'Dr X will not prescribe contraception.' The signs popping up in Australian waiting rooms.

The following sign was spotted in the waiting room of a GP surgery in Sydney’s north recently.

“Patients, please note Doctor [name withheld] welcomes all patients but does not provide prescriptions or consultations regarding family planning.

“As a matter of conscience, he does not provide prescriptions or referrals related to any form of birth control. This includes the contraceptive pill hormonal and non-hormonal implantable devices and sterilisation procedures.

“Doctor X does not provide prescriptions or referrals regarding assisted reproductive technologies, fertility specialists or in-vitro fertilisation.

“Doctor X or our reception staff would be more than happy to discuss this with you if you have any questions.”

Watch: Arguing the case for pro-choice…

It’s one of several similar declarations from doctors that have been shared on social media or via news outlets (notably, Buzzfeed) since late last year.

There are suggestions that they could be a symptom of the Federal Government’s Religious Discrimination Bill — a controversial piece of proposed legislation that (among other things) would allow doctors to refuse to provide treatment that contradicts their faith.

Let’s take a look at how we got here, what it means for women, and who the winners and losers are if the vote passes.

What is the Religious Discrimination Bill?

A piece of proposed legislation, soon to be voted on by Parliament, that prohibits discrimination on the grounds of religious belief or activity in certain areas of public life. Among them, medical services, schools, employment, social media, aged care and hospitals. (You can read our previous article about what that looks like here.)

It sprung from the marriage equality vote back in 2017, when then-Prime Minister Malcolm Turnbull announced a review into whether Australian law adequately protects freedom of religion. Chaired by former Australian Attorney-General Philip Ruddock, the probe largely served to appease conservative MPs who threatened to derail the vote.

Fast forward to the 2019 Federal election, when the Morrison Government committed to addressing religious freedom, including implementing some of the 20 recommendations made by the Ruddock review.

In August that year came part of that promise: the draft Religious Discrimination Bill.

After critical public feedback (some said it went too far; others not far enough), a second draft was released in December. Public consultation on that version closed on January 31 and is currently being considered before the Bill is put to Parliament for a vote.

In the meantime, a number of campaigns have emerged in an effort to quash the Bill, which activists say will green-light hate speech, further marginalise LGBTQI Australians and threaten women’s access to judgement-free reproductive healthcare.

It’s the latter we’re touching on here.

The threat to women’s healthcare.

The proposed Bill allows health practitioners (doctors, nurses, midwives and psychologists) “not to provide or participate in particular procedures, treatments or other services in contravention of their fundamental religious beliefs”.

For example, a doctor of strict Catholic faith could refuse to provide abortions, contraception and fertility treatment.

The draft Bill stresses that the practitioner’s “objection must be to a procedure, not a person”.

This is already allowed in some states, including Victoria and NSW, where health professionals can ‘conscientiously object’ to providing certain procedures or treatments that conflict with their personal values or beliefs (Hence the signs mentioned earlier). However, in the case of abortion, for example, they are obligated by state law to refer the patient to another provider.

There is no such obligation under the proposed Bill. This means a doctor could essentially leave a patient out in the cold.

This is part of the reason that the Human Rights Law Centre has described the proposed Bill as “one of the biggest threats to reproductive health care in decades”.

Adrianne Walters, Senior Lawyer with the HRLC, told Mamamia that the proposed Bill “unacceptably elevates” doctors’ freedom of religion over their patients’ health.

“The proposed law, if it passes, tells doctors, pharmacists and other health professionals that it is okay to abandon and pass judgement on a patient in a time of need,” she said.

“Despite the emotional, physical and financial harm it can cause a woman to be turned away by her doctor without any information about where else to go, it is her doctor who will be given better protections by this unbalanced law. This is inconsistent with the ethical and professional duties of doctors and will make it harder for women to access time-sensitive treatments, like emergency contraception and abortion.”

The Australian Medical Association, the peak body representing doctors and medical students, has also expressed concern about the Bill.

In its submission in response to the second draft, the AMA argued that sections of the Bill “do not reflect and support the professional standards of the medical profession, rather the Bill appears to override those standards, reduce patient safeguards and derogate patients’ rights to access health care.”

Another blow to rural women.

One of the big concerns about the impact of the Bill on women’s healthcare relates to women in rural areas who already have limited healthcare options.

What happens if the one doctor in town refuses to provide a medical termination, or if the sole pharmacy for the region is free to lecture customers on their religion’s teachings about contraception?

Well, that’s happening already, even without the protections of the proposed Bill.

A 2019 Melbourne University study reported evidence that a number of Victorian doctors had: failed to refer women to another provider after objecting to perform an abortion; attempted to make women feel guilty for seeking an abortion; and deliberately attempted to delay women’s access to abortion services.

Several family planning services have also reported anecdotal evidence of women being abandoned by doctors or left feeling ashamed for seeking reproductive healthcare.

It’s likely that such cases would become more common if the Bill becomes law.

Listen: The signs in doctor’s surgeries that have women worried.

Rural Australian women already have difficulty freely accessing such services. As Mamamia previously reported, many are forced to travel long distances and sometimes interstate — at a significant financial and emotional cost — to obtain an abortion.

And the toll of this restricted access is significant.

Preventing women from obtaining timely medical termination can mean that they are later required to undergo a riskier surgical termination. That’s not to mention the impact on their mental wellbeing.

As sexual and reproductive health specialist Dr Catriona Melville has previously explained to Mamamia, “Women who are denied access to abortion that does increase their stress levels and causes anxiety and actually compounds an already challenging situation.”

Advocates of the proposed Bill point out that it would compel a health professional to provide the service if their employer or the patient would suffer “unjustifiable adverse impact”.

But it remains unclear how that would be interpreted by the courts.

In the meantime, it’s up to our MPs to vote on our behalf, to decide what ought to come first: a doctor’s personal beliefs, or their patient’s right to access perfectly legal healthcare, free of judgement?

Featured image: Getty

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