Bolivian doctor loses his position for refusing to commit an abortion

The National Health Fund suspended Dr. 'N.M.' for having refused to perform an abortion on a woman pregnant with an anencephalic child.
Mon Mar 25, 2019 - 9:00 am EST
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LA PAZ, Bolivia, March 25, 2019 (LifeSiteNews) — A Bolivian doctor has been suspended by that country’s National Health Fund (Caja Nacional de Salud) for having refused to perform an abortion on a woman pregnant with an anencephalic child. “N.M.,” as he is known, will also be prosecuted before an administrative court, together with the former director of the Jaime Mendoza Workers’ Hospital in Sucre, where the refusal took place.

Abortion is illegal in Bolivia except in cases of rape, incest, danger to the mother’s health, or a lethal malformation of the unborn child.

It was this last case that was invoked by a woman from Cochabamba in February of last year after medical examinations revealed that her baby had a serious congenital malformation. She was five months pregnant. Anencephaly is not incompatible with a live birth, and children with this condition have been known to live for months or even years.

Following the protocol in such cases, doctors and specialists formed a medical board to decide how proceed. They offered three options: one, simply to go on with the pregnancy; two, to give information to the family about the fetus’s malformation; three, to obtain jurisdictional approval permitting an abortion. (This approval, according to the ministerial resolution dating back to January 2015, is not necessary when rape or incest are involved.)

However, all the professionals at the hospital said that in the absence of a judicial approval and also because of their right to conscientious objection, they would not perform the abortion. As the regional director of the National Health Fund, Javier Menacho, put it, “no one can be obliged to end the life of a human being.”

During a press conference in which he gave his support to “N.M.” and the hospital’s ex-director and staff, Menacho clarified that the woman’s family asked for her discharge from the hospital; she then went to another establishment, where the abortion was performed.

It was she who lodged a complaint against the doctor who had refused to kill her child, stating that her rights had been violated. Together with the ex-director of the hospital, “N.M.” is accused of having ignored the constitutional ruling that permits legal abortion when a pregnancy puts the mother’s health or life in danger.

On Tuesday, March 2019, the decision to suspend “N.M.” as interim chief of the gynecology and obstetrics department of Jaime Mendoza Hospital, where he refused to perform the legal abortion, was made public by the local “Defender of the People,” as the public ombudsman is known in Bolivia. An ombudsman’s resolution presented last week to the National Health Fund had asked it to establish responsibilities, be they civil, criminal, or administrative, against all those who resisted the constitutional ruling, hence the decision to suspend the doctor despite his right to conscientious objection.

The ombudsman’s report said that an inquiry has shown that the mother’s right to health, life, and physical and psychological integrity was breached. This was despite the face that being pregnant with an anencephalic child does not constitute a risk for the mother’s life, health, or physical integrity. According to the doctors who attended to “P.A.A.,” there was never a risk to her life.

In any case, from a moral point of view, a risk to the mother’s life does not justify direct abortion and should not trump a doctor’s right to conscientious objection, should abortion be legal in that case. But in many countries, the abortion lobby is pushing hard to oblige doctors to perform abortions when the mother’s life is in danger. In the Bolivian case, it is going one step further by attempting to impose eugenic abortions on unwilling doctors.

The Sucre affair has already had one consequence: at the National Health Fund, in agreement with the ombudsman’s delegate for Chuquisaca, Edwin Martinez, the regional administrator will put in place a staff “socialization” and training program about health institutions’ obligation to provide safe abortion when legally possible.

Hospitals as such are not entitled to conscientious objection in Bolivia.

Individual doctors definitely do have a right to refuse abortions. But the lawsuit against “N.M.” shows how fragile that right is.

The president of the Medical Association of La Paz, Luis Larrea, has already stated that it is looking at how it will support a colleague who has “every right to perform or not to perform an operation that takes another being’s life.” “We respect the Hippocratic oath which obliges to save lives and not to go against life,” he told a local radio.

A former Forensic Institute director, Dr. Antonio Torrez Balanza, who currently presides the Forensic Medicine Society of Sucre, underscored the contradiction between “law and principles.” For doctors, he said, “to respect the Hippocratic oath to defend life is a basic principle recognized by the political Constitution of the State that quite logically applies especially to doctors, as well as the religious factor that prevents them from destroying life. The code of ethics of the Medical Association says life must be respected,” he insisted.

  abortion, bolivia, freedom of conscience

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