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HEALTH

What you need to know about Spain’s plan to change its abortion laws

In Spain women can get an abortion for free in all public hospitals up until 14 weeks, no questions asked. But the reality is that many doctors refuse to perform them. The Spanish government is revising its laws to make sure it is enforced across the country.

What you need to know about Spain’s plan to change its abortion laws
Anti-abortion supporters take part in a march in Madrid in 2014. In Spain women have the right to abortions up to the 14th week of their pregnancy, but many doctors across the country refuse to perform the procedure. Photo by DANI POZO / AFP

Under the current legislation introduced by the previous Socialist government in 2010, women in Spain have the right to abortions up to the 14th week of their pregnancy, which is standard in much of Europe.

They also have the legal right to abort up to the 22nd week of pregnancy in cases where the mother’s health is at risk or the foetus has serious deformities.

‘Conscientious objectors’

However, in practice this law translates into a very different reality.  

Many doctors across Spain refuse to practice abortions, calling themselves “conscientious objectors”.

So many doctors deny the procedure across the country, that in five out of the 17 autonomous regions in Spain, no public hospitals offer abortions, according to data from the Health Ministry

This causes stark regional inequalities, forcing thousands of women to either travel to another part of the country, or pay for one in a private clinic, despite the 2010 law stating that “all women should benefit from equal access to abortion regardless of where they reside”.

According to the data, the provinces of Teruel, Ávila, Palencia, Segovia, Zamora, Cuenca, Toledo and Cáceres have not performed a single abortion in the past 30 years.

And, another even more revealing statistic: in 2019, 85 per cent of abortions took place in private clinics.

The map below shows the provinces that never perform abortions in red, the ones where it has varied over the years in orange, and the ones where they have always been available in green.

READ ALSO: Why does Spain top Europe’s Covid vaccination league table?

Law reform

The minister of equality, Irene Montero, has proposed a reform of the current law that would limit doctors being able to refuse the procedure.

“Conscientious objection cannot be an obstacle for women to exercise their right to terminate a pregnancy,” Montero said in a tweet. “We must reform the law to regulate it and make sure abortion is guaranteed in the public health system.”

Montero said the draft law would be ready in December after a consultation process.

However, others have said doctors should not be forced to perform abortions.

The president of Madrid’s regional government, Isabel Díaz Ayuso, said she would not force “any doctor in Madrid’s public health system to practice an abortion against their will” because doctors study medicine “to save lives and not to do the opposite”.

Conservatism

The situation shows abortion remains a dividing issue in Spain, where a large part of the conservative population is still opposed to a law that was introduced over a decade ago.

The former conservative Prime Minister Mariano Rajoy had promised to tighten Spain’s abortion law before he came into power in 2011.

However he was forced to drop the plans in 2014 due to disagreement within his Popular Party (PP). This angered many Catholic and other pro-life groups.

The reform would have ended women’s rights to freely terminate their pregnancies up until the 14th weeks. 

In 2015 Rajoy’s government passed another reform requiring girls aged 16 and 17 to get their parents’ consent if they wished to terminate a pregnancy. But the measure failed to pacify pro-life campaigners.

Montero also announced plans to repeal the 2015 reform as part of the draft law.

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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