Comments on: Let’s call ‘conscientious objection’ by its name: Obstruction of access to care and abortion in South Africa https://ohrh.law.ox.ac.uk/lets-call-conscientious-objection-by-its-name-obstruction-of-access-to-care-and-abortion-in-south-africa/ Oxford Human Rights Hub Wed, 24 Feb 2021 10:05:32 +0000 hourly 1 By: NoMoreStigma https://ohrh.law.ox.ac.uk/lets-call-conscientious-objection-by-its-name-obstruction-of-access-to-care-and-abortion-in-south-africa/#comment-183483 Wed, 23 Jan 2019 08:14:14 +0000 https://ohrh.law.ox.ac.uk/?p=64713#comment-183483 In reply to Helen.

You raise valid points. However, pregnant people in rural communities seem to be far down on your list as they are the people disproportionately affected by the failing referral system and the overriding theme of medical practitioners conscientiously objecting to providing the service. I am not denying the right of the practitioner, but there needs to be a better system for referral. I run an abortion support group for people trying to access this legal service. Most people are from rural communities and do not know where to turn when on their fifth visit to the (only) clinic in their area they are still not assisted. Many of these fetuses become living humans, many of these pregnant people seek unsafe abortions and this causes a lot of long term damage, not only to the pregnant person’s health, but to the medical system at large. There needs to be a mid-way. Dr Nthando Godi write an open letter stating that medical practitioners must upon employment and placement disclose their belief system and their stance on providing abortion, so that government can track where people should be placed and where they need to be referred to. Without this system in place the CTOPA, as the article mentioned, is a failure, just like the notion that South Africa is a ‘Rainbow nation’.

]]> By: Helen https://ohrh.law.ox.ac.uk/lets-call-conscientious-objection-by-its-name-obstruction-of-access-to-care-and-abortion-in-south-africa/#comment-183450 Sun, 09 Dec 2018 17:06:50 +0000 https://ohrh.law.ox.ac.uk/?p=64713#comment-183450 First things first: South Africa has a brilliant law in the Choice of Termination of Pregnancy Act. The terms of the Act are clear, they facilitate on demand abortion in the first trimester and a very low level of harm is required to access from 12 to 20 weeks. It does your cause no good to pretend that the requirements of an Act are “onerous”! There were even examples of minors accessing abortion via their SCHOOL without the parents’ knowledge or consent.
However, with regard to your main point in conflating “conscientious objection” on the part of medical staff to not be required to take part in scheduled Abortions because it offended against their Beliefs, into the notion that medical staff are Obstructing for not playing an active role in a particular woman getting an elective Abortion, I was surprised you gave no context of how we got to where we are today. For all that you wrote, the name Sister Charles never featured!
In 2004/5 I received a call from Sister Charles and her Counsel at the Equalities organisation I then ran. I was pro-Choice and had written extensively on the Choice of Termination of Pregnancy Act from the perspective of how it aided women. Sister Charles was a Theatre Nurse with many, many years experience who was also a practicing Christian. She had written to her employer explaining that she was happy to assist with emergency operations that could probably result in the death of a pregnant woman’s foetus, but she could not agree to take part in scheduled elective Abortions because in her Belief this was tantamount to murder. She was disciplined for this stance. Her case went all the way to the Con Court and senior Labour Courts. This is why medical staff have a right to exclude themselves from assisting with Abortions. The policy retains staff members who are expected to deal with a variety of conditions, but does not compel them to assist with Abortions (where they may not give the standard of care we would all want for women, or open them up to disciplinary hearings, etc).
This is perfect. It is absolutely appropriate that people arguing for Pro-Choice understandings of Abortion Rights see that choice cuts both ways. I am delighted that this is the law.
What your whole article has done is frame these medical professionals as part of a body of “gatekeepers” because some of them may not direct women towards alternative medical care. Medical care in South Africa is not operated from Speak Easies. Clinics and hospitals function on a Walk-In basis in most places, and there are several superb Teaching University Hospitals that people can approach. There are also many organisations giving advice on access to abortion and other maternity services. In short, the message gets out there (and I know this because I’ve used these services personally). The notion that a woman in South Africa has a single option, and that this first port of call provider has the power to completely shut off access to Abortion is not true. There have always been stories of judgemental clinic staff, or staff that were related to members of the community, and so people were reluctant to access HIV, Abortion, STI etc services. But there have always been more than one option available to patients too.
There has recently been articles published in Europe relating to the PTSD that those staffing Abattoirs face, with seemingly large numbers of staff having lasting damage from being involved in the killing of animals for the human food chain. So we should be live to the notion that inability to take part in Abortions where staff will see the human form of a foetus reaches beyond those whose religion declares life starts at conception.
That those who cannot in all conscience assist with elective Abortions, because they ideologically or theologically view the foetus as a separate human life should not be subjected to the derogatory terminology present in this article. A State can operate in a way that balances several divergent needs, in fact, it is the best type of State of all.
Defining the obstruction of Abortion services as not pointing a patient towards another service provider, and then attempting to criminalise a professional medical person for this is a sledgehammer to crack a nut.
The Dept should not be looking to alienate and remove its staff, but rather improve its communication channels with patients and give over dedicated space in clinics for Abortion Advocacy groups to promote understanding of the law and services to women. South Africa has a long process requiring even highly skilled foreign nurses to undertake before working in the country and theatre and midwife services must be studied by everyone. Losing experienced staff, or deterring the entry to the profession of enthusiastic people, is every bit as important an aim as ensuring that women receive the Abortion services the law provides them with. “Centring” the patient requesting the Abortion service seems fine in an individual setting, but the Bill of Rights extends beyond them and includes ALL South Africans.
I hope the Dept rethinks its stance.

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