Labour’s half-baked abortion proposal

On Monday Parliament approved at first reading stage Bill number 28 which Bill seeks to clarify the provisions of the Criminal Code relative to therapeutic abortion. Specifically, the objects and reasons of the Bill seek to “provide clarification on the parameters that shall apply in the Criminal Code to circumstances of necessity in which a medical intervention is required in order to protect the life and health of a pregnant woman suffering from a medical complication”.

Some may consider that Bill 28 is a good first step in a country which has continuously avoided debating abortion. Unfortunately, government’s proposal is half-baked.

After years of avoiding a national debate, it would have been much better if government published a detailed White Paper explaining its views on abortion and the related issues and principles. It is about time that we recognise that the country’s abortion legislation is not fit for purpose. After being ignored for 160 years Maltese abortion legislation requires to be brought in line with medical and scientific progress over the years. It also requires a substantial redrafting in view of the fact that for over a decade Malta has embraced ethical pluralism.

It is clear that government has limited itself to addressing the political fallout resulting from the recent case of the American tourist Andrea Prudente as a result of which Malta failed in the provision of the expected medical care.

We do not require a half-baked reactive proposal but rather a proposal which addresses twenty-first century reality. Whether we like it or not, abortion is a regular occurrence among Maltese too! Indications point towards an average 400 abortions which are carried out annually, a substantial portion of which through the use of abortion pills acquired through the post. Others are carried out through abortion tourism, primarily in the United Kingdom as is evidenced by annual published medical returns for England and Wales.

Apparently, the Labour Party is short on ideas as it has even failed to address abortion in its electoral manifesto for the March 2022 general election.

In contrast to the reluctance of the Labour Party to come forward with proposals, the Maltese Greens, which I lead, have, over the past months presented proposals which in addition to the required clarifications in our legislation seek decriminalisation as well as the specific introduction of abortion in three extraordinary circumstances: namely when the pregnant female’s health or life is under threat, in cases of a pregnancy brought about violently (rape and incest) as well as in the case of non-viable pregnancies.

Some have considered our above proposals as being too little, others as being too much. We consider that in view of the prevailing local circumstances our proposals are just right, a substantial improvement over government’s half-baked proposals and an overhaul of the current mid-nineteen century legislation, which is out of tune with what is expected in this day and age.

There are other related issues which we should also discuss. During this week a group of local academics and some hangers-on have published a discussion paper which discusses government’s abortion proposal.

The proposals in the said discussion paper seek to tightly define the circumstances which justify a medical intervention to protect the life and health of a pregnant woman. It also seeks to exclude all forms of abortion by tightly defining the applicable parameters.

It is a point of view which should be considered and discussed. This is what a mature public debate should be about and what government has been continuously avoiding. I would however expect other academics having different views to come out of the deep freeze and speak up.

We should look beyond the restrictive proposals presented in the discussion paper. Since the 2011 divorce referendum Malta has embarked on a journey of ethical pluralism which respects a plurality of views and ethical norms. The discussion paper is a negation of this journey and an attempt to change course, which attempt should be resisted.

At the end of the day the debate is not about what is right and wrong but on who should take the decision and the parameters within which it is permissible to act. We are not living in a theocracy. Differing views and values can definitely co-exist.

Let the debate, at last, begin.

published on Malta Independent on Sunday : 27 November 2022

An invitation: keep the doors open

The abortion debate gets nastier by the minute. This was expected. It may even get worse!

The priest who described pro-choice PN candidate Emma Portelli Bonnici as a later day Hitler, kicked off this week’s instalment! The Archbishop’s Curia at Floriana forced the removal of the facebook post where he published these views: yet the damage was done. Will we ever learn to discuss anything respectfully? Is this too difficult to expect?

The Labour Party is being extremely cautious. It is very rare to hear any Labour Party speaker express himself or herself on the subject of abortion. Labour is aware of the different and contrasting views within its ranks when debating abortion. That in itself is healthy and could potentially lead to a mature debate. The current Labour Party leadership, however, as readers are aware, is acutely conservative on the matter even though there is a progressive element among its voters which is of the opposite view. This includes a couple of present and former electoral candidates and MPs/MEPs.

The PN on the other hand, going by Bernard Grech’s declaration earlier this week has not yet learnt its lessons from the divorce referendum campaign, ten years ago. I respect its political position on the matter but I still cannot understand its constant denigration of those within its ranks who have the courage to speak their mind. Stifling political debate is very damaging.  It has long-term effects which go much beyond the current debate!

As pointed out elsewhere, Bernard Grech’s declaration signifies one thing: the abortion debate is closed within the PN ranks, and anybody who dares think otherwise should start packing. From where I stand that is the clear message conveyed by Bernard Grech.

Within ADPD, the Green Party, last May, after a three year long internal debate, we approved a clear political position in favour of decriminalisation of abortion, as a result of which any woman opting for an abortion would not be subject to criminal action. We further emphasise that abortion should not be normalised but that it should be limited to specific, extraordinary and well-defined circumstances.

We have highlighted that Maltese legislation on abortion is not fit for purpose. It needs to be brought up to date after more than 160 years since its enactment. It requires to be brought in line with medical and scientific progress over the years.

We identify three such extraordinary circumstances in which abortion is justified, namely, when the life of the pregnant woman is in danger, when a pregnancy is the result of violence (rape and incest) and when faced with a pregnancy which is not viable.

There is definitely an urgent need for more emphasis on reproductive and sexual health education at all levels of our educational structures. This is a gap which needs plugging at the earliest!

We have been criticised by some as not going far enough. Others have stated that we have gone much too far.

Empathy, the ability to understand and share the feelings of others, is key in the abortion debate. It is essential that women who undergo abortion are not threatened any more with persecution and prosecution. They need the state’s protection as a result of which more will seek help before taking critical decisions. This will save lives as well as avoid unnecessary medical complications.

The abortion debate in Malta is unfortunately characterised by long periods of silence, alternating with outbursts of hate, insults and extreme intolerance. This is definitely not on. Political parties should take the lead by encouraging contributions to a clear and objective debate.

While others close their doors to the debate, ours will remain wide open.

published in The Malta Independent on Sunday : 14 November 2021

L-abort: nippruvaw niddiskutu bil-kalma

Id-dibattitu dwar l-abort hu wieħed emottiv. L-insulti u t-tgħajjir li għaddejjin huma bla limitu. Huwa f’din l-atmosfera li qed issir id-diskussjoni. Ċerti nies ma jitgħallmu qatt.

Id-dibattitu huwa ibbażat fuq l-istess punt fundamentali tad-dibattitu dwar id-divorzju: fil-pajjiż jirrenja l-pluraliżmu etiku. Jiġifieri jeżistu valuri kuntrastanti. Kuntrasti li ilhom jinbnew ftit ftit tul is-snin imma li ġew moħbija mil-lenti pubblika. Id-diskussjoni kienet waħda ipprojibita. Ma saritx minħabba l-biża’ minn soċjetà intolleranti, frott tal-fundamentaliżmu li għixna fih għal ħafna snin. Is-soċjetà tagħna illum żviluppat f’soċjetà lajka li immanifestat ruħha fir-referendum dwar id-divorzju u fl-aċċettazzjoni tad-drittijiet LGBTIQ.

Mhux kull abort hu xorta. Mhuwiex ġustifikat li taqbad l-“agħar każ ta’ abort” u tuża lilu bħala eżempju.

Il-kampanja kontra l-abort hi iffukata fuq abort bla limitu li ma jeżisti kważi mkien. Fuq l-iktar każ estrem, kontinwament jinbena argument li jappella għall-emozzjonijiet flok għar-raġuni. Argument li jbezza’ lil uħud imma li ma jikkonvinċix lill-kotra li kapaċi taħseb b’moħħa.

Il-kampanja favur id-dritt tal-għażla (pro-choice) min-naħa l-oħra tagħmlu l-argument li mara għandha dritt li tagħżel dak li trid, x’ħin trid u bla ma jindaħlilha ħadd. Dan jinkludi dritt li tagħżel jekk u meta tidħol għal abort. Argument neoliberali fejn il-libertà individwali m’għandhiex limiti.

Id-dibattitu hu kuntrast bejn dawn iż-żewġ estremi. Id-djalogu min-naħa l-oħra taf twasslek x’imkien ieħor li jkun aċċettat abort f’każijiet limitati fejn is-sens komun jgħidlek li dan hu ġustifikat. L-argumenti emottivi dan kollu jinjorawh u allura jimminaw d-diskussjoni matura li tant neħtieġu f’dan il-pajjiż. Il-pajjiż ma jeħtiegx l-abort bħala stil ta’ ħajja imma l-abort bħala rimedju f’ċirkustanzi straordinarji.

F’Malta l-abort isir. Jagħmluh n-nisa li jixtru pilloli online u jeħduhom mingħajr ma jikkonsultaw tabib, bil-kumplikazzjonijiet kollha possibli. Ma teżistix statistika dwar kemm minnhom jidħlu l-isptar bħala riżultat ta’ dan.

L-abort isir ukoll fl-isptar Mater Dei f’ċirkustanzi fejn tittieħed azzjoni biex tkun imħarsa l-ħajja ta’ nisa tqal li jiffaċċjaw kumplikazzjonijiet fit-tqala. Riċentment kellna l-polemika dwar t-tqala magħrufa bħala “ectopic”, jiġifieri meta l-bajda ffertilizzata teħel f’tubu intern fil-mara. Dan it-tubu (Fallopian tube) hu żgħir u jekk ma tittieħed l-ebda ażżjoni jinfaqa’ u jipperikola l-ħajja tal-mara tqila.

Il-kura li tingħata f’dawn iċ-ċirkustanzi hi mediċina li taqla’ l-bajda iffertilizzata minn mat-tubu u tarmiha. Jekk dan idum ma jseħħ jikber il-periklu u tkun meħtieġa operazzjoni. Fiż-żewġ każi dan hu abort li bħalu jsiru numru kull sena f’Mater Dei. Imma ħadd ma jgħid xejn, għax kulħadd jaċċetta li dan hu intervent meħtieġ, anke jekk il-liġi tqis din is-sitwazzjoni bħala illegali.

Hu ċar li l-opinjoni pubblika f’Malta, fil-parti l-kbira taċċetta l-abort meta dan hu meħtieġ biex iħares il-ħajja tal-mara. Meta tiddiskuti bosta jaslu biex jaċċettaw li l-abort f’dawn iċ-ċirkustanzi hu tollerabbli.

Hemm ċirkustanzi oħra fejn l-abort hu inqas kontroversjali. Qed nirreferi għal meta jsir abort f’kaz ta’ stupru jew f’każ ta’ inċest. Fejn it-tqala hi sfurzata, bi vjolenza, hu ġustifikat li jsir abort preferibilment fil-fażi l-iktar kmieni possibli tat-tqala. Mara li għaddiet minn vjolenza ma tistax issib il-liġi bojja lesta biex tikkastigha, għax inkella tispiċċa soġġetta għal vjolenza doppja.

Xi żmien ilu ktibt artiklu fejn kont ikkumentajt dwar il-fatt li hawn min fil-fażi inizjali tat-tqala jagħmel xi testijiet u jekk minnhom jirriżulta xi difetti fil-fetu, il-mara tirrikorri għal abort. Dan mhux aċċettabbli. Imma mhux biżżejjed li ngħidu hekk. Hemm ħtieġa li nifhmu lil min jagħmel din l-għażla u nistaqsu jekk parti mir-raġuni hijiex soċjetà li ma tindukrax biżżejjed familji li jgħaddu minn sitwazzjonijiet ta’ disabililtà. Minkejja li sar progress kbir xorta għad hawn nuqqas enormi kemm ta’ komprensjoni kif ukoll ta’ għajnuna iffukata lejn min għandu bżonnha.

Xi kultant naqraw b’min jirrikorri għal abort għax it-tqala u t-twelid jitqiesu xkiel għall-iżvilupp tal-karriera! Hemm soluzzjonijiet diversi għal dawn it-tip ta’ ċirkustanzi, minn edukazzjoni aħjar dwar is-saħħa riproduttiva għal sens ikbar ta’ responsabbilta’ mhux biss tal-mara imma wkoll tar-raġel.

L-aħħar eżempju huwa fejn issir għażla favur l-abort minħabba l-faqar. Jintqal li hawn każi fejn il-mezzi ta’ familja huma tant ristretti li ma jifilħux għal wild ieħor. Anke hawn hemm soluzzjonijiet li minħabba n-nuqqas ta’ dibattitu pubbliku ftit li xejn jiġu esplorati. Irridu nindirizzaw l-għerq tal-faqar u mhux il-konsegwenzi tiegħu. Inkella nibqgħu fejn konna. Anke hawn in-nuqqas ta’ edukazzjoni dwar is-saħħa riproduttiva hu enormi.

Mhux in-nisa biss jeħtieġilhom jitgħallmu iktar imma anke l-irġiel għandhom ħtieġa kbira għal dan: uħud jeħtieġu doża iktar qawwija ta’ rispett u sens ta’ responsabbiltà.

Id-dekriminalizzazzjoni, almenu f’ċerta aspetti, hi parti essenzjali mit-tibdil meħtieġ. L-ebda mara m’għandha tkun soġġetta għal passi kriminali għax ħadet il-pilloli li waslulha bil-posta inkella għax irrikorriet b’xi mod għall-abort wara vjolenza li taqqlitha. Il-mara li tagħmel abort hi ukoll vittma hi stess u teħtieġ l-għajnuna u mhux is-swat tal-liġi.

Fid-dawl ta’ dan kollu l-proposta ta’ Marlene Farrugia iktar kmieni din il-ġimgha ser isservi biex taċċellera d-dibattitu pubbliku. Imma jkolli ngħid li saret ftit bil-għaġġla u hija nieqsa minn preparazzjoni pubblika dwarha.

Neħtieġu dibattitu kalm għax hu b’hekk biss li nistgħu nifhmu iktar lil xulxin. Dan hu dibattitu li mhux ser jispiċċa fi ftit ġranet iżda ser idum. Jekk ma nagħmluħx bil-kalma ma nkunu wasalna mkien.

ippubblikat fuq Illum : il-Ħadd 16 ta’Mejju 2021

The abortion debate

The abortion debate is very emotional. Many insults are flying around. Some, unfortunately never learn.

The basic premise underlying the abortion debate is identical to that of the divorce debate: ethical pluralism reigns. Meaning that different values and attitudes co-exist. It is a clash of values that has been building up over a number of years, far away from the public eye.  Discussion has been continuously postponed due to the fear generated by an intolerant society founded on fundamentalism. A lay society has in the meantime developed and manifested itself clearly in the divorce referendum and subsequent acceptance of LGBTIQ rights.

It is incorrect to select “the worst” type of abortion and presenting it as the prototype

The “pro-life” campaign against abortion is focusing on “abortion on demand” which practically does not exist anywhere and presenting this as the prototype.  On this basis the campaign propagates an emotionally charged message instead of appealing to a reasoned approach. A message aimed at instilling extreme fear even though it is not the least convincing.

The pro-choice campaign on the other hand argues that a woman has the right to determine her choices without interference from anyone. This includes the right to determine if and when to have an abortion. This is a neo-liberal attitude which considers that there are no limits to individual liberty.

The debate is a contrast between these two extremes. Dialogue, on the other hand, leads you elsewhere, considering the exceptional circumstances in which an abortion may be justified. The emotional arguments ignore all this thereby undermining the mature discussion which this country has a right to. The country does not require abortion as a lifestyle: rather it is required as a remedy in extraordinary circumstances.

Abortion is practised in Malta. It is practised by women who purchase abortion pills online which they take without medical direction. All sorts of medical complications arise.  No statistics are available as to the number of those who require hospitalisation as a result.

Abortion is carried out at Mater Dei Hospital in circumstances to safeguard the life of women who face serious complications at some point in their pregnancy.  Recently the press highlighted the controversy on ectopic pregnancies, that is when a fertilised ovum is lodged in the female Fallopian tube. If left untreated this leads to a rupture of the said tube thereby placing the life of the pregnant woman in extreme danger.  

The medicine administered in such cases serves to dislodge the fertilised ovum which is subsequently discharged. If there is a delay in administering the medicine, or if this is ineffective, a physical intervention (surgery) would be essential.  In both circumstances this is an abortion which is carried out a number of times annually in the state hospital. However, no one ever complains as it is considered by all as a necessary and essential intervention, even if the law considers this as an illegal situation.

It is clear to all that public opinion in Malta generally accepts abortion when this is carried out to address the danger to the life of a pregnant woman.. At the end of the day in these circumstances abortion is tolerated.  

There are other circumstances when abortion is acceptable. I refer to cases of rape or incest. When a pregnancy is the result of violence, an abortion, preferably in the earliest possible stages of a pregnancy is acceptable.  A woman who has been subjected to violence should find comfort in the law otherwise she would be subject to violence for a second time.

Some time back I had written an article about tests being carried out in order to identify specific abnormalities in the foetus. In such cases depending on the results of the tests, abortions are being carried out.

This selectivity is definitely unacceptable. However, one must look beyond this and try to understand the underlying reasons for such choices. One would immediately understand that the prospective parent/s are making a forceful statement that notwithstanding existing help they feel that they are not able to shoulder the burden of the indicated disability. Notwithstanding the substantial progress registered over the years there are still substantial gaps. Parents feel this much more than anyone else. 

Occasionally we read about abortion resorted to in order not to endanger career development.  There are alternatives to such a course of action starting from education on reproductive health which ought to instil a greater sense of responsibility in both man and woman.

Poverty is another situation which may lead to opting for an abortion. It has been asserted that in circumstances of poverty a woman may opt for an abortion. Alternatives exist even in such circumstances: these have however been ignored.   It is poverty which has to be addressed and not its consequences.  Even in these circumstances the impact of a lack of education on reproductive health is glaring.  

Providing adequate reproductive health education would in the long run lead to less abortions.  This is required not just by women but also by men who generally require a greater sense of responsibility.

Decriminalisation is central to the change required. No woman should be subject to criminal action for making use of abortion pills which she receives through the post or for opting for an abortion after being violently impregnated. Women who opt for abortion are themselves victims who should find full protection of the law and not be criminalised.

In the light of the above the proposals put forward by Marlene Farrugia earlier this week will aid the development of the public debate.  Unfortunately matters were done somewhat in a hurry as the public was not prepared for these developments. But maybe shocking the public was part of the strategy!

We require a calm debate as this is the only manner in which we can clearly understand each other’s arguments. This is a debate that will not be over in a few days.  Being rational and calm is the least we can do.

Published in The Malta Independent on Sunday : 16 May 2021