The reasons for conscientious objection to abortion are often founded in religion, especially in predominantly Catholic countries like Spain, Italy, and Ireland; however, the documentary makes clear that the effects of conscientious objection clauses go far beyond individual doctor-patient relationships. Many people in the medical field may claim to be conscientious objectors for reasons of wanting to avoid stigma associated with abortion procedures, whether they agree with on religious grounds or not. The result is that in some regions, 90-100% of obstetricians and gynaecologists may claim to be conscientious objectors, forcing women to go elsewhere to get accurate medical advice or denying them vital care altogether. Furthermore, a widespread culture of conscientious objection can lead to a lack of training available to professionals in the techniques needed to carry out safe terminations. These factors often culminate in effective inaccessibility to safe abortions, causing many women to risk complications associated with illegal abortions rather than continue an unwanted pregnancy.

Following the screening, Joyce Arthur, one of the filmmakers and the founder and executive director of Abortion Rights Coalition of Canada, spoke with Ashley Major of the International Human Rights Program about her involvement in the film. While she noted that doctors have an obligation to provide care, conscientious objection is “simply the refusal of care.” Ms. Arthur highlighted that where conscientious objection clauses are in place, there is no oversight to ensure that even if a doctor refuses to provide an abortion, he refers the woman to someone who will or who will otherwise provide her with urgent care. There is “no follow up on what happens to women after being denied abortion for reasons of conscience,” said Ms. Arthur, indicating the level of harm that a woman may endure depending on her doctor’s beliefs. She also points to the complete lack of accountability and monitoring of conscientious objectors as a pitfall of the system as women often don’t know if they are being treated by a conscientious objector until much later. What Ms. Arthur sees as hope for women to exercise their right to bodily autonomy in countries which allow for conscientious objection to abortion is the development of abortion pills which put the power in the hands of the woman herself to make choices concerning her body; however, Ms. Arthur cautions that in some instances where these pills cause complications which require medical treatment, the woman may be at risk of being reported for undergoing an abortion, which in some countries may carry criminal penalties.