Medical Law International

In 1973, Denmark broke new ground when it introduced abortion as a legal right. We explore the drivers of Danish abortion law reform and demonstrate that liberalization was effectuated as the answer to a number of societal concerns. In observing the absence of autonomy as a winning argument for abortion law reform, we find that the Danish case is in alignment with the existing literature. Moreover, this article contributes to the understanding of how the historical drivers affect modern-day issues in abortion, including the fact that expansive autonomy for women is still not prioritized. Thus, we argue that liberalizing abortion regulation for reasons other than achieving reproductive autonomy comes at a price: downstream, it becomes difficult to achieve full autonomy in health law regulation because the initial reasoning behind liberalization continues to provide a certain framing even for present-day abortion issues. This observation can be of importance for those working in other jurisdictions to implement expansive autonomy in reproductive rights.

The law on healthcare decision-making in Ireland is in a period of transition and will be enhanced with the full commencement of the Assisted Decision-Making (Capacity) Act (ADMC Act) 2015. The legislation is intended to empower a person to make decisions relating to their healthcare and personal affairs where they lack or may in the future lack the capacity to make their own decisions. This is especially relevant for the older person in terms of planning for future healthcare decisions. This article reports on quantitative and qualitative research which examined the exercise of autonomy by the older person in Ireland in the context of healthcare decision-making. The research compared the lived experience of healthcare decision-making with the existing legal and policy framework. The research sought to identify what is currently understood about the ADMC Act and awareness of the changes it will bring about in decision-making for the older person. These data assist in identifying strengths, such as a feeling of involvement, and weaknesses, such as an asymmetry of information, in the operation of the current decision-making framework while also identifying potential hurdles to the meaningful implementation of the 2015 Act.

In 2018, Australian paramedics entered the National Registration and Accreditation Scheme for Health Practitioners. The scheme represented a significant change in the way paramedics were regulated and able to self-identify. Equally, it brought substantial changes to the individual accountability and responsibilities of practitioners. Response to these reforms was largely positive; however, diverse views existed on the intent and impacts of the scheme. Paramedics were surveyed immediately before registration commencement to examine their views concerning the new regulatory framework. Supportive views included acknowledgement of regulation’s public safety function and potential advancement of the profession. Dissenting views predicted increased practitioner risk and degradation of working conditions. Importantly, this study explores how members of the same profession can have diverse views of the same regulatory scheme. This study supports the notion that paramedicine consists of diverse subcultures with differing worldviews. This presents challenges in ensuring cohesive professional engagement with regulation and the evolution of the profession.

This article explores the approach of international human rights bodies to conscientious objection to abortion, by requiring states to implement mandatory referral mechanisms where conscientious objection is permitted. This, however, represents an inadequate compromise position as many objecting healthcare professionals also object to referral and circumvent those requirements. Furthermore, referral cannot address the broader issues with the overuse and misuse of conscientious objection provisions which obstructs access to abortion services. After considering the harms caused by conscientious objection and suggestions for alternative regulatory responses, this article proposes that the international human rights framework should aim to strike a contextual balance between freedom of conscience and ensuring access to abortion. This new approach should place clearer obligations on states to properly regulate conscientious objection, including obligations to address socio-cultural stereotypes around motherhood and the foetus, which result in widespread conscientious objection.