"Gatekeepers" of abortion in Australia: Abortion law and the protection of doctors

Abstract

Abortion law in Australia is not consistent across the states and territories, but the common characteristic is that an abortion can be lawful where a medical professional is involved. A number of authors have therefore argued that this positions doctors as ‘gatekeepers’ to abortions (Leslie Cannold 2000, Janet Hadley 1996, Heather Douglas 2009, and de Crespigny & Savulescu 2004). This characterisation of ‘gatekeeping’ suggests that doctors perform a regulatory function over women’s reproductive decisions. However, without examining the emergence and the practice of this gatekeeping role, it only remains an assertion that doctors regulate women’s abortion choices.

The design of this thesis draws on the work of Foucault, in particular his approach to studying power. It accepts Foucault’s position that power exists only when it is put into action (Foucault 1982, 788). My study of gatekeeping examines the gatekeeping role through this lens, examining how the social expectation of regulation for doctors established under the law aligns with how doctors practice this regulation. With this in mind, the thesis draws sequentially on multiple sites for investigation, including law, education and medical practice, moving from the framing of abortion legislation through to the decision-making practices of doctors.

This thesis finds that the law in all Australian jurisdictions relies on doctors to perform a function that is not legally or institutionally well-defined, but instead is shaped by and relies upon the values and beliefs held by individual doctors. There is thus a legal expectation of regulation established by the gatekeeping role, but doctors can exercise their own judgement in how they choose to practice the role. The thesis concludes that abortion law in Australia involves balancing the rights and responsibilities of women and doctors in the context of the social contentiousness of the abortion issue. The law balances multiple factors, from the protection of women’s choices to women’s health needs, and the legality of the doctor in facilitating access to the procedure to the rights of doctors to practice medicine according to their own conscience. This results in variable consequences for women seeking abortions, depending on the presiding doctor. Show more