We’re 10 days into the debate about whether the government is proposing to introduce abortion by stealth. The debate has moved forward but is rapidly getting stuck in the political swamp.

The onus is on the government to show that the bill has no loopholes. So far, it has stuck to reiterating that it’s not an abortion bill and casting aspersions on the doubters. That’s not enough.

The signatories to the expert paper published last week include three constitutional experts and several leading gynaecologists and obstetricians. Between them, they’re saying what the government claims doesn’t stand up to legal or medical scrutiny.

Does the government have legal experts to back its claim that its amendment has no loopholes? Are they ready to stake their reputation that, if the bill becomes law, no doctor will be sued for refusing to perform an abortion, irrespective of the legislators’ intentions?

Does the government have health experts who are ready to contradict, on medical grounds, the considerations raised in the position paper?

If the government has these experts, we need to hear from them. It’s also the government’s responsibility to give concrete answers to the objections.

To begin, there is the question of legal judgement.

First, why does the prime minister keep saying the bill will prevent the Prudente case from ever being repeated? In parliament, he said the case could have been a tragedy. In court, the state is arguing that Andrea Prudente’s life was never in danger.

Therefore, if the bill has anything to do with preventing a repetition of the Prudente case, it can only be to be able to grant a patient like her an abortion. Yet, this is what the government is denying.

The question goes to the heart of Robert Abela’s judgement. So far, we have it only on Abela’s word that the bill is watertight. But if Abela denies making a mistake in roping in the Prudente case – while refusing to square his position with that of the state before the court – why trust him on anything else to do with this case?

Second, we need to understand better where the government disagrees with the experts’ proposed alternative bill.

They want mental health issues to be explicitly excluded by the bill. Chris Fearne has objected. But does he have any other objection to the experts’ wording?

Specifically, does he object to ‘termination of pregnancy’ being replaced by ‘death or bodily harm of an unborn child’? If he has no objection, the government would go a long way to reassuring many people. If he does, he needs to explain why.

The next set of issues has to do with medical experience.

Fearne has said that for the bill explicitly to exclude mental health is to downplay its importance. Not quite.

We should have the courage to call things by their name- Ranier Fsadni

No one’s trivialising mental health. The issue is not whether it’s serious. It’s whether it justifies the termination of pregnancy.

The matter arises in a broader context. The UK’s experience (with a law couched in terms similar to the bill) is that many abortions end up performed in the name of safeguarding mental health, even when the mother’s life is not at risk.

Why wouldn’t the UK experience repeat itself here? Is it something in the bill? Or will there be additional safeguards (such as a regulatory system like that proposed by the experts, where the decision to terminate is a collective one that involves at least three specialist professionals)?

We need more clarity about the extent of the government’s disagreement with the experts.

Abela has excluded stress and guilt feelings as justification for the termination of pregnancy. What about other conditions mentioned by the experts, like organic mental disorder and rape?

The experts effectively claim that mental health issues, in the context of pregnancy, never put the mother’s life at risk (or, more precisely, if they do, it’s because they become physical health issues as well). Does Fearne have clinical evidence that points to the contrary?

If the government accepts that mental health issues are not life-threatening, what makes them such a grave threat to health that they warrant a justified termination of pregnancy?

That question leads to the final issue, which concerns ethical judgement.

The critics of the bill have no issue with medical intervention when the mother’s life is at imminent risk. But they do vociferously object to the inclusion of ‘health in grave jeopardy’ as an additional justification.

The government is adamant that the phrase should be included, although it has not been clear on why. Are serious threats to health included because, in practice, doctors need to make snap judgements? Is it because, sometimes, to save a life you need to make a snap decision in a moment when you can only determine health threats, not risks to life?

Or does the government believe that serious threats to health should be included on independent grounds, irrespective of whether they might pose a risk to life?

Because if it’s the latter case, then it’s an argument worth having. But we’d clearly be having a discussion that weighs a mother’s quality of life against the life of an unborn child.

We’d be debating abortion. And we should have the courage to call things by their name.

 

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