Abortion secrecy law amendment faces dual opposition

Amending the abortion law to stop doctors from reporting abortions without the woman’s consent has been shot down by both pro-life and pro-choice doctors, albeit for different reasons.

With the pro-life camp saying this created “a double standard” that ultimately protected one crime over another, the pro-choice side argued that this is “misguided” as it does not provide wide-enough protection from prosecution – and no woman in her right mind would consent to being reported.

Last week, Prime Minister Robert Abela said the government is looking into amending the Professional Secrecy Act so that doctors can only report an abortion to the police if the patient gives their consent.

He spoke after, on Thursday, a 28-year-old woman was handed a suspended jail sentence after she pleaded guilty to having an abortion. It is understood that the woman bought abortion pills from the internet. 

Abela echoed the words of Health Minister Jo Etienne Abela when he spoke about concern that the current situation could lead to women putting off seeking medical help for fear of criminal action.

In April, Times of Malta revealed how four of the seven abortions reported to the police over the past decade were flagged by doctors at Mater Dei Hospital.

Maltese law does not explicitly require medical practitioners to report patients who have had an abortion. However, under the Professional Secrecy Act, professionals are permitted to disclose confidential information if it is deemed necessary to prevent, reveal, detect or prosecute a criminal offence, or to avoid a miscarriage of justice.

This subjective element results in some doctors reporting it and others not.

A ‘misguided’ solution

Isabel Stabile and Natalie Psaila Stabile, from Doctors for Choice, said that amending the Professional Secrecy Act to require patient consent before reporting women for an abortion is “frankly misguided”. 

“Would any woman who’s thinking straight ever give consent to this? Why would they, unless they’re vulnerable in some way – maybe they misunderstand what it entails, or they have an intellectual disability,” they said.

Besides, this would not stop other healthcare providers, ancillary staff, a partner or ex, or anyone else who finds out that an abortion has taken place.

Finally, they argued, it did not get to the heart of the matter – that abortion care is healthcare.

“If the prime minister wants to avoid having women going to court for an abortion, then he should have abortion decriminalised immediately. Granting pardons after women have been dragged through hell and back is simply unacceptable,” they said.

While a suspended jail term did not land the woman in jail, the threat hangs heavily over their heads, they said.

“No one wants to have an abortion, so this country must work harder on providing better sex education for all, including adults and all genders; make contraception free and accessible; decriminalising those who have to resort to having an abortion when all else fails,” they said.

A double standard

Miriam Sciberras, from the Life Network Foundation that opposes abortion, criticised the government’s proposed amendment as creating “a double standard”.

She described the suspended jail term handed down to the woman who had the abortion as “the court’s wise decision, light in punishment, yet clear in acknowledging that a life was lost, and speaks volumes. It reveals the contradictions we are facing as a society. If abortion is considered a criminal act under the law, why should it be uniquely protected from the legal standards applied to all other crimes?

“In every other case where someone is harmed or at risk, doctors are expected to report, whether it involves domestic violence, child abuse, self-harm or gunshot wounds. These are seen as serious threats to life, and rightly so. Why, then, should abortion be the exception?”

Sciberras argued this isn’t about punishing women but about ensuring they receive support, information and protection – especially when coerced or desperate. She asked: “Who will be the voice of the child in the womb?”

She emphasised the need for consistency in laws and genuine concern for human life. Just as society intervenes when a child or woman is at risk, the same should apply to the unborn. Sciberras also criticised the portrayal of abortion as safe and simple, saying the physical, emotional and psychological risks are often downplayed. Instead, pro-abortion doctors used complications to push for broader access, not stronger safeguards.

Women, she said, deserve full disclosure of physical, emotional and psychological risks, including effects on fertility.

“We cannot pretend that legal silence equals compassion. True compassion means being willing to speak hard truths, not to condemn, but to care. It means creating a culture that supports women through crisis pregnancies, that offers alternatives and that treats both mother and child as lives worth defending.”

A different solution

Daniel Bianchi, a lawyer and health law lecturer at the University of Malta, explained there are broadly three bands of reporting by a professional: instances when it is mandatory to report, instances when it is mandatory not to report and instances when a professional may report but is not obliged to.

“It may then be questioned why, instead of effectuating a change in respect of one offence alone, the government is not considering amending the law so as to altogether ban reporting by healthcare professionals to the police or other entities unless specifically mandated by law?

“After all, any person who, for instance, as a consequence of allegedly committing an offence is unwell could hesitate from seeking medical attention if that can lead to healthcare professionals filing a report to entities such as the police,” he said.

Bianchi noted that if the proposed change to the law arises out of concern for the health of persons who suffer ill health as a consequence of allegedly committing an offence, then juridical coherence demands that the law would have to be changed so that no healthcare professional can make a report to the police unless so mandated by law and this change would not then be restricted to one offence alone.

“My hunch, however, is that there are different ways to better address the government’s concern on this matter and those should first be studied further,” he said.

'The law doesn't need changing'

Lawyer Emma Portelli Bonnici, from Lawyers for Choice, said there is a straightforward fix that does not require a parliamentary process.

“The law doesn’t need changing - there already exists no obligation at law for doctors to report women who have had an abortion", she said.

"The issue is how that law is being interpreted, particularly by the legal team at Mater Dei, who, I am informed, are advising doctors to report. That advice is legally flawed.

"What’s needed is clear guidance from the Ministry for Health and the Malta Medical Council to clarify that no such obligation exists.”

Bonnici warned that amending the Professional Secrecy Act was not only unnecessary but could be harmful.

“This kind of superficial change risks doing more damage than good. If we shift the burden of reporting onto the woman - rather than allowing professionals to act when there are signs of coercion or abuse - we are stripping away vital protections", she said.

"I want a woman who says her partner forced her to have an abortion to be protected, and for the partner to be investigated. Turning this into a consent-based offence risks silencing victims further", said Bonnici.

"If we truly want to protect women, the fix is simple - decriminalise abortion."