Italy's conscientious doctors

Vincenzina Santoro
3 October 2012
Reproduced with Permission

Jesi is a lovely Italian hill town not far from Ancona on the Adriatic coast in the center-north of the country. A few weeks ago the local hospital let it be known that they faced a doctor shortage of sorts. It seems that all of the town's 10 gynecologists refuse to perform abortions. They are all conscientious objectors. The local office of the communist labor union spread the news because they claimed women's rights were being denied, although Italy's abortion legislation (Law 194/78) explicitly provides a right for doctors and other medical personnel to refuse to participate in the procedure.

Jesi's top medical bureaucrats began a search for doctors elsewhere in the Marche region where the town is located. A doctor from nearby Fabriano, 40 kilometers away, agreed to be on call in case of need and to go to Jesi if an abortion seeker would not go to Fabriano. However, his services may or may not be much in demand.

While abortion doctors in the entire Marche region seem to be rare, abortions are not that many to begin with. Italian Ministry of Health data on abortions indicate that women from the Marche region had 2,458 abortions in 2009, but that nearly one-fourth had their procedure done outside their resident province and 10% outside the region.

Further north, in the town of Treviglio, near Bergamo in Lombardy, a similar problem has arisen: 24 out of 25 anesthesiologists in the four hospitals serving a population of around 350,000 refuse to be involved in abortions, and 24 out of 28 gynecologists-obstetricians are also conscientious objectors. Other medical facilities in the Bergamo province also report a high number of objectors but the supply is not as tight as in Treviglio. Nonetheless, press reports indicate that in the entire province of Bergamo, five percent of the 1,867 abortions performed in 2010 were on women from outside the area. It seems that there may be even more conscientious objectors elsewhere in Lombardy, Italy's most prosperous region.

If such refusals are helping the downward trend of abortions in Italy, there are also incentives for women to keep their babies. The regional government of Lombardy has put in place a program to assist resident women who wanted an abortion for economic reasons but changed their minds. Progetto Nasko - or Project I am Born - grants a mother keeping her child 250 euros per month for 18 months after she obtains medical confirmation of her pregnancy and demonstrates evidence of economic hardship. The expectant mother receives a prepaid rechargeable card which is managed by one of several Centers for Aid to Life (Centri di aiuto alla vita).

The examples above are part of Italy's experience since abortion was legalized in 1978. Not all countries compile data on abortions as detailed as that of Italy's Ministry of Health, but the results coming out of Italy, as discussed in a previous MercatorNet article by this author, indicate that in 2010, the total number of abortions in Italy declined 2.7 percent to 115,372 and were 51 percent below the 1982 peak. At the same time, the number and share of conscientious objectors in the medical profession have steadily increased.

Evidently moral and ethical factors do play a role in people's professional lives. Respect for life and human dignity should be a consideration falling under medical doctors' oath to "first do no harm." Ethical considerations are not always in harmony with economic perceptions, but every child brought to light in Italy helps advance the precariously low fertility rate, which has been inching up in recent years and reached 1.42 in 2011, up from 1.35 in 2006 and 1.25 ten years earlier.

The latest data (2007-2009) also show that the overwhelming majority of Italy's gynecologists are conscientious objectors when it comes to abortion. A regional breakdown shows a range from a low of 52 percent in Emilia-Romagna (part of Italy's so-called "red belt", in political terms) to a high of 85 percent in Basilicata in the south. Indeed, objectors account for over three-quarters of their profession in 10 out of the 21 Italian regions. The national average has been as high as 71 percent. Jesi and Treviglio are just two local examples of good news on the life front coming out of Italy.