I'm Ruby Jones and you're listening to seven AM. As hard fought gains in reproductive medicine, voluntary assisted dying, and LGBTQI healthcare have been made, another story has emerged, one where religious pharmacists, doctors and hospital systems believe it's justifiable
to withhold medication or support, often with devastating consequences. Now, one in five pharmacists in Australia will refuse you care if the medication you're asking for doesn't align with their beliefs, and in some parts of the country that number is closer to half. Today. Writer and reproductive health advocate Hannahbambra on the unconscionable reality of conscientious objection. It's Tuesday, January sixth.
This episode was originally published in September. So Hannah, I thought we could start with the story of Ava, although I know that isn't her real name, but tell me about her.
Yeah. So, Aver is twenty two and she's studying medicine in Ballarat and as a young person, she went to her local pharmacy thinking that she would be able to pick up emergency contraception, and she was shocked when the pharmacist in one of the local pharmacies in Ballarat refused her access to what's commonly known as the morning after pill. The pharmacist sort of brushed her off and said, I
don't have time for that today. All of her friends describe her as a really kind of non confrontational person, but she was really angry and upset and frustrated that pharmacist did not recommend another pharmacy where she would be able to get emergency contraception. So she was left scrambling trying to find an alternative option, and eventually she did, but it took up most of her day trying to find the contraception that she needed.
And just tell me more about why that pharmacy would not give her them wrding after her.
So, even though she's a non confrontational person, she went back to that pharmacy and had a chat with her. She realized that this person was a religious conscientious objector, and healthcare professionals are meant to explain that they are denying access on religious grounds, and they are supposed to refer to someone on to somewhere where they can get their medication. But we see it playing out very differently,
and it's really hard to police. So if someone has a bad experience with a healthcare professional, they can report them, but at the end of the day, that often isn't recorded. It's very difficult to prove and I feel like nobody's talking about it, but it's actually really prevalent and prolific. A lot of people are denied a huge range of drugs, including consciouses.
Okay, well, let's talk more about that. As you started looking into this further, what did you uncover about all the different ways in which people can be denied medical care if their needs somehow come into conflict with this idea of conscientious objection.
So conscientious objection is broadly accepted in Australia, but the rules kind of vary state by state, so it can happen at every stage of the healthcare system in Australia, GPS, hospitals, nurses, pharmacists, and a survey from a few years ago said that twenty percent more than twenty percent, up to one in five pharmacists would happily deny someone healthcare if it was against their personal beliefs and they felt that that was justifiable,
even if it meant that that individual person didn't go on to get the health care required that they needed. Conscientious objection is broadly about religious beliefs, so a lot of people think about that as abortion, and particularly medical abortion is something that people need to pick up in pharmacies, but it's also for things like PREP, which is HIV prevention. Same sex couples can also be denied IVF medication that they've paid hundreds of dollars to be able to access, contraception,
medical terminations. There's a huge range of things that pharmacists, doctors, nurses, and even entire hospitals are allowed to deny people based on their personal beliefs, even if they are legally entitled and eligible for that medication.
Right. And as you've said, this is particularly a problem when it happens in a regional town where there may not be another option. Ava did eventually find the medication, but what happens when that is not possible.
So through my reporting on conscientious objection, another person that I spoke to, it's call her Anika. Anika worked in high schools as a nurse and also in clinics as a sexual health nurse for a long time, and she is really passionate about increasing access in regional areas but speaking to her really opened my eyes at how bad this can be in some regional and remote towns and cities. So Anika told me about a young girl and her late teens who approached her after her contraception had failed.
She asked Anakar if she was able to find her emergency contraception, and unfortunately, the pharmacist in that town was a conscientious objector. Because that pharmacist refused them access to the morning after pill and the young girl couldn't drive. That girl then went on to become pregnant unfortunately, and the only doctors in the town also wouldn't prescribe abortion,
medical abortion or refer her on to so abortion. This young girl then had to figure out how to access a surgical abortion, and at that time she wasn't able
to drive to Melbourne. She didn't want her parents to know, but it's pretty hard for someone to leave their country town, find their way to an abortion clinic and get back by the end of the school bell that girl was eventually able to go to a regional hospital and get an abortion, and at that time they were allowing protesters at the front, so she had been denied contraception because of her pharmacist and her doctor who were the only people in the town who could issue those drugs, and
then she had to walk through a sea of people telling her that she was a murderer at eighteen years old to be able to get an abortion.
Coming up, Where does conscientious objection in healthcare come from? Hannah? The idea of conscientious objection in healthcare? Where does it come from? And has it always been a feature of the way that our healthcare system works.
It hasn't really, So it's over the past, let's say, fifty sixty years, as some aspects of healthcare and medicine have become more wildly available to people, it's been a bit of a compromise with religious groups. So, for example, abortion in Australia has taken since the nineteen seventies to
be completely legalized. Their last state to completely decriminalize abortion was Western Australia and that was last year, which I think would shock a lot of people that Victoria was one of the early adopters and completely decriminalized abortion in
two thousand and eight. And decriminalized of abortion is relevant to this because before decriminalization of abortion, people didn't have to think of reasons not to give access to this care, so they didn't have to conscientiously object because there was nothing to conscientiously object from. And similarly, voluntary assisted dying and forms of contraception and things like PREP which is a HIV prevention have only come about and become accessible
to people over the past couple of decades. So since decriminalization. One of the kind of bargaining tools that the federal government and healthcare system was able to use with religious groups was well, we're not going to force anyone to issue these medications. Doctors can opt out if they want to, and that's where the idea of conscientious objection in health care came from. But healthcare is very different to other professions.
Yeah, tell me about that, because you don't really hear of conscientious objection in any other professional context. Yeah.
Absolutely, if you're a lawyer. The legal profession in Australia really upholds this idea that everyone is deserving of legal rights and representation. There is some parts of sort of private institutions I guess, where someone can say, oh, I don't want to sell products to these particular people, but those institutions exist in a free market. Healthcare is publicly funded Yeah, it.
Sounds like there is a real issue around transparency here, that it is not always made clear to the person why they are being denied care. But also they aren't necessarily able to access that kind of information about a provider ahead of time. Yeah.
Absolutely, And I think that's partially why it's so problematic. There's people who really need timely, safe and trustworthy care and they're being turned away without even realizing what they're going into. So if a practitioner did list on their website or in a publicly available register which doesn't exist at the moment, that they don't offer these kinds of care, then someone would be able to make informed choices. But at the moment, people might be going into a GP's office.
Sometimes it's even their family doctor that they've seen since they were young, But they might be heading in thinking that they're able to ask for something which is legal, which they're eligible for, which is widely accessible, and that GP can make a decision based on their own personal
values that they think that person should not access that care. Okay, and so I mean, perhaps this is a controversial question, but do you think that there is a case to be made here that the idea of conscientious objection in health care should be reconsidered absolutely. I think religious groups use the example that you can't force someone to perform abortions, but this isn't about asking people to perform surgical abortions or administer drugs for voluntary assisted dying. Those are very
specialized skills that people opt into. What this is about is about access to getting that care. So at the moment, nurses, doctors, pharmacists, entire hospitals or age care facilities can create barriers for
very vulnerable people. And personally, I have very little sympathy for someone who thinks their right to avoid writing or filling a script is more important than a teenager having to keep a pregnancy or a terminally ill patient having to continue suffering or dying without the dignity that they deserve. And I think there is some peak bodies like the Australian Nursing and midwiff Re Federation, which says if practitioners are thinking that conscientious objection is going to frequently come up,
then maybe they need to seriously consider other employment. And I think that arguably, if you're working in reproductive healthcare, if you're a midwife, it's really likely that you are going to need to talk to people about things like contraception, fetal abnormality testing, pregnancy options. If you're unwilling to put your personal beliefs aside and talk about some of these very real things that are coming up for people, even with wanted pregnancies, then you're in the wrong job.
Well, Henna, thank you so much for your time, Thank you for having me, Thanks for listening. Tomorrow, we're bringing you a fascinating two part episode about the bit of fallout between James Murdoch and his dad. Rupert. Our guest, a reporter with The Atlantic, managed a rare thing to pierce the wall of secrecy that surrounds the Murdoch family and to get a frank, first hand account of what happened when this powerful family ended up in court. It's
compelling listening and I hope you enjoy it. See you tomorrow.