Victorian Parliament considering decriminalisation bill
The right to conscientious objection to abortion is under threat in the Australian state of Victoria. The lower house of the local parliament has just passed a bill which removes abortion from the criminal code and allows unrestricted abortion up to 24 weeks. If the doctor secures the approval of a colleague, he can do an abortion up to the time of birth. Now the bill passes to the upper house, where it will be debated later in the year. It may pass, although this is far from certain.

One objection to the bill is that it removes a right to conscientious objection which is recognised by most of the major medical professional bodies, including the Australian Medical Association and the Royal Australian College of Nursing. Although it recognises that some doctors may have a conscientious objection to abortion, it requires them to refer women to a doctor who will perform one. Furthermore, "in an emergency where the  abortion is necessary to preserve the life of the pregnant woman”, the doctor must perform one. The bill’s opponents claim that this is unprecedented and will overturn age-old respect for freedom of conscience in professional healthcare and will diminish the conscientious exercise of professional judgement.

Lesley Cannold, a well-known Australian bioethicist who serves on several government ethics bodies, countered this with a scathing attack on the notion of conscientious objection in The Age newspaper. Pro-life doctors, she writes, are more concerned about their right to impose their values on women than their obligation to help them when they are in distress. "It is unconscionable for someone to defend the right to follow his conscience, then deny that very same right to someone else," she says. This argument seems to have resonated with members of parliament, as some used it in the course of a long debate in the lower house.

However, when her argument is examined a bit more carefully, it seems possible that the two sides are talking at cross-purposes. Ms Cannold believes that "The right to act according to the dictates of our conscience is founded in the value of autonomy. Autonomy means self-rule. An autonomous person is one who is free to direct her life according to her own values." In other words, conscience expresses an arbitrary, even irrational choice.

However, defenders of conscientious objection claim that only a malfunctioning conscience operates like that. A properly-oiled conscience makes good choices based on reason and evidence, not on whimsy. They see abortion as a breach of the basic principle of medicine to "first do no harm", especially to the sick and vulnerable, based on abundant medical, sociological and psychological evidence. Unless this basic misunderstanding can be cleared up, it is unlikely that there will be any rapprochement between the two sides. As a result, doctors, nurses and pharmacists who oppose abortion could be forced to provide services they abhor in Victoria.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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