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  • Writer's pictureDoctors for Choice

How Bill 28 went from being a law that protects women, to a law that may cost women their lives

A lot can change in a few months, and this is certainly true of Bill 28. This Bill was introduced in the Maltese parliament last year after the case of Andrea Prudente - a US citizen on holiday in Malta who suffered ruptured membranes at 16 weeks of pregnancy and was at risk of dying. She had to be flown to Spain to terminate her dangerous pregnancy because this could not be done legally in Malta at the time. The original text of the Bill said:


243B. No offence under article 241(2) or article 243 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 her health in grave jeopardy.".


This meant that doctors would be able to legally terminate a pregnancy in the narrow circumstances of when the pregnant person develops a complication that is putting their health at grave risk, or is putting their life at risk. This was by no means a progressive law, in fact it would have remained the most restrictive abortion law in the EU. As expected, a lot of backlash followed from conservative lobbies, and the president George Vella also played a pivotal role in sending the government back to the drawing board. Today, the government came back with a new text for the Bill which says:


243B. No offence under sub-article (2) of article 241 or article 243 shall be committed when the cessation of a pregnancy or damage to the foetus results from a medical intervention carried out for the purpose of saving the life and protecting the health of a pregnant woman suffering from a medical complication which may put her life at immediate risk or her health in grave jeopardy which can lead to death:


Provided that the exemption from criminal responsibility by virtue of this article shall apply only when after having considered the medical practices current in Malta circumstances of necessity still subsist which dictate that the medical intervention be carried out and if the following conditions are fulfilled:


(a) in the case of a pregnant woman suffering from a medical complication which may put her life at immediate risk the medical intervention is done when in the reasonable opinion of the medical practitioner carrying out the intervention the foetus has not reached the period of viability;

Or


(b) in the case of a medical intervention carried out due to a medical complication which places the health of a pregnant woman in grave jeopardy which may lead to death:

(i) that in the reasonable opinion of the medical team the foetus has not reached the period of viability and cannot be delivered according to the standards of the medical profession;

And

(ii) that the medical intervention is carried out only after the medical team has confirmed the necessity of the intervention; and

(iii) that the medical intervention is carried out in a licensed hospital having the facilities required for the necessary medical intervention to be carried out;


(c) For the purposes of this article:

“medical team” means three medical practitioners registered as specialists with the Medical Council under the Health Care Professions Act two of whom being obstetricians or gynaecologists one of whom being the obstetrician who carries out the intervention, and the third medical practitioner being a specialist in the condition from which the pregnant woman is suffering;

“period of viability” means the point in a pregnancy at which the foetus is capable of living outside the uterus according to current medical practices.”


The new text is much longer than the original, but in essence it means that to qualify for a legal abortion in Malta, two main conditions have to be met:

A) There is a complication that can lead to the death of the pregnant person, and

B) Three specialists must approve the termination of pregnancy, unless it is an extreme emergency in which case a single doctor can proceed on their own.


This means that the government's compromise with conservatives will force women to continue with their pregnancy until there is a risk of death, and even when the risk is identified the termination can only proceed once three specialists have consented. This means women will face unnecessary delays to treatment, and may ultimately end up harmed or dead. The law ties doctors' hands and anyone who acts outside these restrictions faces four years in prison and a revocation of their medical licence. Ireland had a similar law to the new Bill 28, until its citizens became so concerned about the harm it was causing that they voted to legalise abortion in a referendum.


The new version of the Bill has been met with triumphant cheers from the Maltese right wing, including from organisations that are openly affiliated with regressive anti-civil rights networks in Europe. In essence, the Maltese government has gone from passing a law that was progressive in the Maltese context, to passing the most restrictive abortion ban in Europe approved by the most conservative anti-civil rights lobbies locally and abroad. This is hardly a feat a government that calls itself progressive and socialist should be proud of.

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