A group of 135 doctors have signed a judicial protest asking for a review of Malta's blanket ban on abortion care, after an American woman had her request to terminate a non-viable pregnancy turned down by the Maltese health authorities.

Andrea Prudente, 38, was 16 weeks pregnant when she began bleeding profusely and was told by doctors that the pregnancy was no longer viable. Her US health insurance deemed the situation life-threatening and last week flew her out to Mallorca for the procedure.

According to gynaecologist Isabel Stabile, who filed the protest on behalf of the 135 doctors, this exact same medical scenario happens to an estimated two to three women per year in Malta.

"Most women living here do not have private insurance to help them evacuate to get their much-needed treatment abroad. Our laws are neglecting these women, risking their lives needlessly," Stabile said in a statement.

This exact same medical scenario happens to an estimated two to three women per year in Malta

In Malta, the termination of unviable pregnancies where a heartbeat is still detected is delayed until the woman’s life is at risk because abortion on the island is illegal under all circumstances.

In a similar case to Prudente's, a Canadian woman had to be flown out of Malta in 2014 to terminate an unviable pregnancy.

On Monday, Stabile said that with Prudente's case, Malta had also failed the medical profession.

"Medical teams had their hands tied when they were unable to offer Prudente the care she needed, according to research-based evidence. Health professionals in the US advised Prudente to ask for a termination of pregnancy, but providing this care under current law would have put both woman and doctor liable to a prison sentence.

"Instead, legally mandated conservative management followed. Doctors in Malta refuse to accept this legal situation," she said on behalf of 135 doctors - including specialists in obstetrics and gynaecology, family medicine, psychiatry and paediatrics who signed the judicial protest asking for a review of the blanket ban.

"The overwhelming sentiment behind this demand is empathy. Moreover, our responsibility towards our patients demands that we try to treat conditions before they become unstable and life-threatening. In cases of complicated pregnancy, abortion may be required to protect a woman’s physical and mental health."

What does the judicial protest say?

The protestants feel aggrieved that abortion in Malta is not only criminalised against the women carrying the foetus, but also medical doctors, with the prohibition directly impacting their work according to their Code of Ethics.

They also feel that such criminalisation not only puts the lives of women in physical danger, but also impacts their mental health and therefore breaches women’s right to life and health.

Additionally, it prohibits doctors from providing necessary care in pregnancy cases with complications, and they, therefore, cannot adhere to international standards, including those given by the World Health Organisation, the International Federation of Gynaecologists and Obstetrics and the Royal College of Obstetricians and Gynaecologists.

This lack of protection and access to medical care is tantamount to a breach of fundamental human rights of women by means of the European Charter of Human Rights, Universal Declaration of Human Rights, Civil and Political Rights Covenant, Disability Rights Convention, Economic, Social and Cultural Rights Covenant, Convention of Elimination of Discrimination Against Women, ICPD Programme of Action, Beijing Platform for Action, UN General Comment 14, the European Convention of Human Rights as well as the right to health as per Article 11, read in conjunction with Article E and Article 1 and 26 of the European Social Charter that forms an integral part of the Maltese laws.

The protestors are demanding the removal of Article 243 from Chapter 9, Laws of Malta so that medical professionals will no longer be criminalised.

They are also calling for the introduction of regulations so that medical professionals can provide immediate care in cases where complications in pregnancy arise.

What does the law say?

Article 241 of the criminal code stipulates that whoever causes a miscarriage - whether the woman consents or not - could be liable to imprisonment between 18 months and three years. 

Women who bring about their own miscarriage or consent to one will face the same punishment.

And according to article 243, physicians, surgeons, obstetricians or pharmacists who “knowingly prescribe or administer the means whereby the miscarriage is procured” could be imprisoned for 18 months to four years and also be banned from practising their profession. 

Doctors for Life react

In a statement, Doctors for Life said that the judicial protest is calling for a carte blanche on abortion for doctors.

They also claimed that doctors signing it had no access to the document before they put their name to it.

In their statement, the doctors said the protest was not requesting a refinement of the law so that it is more explicit in permitting therapeutic abortions covered by the double effect.

"Instead, the judicial protest is requesting that article 243 is removed entirely therefore allowing any doctor or practitioner to perform any kind of abortion for any reason."

They added it was "lamentable" that doctors signing the form to include their names were not automatically shown the judicial letter itself or a full explanation of what would be specifically requested.

They claimed the letter was still being drafted while signatures were being collected and this meant that doctors who signed it may not actually be in agreement with such a drastic change in the law.

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