Saturday 22 September 2018

Women could face gaps in abortion pills access if GPs opt out of service

Dr Brendan O’Shea
Dr Brendan O’Shea
Eilish O'Regan

Eilish O'Regan

Women in some parts of the country could face difficulties in accessing abortion locally, if groups of GPs decide to opt out of providing the service on grounds of conscience or resources.

All doctors have the right to conscientious objection to being involved in procedures, even if abortion is legalised up to 12 weeks after a referendum later this year.

Both the Irish Medical Organisation (IMO) and the National Association of General Practitioners (NAGP) have reminded Health Minister Simon Harris of the need to ensure any widening of abortion law is clear and has proper systems in place to protect both the doctor and patient.

Draft legislation is being prepared by the Department of Health, allowing for unrestricted abortion in the first 12 weeks of pregnancy, if the Eighth Amendment is repealed.

It will allow abortion pills to be administered not just by GPs but also other specialists such as gynaecologists.

It is unclear how many GPs or other specialists would object to being involved in any proposed law allowing for abortion pills. However, several faced a similar dilemma when the morning-after pill became available.

In some practices where there were a number of doctors, some GPs delegated the work to a colleague.

Dr Brendan O'Shea, of the Irish College of General Practitioners, said: "A doctor has an ethical obligation not to allow his or her personal moral standards to influence treatment of patients.

"Where the doctor has a conscientious objection to a course of action, they must explain this to the patient and provide the names of other doctors available to the patient.

"Effective communication in a crisis situation demands time, considerable patience and careful thought.

"The GP must enable women to reach an informed decision, to minimise emotional disturbance, whatever decision is made, and to lessen the risk of further unwanted pregnancy."

Much will depend on how onerous the legislation is on doctors in terms of counselling the woman, and whether she will have to take the two abortion pills in the surgery or at home.

Several GP practices have already had to close down their lists to new patients because of the volume of demand.

In the UK's National Health Service, an early abortion is available from a GP or family planning clinic.

It also allows for fee-paying abortion providers to deliver the service.

Dr O'Shea said crisis pregnancy was a common experience for Irish women and was commonly managed by GPs. Around 13pc of all pregnancies are considered to be crisis pregnancies.

Some 62pc of women go ahead with the pregnancy and 21pc have an abortion. Around 14pc miscarry and 1pc give their baby for adoption.

Nurses and pharmacists who may be involved in the proposed abortion service will also be able to opt out on grounds of conscience.

Many women are expected to prefer to go to a family planning clinic or Well Woman Centre for the pills.

However, if they develop complications, they are likely to be referred back to their own GP.

The proposed legislation is expected to make it mandatory for a three-day gap between the woman seeking an abortion and returning for the medication.

It is expected that a woman must take the pills inside a hospital or licensed clinic.

Irish Independent

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