Abortion bill amendment won't improve care for multicultural communities: Doctors


A NSW MP claimed an informed consent amendment was needed to ensure vulnerable migrant women were not subjected to unwanted abortions.

The peak body representing doctors in Australia has slammed an amendment to the bill seeking to legalise abortion in NSW that put in writing the need for informed consent before an abortion can be performed as “entirely unnecessary”.

The amendment, introduced by Attorney General Mark Speakman, passed 47 votes to 41 on Thursday despite opposition from the bipartisan supporters of the bill.

Speaking in favour of the change, Liberal MP for Mulgoa Tanya Davies said the amendment was most important for multicultural communities who “may have issues understanding the English language”.

“Some women from multicultural backgrounds, or who are refugees, do not even understand English; they cannot read English,” Ms Davies told the NSW lower house.

Member for Mulgoa Tanya Davies speaks during amendments to the introduction to the Reproductive Healthcare Reform Bill 2019.
Member for Mulgoa Tanya Davies speaks during amendments to the introduction to the Reproductive Healthcare Reform Bill 2019.

“They are at a greater risk of being made vulnerable because the bill in its current form does not insist that a medical practitioner receive their informed consent before conducting a termination.”

But Australian Medical Association NSW vice-president Danielle McMullen told SBS News this reasoning was flawed because doctors already abide by informed consent on all medical procedures.

“It's just entirely unnecessary and any extra layer just adds confusion both to women and to doctors trying to treat them," she said.

"They [amendments] can really undermine the purpose of the bill which was to reduce the stigma around termination of pregnancy and bring it in line with other health procedures."

Members of NSW's lower house erupt into cheers as the bill to decriminalise abortion passed the lower house.
Members of NSW's lower house erupted into cheers as the bill to decriminalise abortion passed the lower house.
SBS News

Dr McMullen said it was important to provide particular attention to the health needs of multicultural communities but said the amendment did not add anything to the system in place to ensure language barriers did not impact the ability of people to consent to treatment. 

Under the proposed legislation informed consent means consent that is given "freely and voluntarily" and "in accordance with any guidelines applicable to the medical practitioner".

But according to Dr McMullen, the concept of informed consent goes a lot further.

"Medically speaking [informed consent] means that patients understand what the procedure is that they're going to have, the likely outcome, the potential risks and also the cost," she said, adding that written consent was generally needed for surgical procedures while verbal consent can be enough for other procedures.

During the debate, NSW Health Minister Brad Hazzard, who was one of 15 co-sponsors of the bill, said the amendment was unnecessary because informed consent is “already addressed in existing protocols”.

“Other than in an emergency, no doctor would consider it appropriate to undertake any procedure without informed consent. It does not matter whether it is a termination, an appendectomy or taking tonsils out - it is informed consent,” he said.

“The requirement of informed consent is already there. It underpins everything a doctor does.”

According to Dr McMullen, language barriers in medical care are already addressed by providing written material in language for common conditions and using a free translation service, which is available either face-to-face or over the phone.


"Often a combination of verbal and written information is best practice just across healthcare procedures in general and the appropriate use of translators is important," she said. 

Ms Davies also introduced an amendment that would explicitly prevent abortions being used for "gender selection", claiming that many Indian, Chinese and East Asian migrants in Australia still subscribe to a "son preference".

Chair of the Ethnic Communities Council of NSW Marta Ferracciano told SBS News she could not comment on whether this practice existed in some communities. 

"In Australia, we have a diverse society where some people will agree and some people will disagree with this legislation ... it is an individual decision and each family has to make it based on their own beliefs and culture," she said in reference to the wider abortion bill. 

In a statement on Friday, Mr Hazzard said MPs agreed to the Ministry of Health undertaking a review to determine whether the practice of gender-based terminations occurs within NSW.

“I am concerned at some misinformed commentary that seeks to overshadow the intention of the Reproductive Health Care Reform Bill 2019, which was to put terminations into a medical and health framework instead of the Crimes Act," he said.

Late on Thursday night, the private member's bill to remove abortion from the 119-year-old NSW criminal code passed the NSW lower house after three days of heated debate.

MPs from all sides of politics voted in favour of the Reproductive Health Care Reform Bill 2019 59 to 31, with cheers and claps ringing out across the chamber.

The proposed law will now proceed to the upper house where it is expected to be passed.

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