The wording of Bill 28 has changed completely since it was first announced, and the most marked difference is in the level of protection it offers to women's health when they are pregnant. Here are the three main reasons why the new version of Bill 28 no longer protects women's health.
1. A pregnancy can no longer be terminated unless there is a risk of death.
The original version of Bill 28 stated that a doctor could legally terminate a pregnancy when there is a medical complication that puts the health of the pregnant woman in grave jeopardy. Despite government promises that they would not compromise on this principle, they went ahead and did exactly that: compromise on this principle. The new version of Bill 28 states that a pregnancy can only be legally terminated if there is a medical complication that puts the woman's health in grave jeopardy that can lead to death.
In practice, this means that unless there is a risk of death, a pregnancy cannot be terminated. And despite the government saying this could be interpreted liberally, in practice Maltese gynaecologists have already said that a woman suffering ruptured membranes in early pregnancy will not qualify for a termination of pregnancy under the new law, until she gets a life-threatening infection. This means a case like that of Andrea Prudente will soon happen again, and as happened to Savita in Ireland and to Dorota in Poland, the next woman to have ruptured membranes in Malta may lose her life.
2. Unless the woman is imminently dying, three consultants must authorise the abortion.
The original version of Bill 28 did not include a requirement for more than one doctor to authorise a termination of pregnancy in the circumstances it allowed. The new version of Bill 28 requires no less than three doctors on the specialist register to authorise the abortion when a woman's health is in grave jeopardy that can lead to death. So once a risk to death is identified, unless death is happening at that point, the doctor has to obtain permission from three consultants (or specialists on the Medical Council register). As consultant gynaecologist Mark Sant said in an interview with the Sunday Times of Malta, this is a complex mechanism that may introduce delays. And in these situations, delays may mean loss of life.
It is also important to note that the new Bill 28 does not require any three doctors, but requires three doctors on the specialist register. This means no house officers, no specialist trainees, and no registrars - which are by far the more available grades of doctor in hospital. The decision will need to come from three consultants or resident specialists, two of whom need to be gynaecologists, and the third a consultant in whichever field specialises in the condition the woman is suffering from.
3. There are several more conditions that have to be met.
Even after a risk of death is identified, and even after three consultants become available, there are still several other conditions that have to be met. The woman has to be in a "licenced hospital," the consultants must verify that the termination is necessary, and the consultants must verify that the fetus is not yet of a viable age.
When one looks at all these conditions together, it is easy to see how this law will make it almost impossible for women to access a termination of pregnancy until they are literally at death's door. The government is not being honest when it says under the new law doctors can act before a woman is on death's door. After they have passed a law with so many conditions that make it impractical to use in most situations, doctors will not be able to overcome all these barriers and act until the very the last minute, by which time it may be too late to save the woman.