Doctor’s Role in Protection of Dignity and Human Life

in Poland

Marek Kośmicki & Joanna MazanThe Catholic Association of Polish Doctors & Federation Life

Warsaw, Poland

10th Congress of FEAMC – New Challenges for Medicine and Health Care in Europe –

July 1-4, 2004; Bratislava, Slovak Republic

„A nation that kills its own children is a nation without a future”

John Paul II

• In our times many countries in the world witness intensive battles between the culture of life and the culture of death.

• A good example of such struggle between different attitudes towards life is our country – Poland.

April 27, 1956, the Act

regulating conditions for permitting abortion The Act allowed for abortion under three circumstances: 1. Hard living conditions meaning the so-called ‘social

reasons’*, 2. When there was a suspicion that the pregnancy was a

result of crime,3. Medical advice. .............* Social reasons were of the greatest importance, as in practice it meant the

lack of any restrictions with regard to abortion, i.e. ‘abortion on a woman’s request’.

1957-1992

• The media, which were almost completely controlled by the state, promoted only the positive attitude towards abortion.

• The main argument of the state propaganda was the woman’s ‘liberation’ from the necessity of giving birth and parental burden.

• Legal abortion was to be a symbol of progress and a benefit offered by a ‘socialist government’.

• Many doctors who objected to carrying out the procedures stipulated by the Act were dismissed from work.

• Young doctors who refused to perform abortion were barred from practising obstetrics and gynaecology.

• Over this 35-year period, it caused a certain negative selection of candidates to specialise in obstetrics and gynaecology:

• Only a doctor who did not oppose carrying out abortion could become a gynaecologist.

• A gynecologist who had no objections to performing abortion in his department could become and remain the head of department.

-50

0

50

100

150

200

250

300

350

400

450

500

550

600

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

years

(thousand)

source: Central Office of Statistics

Birthrate in Poland (1950-2002)

Pro-Life movements in Poland1970’s – to date

• ‘Care of Life’, Lublin & Katowice; ‘Gaudium Vitae’; ‘S.O.S’; ‘Pro Familia’, Warsaw; Prayer Crusade, Cracow; Pro-Life branch of Polish Doctor’s Association.

• Currently, those NGO’s are joined into the Polish Federation of Pro-Life Movements, recently called briefly ‘Life Federation’

• Doctors were and are involved as consultants and authors of pro-life literature.

• Doctors are also involved in concrete support of families and single mothers in need.

Pro-life organisations

played a key role in changing the

social mentality to be more geared

towards protecting life.

Change in social mentality

towards pro-human life attitude in Poland, 1980’s/90’s It was most difficult, but a very important action.

Without such change of public opinion’s attitude, no changes in

state legislation would be approved by the society.

People had to be prepared to the new law concerning into such extent their private lives.

January 7, 1993, a new Act on family planning, protection of human foetus , and

conditions for permitting the interruption of pregnancy.

The new Act limits abortion

to three conditions:

1. Pregnancy is a threat to the life or health of the mother

2. Conception is a result of crime (rape or incest)

3. Child is gravely ill.

1996-97 Abortion on demandis legal again

A modification of the Act in August 30,

1996, allowing for abortion

on social grounds.

• Manifestations against the modification of the Act were organised.

• A praying sit-down protests in front of the clinics where abortions were carried out.

• Three million outcries were sent to the Senate opposing the modification of the Act.

May 28, 1997, the Constitutional Tribunal: „Human life from conception is a value

protected by the Constitution”

„The law cannot be conflicting with the absolute human right to life from the moment of conception till natural death and the state cannot give this right but has the duty to accept and to protect it”.

The Constitutional Tribunal, Poland, 1997

The Act was brought back in the original version from 1993, which meant that ‘abortion on request’, i.e. on the social grounds was illegal.

2003 – 10th anniversary of passing

a bill on family planning and protection of human foetus The aim of the bill is care for the mother’s and child’s life

and health as fundamental welfare.

In 1993-2003 :

1. The number of abortions has decreased.

2. There is a systematic decrease in:

a. the number of deaths of women during pregnancy

b. the number of miscarriages

c. the still births ratio

d. the infant mortality rate.

Abortions recorded in Poland 1980-2002

0

20

40

60

80

100

120

140

160

1980

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

years

Number (thousand)

source: Council of Ministers report of executing in 2001 the Act made on January 7, 1993 and Department of Health and Social Security report for the year 2002

0

10

20

30

40

50

60

70

80

90

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

years

Number

The number of deaths of mothers in Poland, 1991-2000

source: Council of Ministers report of executing in 2001 the Act made on January 7, 1993

0

10

20

30

40

50

60

70

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

years

Number (thousand)

The number of miscarriages in Poland, 1990-2001

source: Council of Ministers report of executing in 2001 the Act made on January 7, 1993

Present situation, 2004 - we cannot consider

solutions from the year 1993 to be definitive At present, labor

and discussions are taking place in

the Polish Parliament (Sejm)

on introducing changes to the bill

which protects life.

More emphasized by the media are the opinions propagating again the legalization of abortion due to social reasons.

However, there are other possibilities under discussion limiting the exceptions to the prohibition of abortion, for example due to congenital defect diagnosed during pregnancy.

The new amended version

of the Medical Ethics Code, Poland 2004 The Medical Ethics Code, 2004 includes: 1. Provisions barring doctors from euthanasia (article 31)

2. Insisting that in treating a pregnant woman a doctor is also responsible for the health and life of her child (art. 39)

3. Forbidding doctors from participation in human cloning, whether reproductive or therapeutic (art. 39a)

4. Forbidding scientific experiments on human subjects in their embryonic stages and restricting therapeutic experiments on human embryos only to such instances where the foreseen health benefits to the embryo significantly outweigh the health risks to the embryo (art 45)

Present discussion in Poland, 2004

The preliminary position that the

Polish government has adopted (2004), allows for the use of human embryonic

stem cells.

The Chief Medical Council has stated

its view (2004) that it is illicit to

harvest stem cells from human

embryos.

Present discussion in Poland, 2004 The chairman of the Chief Medical Council

There are no ethical contraindications for medical objectives to using human embryonic stem cells (for example from the umbilical cord blood or bone marrow) as long as it does not hurt the donor. However „the destruction of a human embryo to benefit other members of the human species homo sapiens sets a dangerous precedent for humankind”.

Doctor Konstanty Radziwill, the Chairman of the Chief Medical Council, Poland 2004

Final remarks

Many people in Poland believe that life protection, from conception to natural death, is

still the primary objective in our times.

The clear majority of doctors in Poland declare themselves to be in

favor of life.