It is one of those ethical topics little known to the general public but which still quietly divides healthcare professionals. "A doctor is never obliged to perform a voluntary termination of pregnancy," reads Article L2212-8 of the Public Health Code. This clause also applies to midwives, nurses, and auxiliary medical staff. Each time the law concerning abortion evolves, since it was passed 50 years ago, on January 17, 1975, this specific conscience clause resurfaces in debates before ultimately being reaffirmed in the law.
A general clause also existed, allowing practitioners to refuse to perform any act for professional or personal reasons. Found in Article 47 of the Medical Code of Ethics, the regulatory clause gave all practitioners the right to refuse care, "except in emergencies or when it would fail their duty of humanity." The coexistence of these two texts led healthcare workers to refer to a "double conscience clause" for abortion. This special treatment continues to raise questions.
Understanding the fierce opposition 50 years ago from lawmakers and a significant portion of the medical community sheds light on the compromise defended by Simone Veil. To enact the law decriminalizing abortion on January 17, 1975, Veil, then minister of health under President Valéry Giscard d'Estaing, introduced a text that strictly regulated the procedure. It allowed abortions up to 10 weeks of pregnancy for women declaring themselves in a state of "distress" and granted doctors the option to invoke a specific conscience clause. At the time, abortion was not considered a right but rather a concession made for the sake of women's health.
'Clarify the ambiguity'
It took nearly 40 years to remove the requirement for a woman to declare herself in a state of "distress," which occurred in 2014. However, the second condition – the conscience clause – remained in place. "There is no easy answer," said Joëlle Belaïsch-Allart, president of the National College of Gynecologists and Obstetricians of France. "I think there are still arguments for maintaining the specific clause, with the obligation to redirect the patient being one of them." A health professional invoking this particular clause was required by the Public Health Code to "inform the woman of their refusal without delay and immediately provide the names of practitioners likely to perform the procedure."
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