Guidelines on Abortion. Expert commentary by Dr. Maciej Socha, MD, PhD, and Natalia Broniarczyk from the Abortion Dream Team. “Guidelines do not change the law”

Activist and co-founder of the Abortion Dream Team Natalia Broniarczyk and professor of Nicolaus Copernicus University, dr hab. n. med. Maciej Socha – head of the Department of Obstetrics and Gynecology at St. Wojciech Hospital in Gdańsk and provincial consultant in the field of obstetrics and gynecology and perinatology for the Kuyavian-Pomeranian Voivodeship – talked in “Tak jest” on TVN24 about guidelines for doctors and medical entities regarding access to the procedure for terminating pregnancy.

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Maciej Socha stressed that “the guidelines of the Ministry of Health do not actually change the applicable law.”

At the same time, he expressed hope that “they will allow some doctors to stop pretending that they do not know the law or that there are other interpretations of the law that have allowed them so far not to notice that the premise of a threat to the health or life of the patient caused by psychiatric disorders or any event related to the patient's health – whether cardiological or neurological, but of course we are talking here, let's say it clearly, about mental health – that these are premises that allow us to terminate the pregnancy”.

– I would very much like us to stop being blind to this premise. It is absolutely sufficient and thanks to the Ministry of Health now every one of my colleagues who had doubts simply has to admit that they have heard it and know that it is so – he added.

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Socha emphasized that “in a situation where we are talking about a threat to someone's health, a threat to someone's life, we have no doubt that a psychiatric premise is sufficient to terminate the pregnancy.”

He also noted that “for political reasons – let's not be afraid or ashamed to talk about it – some people were afraid of the consequences that could possibly fall on these doctors”. – In view of this, we heard various interpretations that this threat should perhaps be more direct or less direct, should be relative or absolute – indicated the provincial consultant.

He also said that according to the law, the premise assuming the possibility of terminating a pregnancy up to the 12th week “is related to a prohibited act”. – However, if the patient is pregnant, and continuing the pregnancy – regardless of the week – threatens her health or life, then we must make a decision on how to end this pregnancy. Regardless of the duration of the pregnancy, in which week of pregnancy the patient is – he added.

SEE THE FULL ACT: Act of 7 January 1993 on family planning, protection of the human fetus and the conditions for the admissibility of termination of pregnancy

Natalia Broniarczyk said on TVN24 that she “was counting on these guidelines”. – These were the guidelines we had been waiting for since the death of Mrs. Iza from Pszczyna – she added. She assessed that “this is a document that came much too late and this is a document that, unfortunately, instead of improving our situation significantly, reminds us a bit of how short the leash is”.

– Today, the minister came out and told it like it is. She reminded (…) how restrictive this law is de facto and reminded doctors that they have to act within the limits of this law. But this is still a very short leash for patients, for women – she commented.

The activist also pointed out that “today we have a huge crisis of trust between patients and doctors”. – And I miss the Ministry of Health emphasizing that it is not only about politics, but also about (…) a woman leaving the hospital not leaving with trauma, not leaving with a sense of guilt imposed by the medical staff, but also that the termination of pregnancy is performed in accordance with the latest medical knowledge, in accordance with the recommendations of the World Health Organization – she continued.

When publishing the guidelines, the Ministry of Health wrote in a statement on its website: “We emphasize that these guidelines in no way go beyond the applicable law.”

The content of the document, containing guidelines on the applicable legal provisions regarding access to the termination of pregnancy procedure, is divided into several topics. These are: Conditions for the admissibility of termination of pregnancy; Determination of circumstances determining termination of pregnancy; Date of performing the termination of pregnancy procedure; Place of performing the termination of pregnancy procedure; Person authorized to perform the termination of pregnancy procedure; Woman's consent; Right to information; Termination of pregnancy procedure as a guaranteed benefit; Conscience clause; Patient's objection to a doctor's opinion or decision; Exclusion of criminal liability.

In the subsection “Deadline for performing the procedure for termination of pregnancy” it is recalled that “in the event of a reasonable suspicion that the pregnancy is a result of prohibited acttermination of pregnancy is permissible if no more than 12 weeks have passed since the beginning of the pregnancy“. “In the guidelines of the Prosecutor General of 7 August 2024 on the rules of procedure of common organizational units of the prosecutor's office in the scope of conducting cases concerning refusal to terminate pregnancy and so-called medical abortion, in point 7, it is indicated that there is an obligation to efficiently perform procedural activities in order to be able to make a decision on issuing a certificate constituting the basis for performing the procedure of terminating pregnancy within a time limit enabling it to be carried out within the statutory 12 weeks from the beginning of pregnancy,” it was added.

The Ministry further emphasized that “the provisions of the Family Planning Act they do not regulate the deadlineto what extent it is possible to terminate a pregnancy in a situation where it threatens the life or health of the pregnant woman“. “From a legal point of view, the performance of the termination procedure in these circumstances should not be conditioned by the duration of pregnancy,” it was explained.

It also describes how to determine the circumstances that justify termination of pregnancy in a situation where the life or health of the pregnant woman is at risk.

“The Family Planning Act does not provide a closed list of indications for termination of pregnancy. in the event that pregnancy poses a threat to the life or health of the pregnant woman. The provisions of the Family Planning Act, using the general category of health, do not in any way determine which area of ​​health this health threat should concern. It can therefore concern any area of ​​health, both physical and mental.. The Family Planning Act does not specify the concept of 'threat', leaving it to the assessment of a doctor acting on the basis of current medical knowledge; the regulations do not use any valuation in this case, they do not indicate that the threat is intended to be sudden or immediate and should not be interpreted as such” – we read.

It was also written, among other things, that “the provisions of the Family Planning Act they do not limit the doctor's specializationauthorized to determine whether there is a premise permitting termination of pregnancy”. “The existence of such a circumstance – in accordance with art. 4a sec. 5 of the Act on Family Planning – is determined by a doctor other than the one performing the termination of pregnancy, unless the pregnancy directly threatens the woman's life” – the Ministry of Health reminded.