Obstruction of Access to Care

Contraception, Sterilisation, and Abortion Act 1977

46 Conscientious objection

(1) Notwithstanding anything in any other enactment, or any rule of law, or the terms of any oath or of any contract (whether of employment or otherwise), no medical practitioner, nurse, or other person shall be under any obligation—

(a) to perform or assist in the performance of an abortion or any operation undertaken orto be undertaken for the purpose of rendering the patient sterile:

(b)
to fit or assist in the fitting, or supply or administer or assist in the supply or administering, of any contraceptive, or to offer or give any advice relating to contraception, —

if he objects to doing so on grounds of conscience.

‘Conscientious objectors’ are legally permitted to refuse to provide patients with legitimate health care services that are an accepted part of the specialty the objector was trained in. This means a doctor can refuse to refer you for an abortion, or refuse to provide you with an order or a prescription for contraception, or refuse your request to be sterilised.

It means a nurse can refuse to assist in those procedures. It means a pharmacist can refuse to fill your legal prescription for contraception, or emergency contraception.

Obstruction of access to medical care  discriminates against women and other people who can become pregnant, because contraception, like abortion, is routine health care used primarily by them.

Without reproductive health care women would find it much more difficult to plan their lives and futures, and gain economic independence.

Before 2010 objecting doctors at least had to refer you to a doctor who would actually provide the service. But in 2010 the High Court said such assistance compromised doctors ’consciences’.

The Medical Council of New Zealand could have appealed that decision, but it did not. So now, all the objecting doctor is legally obligated to do is tell you the care is available from another doctor (but not which one) or a Family Planning clinic, and show you the door.

They are legally authorised to waste your time, energy, and money.

 

ALRANZ believes the current situation is unfair to patients.

The patients are not doing anything wrong, and yet the law places the burden of their doctors’ conscience on them to navigate the system, and endure humiliation, expense, and delays in receiving care, all without redress.

It is the providers, not the patients, who are deviating from the norm in refusing services that would normally be considered part of their job.

Why shouldn’t the cost be borne by the person with the objecting conscience?

Some have suggested providers should be compelled to provide the services associated with their specialties, or find another job. But would you REALLY want to get a vasectomy or an abortion from someone who does not want to perform one?

It would be fairer to require providers to alleviate the harm they have caused. Providers should be required to compensate the patients to whom they deny service.

Nobody would want to receive abortion care from someone who does not want to provide it. But there should be a lot more in the way of consumer protection.

Obstructing doctors should be required to disclose what care they refuse to provide to their patients at their initial consultation, and register what care they refuse to provide on a registry maintained by the Health Ministry. Doctors should not be permitted to charge a fee for any consultation in which they refused a service they have not disclosed on the registry.

Taken together, these elements work together to hold both doctors and patients accountable – doctors have an incentive to disclose honestly and completely, and patients have an incentive to check the registry, and protection if the checking the registry did not help because the doctor did not disclose everything.

See our blog post for a more complete treatment of our proposals regarding conscientious objection.