Pregnancies Don’t Need Support, Women Do
Anyone who followed the debate on RU486, and understood the complex politics surrounding it, knew it was coming: a quid pro quo for the Health Minister to soften the blow of losing his powers to deny Australian women access to RU486. It came last Thursday: a $51 million dollar package for two pregnancy support measures a new counselling hotline and Medicare rebate. Then came the story of a push in Victoria to remove abortion from the Crimes Act.
Counselling is like motherhood: something few want to oppose. But the truth is that some counselling isn’t what is seems. Far from improving the quality of women’s decisions, mental health or lives, biased counselling – funded by the Commonwealth to the tune of $350,982 – can cause lasting damage to women’s lives and mental health. Sadly, it appears that this is precisely the sort of “counselling” the Federal Government has in mind.
There is one key feature that attaches to all legitimate counselling: the commitment to fostering a woman’s autonomy. At the heart of all ethical medical practice, you will find the key value of autonomy, the Greek root of which means “self-rule”. Why? Because only people free to direct and govern their lives according to their own values are recognised by others as having what Australian philosopher Robert Young describes as “the dignity that moral agency bestows”.
There are three reasons to doubt that the Government’s proposed measures will foster women’s autonomy and protect their dignity. The first is that, as their title makes clear, they are designed to support pregnancies, not women. If pregnancy maintenance, not quality decision-making, is the name of the game, it’s hard to see how factually accurate and non-directive support and advice is on the cards.
Ditto the undisguised aim of both measures: to reduce the abortion rate. The Government says they are necessary to address Australia’s high abortion rate. At the news conference launching the plan, the Prime Minister said: “We don’t like the number of abortions. We think it’s too high.” How can a service designed to stop women having abortions (how else to reduce the abortion rate?) provide impartial, non-directive advice? How can such a service meet the ethical requirement of promoting women’s autonomy? Won’t the successful tenderer be evaluated on how well it achieves the Government’s aims of reducing the abortion rate? If so, how can we expect this service to do anything other than discourage women from choosing abortion?
This worry is exacerbated by the Government’s insistence that religious organisations will be eligible to tender for the telephone helpline contract. While abortion service-providers and counsellors working in abortion clinics have been seen as having a “conflict of interest” that renders them incapable of providing impartial, non-directive support and referral for all three options available to pregnant women – abortion, adoption and continuing – religious providers are not. This beggars belief, particularly given the widespread acceptance of medical conscientious objection not just to providing abortion services, but referring women to someone who will.
Moral conflicts of interest are as real as financial ones, and there is little doubt that a tender process truly committed to identifying a service committed to fostering women’s autonomy would rule out applicants with religious or philosophical objections to abortion.
The truth is that if the Government wants to reduce the abortion rate, the most ethical and effective approach is to tackle unplanned pregnancies. No woman wants to be pregnant when she feels unable – because she is unemployed, homeless, single, living in a violent home or is just a teenager herself – to be a good and responsible parent to the child. This makes government support for education and contraception access programs not only the most effective way to lower the abortion rate, but – because it supports women to achieve shared aims – the only ethical one.
Pregnancies don’t need support, women do. They also need respect. The aim of any legitimate counselling service must be to foster women’s autonomy, not to achieve government aims such as reducing the number of abortions or increasing the birthrate. Using women as a means to government or church ends is not just unethical, it may lead to women being deceived or induced – perhaps even coerced through false information or an absence of timely advice – into having an unwanted child: not a recipe for happy families.
If a financial conflict of interest is seen to render those involved with abortions ineligible to provide impartial advice, support and referral for all three options with an unplanned pregnancy, a moral conflict of interest surely rules religious and pro-life providers out, too.
At a minimum, the potential for abuse of trust must be acknowledged. It is likely that women will assume that neutrally named services, particularly when promoted with the Australian coat of arms, will support them to make a choice consistent with their situation and values. If the agency running the helpline has a religious or philosophical objection to abortion, women need to be informed of this on all advertising materials.
They must also be told it when they ring. And offered an alternative number for a legitimate service. One that has no other agenda than assisting her to make the choice that is right for her, and no religious beliefs to limit the support they provide for her to carry it out.
Women need counselling, not coercion The Age