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