Dr Gilbert Gravino and Liza Caruana-Finkel
Malta's first rally for choice, September 2019
Matters of human rights and essential healthcare should not be left up to any majority. Surveys must not serve to dictate whether abortion remains illegal or becomes legal based on majority opinion. A pregnant person must have access to safe abortion irrespective of the views of different population groups. However, surveys certainly remain valuable from a sociological perspective, shedding light on the changes in attitudes and behaviour with regards to abortion in Malta. The views of medical doctors are also important since the complete ban on abortion has an impact on the patient-doctor relationship, advice, and care that patients receive.
A pregnant person must have access to safe abortion irrespective of the views of different population groups.
Surveys need to be designed to provide a comprehensive and nuanced overview of the different circumstances and the different gestational ages. They must be clear about what exactly is being questioned – Personal moral values? Decriminalisation? Legalisation? Any one person may have different answers to these questions. Questions such as ‘Do you agree with abortion...?,’ which have been previously used to survey the general public, lack clarity in this regard. Anonymity in research is crucial, which is not purely preserved through telephone conducted surveys. The language used in surveys also matters. The use of inaccurate terminology and sensationalising the content of the questions to veer respondents one way or the other must be avoided. Failure to do so results in surveys yielding a skewed representation of the true sentiment of those participating.
Within their limitations, previous surveys published by Media Today (Malta Today, 2018 and 2019) suggest a strong opposition to abortion by the general public. A more recent survey (2020) conducted by the same media house and published on Illum was more specific and asked participants whether they agree with triggering the process of legalising abortion in Malta, but did not take into account the different circumstances or gestational ages. This survey also suggests that most of the general public remains opposed to legalisation. However, these surveys also showed that the attitude is more favourable towards legalisation amongst the younger generations.
Another survey, targeted at Malta’s university students, concluded that the majority were against the legalisation of abortion (58.4% vs 41.6%), but then also reported a majority (62.3%) who agreed that abortion is justified when a woman’s life is in danger (University of Malta student survey report by KSU, March 2019). This is somewhat contradictory, and suggests that most university students do not actually agree with a total legal ban on abortion, but rather agree that abortion is justified when a woman’s life is in danger.
Results from our study, published in Sexual and Reproductive Health Matters Journal
Our recent study on the views of Malta’s medical doctors on abortion, which allowed for a comprehensive and nuanced overview of the different circumstances and the different gestational ages, showed that the majority of doctors do not agree with a total legal ban. This was conducted with rigorous methodology and data analysis, and published in a peer reviewed journal. A clear majority was in favour of legalisation when a woman’s life is in danger and in case of a non-viable fetal anomaly. Contrary to the long-held general perception that most doctors in Malta support the current legislation, this study provides evidence that this is not the case. In fact, doctors within each of the most relevant specialities agreed with its legalisation (at least in certain circumstances), including obstetricians/gynaecologists, general practitioners, psychiatrists, paediatricians, and public health specialists. Unfortunately, there was still a considerable percentage of doctors who opposed legalisation of abortion even in critical situations such as when a woman’s life is in danger (for which 21.8% were against at any gestational age). Results also showed that older and/or religious doctors were in greater disagreement with the legalisation of abortion, when compared with younger and/or non-religious doctors.
The fact that the surveys conducted so far show young generations being more supportive of legalising abortion and that Malta is becoming more secular, favours a future where many more will support access to abortion. All local surveys, and our recent developments with the pro-choice movement having built its momentum, suggest that Malta will become more accepting of abortion as part of comprehensive reproductive healthcare. This will not happen without resistance. It will take time to deconstruct the false sense of security created by centuries of political, religious, and cultural indoctrination against abortion, and simultaneously build a foundation of understanding on this procedure truly based in healthcare, empathy, and respect for one another’s choices.