Doctors issued with new ethical guidelines on providing abortion

The Medical Council has issued revised ethical guidance for doctors following the introduction of abortion legislation earlier this year.

A new version of its ethics document provides updated guidance for doctors who have conscientious objections to particular forms of treatment, procedures or care, not just in relation to abortion.

The amended guide to professional conduct and ethics for doctors says termination of pregnancy is legally permissible within the provisions of legislation introduced in 2018.

It says doctors have a duty to provide care, support and follow-up for women who have had a termination of pregnancy.

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The revised guide says that doctors may refuse to provide, or to participate in carrying out, a procedure, lawful treatment or form of care which conflicts with their sincerely- held ethical or moral values. However it also sets out obligations that the doctor will have to the patient in such circumstances.

“If you have a conscientious objection to a treatment or form of care, you should inform patients, colleagues, and, where relevant, your employer as soon as possible. If you hold a conscientious objection to a treatment, you must:

- inform the patient that they have a right to seek treatment from another doctor; and

- give the patient enough information to enable them to transfer to another doctor to get the treatment they want.

The guide says where doctors in such circumstances refer a patient and/or facilitate their transfer of care, they should make sure that this is done in a safe, effective and timely manner.

“You should help make it as easy as possible for the patient. When discussing the referring and or transferring a patients’ care to another health professional, you should be sensitive and respectful so as to minimise any distress your decision may cause. You should make sure that patients’ care is not interrupted and their access to care is not impede their access to care.”

The guide says doctors should not provide false or misleading information, or wilfully obstruct a patient’s access to treatment based on your conscientious objection.

“If the patient cannot arrange their own transfer of care, you should make these arrangements on their behalf. In an emergency situation, you must provide - as a matter of priority - the care and treatment your patient needs.”

The Medical Council said on Friday that it had appointed an ethics working group to advise it on any amendments to its ethical guidelines, which were updated in 2016.

It said this group had sought input from doctors and key stakeholder groups, and the public.

The chairwoman of the ethics working group, Dr Suzanne Crowe, said: "The majority of the amendments made are to be read from the practising of medicine point of view and not in isolation for any one procedure. The ethical guide contains guidance and information on a variety of matters which affect the medical profession on a daily basis, and we urge doctors to consult this edition for the most up-to-date, relevant and inclusive advice."

Dr Rita Doyle, Medical Council president said: "When the eighth edition of the guide was launched three years ago, it was envisioned that rolling changes would be incorporated to keep the guide up to date, and this is the first of these changes. The current medical landscape can be fraught with uncertainty for doctors, and this guide aims to clarify the Medical Council's advice in these areas."

Prior to the introduction of abortion last January, the Medical Council deleted a number of paragraphs in its ethics guide to remove "any conflict" with the legislation introduced by the Oireachtas.