Mexican Supreme Court invalidates medical conscientious objection law

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Mexico's Supreme Court on Monday invalidated an article of the General Health Law that broadly provided for medical personnel's conscientious objection to participating in treatments, such as abortion.

“The law did not establish the guidelines and limits necessary for conscientious objection to be exercised without jeopardizing the human rights of other persons, especially the right to health,” the Supreme Court of Justice of the Nation announced Sept. 20.

The law, adopted in 2018, did not allow medical professionals to invoke conscientious objection "when the life of the patient is put at risk or it is a medical emergency."

Marcial Padilla, director of the prolife platform ConParticipación, commented that “instead of adopting conscientious objection in its entirety,” in its ruling the Supreme Court "puts it in suspense, saying that it does not like how it is formulated, because it prevents the realization of abortion, according to the terms that they wish."

The court is expected to discuss Sept. 21 clear guidelines for the exercise of conscientious objection and whether they will exhort or order the Congress of the Union to use a specific text in legislating on the topic.

Discussion of conscientious objection at the Supreme Court began Sept. 13. It recognized a right to conscientious objection, while adding that this does not restrict the right to health.

In recent weeks the Supreme Court has also invalidated several articles that protected life from conception in the penal code of the state of Coahuila, and parts of the Sinaloa state constitution protecting life from conception. The rulings are expected to have wide-ranging effects throughout Mexico.

Elective abortion has been legal up to 12 weeks of pregnancy in Mexico City and the states of Hidalgo, Oaxaca, and Veracruz. In general, abortion is illegal in the rest of the country, but in most cases there are exceptions for rape and the life of the mother. The penalties and scope of the laws vary from state to state.

A group of 30 medical associations in Mexico had on Sept. 15 defended conscientious objection. Their statement expressed “rejection of legislative resolutions and their consequential actions from now on that could violate our human rights in the practice of our professions."

"For healthcare professionals, the long established freedom, with a scientific basis and adherence to the ethical codes that govern good practices, should always be an absolute and unlimited right in its exercise," they stated.

Therefore, “conscientious objection may be required when there is a disagreement between scientific, legal and ethical principles to perform professional procedures and activities, which would allow them to excuse themselves from directly practicing or participating in any program, activity, treatment or research that contravenes their personal convictions, principles, values or their religious beliefs.”

In their statement on conscientious objection, the various medical groups affirm that making use of this right “is a legitimate action in the face of serious and fundamental issues, since it defends their dignity and freedom as long as the reasons given are serious, sincere, well-founded and do not endanger people’s life or physical well being.”

"The State must guarantee to physicians as persons that they are, the protection of their fundamental rights, in a manner analogous to the protection of the rights that patients deserve due to gender, orientation or sexual preference" they stressed.

"Today the associations of medical professionals have become a vulnerable group with the effort to restrict their freedom and autonomous decision-making through unilateral criteria, by trying to eliminate their right to conscientious objection," they warned.

The professional organizations noted that this occurs "only because of social pressure or demands every time that other adequate options are ignored to resolve these disagreements, through the adoption of other adequate, viable and satisfactory options for the exercise of the fundamental rights of both parties."

The Mexican medical associations also emphasized that conscientious objection is a fundamental human right recognized in various national and international documents such as the Universal Declaration of Human Rights.

"The doctor is a professional of science and conscience, who cannot be reduced to a mere instrument of the will of the patient, since like the patient, he is a free and responsible person, with a unique collection of values that regulate his life,” they pointed out.

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They also lamented that "the unawareness of society and the authorities of the rights of doctors negatively and disproportionately affects their fundamental rights."

For the medical associations, “considering the right to conscientious objection in matters of health to be unconstitutional is disproportionate and erroneous since the State omits its responsibility to guarantee to doctors as an essential component of society, the human right to the protection of their mental and emotional health, preventing the highest possible enjoyment of physical and especially mental health.”

“From the well grounded reasons laid out above, it is clear that it is our right to demand respect from the authorities for professional autonomy in decision-making, an absolute guarantee in the exercise of freedom, reason and conscience so that the human rights of all parties involved are protected” they said.”

Finally, they stated that “the federations, associations and boards of medicine as the sole and legitimate representatives of the medical profession, will always continue to be vigilant over the good practice of medicine, so that it is carried out, without external pressure, meeting even the least significant of the requirements of quality and ethics.”

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