When it comes to amendments to abortion law, clarity is paramount

iI is essential for it to be acceptable to the medical professionals... after all, they will be the ones in that operating theatre, not the politicians who often spout a lot of rhetoric, then wash their hands and go home

Doctors will be on the frontline dealing with the ethical dilemmas
Doctors will be on the frontline dealing with the ethical dilemmas

There are certain issues in life which are not black and white but which are mired in different shades of grey. For me, abortion is one such issue, which is why I am always reluctant to make any categorical, sweeping statements. It is such a sensitive, personal decision and I cannot fathom what it must feel like to be in the shoes of a woman who is considering it, nor would I even presume to do so. And I would certainly never judge her. 

However, I also respect the fact that for others there are no ifs and buts, and they come down firmly against abortion, no matter what the circumstances are, without hesitation. The pro-choice lobby can also be very adamant, upholding and demanding the woman’s right to choose, at all costs. But I also think there is a substantial group of people who prefer to steer clear of the vociferous public name-calling, who will confide that their feelings on the issue are neither of these two extremes, but fall somewhere in the (greyish) middle. 

Of course, opinions are one thing, but when it comes to legislation there can be no grey areas.  

This week, Health Minister Chris Fearne tabled a motion to amend Malta’s abortion law, which up until now has made it a criminal offence for any pregnancy to be terminated, under any circumstances, with both doctors and the pregnant woman liable to prosecution. The amendment states that no offence shall be committed “when the termination of a pregnancy results from a medical intervention aimed at protecting the health of a pregnant woman suffering from a medical complication which may put her life at risk or health in grave jeopardy.” 

I don’t think anyone has any issue with “putting her life at risk” part – I think we can all agree that no one wants women to be allowed to die. However, the ambiguity lies in the phrase “or (putting) her health in grave jeopardy.” 

Critics of the amendment have rightly pointed out that this vagueness opens up a dangerous can of worms. They claim that this is introducing abortion into Malta by stealth, because who is to say what a woman, who desperately wants an abortion, will say in order to claim that the pregnancy constitutes a jeopardy to her health? 

There are two problems with this hazy wording when it comes to such a crucial national issue. First, if Labour wants to make abortion legal it should go ahead and do it, and then face any flak which comes with that decision, rather than doing it in what seems like an underhanded, sneaky way so that they can raise their hands and claim “it wasn’t us”. 

This perception that the government is not being clear and upfront about the abortion law was underscored by the PM’s own statement that “it will be up to doctors to decide what conditions justify a medical intervention that would result in the termination of a pregnancy.” This, to me, is a shirking of political responsibility which is placing the onus squarely on doctors’ shoulders on how to interpret this wording, especially since in the next breath, the PM said that anyone caught “abusing or stretching” the law would be criminally prosecuted. It is highly unfair to expect doctors to decipher what is meant by this amendment and then still leave them open to prosecution. 

The second problem with the lack of clarity is an even more potentially alarming situation which has been flagged by Prof. Kevin Aquilina. The fluid phrase, “jeopardy to her health” could, he argued, also refer to mental health issues. “If the pregnant woman is suffering from a temporary depression or stress, or remorse from having fallen pregnant, or does not have sufficient money to raise a new born child, the pregnant woman – so as not to put her health in grave jeopardy may, on the ninth month of the pregnancy opt to terminate the foetus’s life even though the foetus might be delivered prematurely and healthily without any risk, threat or danger to the pregnant woman’s life.” 

While I personally think that this is a very far-fetched scenario (in the majority of countries and states, there is always a cut-off point to prevent late-term abortions), the fact that there is this glaring loophole should be enough to make the proponents of this amendment go back to the drawing board and make sure it is not allowed to go through as it is. I doubt whether even the most vehement of pro-choice advocates would agree to what is known as partial birth abortion (and in case you don’t know how it is performed, I suggest you look it up).  

Speaking on Wednesday, PM Abela continued to insist that the amendment will in no way introduce abortion, but will simply ensure that an “unofficial, long-standing practice among doctors at Mater Dei Hospital” is codified into law. If this is truly the case, then I don’t see why there should be any problem with rewording the amendment and removing any ambiguous phrases which are open to loose interpretation. 

Meanwhile, in a statement, Doctors for Life said they shared “the grave concerns” expressed recently by 80 academics in a position paper arguing that the wording as proposed by the government will be loosely interpreted to allow for abortion on demand. They pointed out that 98% of abortions in the UK are performed for mental health reasons. 

Instead, the academics have proposed rewording the amendment to read as follows: “No crime is committed under article 241(2) or article 243 when the death or bodily harm of an unborn child results from a medical intervention conducted with the aim of saving the life of the mother where there is a real and substantial risk of loss of the mother’s life from a physical illness.” So far, 450 doctors have signed a petition supporting this new wording and since the PM has put the ball in their court, so to speak, then their stand on this issue should count for something.  

In the meantime, however, the Malta Association of Psychiatry also issued their views: “If other illnesses are  to be considered a threat to maternal life for termination purposes, the same criteria should apply to  psychiatric illness… While  women’s mental health is being discussed,  psychiatrists, who are experts in this field, and are also the professionals who would be expected to contribute primarily to decision-making in individual cases, have not been included nor invited to discussions.” This is a valid point and the association is correct in saying that it should be consulted on this extremely delicate aspect. 

The battle-lines have been drawn between the pro-life and pro-choice lobbies over this heated issue (as has happened in countries all over the world whenever abortion laws are debated), however it is important for the discussion to remain rational and mature. We cannot have it being derailed by silly posturing in parliament by the Opposition leader who appeared to be mocking the pregnant American woman, Andrea Prudente. This is the woman who learned that her baby was not viable while on holiday with her husband in Malta, but was denied a termination because of our abortion laws. Doctors told them they could not intervene unless the mother’s life was at risk so the woman had to be airlifted to Spain for an abortion. The couple subsequently filed a lawsuit against the Maltese government.  

It also does not help the anti-abortion cause one bit that former Nationalist MP Jason Azzopardi and blogger Simon Mercieca have claimed it is a “fact” that the US couple was brought to Malta as a deliberate ploy and with the pretext that the woman’s life was in danger, in order to create controversy and thus introduce abortion to Malta. The truth is probably much more straightforward: that ultimately it was going to happen that a pregnant woman from another country would end up at Mater Dei in such a predicament and be faced by the strict anti-abortion law which is in place. The couple have now filed a defamation lawsuit against both Jason Azzopardi and Simon Mercieca who now need to substantiate their claims. 

Although the topic of abortion tends to lead to histrionics, we need to resist this temptation and ensure that the legislation which is passed is sensible and leaves no room for vague up in the air interpretations. 

There is no mad rush either… we have waited this long to enact this amendment, so surely we can wait for it to be word perfect before it is approved in Parliament. Above all, it is essential for it to be acceptable to the medical professionals who will be the ones on the frontline dealing with these ethical dilemmas – after all, they will be the ones in that operating theatre, not the politicians who often spout a lot of rhetoric, then wash their hands and go home.