Poland's prime minister Donald Tusk said on Friday that a so-called “conscience clause” in abortion legislation could not be used as a justification for refusing to take steps that could save a woman's life.
Tusk added that he had asked the justice minister and health minister to work on rules that could result in a hospital losing its contract with the National Health Fund (NFZ) if it refuses to perform a justified termination.
“I have requested the justice minister and prosecutor general, as well as the minister of health, to present guidelines to the pertinent institutions and people under which, for example, in the case of refusal of a justified termination of pregnancy a hospital will lose its contract with the NFZ in the field of gynecology if it refuses, without a clear justification, a termination of pregnancy and thereby leads to a threat to a woman’s health or life,” Tusk said during a sitting of the National Council of his Civic Platform party.
The prime minister added that the conscience clause could “under no circumstances replace the obvious duty that is the primary duty of every doctor, that is when it is necessary to save a woman's life or health.”
He added that the “conscience clause cannot be a justification for refusal of actions that save the life or health of a woman.”
The “conscience clause” in Polish medical law, which allows medical practitioners to refuse to conduct the procedure on ethical grounds, is seen by many as exacerbating the problem of access to abortion in the limited number of cases in which it is permitted by law.
Abortion law in Poland
Poland is among the EU countries with some of the strictest limitations applied on legal abortion, with the exception of Malta, which, after a heated public debate, legalized abortion in the case of the mother’s life (but not her health) being at risk in 2023.
In Poland, since 1993, the so-called “abortion compromise” permitted the legal termination of pregnancy up until the 12th week of the gestation period in three cases. The life or health of the mother is at risk, the pregnancy came about as a result of a felony (rape, statutory rape, or incest), or if the fetus is suffering from a congenital condition, be it lethal or not.
But a 2020 ruling by the country’s top court, the Constitutional Tribunal, effectively banned abortion in cases where prenatal tests indicate a high probability of severe fetal abnormality.
In the years leading up to the ruling, about 98% of the between 1,000 and 1,100 abortions performed were carried out on account of fetal abnormality. Of the other cases, most are related to the risk to the mother’s life or health, with the number of abortions justified by the pregnancy being a result of a felony numbering in single digits, and in some years the number being zero.
But even though the Poles’ attitudes toward abortion are rather conservative, with surveys frequently showing that only about one-third believe that abortion should be available on demand and/or for any reason, a survey conducted as recently as 2023 by CBOS shows that about one in ten believe a woman should have access to abortion in cases of risk to life, health, or rape, and more than 60% believed the same to be the case of fetal abnormality.
“I have requested the justice minister and prosecutor general, as well as the minister of health, to present guidelines to the pertinent institutions and people under which, for example, in the case of refusal of a justified termination of pregnancy a hospital will lose its contract with the NFZ in the field of gynecology if it refuses, without a clear justification, a termination of pregnancy and thereby leads to a threat to a woman’s health or life,” Tusk said during a sitting of the National Council of his Civic Platform party.
The prime minister added that the conscience clause could “under no circumstances replace the obvious duty that is the primary duty of every doctor, that is when it is necessary to save a woman's life or health.”
He added that the “conscience clause cannot be a justification for refusal of actions that save the life or health of a woman.”
The “conscience clause” in Polish medical law, which allows medical practitioners to refuse to conduct the procedure on ethical grounds, is seen by many as exacerbating the problem of access to abortion in the limited number of cases in which it is permitted by law.
Abortion law in Poland
Poland is among the EU countries with some of the strictest limitations applied on legal abortion, with the exception of Malta, which, after a heated public debate, legalized abortion in the case of the mother’s life (but not her health) being at risk in 2023.
In Poland, since 1993, the so-called “abortion compromise” permitted the legal termination of pregnancy up until the 12th week of the gestation period in three cases. The life or health of the mother is at risk, the pregnancy came about as a result of a felony (rape, statutory rape, or incest), or if the fetus is suffering from a congenital condition, be it lethal or not.
But a 2020 ruling by the country’s top court, the Constitutional Tribunal, effectively banned abortion in cases where prenatal tests indicate a high probability of severe fetal abnormality.
In the years leading up to the ruling, about 98% of the between 1,000 and 1,100 abortions performed were carried out on account of fetal abnormality. Of the other cases, most are related to the risk to the mother’s life or health, with the number of abortions justified by the pregnancy being a result of a felony numbering in single digits, and in some years the number being zero.
But even though the Poles’ attitudes toward abortion are rather conservative, with surveys frequently showing that only about one-third believe that abortion should be available on demand and/or for any reason, a survey conducted as recently as 2023 by CBOS shows that about one in ten believe a woman should have access to abortion in cases of risk to life, health, or rape, and more than 60% believed the same to be the case of fetal abnormality.
It should be of little surprise, that the 2020 TK ruling has sparked public discontent, leading to public outcry, mass protests, and a plunge in the support for the then-ruling Law and Justice (PiS) party, which was blamed for the court ruling, having staffed the body with its appointees. PiS failed to recover from the slump in the following years, and the slashing of access to abortion is often listed among the reasons PiS lost power in the aftermath of the October 2023 elections.
Damned if they do, damned if they don’t
Furthermore, the ruling has, its critics claim, led to doctors refusing to perform an abortion, even when the procedure is justified because it might trigger a career-destroying criminal investigation.
In one high-profile case, doctors refused to remove the body of a dead twin fetus until two days after its sibling had also died. The mother’s family claimed she died as a result of the delay.
In another, more recent case, a woman’s pregnancy became unviable after her waters broke at a stage of fetal development that made it impossible for the child to survive outside of her womb. The doctors, however, refused to terminate the unviable pregnancy until its heart stopped beating, which ultimately resulted in the woman developing a fatal case of sepsis.
Officials with the Ministry of Health under PiS called the case an example of medical malpractice on account of the doctor’s failure to terminate the pregnancy in a situation it justified by law but laid the blame at the feet of activists and media, saying that they were the ones responsible for creating an atmosphere of fear in which doctors were uncertain whether performing an abortion would not result in legal problems for them.
Damned if they do, damned if they don’t
Furthermore, the ruling has, its critics claim, led to doctors refusing to perform an abortion, even when the procedure is justified because it might trigger a career-destroying criminal investigation.
In one high-profile case, doctors refused to remove the body of a dead twin fetus until two days after its sibling had also died. The mother’s family claimed she died as a result of the delay.
In another, more recent case, a woman’s pregnancy became unviable after her waters broke at a stage of fetal development that made it impossible for the child to survive outside of her womb. The doctors, however, refused to terminate the unviable pregnancy until its heart stopped beating, which ultimately resulted in the woman developing a fatal case of sepsis.
Officials with the Ministry of Health under PiS called the case an example of medical malpractice on account of the doctor’s failure to terminate the pregnancy in a situation it justified by law but laid the blame at the feet of activists and media, saying that they were the ones responsible for creating an atmosphere of fear in which doctors were uncertain whether performing an abortion would not result in legal problems for them.
Source: PAP, TVP World
