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Medical Council issues Update to Doctors in relation to the Health (Regulation of Termination of Pregnancy) Act 2018

From the commencement of the Act the Medical Council will delete Ethical Guidance relating to Termination of Pregnancy while Ethical Guide review process continues

Thursday, 20th December 2018:

The Medical Council will be writing to all registered doctors to provide them with an update relating to the Guide to Professional Conduct and Ethics for Registered Medical Practitioners and the paragraph dealing with termination of pregnancy.

The Medical Council decided last night at a specially convened meeting to delete paragraphs 48.1 to 48.4 of the Ethical Guide, thus removing any conflict between the Ethical Guide and the Legislation. Paragraph 48.5 of the Guide, slightly edited, “You have a duty to provide care, support and follow up for women who have had a termination of pregnancy” will remain in place.

The Medical Council is working through a detailed process to update the Ethical Guidance following the enactment of the Health (Regulation of Termination of Pregnancy) Act 2018. The Ethics Working Group is reviewing a number of paragraphs of the Guide to ensure that the Guidance is relevant and appropriate for doctors and for patients in light of the new legislation.

Speaking about this update, Chairperson of the Medical Council Ethics Working Group and member of the Medical Council, Dr Suzanne Crowe said “We are currently engaging in a very comprehensive process to update the Medical Council guidelines having only recently closed a consultation with doctors and key stakeholders in which over 1,400 responses were received.

“Today’s announcement ensures that our Ethical Guidance is not in conflict with the new legislation and provides reassurance to doctors who are involved in delivering this service.

“We have deleted the guidance in paragraphs 48.1 to 48.4 which relates to the Protection of Life During Pregnancy Act 2013 and the provision of information relating to termination of pregnancy. Doctors still have a duty to provide care, support and follow up for a person who has had a termination of pregnancy, as outlined in paragraph 48.5.

“The Working Group is continuing to draft revised guidance following the consultation and once the new wording is finalised, we will once again consult with doctors and relevant stakeholders, however this process will not be completed by the implementation date of the legislation,” concluded Dr Crowe.

In the consultation to date, four paragraphs of the Guide to Professional Conduct and Ethics for Registered Medical Practitioners are being reviewed, namely ‘Paragraph 7 Dignity of the patient’, ‘Paragraph 8 Equality and diversity’, ‘Paragraph 48 Abortion’ and ‘Paragraph 49 Conscientious objection’ to ensure that doctors have sufficient ethical guidance going forward.

Medical Council President, Dr Rita Doyle, said “Our priority is to get our guidance right. Not just for the doctors providing the service, but for the people who will be availing of these services. We want to ensure that the guidance we provide is inclusive, relevant and useful.

“We must take the time to get our Ethical Guidance correct but we do not wish to be a barrier to the provision of services upon the commencement of the Act, which is why the Medical Council has decided to take this approach.

“The Council is committed to keeping doctors and stakeholders involved in the process and we will continue to do so into the New Year until the revised guidance is finalised,” concluded Dr Doyle.

ENDS

Notes to Editor:

  • The Guide to Professional Conduct and Ethics for Registered Medical Practitioners, 8th Edition (2016) is available here
  • Ethical guidance in other sections of the guide covers the provision for termination of pregnancy upon the commencement of the Act.
  • The Medical Council appointed an Ethics Working Group at its first meeting of the new Council Term to specifically review and advise the Medical Council on any required edits to the Guide to Professional Conduct & Ethics for Registered Medical Practitioners.
  • Paragraph 48.1 to 48.4 is being deleted with 48.5 remaining slightly edited (‘abortion’ to ‘termination of pregnancy’) upon the commencement of the Act.
  • The four paragraphs of the 2016 Guide being reviewed are:
    • 7 Dignity of the patient
      • 7.1 You must always treat patients with respect.
    • 8 Equality and diversity
      • 8.1 Patients’ cultural background and ethnicity have an important effect on their health outcomes. You should try to understand patients’ culture and respond to their individual needs. You should not discriminate against patients or colleagues on any grounds
      • 8.2 Patients have the right to be offered all treatment options that are likely to be of benefit to them.
    • 48 Abortion
      • 48.1 You have an ethical duty to make every reasonable effort to protect the life and health of pregnant women and their unborn babies.
      • 48.2 During pregnancy, rare complications can arise where a therapeutic intervention is required which may result in there being little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to terminate the pregnancy to protect the life of the mother while making every effort to preserve the life of the baby.
      • 48.3 Abortion is legally permissible where there is a real and substantial risk to the life of the woman which cannot be prevented by other means. This risk, while substantial, may not be immediate or inevitable in all cases. This risk should be assessed in light of current evidence-based best practice.
      • 48.4 With regard to abortion abroad, it is lawful to give information in Ireland subject to strict conditions. However, it is not lawful to promote or advocate an abortion in such cases.
      • 48.5 You have a duty to provide care, support and follow up for women who have had an abortion.
    • 49 Conscientious objection
      • 49.1 You may refuse to provide or to take part in the provision of lawful treatments or forms of care which conflict with your sincerely held ethical or moral values.
      • 49.2 If you have a conscientious objection to a treatment or form of care, you should inform patients, colleagues and your employer as early as possible.
      • 49.3 When discussing these issues with patients, you should be sensitive and considerate so as to minimise any distress your decision may cause. You should make sure that patients’ care is not interrupted and their access to care is not impeded.
      • 49.4 If you hold a conscientious objection to a treatment, you must inform the patient that they have a right to seek treatment from another doctor; and give the patient enough information to enable them to transfer to another doctor to get the treatment they want.
      • 49.5 If the patient is unable to arrange their own transfer of care, you should make these arrangements on their behalf.
      • 49.6 In an emergency, you must make your patient’s care a priority and give necessary treatment.