Members of House of Keys play hardball with new amendments to the Abortion Reform Act:  threats to ‘reform’ derailed by some significant changes.

CALM is, and always has been, about Giving Choice a Voice

The amendments being proposed by certain Members of the House of Keys on Tuesday remove, restrict and limit choice.

CALM cannot support any of them

Please remember why we – and you – want to reform the existing law and what is important:

The ordinary women who require a simple, non-criminal, non-judgemental medical abortion to be available in the Isle of Man, and who will then be able to get on with their lives.

CALM – Giving Choice a Voice

The amendments listed below:

• deliberately deny a woman choice in her own reproductive health care
• deliberately ignore the results of the biggest public consultation ever held in the Isle of Man when over 85% of respondents said they wanted reform of the current abortion law
• deliberately ignore the fact that the second reading of the Abortion Reform Bill was carried unanimously by the House of Keys. Nobody objected, nobody said reform of the Termination of Pregnancy (Medical Defences) Act of 1995 was unnecessary

Eighteen of the sixty amendments tabled are worthy of further analysis.  The most restrictive amendments are tabled by Chris Robertshaw MHK and Howard Quayle MHK and will, if carried, make the whole Abortion Reform Bill 2018 a nonsense.

Many of the amendments tabled strive to muddy the waters with over-complication, obfuscation, and deliberate emphasis on very rare cases. It’s important we keep firmly focused on our message.

CALM – Giving Choice a Voice

CALM would like you to write to your MHKs and say why they shouldn’t vote for any of these amendments at the sitting of the House of Keys on Tuesday 6 March 2018.  Thank you.

Please feel free to use the detail below to help – but this is your opportunity to write your own stories, in your own words.

Here are three links which you’ll find useful

AbortionReformBill_Amd Concatenated Final Revised

http://www.tynwald.org.im/memoff/member/Pages/default.aspx

For simplicity, we’ll stick to the order on the list of amendments

CLAUSE 3, Amendment 3

Chris Robertshaw MHK redefines ‘health’.

The World Health Organisation (WHO) definition of health “means a state of complete physical, mental and social well-being, and not merely the absence of disease of infirmity.” This definition is accepted in the majority of civilised countries.  Does the Isle of Man really want to be in breach of international human rights law?

Mr Robertshaw’s amendment would substitute this sentence with “health means the physical or mental health of the person or foetus”.

This is not only at odds with the WHO definition but is also at odds with the advice of the Isle of Man Director of Public Health – which could have ramifications for other IOM law and public health guidelines.

IMPLICATIONS: this amendment could restrict abortion access in the future if in any way the health of the foetus is judged equal to – or more important than – the health of the pregnant woman.

This could mean that a seriously ill or dying woman could be kept alive as an incubator for the foetus – as currently happens in Ireland (the repeal of this very clause, their 8^th amendment, is going to a referendum vote in Ireland this year).

CALM cannot support this amendment

CLAUSE 6, Amendment 8

Chris Robertshaw MHK seeks to reduce limit for abortion on request from 14 to 12 weeks.

Latest statistics from England and Wales show that:

• 81% of abortions take place between 3 and 9 weeks
• 11% between 10 and 12 weeks
• 7% between 13 and 19 weeks
• Only 2% over 20 weeks

At 14 weeks, over 94% of abortions can be carried out without excessive bureaucracy and in a safe and unjudgemental manner.

IMPLICATIONS: If this amendment is passed, and the limit reduced to 12 weeks, women will continue to travel for the same procedure at their own expense to other jurisdictions without any support from their own GP or health professional at home, or buy and import medical abortion pills online without any support, and unable to tell their doctor what they’ve taken.

It will not stop abortions happening: it will only force women to make unsafe choices.

CALM believes that women should able to have safe and legal abortions on the Isle of Man up to 14 weeks.

CALM cannot support this amendment

CLAUSE 6, Amendment 14

Chris Robertshaw MHK seeks to reduce 24 week limit to 22 weeks.

This would put Isle of Man law at odds with England and could cause problems with late referrals (NB Mr Robertshaw’s own expert witness Lord Daniel Brennan QC cited problems if the two laws didn’t ‘match’ in his evidence to the House of Keys on 30 January “it would by unfortunate if in different parts of our Islands different processes applied”)

This change is probably related to foetal viability, but definitive studies show that only 0.4% of babies born at 22 weeks survive without disability and at 23 weeks this only rises to 8%.

As Obstetrician Mr Bob Fayle was careful to point out in his evidence to the House of Keys on 30 January, there is a difference between terminations for medical reasons and early delivery of babies.  It is also worth noting that pregnancies of 20 weeks plus are usually of much-wanted babies, and a decision to have a late termination for medical reasons should not be allowed to be rushed.

IMPLICATIONS:  Foetal anomalies are usually detected at a 20 week scan (which might not even happen until 21 weeks) and should a woman find at her 20 week scan that the foetus is unviable, or will suffer considerable life-threatening or life-limiting conditions she would only have a maximum of 2 weeks (including appointments at specialist centres off-Island) to research, learn and make a decision – a choice – whether to continue with the pregnancy or not.

If this amendment succeeds:

• The pregnant woman’s choices (and those of her family) are severely restricted, and this reduction in time limits could mean she makes a quick decision which might have severe long-term effects on her mental health.
• The difference between IOM and English law would mean a woman and her doctors would be breaking the IOM law if she was referred to an English specialist clinic after 22 weeks. This affects the treatment(s) and support doctors and other professionals can offer their patient and is completely unworkable within the UK Abortion Act 1967.

CALM cannot support this amendment.

CLAUSE 6 Amendments 11, 15, 19

Chris Robertshaw MHK seeks to make abortion available only when two doctors agree.

Here is why CALM thinks insisting on the agreement of two doctors is unacceptable:

1. There is no other healthcare procedure which demands two signatures
2. Many professional organisations in the UK are campaigning for this to be abandoned under the Abortion Act 1967
3. This is a remnant of our previous Termination of Pregnancy (Medical Defences) Act 1995

IMPLICATIONS:  A woman would have no autonomy over her body and cannot trusted to make any decision over her own reproductive healthcare.

The sole reason for this amendment is to increase delay and reduce choice.

CALM cannot support this amendment

CLAUSE 6 Amendment 12

Howard Quayle MHK seeks to remove the following lines:

‘This subsection applies if, according the pregnant woman, there are serious social grounds justifying the termination of the pregnancy’

IMPLICATIONS:  This is Mr Quayle’s attempt to prevent women obtaining an abortion for social grounds, for example women seeking abortions past 14 weeks because they are in an abusive relationship or have addictions or are in prison.

If this amendment is successful and if Mr Robertshaw is successful in his attempt to change the legal definition of ‘health’, abortions after 14 weeks (12 weeks if Mr Robertshaw has his way) would only be allowed in the Isle of Man in the case of rape, incest or other unlawful intercourse, danger to mother’s life and/or death of the foetus – exactly the terms of the Termination of Pregnancy (Medical Defences) Act 1995.

This is not reform.

CALM believes women will continue to go to another jurisdiction for a termination without any support from the Isle of Man healthcare system.

CALM cannot support this amendment.

This is where it starts to get complicated with a further amendment (13  – below) if amendment 12 fails.

CLAUSE 6 Amendment 13

If Mr Quayle fails to get support for amendment 12, he will move another to insert a further paragraph:

After ‘this subsection applies if, according the pregnant woman, there are serious social grounds justifying the termination of the preganancy’, Mr Quayle will move to add these lines:

“… and this is supported in evidence in writing as may be specified in regulations from an appropriately qualified professional…. (a) a consultant psychiatrist (b) a consultant surgeon or (c) a person possessing such other qualifications as may be specified in regulations”

IMPLICATIONS:  Not only would Mr Quayle require a woman to see two doctors before being permitted an abortion, one of them would probably have to be a consultant psychiatrist or consultant surgeon.

CALM believes this is a cynical attempt by Mr Quayle to revert to the conditions of the Termination of Pregnancy (Medical Defences) Act 1995, which the House of Keys agreed unanimously at the second reading should be reformed.

A decision to have a termination should be that of the woman, with advice and support from health professionals.  If a second doctor has to be consulted, particularly with these professional qualifications, there will be an inevitable delay and the abortion may not be carried out within the 14 week (or 12 week – if Mr Robertshaw’s earlier amendment is carried) time period.

This is a clear restriction of choice and of a woman’s right to make decisions regarding her own reproductive healthcare.

CALM cannot support this amendment

CLAUSE 6 Amendments 16, 17,18

Amendment 16: Chris Robertshaw MHK seeks to delete Clause 6 (8)(d)(ii)

This clause allows an abortion when, if there was a substantial risk that were the child born alive …“the child would suffer a significant impairment which likely to limit either the length or quality of the child’s life”

If this amendment was passed, it would mean the abortion could only take place if there was a substantial risk that, were the child born alive …”the child would die shortly after birth because of severe foetal development impairment”.

IMPLICATION:  a woman would have to carry a severely handicapped or disabled child to term and then be obligated to support it in whatever way she can for as long as it lives.

If amendment 16 fails, then Mr Robertshaw has tabled two further amendments:

Amendment 17: For ‘significant’ substitute ‘serious’

IMPLICATION: a woman and her health professionals have to define ‘serious’.

Amendment 18: for ‘limit either the length or quality of the child’s life” substitute “limit both the length and quality of the child’s life”

IMPLICATON: If this amendment were to pass it would mean that a child could be born severely damaged, in incredible pain but still live out a full life span.

CALM believes this is tantamount to torture, for the child, its mother and family.   It removes the right of the woman to make a choice over what is best for her child and the extended family.  This choice, to keep or abort the foetus, can only be made with the best advice from the best health professionals and other healthcare providers: it should not be laid down in this law.

CALM cannot support any of these amendments

CLAUSE 6 Amendment 23

This amendment states that the Department (presumably, but not necessarily, the DHSC) may, by order make substantive changes to the Abortion Reform Bill 2018.

This amendment takes the business of law-making out of the hands of our elected MHKs and gives it directly to the Department.  The public has been consulted about the details of this Bill but by tabling this amendment, Graham Cregeen MHK wants to be able to change those details in the future without consultation, debate or anything more than a simple yes/no vote on an order brought in at the whim of the Minister of the day.

IMPLICATIONS:  Tynwald would be able to reduce any time limits for a legal abortion without any public consultation, or a full democratic debate.

CALM cannot support this amendment

CLAUSE 8, Amendments 27, 29, 30 and 31

Chris Robertshaw MHK seeks to redefine ‘treatment’ as ‘activity’

‘Treatment’ is clearly defined at the start of the Bill as beginning ‘with the administration of a drug or the start of a surgical procedure and ends with the expulsion of the products of conception from the womb’

Clause 8 specifically deals with conscientious objection to ‘treatment’ as defined above.

By seeking to widen this to a conscientious objection to an ‘activity’ this amendment would make it possible for a nurse to claim conscientious objection to making a counselling appointment, booking a woman into a clinic, or a cleaner refusing to clean a room where an abortion has taken place.

IMPLICATIONS: on a small island this could severely disrupt the ability to perform abortion services (including provision of counselling) and thus restrict access.

CALM believes that any attempt to restrict access to abortion services – including counselling – is a retrograde step.

CALM cannot support these amendments

CLAUSE 11 Amendment 45

Alf Cannan MHK seeks to remove the whole of clause 11.4, thus removing the protection of women who obtain abortion pills online from prosecution.

Buying and importing pills for a woman’s own use will continue to be illegal.

IMPLICATIONS:  This would considerably reduce choice for those women can’t afford to leave the Island for a private termination, who might be in an abusive relationship, have no reliable child-care or who can’t for any reason see their GP privately or easily.  It will criminalise those women who even in the early weeks of pregnancy, will still break the law, won’t be honest about with their own doctors for fear of prosecution and may suffer severe injury to their own health. The women who believe they have no other option.

If this amendment is passed, it would open the way for the police and customs authorities to track packages and for prosecutions to take place.

(NB Increasing numbers of packages of abortion medication have been stopped by IOM Post, and although prosecution has not yet happened in the IOM, in Northern Ireland woman have been prosecuted for this offence so there is a precedent in a neighbouring jurisdiction)

This amendment criminalises choice – a choice made by those women who most need to be able to exercise choice over their own bodies without fear of prosecution.

CALM cannot support this amendment

CLAUSE 1 Amendment 47

Howard Quayle MHK is seeking to move a new clause (1.17) regarding sex-selection terminations.

There is no realistic need for this legislation on the Island.

Sex-selection for medical reasons is already covered elsewhere in the Bill (Clause 6.3 6.8 – assuming Amendments 8, 14 and 23 aren’t carried).

CALM is concerned about the very rare sex-selection for cultural reasons but in his evidence to the House of Keys on 30 January, obstetrician Mr Bob Fayle said he’d only ever been approached once for this in his career, and that was in the 1980s in England.

CALM believes there is sufficient guidance in place for health professionals to be aware of coercion and control, identify if this is being suggested or requested and act accordingly.

Chris Robertshaw MHK’s invitation to Jasvinda Sanghera to present evidence at the 30 January sitting was, CALM believes, a rather cleverly introduced red herring – diverting attention away from the real reasons for the Bill by including forced abortion, forced pregnancy, forced marriage and female genital mutilation (FGM).

These issues are not about the legal status of abortion, but about violence and abuse – and should be the subject of another Bill entirely.

This amendment to the Abortion Reform Bill 2018 is unnecessary.

CALM cannot support this amendment.