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  • Writer's pictureDoctors for Choice

The new abortion law considers Malta's doctors to be either incompetent or criminal

Updated: Jul 1, 2023

There are many things wrong with Malta's new abortion law, but perhaps the clause that raises most questions and eyebrows is the one that requires three doctors on the specialist register to approve an abortion when a woman's health is at grave risk that can lead to death. This ad-hoc group of three specialists is described in the law as a "medical team," even though it does not reflect a real-world medical team in a hospital, which usually is one consultant together with speciality trainees, house officers, and sometimes also medical students. Only the consultant would be on the specialist register, unless there is also a resident specialist within the team.

It seems any doctor seeking to avail themselves of this new law to save a woman in grave danger will have to phone up two (or three if they are not on the specialist register) colleagues to discuss the case and get them to approve the treatment. Whoever came up with this arrangement must have a deep distrust of doctors. Here's why:

This new law assumes an individual doctor is incapable of making clinical decisions

By requiring three doctors to make a clinical decision, the law is signalling that it considers individual doctors to be incapable of making correct decisions, even in relatively straightforward cases. Any doctor on the specialist register for obstetrics and gynaecology should be fully capable of deciding whether a woman's health is at grave risk that can lead to death, and to carry out a termination of pregnancy if the woman consents. A doctor on the specialist register would have completed foundation training and then several years of specialist training. Their competence would have been formally assessed throughout their training, even in formal settings such as college membership exams. There is no reason for the law to doubt the competence of any specialist.

The law also excludes any doctor who is not on the specialist register from the decision-making process. This is also wrong, because specialist trainees especially those in the last years of their training should be have the opportunity to make independent decisions, or make decisions with minimal supervision.

This new law questions doctors' integrity

In defending this new law, government politicians stated that the main reason behind the new wording of the law was to "prevent abuse." Since we are dealing with criminal law, any doctor who "abuses" such a law is breaking criminal law and is therefore criminal.

By preventing doctors from making decisions independently about termination of pregnancy except in the most extreme of cases, there is an assumption in the law that this is a safeguard to prevent doctors from acting criminally. It implies that whoever drafted this law does not trust doctors to follow the law, and almost assumes they will act criminally if given the chance.

In reality, the requirement to have three doctors approve a termination of pregnancy will not "prevent abuse." Abuse was never going to happen anyway, because women who abort a pregnancy for non-medical reasons will simply order abortion medication online, while those with complications but are stable enough to travel will seek a termination abroad. This law was meant to protect those unfortunate women with serious complications who end up in hospital. Now, thanks to the mistust of doctors by whoever drafted this law, women in grave situations will have to wait for their caring doctor to go through the clinically unnecessary process of having their colleagues rubber-stamp their decision. This will only delay essential care, and will eventually lead to someone losing their life.


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