POSITION OF THE CATHOLIC ASSOCIATION OF POLISH DOCTORS

ON THE PERMISSIBILITY OF ABORTION ON THE BASIS OF MENTAL HEALTH

Out of a sense of duty and out of concern for the highest deontological values ​​of the medical profession, we express our position on the issue of the admissibility of abortion, postulated in some circles, in a situation when an expectant mother suffers from mental health disorders caused by the diagnosis of a disease or defect of the child or resulting from the fact of pregnancy itself.

There is a team working at the Ministry of Health whose aim is to develop guidelines for medical entities regarding procedures related to the termination of pregnancy in cases where the life and health of a pregnant woman is considered to be in danger. It will also deal with cases where the mental health of a pregnant woman is at risk and the use of murder of a child in the mother’s womb in such circumstances. Information about the operation of such a team is even more disturbing because the team meets in secret and among its members there are no representatives of doctors who support human life, which means that the principles of reason, democracy, ethics and law have been violated. In the situation in question, there are no legal grounds that would justify the secrecy of the team’s work under the Act on the Protection of Classified Information.[1] , moreover, it seems that the draft of similar guidelines should be widely consulted, especially among doctors. Therefore, we demand insight into the team’s work.

On matters covered by the team’s work, our position is presented below:

1 . In the opinion of Catholic doctors, who recognize the full and irreducible vision of a person with his or her inherent dignity, there is no reason to terminate a pregnancy due to the mental state of the pregnant woman. The position of the Team of Experts of the Polish Episcopal Conference on Bioethics on September 4 this year is correct, in which we can read that “abortion is not one of the therapeutic methods used in treatment” and ” the murder of a child cannot be considered a means of restoring woman’s health. “Such an act does not meet medical standards.”

2. Creating a “new interpretation” of the applicable law in order to expand the list of grounds that may justify the prenatal murder of a child due to the mother’s mental health is manipulation and is inconsistent with the constitution and applicable law [2 ] . This is explicitly stated in Art. 39 of the Code of Medical Ethics: “When taking medical action in relation to a pregnant woman, the doctor is also responsible for the health and life of her child. Therefore, it is the doctor’s duty to strive to preserve the health and life of the child even before its birth.

3. Psychiatric practice shows that an important decision to end the life of an unborn child may have only negative consequences for the mother’s health and its consequences may accompany the mother even until the end of her life in the form of Chronic Post-Traumatic Stress Disorder – PTSD with its very serious consequences negative. This may only worsen the mental condition of a woman who has already been diagnosed with mental disorders during pregnancy. This condition is extremely difficult to treat. Hence, in the case of the mother’s mental disorders, considering them as a reason for abortion cannot be allowed. You should definitely look for recognized therapeutic methods in the form of psychiatric pharmacotherapy, psychotherapy or psychoeducation. This also applies to poor mental health, e.g. in disorders with depressive thoughts and suicidal tendencies or psychotic symptoms. Psychiatric experience teaches that people who are in a bad and unbalanced mental state should not make any important life decisions. No one (whether sick or healthy) has the right to take the life of another person at any stage of their development. The decision to end a pregnancy cannot be justified on the mother’s psychological grounds.

4 . Every life is more important than mental experiences, which are only a component of life. This means that life as such is beyond experiencing any adaptive (stress-generating) difficulties resulting from, for example, becoming pregnant. Pregnancy is a physiological phenomenon, not a pathological one, that the child should be aborted as some kind of “cancer”. If the doctor does not recognize this, it proves his fear of life and health, which are the values ​​he has vowed to serve and uphold.

5. We believe that defining the grounds for killing a child in the mother’s womb due to the state of her mental health is vague and one-sided, and at the same time ambiguous, because it blurs the boundaries of health with the natural mental crisis resulting from the diagnosis of pregnancy. Such a crisis usually takes its natural course, emotions decrease and the perception of reality changes. The problems that come with getting pregnant, such as career disruption and lack of adequate funds, are less important than the happiness associated with motherhood. The proposed procedure involving psychiatrists in making decisions about abortion is a mixture of the competences of psychiatry science with the utilitarian ideology of inhumane treatment of the life of a small human being.

6. Psychiatric certificates issued on the basis of “mental health risk” to women experiencing such emotions due to a temporary crisis related to pregnancy may unjustly annihilate many human lives. In Spain, on the basis of such certificates, approximately 100,000 children are unjustly killed per year in accordance with the letter of inhumane law. Historically, such a model was also used in Great Britain in the 1960s and 1970s as a gateway to abortion on demand [3]. This is not “termination of pregnancy” but rather mass extermination of people. It is hard to resist the impression that the aim is to facilitate and simplify these procedures and, in fact, to introduce abortion on demand at any stage of pregnancy. The exception is a life-threatening situation where the mother cannot be saved. Saving the mother is allowed, which may result in the child’s death. Such a choice by the mother is ethically permissible, but she should be left free to decide whether to save the child if there were any chances of its survival. It should be emphasized once again that the death of a child in the event of an attempt to save the mother’s life is an unwanted side effect and is not the goal of treatment. 

Finally, it is worth mentioning the principle that organizes the science of medicine according to anthropological philosophy, based on the thought of Dr. Frederic Buytendijk that “an undeveloped form is understandable only through a developed form.” [4]

       If a doctor called to serve human life and health kills a baby in the mother’s womb, he is senseless and heartless. According to the Hippocratic Oath, this should result in his exclusion from membership in the medical community.

September 27, 2023

On behalf of the Management Board and members of the Catholic Association of Polish Doctors, gathered in Zakopane on September 8-10, 2023.

  • Dr. Artur Mnich, psychiatry specialist, Małopolska Branch of KSLP
  • Dr. Anna Markiewicz, psychiatry specialist, President of the Małopolska Branch of KSLP
  • Elżbieta Kortyczko, MD, PhD, specialist in pediatrics and neonatology, President of the Management Board of KSLP,
  • prof. Bogdan Chazan, specialist in gynecology and obstetrics, Vice-President of KSLP, Member of the MaterCare International Council ,  Vice-President of the European Federation of Catholic Medical Associations (FEAMC)
  • Dr. Grażyna Rybak, pediatric specialist, President of the Masovian Branch of KSLP

the position is supported by:

  • Catholic Association of Polish Nurses and Midwives (KSPiPP), www.kspipp.pl,
  • Association of Catholic Pharmacists of Poland (SFKP), www.sfkp.pl,

[1] https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20230000756

[2] © Chancellery of the Sejm p. 1/5 2022-08-03 Journal of Laws Laws of 1993 No. 17 item 78 Act of January 7, 1993 on family planning, protection of the human fetus and conditions for the admissibility of termination of pregnancy 

[3] Crook S. ‘A disastrous blow’: psychiatric risk, social indicators and medical authority in abortion reform in post-war Britain; Medical Humanities  2020; 46: 124-134. https://mh.bmj.com/content/46/2/124

[4] Buytendijk F. Das Menschliche. Vege zu seinem Verstaendnis. Stuttgart: Koehler Verlag, 1958.