Issue link: https://maltatoday.uberflip.com/i/1248303
PHOTO BY JAMES BIANCHI 8 maltatoday | SUNDAY • 17 MAY 2020 INTERVIEW It's been a year since Doctors For Choice was launched, in a country where pro-choice views were previously limited only to isolated voices. In your view, has the emergence of a pro- fessional NGO made any sub- stantial difference to the local discussion on abortion over the past year? Yes, definitely. More and more people - especially young people - are engaging with our message through social media. Doctors for Choice advocates for safe, equitable, and accessible sexual and reproductive health- care in Malta. Our main aims are to achieve: comprehensive sexual and reproductive educa- tion; comprehensive and freely accessible contraception; the de- criminalisation of abortion; and changes to the law to allow the provision of safe, equitable, and accessible abortion services. Locally, however, any discus- sion about abortion has also been taboo within Malta's med- ical community: perhaps even to a greater extent. This despite the fact that doctors in Malta inevi- tably have to deal with women seeking abortions and post-abor- tion care. And yet, a 2019 study among 454 local doctors in Malta has al- so shown that the majority actu- ally agree that abortion should be legalised in limited circumstanc- es; such as when a woman's life is in danger, or in cases of terminal fetal anomalies. The setting up of Doctors for Choice has certainly started a conversation amongst Maltese medical doctors as well as future doctors, among whom we have a great deal of support. For the first time in Malta's his- tory, the public can now reach out (anonymously, if necessary) to a local organisation for relia- ble evidence-based information on abortion and reproductive health, that is in line with the recommendations of reputable health organisations including the World Health Organisation and the Royal College of Gynae- cologists. So yes, we believe that the or- ganisation is helping to make people think differently about the issue of abortion and also changing women's experience for the better by giving them the assistance they need based on re- liable information and resources. The pro-choice argument is of- ten countered by the general view that 'life begins at con- ception'; and that, therefore, a newly conceived embryo should have the same rights as a fully developed human being. Do you consider this a misconception… and if so, why? This is a long-held misconcep- tion. Life is a continuum. Sharp boundaries may be convenient, but they are inadequate and ar- bitrary. Like many biological de- velopments (when exactly does one become middle-aged or ma- ture?), the transition from fertil- ised egg to adult human is shown by a steady upward curve. In the words of the British philosopher Johnathan Glover, known for his books and studies on ethics, the contention that a fertilised egg is equivalent to a person is a "morally motivated piece of conceptual revision". I share Glover's view that the "life begins at conception" argument is based on the prior belief (of- ten promulgated by the Catholic church) about how an egg ought to be treated. In terms of the rights of an early embryo/fetus, philosopher Michael Tooley has argued that "bearers of rights must at least have the capacity to desire what they have a right to". We know that awareness requires a sophis- ticated neural network, which has been shown to develop by around six months of pregnan- cy. Given that these neural path- ways are not yet developed, the concept that the early embryo/ fetus could possibly be aware of its own existence seems very far- fetched. Also, pro-life campaigners of- ten tout the importance of the rights of the fetus. In actual fact, the fetus obtains legal rights at birth. So denying an abortion in circumstances such as rape and incest, would give more le- gal rights to the fetus than to the mother. We certainly respect the views of those who believe that life be- gins at conception (presumably, all those who believe in the sanc- tity of human life are also abso- lute pacifists, and would never kill anyone, not even in self-de- fence). Based on scientific evidence, however, we have different views, and as doctors we believe we should be allowed to offer the option of abortion legally and safely to those women who share these views. Allow me to please share my aversion for the use of the term 'pre-born' for the developing embryo/fetus by many pro-life campaigners. I would only accept that description if we refer to all newborns as 'pre-dead'! You say that Malta's abortion laws make no exception, not even when the mother's life or health is at risk. Yet local pro- life doctors argue that in prac- tice, the Thomist 'double effect' principle is applied in such cas- es (whereby it is permissible to cause harm as an unintended side effect of bringing about a good result): making any extra legal provisions superfluous. How do you respond to that ar- gument? Yes, the 'principle of double-ef- fect' - which is an ethical con- cept that originated in Catholic philosophy - is applied locally in such cases. However, our crim- inal code makes no mention of this principle, and does not dis- tinguish between 'direct' and 'in- direct' termination: or any differ- ences in the 'intention'. When medical doctors follow this principle in the management of cases when the mother's life or health is at risk, they are not in compliance with the law as it stands. That is why we believe On 'Doctors For Choice' first anniversary, gynaecologist and founding member Prof. ISABEL STABILE argues that, while abortion remains 'taboo' in political and even medical circles, public opinion on the issue is slowly shifting Challenging the abortion taboo Raphael Vassallo rvassallo@mediatoday.com.mt