Professionals like gynaecologists and psychotherapists are unclear about their legal, moral and ethical obligations when seeing clients who are considering having an abortion or who have had one, according to a sex and relationship counsellor.

Matthew Bartolo, who is also the founder of Willingness, a team of professionals providing counselling services, shared some of the questions which have left professionals in a dilemma:

For example, if they are seeing a couple where the man wants his partner to go through with the pregnancy while the woman does not, what are the professional’s legal obligations? Does the man have a right on his parenthood? Can the father report/sue the professional?

Around 400 Maltese are believed to seek an abortion abroad each year, which means that while it is illegal in Malta, women are still undergoing the procedure overseas.

“Our obligations change according to whether a woman has had an abortion in Liverpool or hypothetically in Malta. One is legal and one isn’t, so of course clarity is needed because if a woman thinks that she’s going to be reported, she won’t look for help,” Mr Bartolo said.

From a professional’s point of view, there is apprehension of the legal repercussions, Mr Bartolo underlined. Some are also unclear on the rights of the partner in the matter, he added.

Strong personal views further complicate the issue, with pro-life professionals unsure of the way their own morals come into play when providing therapy to those who have undergone an abortion.

Andrea Dibben, chairperson of the Women’s Rights Foundation, explained that fear of prosecution and being judged holds women back from seeking a gynaecologist or therapist, even if they have had an abortion in a country where it is legal.

“I get a lot of calls from women who had an abortion asking whether they know of a gynaecologist or therapist who will be okay with seeing them,” she said.

A seminar to be held by Willingness on October 10 will involve a panel of experienced professionals, including Matthew Xuereb, a representative of the Attorney General, and criminal lawyer Ezekiel Psaila, who will move beyond the pro-choice versus pro-life debate to address these kinds of queries.

I get a lot of calls from women who had an abortion asking whether they know of a gynaecologist or therapist who will be OK with seeing them

The discussion is devised to provide professionals with a legal spectrum of rights, obligations and the extent of expression to their clients in consideration of their ethical and moral beliefs on the topic, explained Dr Psaila.

What are the professional’s rights and obligations when working with someone who mentioned planning to have an abortion?

Ezekiel Psaila: During the course of his duties, a professional is neither obliged nor imposed on to divulge such information to the third-party authorities, such as the executive police.

A professional such as a psychotherapist who is working with someone who mentioned planning an abortion, has an obligation not to direct the client but to create a safe environment where the client can understand what they themselves want.

He is entrusted by professional secrecy to provide therapy for the patient and to secure a safe environment holistically for him or her.

If the professional is morally convinced that the patient will be harming himself or those around him, then the professional is obliged to take all medical precautions within his power and to secure that patient’s safety.

The law sets no explicit obligation whereby the professional is obliged to divulge information that has been entrusted to him/her from a patient under professional secrecy and within such person’s professional conduct.

Are professionals legally and ethically responsible for a crime if they support their client throughout the process of them going abroad to get an abortion?

Ezekiel Psaila: Yes, such support would amount to complicity. Legally, a person shall be deemed to have supported an abortion if he/she either commands, instigates, procures, in any way aids, incites or strengthens the determination of their client. According to the law, the professional would have to face the same punishment as their client undergoing the abortion.

As regards ethics, the legal professional cannot act on ethical beliefs which, when advised to their clients, are contrary to law. The discussion on October  10 will address this precisely. What are the boundaries at which moral and ethical expressions could meet with the legal repercussions.

What if an abortion is done locally? Is the professional obliged to report the doctor or person performing the abortion?

Ezekiel Psaila: No and here’s why: Let’s take a step back. If a commoner in the street sees another person committing a criminal offence that is not against a minor or vulnerable person, or a crime against the State, such a person, even with a phone in his hand, is not obliged to report to the police, and is not criminally liable for not doing so.

In this context, if a patient in therapy decides to put forth information regarding a doctor performing an abortion, it is the patient who should report the doctor committing the crime not the professional.

What if the professional is pro-life and asked to support a client who wants to terminate their pregnancy?

Matthew Bartolo: During therapy, the professional’s job is not to direct the client but to create a safe environment where the client can understand what they themselves want.

We are aware that we all have biases and personal experiences that shape these same biases. If we try to impose or push our clients towards a direction, or a choice, this might harm them as they are separate individuals living in a different culture with a different history.

What if a 15-year-old girl discloses that her parents are forcing her to abort?

Matthew Bartolo: Whether it comes to abortion or any other situation where a minor is not being treated correctly by their parents, it is important to contact child protection services and seek support for the minor.

Regardless of the situation presented, the client is the child. Therefore, while there needs to be parental consent in therapy for minors, the client is still the main focus and is the one requiring support from the professional.

In the case of abortion, it is illegal to perform an abortion in Malta, and therefore, in this case, the mother would be forcing the minor to commit a crime, which further adds to the need to involve child protection services and report the mother to the police.