‘Do the right thing’ | Chris Fearne

There’s a lot of confusion surrounding the so-called ‘abortion bill’: starting with the fact that you yourself insist that it has nothing to do with ‘abortion’, at all. And yet, the amendment itself clearly states that - in cases where the mother’s health is threatened - the punitive measures for ‘terminating pregnancy’ (i.e., the medical definition of ‘abortion’) will be removed. Isn’t it true, then, that this amendment IS ‘about abortion’? And that it WILL ‘decriminalise abortion’ (even if only in certain, specific circumstances)?

No, absolutely not. The law that regulates abortion in this country is basically Chapter 9, Article 243 of the Criminal Code: which, in a few words, states that whoever terminates a pregnancy – for any reason, and by whatever means – is liable to a prison sentence. Doctors and specialists face up to four years imprisonment, and will lose their warrants; the mother - or anyone else who assists her - faces up to three years.

That is what the law says, and we are not going to change any of it. Everything will remain exactly as it is today.

And let’s be clear about what the word abortion means. When people out there say ‘abortion’, they don’t mean it in the strictly medical sense of the word. By abortion, they understand cases where a pregnant woman, who is in full health, doesn’t want to have the baby; so she takes the decision to terminate the pregnancy – either on her own, or by going to a pharmacy or a clinic – and remove her unborn child.

That is what people out there understand an abortion to be. And it’s illegal; and it will remain illegal, even after the amendment. Just to be clear.

What we ARE proposing to change, on the other hand, is the fact that what has always been ‘standard medical practice’, to this day – i.e., that a doctor intervenes to save a pregnant woman’s life, when there are life-threatening complications – is, in fact, illegal.

This summer [because of the Andrea Prudente case] we discovered that the law does not allow for any exceptions: even in cases where the mother’s life is in danger; and even when the mother does want to have the baby… but, because of pregnancy complications, it is not possible to save both the mother, and the baby.

Now: as both a doctor, and a pediatric surgeon, I’ve seen cases like this. I won’t go into any specific details: though maybe, some other time, there’ll be opportunity to recount some of these experiences.  But I know of instances where pregnant women who wanted to have the baby – and who cried, when told it was not possible to save it – suffered from medical complications, which forced them, and their doctors, to choose between either terminating the pregnancy, to save the woman’s life… or else, for both the mother and baby to die.

As things stand today, however – and I honestly didn’t know this, until last summer – the law I does not offer any kind of protection, even in cases like this. It simply says that ‘whoever terminates a pregnancy – in any situation whatsoever – should go to prison’. So even if a doctor is forced to terminate a pregnancy to save a woman’s life: in theory, he could be sentenced to up to four years’ imprisonment; and the mother, for three.

And yes: we’re going to change this. This is absolutely not acceptable, to us. But let’s be clear: this is the ONLY thing we are proposing to change. This, and nothing else…

You sound like you were ‘surprised’ to discover - only last summer - that Article 243 of the Criminal Code offers no exceptions whatsoever…

Not just me: all doctors were surprised…

How is that possible, though? People have been pointing out (including in the international press) that Malta has a ‘total abortion ban, in all circumstances’, for decades now. And Doctors For Choice – which formed more than two years ago – have been publicly raising this very issue, right from the very start…

[Shrugs] Fact is, I wasn’t aware of it. And nor were any of the doctors I spoke to, at the time. They, too, were under the impression that the law DID provide some form of exception, in such cases… and let’s face it: most doctors don’t spend their time reading Malta’s laws, do they? But when I asked the Attorney General, specifically, whether the law offered any protection for doctors and women, caught up in that kind of life-threatening situation… the answer I got was, ‘No. Not only does the law offer no protection: but it very clearly indicates that both doctor and mother would have to go to prison, in ALL cases…’.

When pro-choice NGO Women for Women was first formed, they called for the decriminalization of abortion in four, specific circumstances: including ‘when the pregnancy threatens the life/health of the mother’. Isn’t this exactly what you are proposing to do, right now?

Once again, I stress we are NOT discussing the ‘decriminalization of abortion’, here. Abortion – as people out there understand the word: and I repeat, I’m talking about ‘healthy women who choose to terminate their pregnancy for no medical reason’… that is, was, and will remain illegal…

With all due respect, however: not everyone uses the word ‘abortion’ only in that narrow, limited sense. MaltaToday’s readership also includes doctors, health professionals, campaigners, activists (on both sides)… and all sorts of other people who DO actually have a basic understanding, that there is a health issue at stake here…

Well, I’m a politician: I must address the ‘people out there’…

In that case, I’ll rephrase the question: as a politician, do you feel that the word ‘abortion’ has become so politically ‘loaded’, in the Maltese context… that you’ve become afraid to actually use it, yourself?

No, no, it’s not like that at all. All I’m trying to say here, is that… what we are doing, is simply amending Malta’s abortion law to include a legal exception – which doesn’t exist, today - that will offer protection to women and doctors, in cases where the pregnancy puts the mother’s life or health in grave danger. Now: can I be any clearer than that?

No, I’d say that was clear enough. Let’s move onto the bill itself. Critics (including several doctors) have argued that, by including pregnancies which threaten a woman’s ‘health’ – as opposed to physical illness which directly threatens her life – this bill will ‘open the door to abortion-on demand’. They object to the inclusion of ‘mental health’. Can you explain why these people are, in your own view, wrong?

Let’s start with this. In today’s world, whoever tries to minimize the importance of ‘mental health’ - or to simply throw it aside, on the basis that ‘it’s not as important as physical health’ – is doing a grave disservice to tens of thousands of patients, who are afflicted with mental health problems every day of their lives.

Anyone who suffers from mental health problems – regardless of whether they are male, female, pregnant, not-pregnant, old, young, or whatever – needs medical care, just as much as anyone who suffers from any physical health condition. This week the Association of Maltese Psychiatrists issued two separate statements: both of which stated that ‘there is no health, without mental health’. I agree with that, 100%.

So whoever tries to divide healthcare into two separate categories - ‘mental health’ on one side, and ‘physical health’ on the other – as if they were two completely different things… those people are committing a grave mistake. 

Another thing the AMP said is that it is almost unheard-of – I won’t say ‘it never happens’, for the simple reason that you can ‘never say never’; but it is EXTREMELY rare - that a pregnancy would ever have to be terminated, because of a life-threatening risk caused by mental health conditions.

So this idea that we’re hearing: i.e., that, because we are ‘not going to exclude’ people with mental health conditions, it’s as though we’re ‘flinging the door wide open, to thousands of abortions each year’… what can I say? It’s just another ‘mistake’ these people are making. 

And it’s not just me saying this, as a politician: psychiatrists are saying this, too. Psychiatrists are, in fact, saying two very important things, which should serve to put people’s minds at rest. One, that it is a grave mistake to (as the Opposition is doing) separate ‘mental’ from ‘physical’ health: a mistake that would set back Malta’s psychiatric healthcare, by literally decades…

… and two, that it is extremely rare – almost to the point of being completely unheard-of – for any pregnancy to ever be terminated, specifically because of mental health conditions.

In other words, what Maltese psychiatrists are saying is: ‘Don’t worry. We don’t get cases like this…’

This raises the (purely Devil’s advocate) question: if such cases are so entirely unheard-of, why even include ‘mental health’ at all?

For the reason I already gave. You can ‘never say never’. So even if it is extremely unlikely to ever happen… if a case does arise, where a pregnant woman’s mental health is so severely threatened, that her pregnancy has to be terminated, to save her from serious harm… that case will not be left out, either.

Let’s turn to the political ramifications. It seems that the Labour government was slightly taken aback, by the sheer extent of resistance (including internal) this amendment is facing.  Apart from the sizeable turn-out at last Sunday’s protest: the Prime Minister is already hinting at a possible ‘tweaking’ of the amendment itself (a sign, perhaps, that he is under more pressure, than he actually expected to be). Do you agree that the Labour Party has underestimated the strength of the pro-life lobby; and were you surprised by the (apparent) backlash?

Well: I, for one, am certainly not ‘surprised’, that the Nationalist Party would jump onto a bandwagon, and try to frighten people by saying things which are totally untrue. Nor does it surprise me in the slightest, that the PN would once again be distorting the facts, for its own political reasons. Because every time we ever introduced similar amendments, in the past: they’ve always accused us of trying to ‘introduce abortion’.  When we amended the IVF law to permit embryo-freezing; when we introduced PGT-M [pre-implantation genetic testing]… they always said exactly the same thing.

But then, some time passes: and now, they almost want to take the credit for those amendments, themselves! Today, they almost claim that it was ‘thanks to them’, that embryo-freezing was introduced; or that the government only introduced PGT-M, because they insisted on it…

So no, I’m not at all surprised that the PN is playing this card once more; and that, in so doing, it is only showing its true colours, as the extreme right-wing party it has become. There was a time, under previous leaders, when we were seeing certain changes taking place; when [the Nationalists] seemed like they were finally beginning to understand, that today’s society is not the ‘society of 100 years ago’...

…but with the leader it has today, the PN has gone all the way back to its roots. What Bernard Grech is effectively saying, is: ‘This is what we were like, 100 years ago; and – no matter what anyone else says – this is how we are going to carry on being like, 100 years later…’

Not only that; but the PN has become so extremist, that we even have someone who was a PN MP, until a few months ago – Edwin Vassallo – who is openly calling for a ‘purge of the Nationalist Party, from liberal ideas’. A ‘purge’, please note: in other words, a ‘cleansing’.

Now: my own message to all those people that Edwin Vassallo wants to see ‘cleansed’ from his own party, is… ‘Come with us! We’re a liberal party; and we have no problem whatsoever – on the contrary, we would be delighted to welcome you all on board: regardless whether you have voted PN, all your lives. For now that the PN doesn’t want you any longer… Don’t worry! Just join us, so that we can continue to grow!’

At the same time, however, there must be several thousand pro-life Labour supporters, who are also ‘confused’ – not to say ‘alarmed’ or ‘distressed’ - by what they might interpret as a ‘pro-choice stand’ taken by their own party. Can you confirm that the PL is indeed receiving this sort of feedback from its own grassroots? And if so: what’s your message to them? 

If there is any feedback of that kind: it hasn’t reached my ears. But yes: thanks to the ‘clumsy’ [‘goffa’] rhetoric that the Nationalist Party has come up with… some people [within the Labour Party] may have been ‘taken aback’. Not Labour politicians, so much – but people who hadn’t really understood, at the time, what we are trying to do.

But the more people are beginning to understand – not just Labour supporters, by the way: but all ‘well-intentioned people’ [‘nies ta’ rieda tajba’] – that the amendments we are proposing are really ‘pro-life’; and that they are intended to save the lives of mothers, where there is need… the more they will realize that everything the PN is saying, is really all just hype, and spin.

And to be honest: we’re not really seeing that there is any such ‘backlash’, to begin with. The more time passes, the more people are understanding the truth of the situation; and the more they are supporting the amendment.

The Labour Party has also been accused of ‘politicising the issue’, though: Prime Minister Abela himself arguably added fuel to the flames, by mentioning the notorious ‘Interdett’ of the 1960s. Isn’t there some political mileage for the PL, too, in precipitating a ‘culture war’ over abortion?

One thing is absolutely certain: we are NOT proposing this amendment, for political reasons. And we have no political reasons to even do so, either. We have a majority of 40,000, from the last election; I personally got 13,000 votes – the most that anyone who wasn’t a party leader, had ever got before – so I can assure you that neither my party, nor myself, are ‘doing this for votes’.

No: we are doing this, primarily because there’s a need for it to be done; but also because… it’s the right thing to do, quite frankly. We cannot leave women who find themselves in these situations, to just fend for themselves. Yesterday, for instance, there was a report about a young woman who was diagnosed with a medical condition, whereby ‘getting pregnant’ would be fatal for her. This woman – who was named in the article – is ‘condemned’, to either have to go abroad [to get a life-saving abortion] if she ever gets pregnant… or to just never have sexual relations again, in her entire life.

These are real situations, that really happen in our country. Can we just leave everything as it is? I say: no, we can’t. No matter how many votes we lose… we cannot just pretend the problem doesn’t exist and do nothing.