Editorial: Between health and a courtroom

This is not an editorial for or against abortion. It’s about healthcare repercussions.  It is about what happens when a woman in Malta, having already made a difficult, albeit illegal, choice – faces a medical emergency.

She is already in hiding, socially and legally speaking. Now, something has gone wrong. She needs help and must go to hospital. This could be a matter of life or death for the woman.

In the past weeks, we’ve heard that such a woman has two options: lie about what’s happening or face potential criminal action, depending on the doctor she encounters. Alternatively, she can tell the truth and be asked if she consents to being prosecuted, according to a recent proposal.

Either way, criminal prosecution is lurking.

Regardless of anyone’s stance on abortion, one fact should be indisputable: a woman who is bleeding and in distress needs medical assistance. And fear of ending up in court is reason enough not to seek it. This isn’t just about facing legal consequences.

It’s about bearing a scarlet letter in the eyes of family, employers, even society itself. The emotional cost of speaking up is simply too high.

Which means the risk of keeping things as they are – leaving the decision to report a woman up to moral discretion – is also too high.

Under current Maltese law, abortion is illegal except when a woman’s life is at risk. And while the law does not explicitly require doctors to report women who have had an abortion, the Professional Secrecy Act allows them to do so if they believe it is necessary to prevent, reveal, or prosecute a crime.

This subjectivity means some doctors report women. Others don’t. We have heard how the legal team at Mater Dei Hospital has the final say.

Data shows that four out of seven abortion cases reported to the police in the last decade came from doctors at Mater Dei Hospital.

It happened again recently. A 28-year-old woman was handed a two-year suspended prison sentence after admitting she had taken abortion pills. She told the truth in the hospital – and ended up in court.

She wasn’t the first. In 2023, a woman received a conditional discharge. In 2014, two women were given suspended sentences for abortion-related offences.

So, when politicians reacted with “shock”, it felt more like damage control.

Equality Parliamentary Secretary Rebecca Buttigieg, MEP Daniel Attard and MPs Rosianne Cutajar and Ramona Attard expressed their concern after the court ruling, saying the law is frightening people from receiving necessary medical care.

Health Minister Jo Etienne Abela and Prime Minister Robert Abela now say they are considering amending the Professional Secrecy Act to ensure doctors can only report an abortion if the patient consents.

This proposed solution feels cosmetic – one that practically managed to unite both sides, pro-life and pro-choice, in disapproval.

The pro-life camp said it created “a double standard” that protects one crime over another.

The pro-choice camp called it “misguided,” arguing it offers too little protection – and no woman in her right mind would consent to being reported.

Even legal experts questioned it, saying it could backfire and protect perpetrators who force a woman to abort, because doctors would need consent to report. These experts have spoken about the need for clear guidelines to doctors.

This shouldn’t be a political fight. It’s a public health issue.

But the women living through it now – the ones who make that decision, knowing it’s illegal – should not have to choose between health and humiliation, medical care and a courtroom, truth and silence...