Effective from 3 December 2018, the Termination of Pregnancy Bill 2018 (‘The Act’) enables lawful, reasonable and safe access by women to terminations of pregnancy up to a gestational limit of 22 weeks.

Downloadable resources for clinicians

• Summary of the Queensland Termination of Pregnancy (TOP) Legislation
• Termination of pregnancy community services
• Termination of pregnancy treatment options available for patients
• Tips and information for Gold Coast clinicians
• Clinical Excellence website

Summary of the Queensland Termination of Pregnancy (TOP) Legislation

Effective from 3 December 2018, the Termination of Pregnancy Bill 2018 (‘The Act’) applies to termination of pregnancy in Queensland.

Termination performed by a registered medical practitioner is no longer a criminal offence under the Criminal Code; nor is it a criminal offence for a woman to consent to, assist in or perform a termination on herself; nor is it a criminal offence to assist a woman to obtain a termination or supply her with the means to do so.

The Act ensures TOP are treated and regarded as a health issue rather than a legal issue in the state of Queensland. By positioning TOP as a health issue, the Act:

• supports a woman’s right to health including reproductive health and autonomy
• regulates the conduct of registered health practitioners in relation to terminations
• brings Queensland in line with other Australian jurisdictions

Key provisions include:

• Registered medical practitioners may perform a lawful TOP on request of a patient up to a gestational limit of 22 weeks.
• A woman may request a termination, for any reason, without disclosing the reason to the doctor.
• For a woman who is more than 22 weeks pregnant, a termination may be performed by a medical practitioner if they consider that in all the circumstances, the termination should be performed and they have consulted with another medical practitioner who also considers that, in all the circumstances, the termination should be performed. Both medical practitioners must consider:
  • all relevant medical circumstances
  • the woman’s current and future physical, psychological and social circumstances; and
  • the professional standards and guidelines that apply to the practitioner in relation to the performance of the termination.
• In an emergency, a medical practitioner may perform a termination at or after 22 weeks+0 days gestation if they consider it is necessary to save the woman’s life or the life of another unborn child without consulting another medical practitioner or considering all relevant circumstances.
• The gestational limit is set at 22 weeks because:
  • 22 weeks represents the stage immediately before the ‘threshold of viability’ under current clinical practice.
  • the limit is consistent with the Department of Health’s Clinical Services Capability Framework, which requires terminations after 22 weeks to be referred to hospitals.
  • foetal anomalies are usually diagnosed at the 18–20 weeks morphology scan. Additional testing may be required at times and the results may take days or even weeks.
• A medical practitioner, nurse, midwife, pharmacist, or Aboriginal and Torres Strait Islander health practitioner may assist in a termination within their scope of practice. Aboriginal and Torres Strait Islander health practitioners may assist in providing culturally safe and appropriate advice and support to Aboriginal and Torres Strait Islander women in rural and remote areas.
• Student health practitioners are not permitted to assist in the performance of a termination.
• A woman may consent to, assist in, or perform a termination (e.g. by taking prescribed medication, also known as a medical termination).
• It is an offence for an unqualified person to perform or assist in a termination.
• Safe access zones are established around premises that provide TOP to protect the safety and wellbeing and respect the privacy and dignity of women, staff and others who need to access the premises.
• A medical practitioner may refuse to provide or participate in terminations of pregnancy because it conflicts with the doctor’s own personal beliefs, values or moral concerns. This constitutes a ‘conscientious objection’.

Conscientious objection

The law recognises that health practitioners have and may exercise the right to freedom of thought, conscience and religion, and seeks to balance this against the rights of a woman – particularly the right to health including reproductive health and autonomy.

A health practitioner may refuse to perform or assist in a termination if it conflicts with their own personal beliefs, values or moral concerns. This constitutes a ‘conscientious objection’.

If a person asks a registered health practitioner to perform, assist, make a decision or advise about a termination, the law requires a registered health practitioner to disclose their conscientious objection to the person.

In addition, if the person making the request is a woman asking the health practitioner to perform, or advise on, the performance of a termination on the woman, the practitioner must refer the woman or transfer her care to another health practitioner or health service provider who, in the first practitioner’s belief, can provide the service and does not hold a conscientious objection.

The conscientious objection provision does not extend to administrative, managerial or other tasks ancillary to the provision of termination healthcare; or to hospitals, institutions or services.

What this means for health practitioners

A termination performed by a registered medical practitioner is no longer a criminal offence under the Criminal Code; nor is it a criminal offence to assist a woman to obtain a termination or supply her with the means to do so.

The Act does not affect the operation of other general requirements under health regulation and clinical practice which require a medical practitioner to be suitably qualified and credentialed and to act within their scope of practice in relation to any healthcare (including a surgical or medical termination) which they may provide.

When it is an offence to terminate

It is an offence for an unqualified person to perform or assist in a termination.

Students are not included in the definition of registered health practitioner under the Act, and as unqualified persons it would be an offence for them to assist (s319A of Criminal Code). However, student health practitioners are able to observe.

Consent

This Act does not affect or change existing consent requirements. The usual requirements under general law about consent to medical treatment will continue to operate and apply to terminations of pregnancy.

For a young person who does not have capacity to consent to medical treatment, only the Supreme Court may authorise the termination of pregnancy. A parent/guardian cannot give consent. For an adult who does not have the capacity to consent to medical treatment, termination of pregnancy should be consented to by the Queensland Civil and Administrative Tribunal (QCAT).

Clinical standards and guidelines

Health practitioners will be guided by the relevant body regarding codes of ethics, rules of professional conduct, and standards of practice.

The termination of pregnancy clinical guidelines has been updated. Health practitioners are encouraged to familiarise themselves with the new guideline.

• Queensland Pelvic Mesh Service
• Queensland Health – Information for clinicians fact sheet

To refer a patient please visit the Queensland Health website for more information and to access the QPMS referral form.

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