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NEW ZEALAND CARE
OF CHILDREN BILL
Supplementary Order Paper
This is a joint letter from the New Zealand Medical
Association and the Royal New Zealand College of General Practitioners
who are concerned at the Supplementary Order Paper proposed by Judith
Collins (237 of 27 July) to amend the Care of Children Bill.
When the Contraception, Sterilisation and Abortion Act
was passed in 1977, the Guardianship Act 1968 was amended as part of the
abortion legislation to permit pregnant girls under 16 to apply for
approval for an abortion without informing their parents or guardians,
or requiring their consent. The Care of Children Bill (which it is
proposed will replace the Guardianship Act) now under consideration
after being reported back from the Justice and Electoral Committee,
retains this provision, although some Opposition members said they
oppose it.
Our concern relates to the proposal in the
Supplementary Order Paper to amend the clause 37 to require parents or
guardians to be notified before a girl under 16 is referred to a
certifying consultant. The SOP also proposes a legal alternative whereby
if the “female child” objects to such notification, she may appeal to a
Family or District Court Judge who will authorise the application to the
certifying consultant without notification “should the Judge determine
that the female child’s best interests would be so served”. The College
and the NZMA do not consider this to be an adequate alternative, placing
additional pressures on an already fraught girl, and giving no guidance
to her as to how a Judge might measure her best interests. It is also
likely to be difficult to implement this mechanism of objection given
the limited time frames of early pregnancy and legal representation
problems for a girl under 16.
The SOP does not intend that a guardian’s consent
would be required to approve the referral, but the fact of the
pregnancy, and presumably of the girl’s options to seek a certifying
consultant’s approval for an abortion, would be passed on to parents or
guardians. The change proposed is therefore about information, and who
must receive it. It is not about the legality of abortion (or who can
decide to seek one), but about whether the information about a pregnancy
should go beyond the pregnant girl and her general practitioner. The two
medical organisations are strongly opposed to this proposed change.
First, from a medical practitioner’s point of view the
girl is a patient, entitled to the same privileges of privacy, and the
same measure of confidentiality between her and her general practitioner
as any other patient. Confidentiality about the outcome of a medical
consultation is absolutely crucial if an effective doctor/patient
relationship is to be established. The patient must be absolutely
certain that his or her privacy will be respected if all the information
necessary for effective diagnosis and treatment is to be obtained.
Confidentiality is at the core of ethical, safe and effective medical
practice.
Secondly, the Contraception, Sterilisation and
Abortion Act has been effectively operating largely unchanged since
1977. The Act is a careful balancing of the rights of a number of
parties, and any attempts to revise part of it should be considered in
that context, not in associated but different legislation. It would be
unfortunate if the proposed changes outlined in the SOP were seen as an
attempt to limit abortion, in the guise of readjusting the balance of
rights to information of girls under 16 and their guardians. If the
intent is to make access to legal abortion more difficult and thereby to
reduce its incidence, this should be clearly stated at the outset, and
the debate can be considered in those terms.
Thirdly, it seems probable that the risk of dangerous
self-induced or illegal abortions would increase sharply if the SOP were
to be passed. While medical practitioners counsel pregnant girls to tell
parents and seek support, some girls, especially those subject to
abusive relationships, if they know the doctor will be compelled to tell
their parents, will likely self administer pregnancy tests and seek
illegal and dangerous abortions.
The College and the NZMA consider that there are
important medical, ethical and clinical reasons for opposing the SOP,
and a serious risk of returning to the era of dangerous illegal
abortions if it is passed.
15 September 2004
http://www.scoop.co.nz/mason/stories/PO0409/S00123.htm
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