While the prime minister has asserted that abortion will remain illegal with the proposed amendment to the Criminal Code, many remain unconvinced and request clarity on what constitutes grave matters to health.

I commend the prime minister and deputy prime minister for the clarification of the law and, knowing Chris Fearne, the intention is to protect the medical professional who, in turn, wants to protect the life of the mother and not put her at risk.

Yes, indeed, this was brought about, as often happens in these cases, with the case of the tourist who was losing her baby and who potentially was going to be put at risk by making her wait until there would no longer be a heartbeat.

Following the case of Savita Halappanavar in Ireland, this is exactly what is to be avoided. While I have not been involved in the drafting of this amendment (and it is probably not my competence), as a bioethicist I have chosen the path to reconcile opposing views by finding common ground.

Many have questioned the need for an amendment of the law. Indeed, a lawyer wrote that no doctor was ever found guilty when trying to save the mother. However, there are many areas in bioethics which cause doctors mind-boggling trouble, even the risk of being taken to court (as seems to be the case of the tourist).

Knowing you will not be found guilty ‘doth butter no parsnips’. I have been involved in many cases at hospital to merit this assertion. It is not always easy. For us, it is an ordeal and costs money and time. We had the same issue with data protection. This was always protected under the law but even the EU saw that change in times required clearer legislation.

I have argued the same for both the end-of-life and the beginning of life. Focussing on the latter, we need a law in which such cases as the above are clear-cut but also give guidance.

Clearly, Catholic doctors do not see it fit to terminate a pregnancy when they still see a heartbeat. This, notwithstanding that many theologians, following the Irish case, clearly pointed out that the doctrine of double effect could have been invoked.

We have to agree on what constitutes ‘grave’ risk to health- Pierre Mallia

My main concern as a bioethicist is the breaching of patients’ rights. It is all well and good to say that the Irish doctors were negligent as they should have recognised the sepsis early, as a colleague told me. But the main point is that, once you know for certainty that the baby is dying, why go through the risk. Why risk the mother? One can also add why go through the extra cost? The outcome is the same. It is not that one wants to abort a baby.

I am sure that even those who believe that the principle of double effect is not fulfilled, because they see it as a direct action, will agree (or ought to, at least) that medicine ought never to be paternalistic and make decisions which the mother disagrees with.

What we have to agree on is what constitutes ‘grave’ risk to health. Once this is clear, then people’s minds can be at rest that this is not an attempt to bring in abortion through the window. I am sure that this is what the opposition wants as well.

Clarification of laws is more than necessary in ethical issues.

Political talk apart, even at the end of life I have heard patients saying that “it was that last dose of morphine that killed my mother”. I personally experienced it myself. Why ought there even to be a possibility of taking me to court when I am simply doing my duty? Even Catechism allows this. But Catechism is not the law.

pierre.mallia@um.edu.mt

Pierre Mallia is professor of family medicine and patients’ rights and teaches at the University of Malta. He chairs the Bioethics Research Programme of the Faculty of Medicine and Surgery. He also chairs the Bioethics Consultative Committee. This article is his personal opinion and does not represent the opinion of any committee or board he serves on.