The autonomous government of Castilla y León has announced that it will oblige health professionals to offer three options to pregnant women who want to abort: The possibility of listening to the fetus’s heartbeat, that the parents can have a 4D ultrasound and support for psychological care . However, according to Vice President Juan García Gallardo, the woman who goes to have an abortion “is not going to be forced to listen to the heartbeat of her baby if she does not want to”, also criticizing the persecution to which doctors who are they refuse to practice voluntary interruptions of pregnancy, assuring that in their region they will be protected.
For its part, the Ministry of Equality has described the measure as “coercion” and has expressed its “deep concern” about an initiative that they consider “a setback” in an “essential right for women, the right to abortion, which is a milestone in the feminist struggle of our country.
A proposal that is not new
It should be noted that this proposal is not new. Other countries have long implemented it in different ways: in Europe, Hungary and Slovakia, and in the United States the states of Georgia, Idaho, Indiana, Kansas, Michigan, Missouri, Montana, Nebraska, New Hampshire, North Carolina, South Carolina, Oklahoma, Texas, Utah, and Wisconsin. Although in some of these states it is mandatory for the physician to show and describe the ultrasound image to the woman requesting an abortion, in most cases the possibility of doing so is simply offered prior to the abortion.
It should be clarified that trying to impose on any patient the performance of a diagnostic test, in any case, constitutes a violation of the principle of autonomy and the exercise of their free decision, which is why it is bioethically reprehensible. But, nevertheless, implementing measures that offer the possibility, as long as the patient accepts, of providing complementary and transcendental information about the nature of the intervention that is intended to be performed, not only is it not a violation of their rights, but it constitutes an inscribed duty in the process of prior information that every patient should receive before making a decision about any medical intervention.
The fact of providing information before an intervention should not be confused, as some have done, with a form of “guardianship” towards the woman, which would imply a contempt for their autonomous decision-making capacity. Conversely, providing data to someone who has to make a decision, with the aim of making it from the most advantageous position, knowing the options, their alternatives and possible consequences, does not imply an act of medical paternalism, quite the contrary. From positions favorable to abortion, positions that reinforce the option of abortion seem to be favored, hiding or hindering access to others that, offering alternatives, try to avoid it. And this is a form of paternalism. Thus, changes have been implemented in the latest reform of the abortion law that suppress the reflection period or eliminate the obligation to provide information on alternatives and aid in the event of finally deciding not to abort. Attempting to limit the information that a woman who goes to have an abortion should receive, to prevent her from reconsidering her decision, is an attack on her autonomy, her ability to make free decisions and, ultimately, her dignity and rights. Hiding information about the technique to be performed, about the nature of the fetus to be aborted, about available alternatives to the fact of aborting or about side effects and risks associated with this practice, constitutes an attack on the duty to provide the patient with all the necessary information to that can make an informed decision, contrasted, correctly evaluated in its possible consequences and free.
And this is the case for any medical, diagnostic or therapeutic intervention. But it is much more so in the case of abortion, where the most dramatic consequence of the decision to abort is to cause the death of a human being in its initial stages of development. Those who oppose informing, manipulate. And those who manipulate violate the freedom and rights of the women involved.