Doctors for Choice Malta’s position on the proposed conscientious objection clause
Released 02 September 2020
Endorsed by aditus Foundation, Allied Rainbow Communities, Cross Culture International Foundation, Integra Foundation, LGBTI+ Gozo, MGRM (Malta LGBTIQ Rights Movement), Malta Humanist Association, Men Against Violence, Moviment Graffitti, Women's Rights Foundation
The upcoming Equality Bill has garnered plenty of interest, not least amongst those who wish to defend discriminatory practices against the more vulnerable and disadvantaged members of our society. This includes people seeking access to sexual and reproductive healthcare.
We refer to the Malta Medical Council’s (MMC) proposed amendment to the bill: “A healthcare professional is under no obligation to participate in any procedure or administer treatment, when such professional considers these objectionable as a matter of conscience and declares his objection beforehand. The health department is obliged to ensure widespread availability of information pertaining to all legal health services including a list of healthcare workers or institutions providing such services as well as their contact information.”
It is important to point out that conscientious objection only refers to a professional refusing to provide accepted best-practice treatment on the basis of their own morals. So, for example, a doctor refusing to prescribe antibiotics in cases of viral infection would not be conscientiously objecting, but rather, following best practice.
There are multiple problems with the MMC’s proposed amendment. A physician’s primary duty is towards their patients. Conscientious objection due to the doctor’s personal beliefs should not detract from good medical practice or worse, result in harm to the patient. Treatment provided should also follow the latest best-evidence practice. The MMC’s proposal is far removed from this ideal, eschewing the patient’s right to timely access to healthcare. Clear safeguards are needed to balance the rights of doctors with those of patients.
The MMC’s amendment astonishingly tries to do away with the conscientious objector’s duty to refer to another professional who is able to provide the required treatment. The proposal simply states that a list of doctors who carry out the necessary treatment be made available. Omitting duty to refer places an unnecessary and potentially dangerous burden on patients by shifting the responsibility of finding a suitable doctor onto them. Moreover, such publicly available “lists of doctors” can lead to unwarranted attention and harassment of individual doctors by activists.
Rules and policies around conscientious objection should clearly state the important duties of doctors to always safeguard patients, whether they personally agree with the treatment or not. The duty to refer and give impartial information regardless of personal beliefs is of utmost importance. In addition, the patient’s right to access healthcare in a timely and efficient manner must not be significantly impacted by the doctor’s choice to conscientiously object. Furthermore, conscientious objection should never be invoked in the case of lifesaving and emergency treatment. Conscientious objection should also be limited to the procedure itself, where the professional remains obliged to provide care leading to the procedure and after the procedure.
In conclusion, Doctors for Choice Malta is absolutely opposed to the insertion of the conscientious objection one-clause amendment in the Equality bill as proposed by the MMC. This amendment does not have the necessary safeguards since it detracts from good professional practice, diminishes patients’ rights, and makes access to healthcare more difficult. This disgraceful proposal goes against the mission of the MMC, which is primarily to ensure good medical practice and protect patients.