Liow warns docs against unethical practices in abortions
By NICHOLAS CHENG /
Scroll down to also read Women's Aid Organization on " Abortion in Malaysia"
PETALING JAYA: It is unethical for doctors to take advantage of a patient's lack of knowledge and overcharge for performing abor-tions, said Health Minister Datuk Seri Liow Tiong Lai.
Patients have the right to know about the treatment planned and the estimated charges as stipulated under the Private Healthcare Facilities and Services Act.
Any wrongdoing, notwithstanding the quantum or amount of fees charged, is considered illegal and unethical, said Liow.
He said this in response to a news report in The Star yesterday [scroll down to read in full] that some clinics were charging exorbitant fees to perform abortions because many patients were unaware of the legality of the procedure.
Liow clarified, however, that the Malaysian Medical Association fee structure only listed the professional charges and not the total fee, which could include hospital, medication and facility bills.
He admitted that a lot had to be relooked.
On Friday, The Star reported a need for a Law Reform Commission to clarify Section 312 of the Penal Code, which allows abortions in specific circumstances in light of the current misconceptions.
We will discuss with the association and Academy of Medicine to draw up the fees and interpretation of necessary abortions to be included in regulations by early next year.
On Sept 19, the Health Ministry released guidelines for abortions for government hospitals.
The standard operating procedure recommends pre-abortion counselling, where patients are briefed on the procedures and assessed for health risks.
It also suggests an opt-out period of 48 hours before the procedure and for patients to be referred to religious authorities for counselling.
Liow suggested patients receive a second medical opinion before going through with the abortion.
More will be done to educate the public and doctors with regards to the current legal framework of abortions, he said abortions,” he said.
PETALING JAYA: Social stigma and the lack of knowledge on the legality of abortion are putting women in need of such a procedure at risk of exploitation.
It was reported recently that several obstetrics and gynaecology clinics in the Klang Valley, upon request for an abortion, charge between RM1,200 and RM2,500.
A majority of these were for pregnancies within the first 10 weeks and involves the use of general anaesthesia, metal curettage and takes only 10 minutes.
Currently, Section 312 of the Penal Code governs abortions.
It states a termination of pregnancy is legal so long as a medical practitioner registered under the Medical Act is of the opinion, formed in good faith, that the continuance of the pregnancy would involve risk to the life of the pregnant woman, or injury to the mental or physical health of the pregnant woman.
However, Reproductive Rights Advocacy Alliance of Malaysia (RRAAM) co-chair Dr Choong Sim Poey said there was a lack of awareness of this provision and some doctors were making use of their discretion to overcharge.
Many private clinics would give the impression that abortion was an illegal procedure without actually saying it in those words.
He said public misconception, exacerbated by misrepresentations in the media, has led to some doctors getting away with higher charges.
Based on the Malaysian Medical Associations schedule of fees, a surgeons fee for a dilation and curettage (D&C) procedure is around RM500 and the anaesthetists fees is RM345.
A D&C can be used for early termination of pregnancies (0-10 weeks) but many are not aware of this as education on the matter is not promoted, said Dr Choong.
He said women were easy prey in the private sector, especially if they thought the procedure was illegal.
Asian-Pacific Resource & Research Centre for Women founder Rashidah Abdullah said costly fees and unregulated abortions in the private sector made the service inaccessible to low income, migrant and young women.
Citing a recent survey of 120 doctors and nurses, she said 43% responded incorrectly about the legalities of abortion.
Since there are no Health Ministry guidelines on abortion, the availability of such services varies according to the views of the Heads of the Obstetrics and Gynaecological Departments in government hospitals, added Rashidah.
Over 90,000 abortions are done every year according to the National Population and Family Development Board. There are around five deaths every year due to unsafe abortions. ~~~~~~~~~~~
On 13 February 2011, an article in the New Straits Times (“Is abortion the answer?”) highlighted a fact which is little-known but ought not to be. Abortion is not illegal in Malaysia.
Section 312 of the Penal Code states that a termination of pregnancy is permitted in circumstances where there is risk to the life of the pregnant woman or threat of injury to her physical or mental health.
Although terminations are permitted, the law is nevertheless limited. Under the Penal Code it is the doctor alone who makes the decision as to whether a termination should be carried out. This is especially worrying in view of the results from the 2007 survey by the Reproductive Rights Advocacy Alliance of Malaysia (RRAAM) which found that only 57 per cent of 120 doctors and nurses surveyed knew that abortion is legal in certain circumstances.
Women have the right to determine the course of their lives and they have the right to make decisions about their own bodies.
Women must be equipped with knowledge and be aware of the options available to them, so that they can make informed decisions. However expert a doctor may be, doctors will never be fully aware of the facts of a woman's circumstances and so cannot make a completely informed decision about the appropriateness of a given option. It is the woman who has this understanding and it is the woman who should be legally and practically empowered to make the decision.
However, many women cannot make this fully informed decision because they are not provided with comprehensive and unbiased information about sex, contraception, abortion and sexually transmitted diseases. This needs to change.
It is encouraging to note that the government has recently introduced the Social and Reproductive Health Education Programme into the National Service curriculum, so that young people can be given the knowledge they need to make informed choices.
And this is the crux of the issue – when people are provided with clear and unbiased information, they can make the most appropriate decisions for themselves.