The doctor who refused to abort

Polish media outlets have been abuzz this summer with the story of Bogdan Chazan, a prominent Warsaw doctor who refused to provide a woman with an abortion and was subsequently sacked. Chazan’s case illustrates Poland’s version of the battle between pro-life conscience rights and liberal values—a battle pro-life Americans are enduring in legal confrontations over Obamacare’s contraceptive mandate.

The Polish doctor’s troubles began in April, when a pregnant woman wrote to his maternity hospital in Warsaw, the Holy Family Hospital, asking for an abortion. She said her personal physician had detected severe developmental defects in the unborn baby. Chazan, a Roman Catholic who has served as director of the hospital for the past 10 years, wrote back, saying he could not provide an abortion due to a “conflict of conscience.” He provided an address to a hospice that could care for the baby after it was born.

For that exercise of conscience, Warsaw Mayor Hanna Gronkiewicz-Waltz announced in July she was dismissing Chazan from his position at the government-run hospital. She said Chazan did not have the right to refuse the abortion, and said Polish law obliged him to offer the woman an abortion referral. An investigation by the mayor’s office accused Chazan of ordering unnecessary tests that delayed the woman’s abortion request, prolonging her pregnancy beyond 24 weeks of gestation, the time when doctors generally consider an unborn baby “viable.” After viability, abortion of a handicapped baby in Poland is illegal. The hospital was also fined $23,000, and Chazan was given a three-month job termination notice and placed on leave.

Chazan told a Polish news station the dismissal was “the start of an attack on the conscience of doctors and people in management positions in the health service.” He has defended his actions as permissible under a conscience clause in Polish law that is supposed to excuse pro-life doctors from participating in abortions.

Commenting on the case in June, Poland’s prime minister, Donald Tusk, seemed little concerned about conscience rights. “Regardless of what his conscience is telling him, [a doctor] must carry out the law,” he said.

That attitude from Polish authorities could spell trouble for other pro-life doctors and nurses: 3,000 Polish medical professionals and students, including Chazan, have signed a “Declaration of Faith,” saying they will not provide services contrary to their beliefs, including as abortion, euthanasia, or in-vitro fertilization. Could they be dismissed next?

The woman ultimately gave birth to a baby boy at another Warsaw facility, the Bielanski hospital. A doctor there, Romuald Debski, tried to paint abortion as compassionate by describing the baby’s deformities in uncompassionate detail. “This child does not have half of its head, has a hanging eyeball, its face is split, it has no brain inside,” said Debski, according to Reuters. “If Professor Chazan saw the life that he saved, he would have a different attitude.” The baby died a few days after birth.

This isn’t the first time Chazan has made a costly stand on principle: Twelve years ago, he was dismissed as head of the obstetrics and gynecology clinic of another Warsaw hospital, the National Research Institute of Mother and Child, following a similar situation. “Lo and behold, lighting does strike twice!” said Robert Walley, the executive director of the Newfoundland-based MaterCare International, a Catholic ob-gyn charity where Chazan serves as a council member. “He has shown great courage.”

I reached 69-year-old Chazan—amid his bustle to clean out his hospital office—and asked about the recent controversy and his current situation.

Your dismissal from Holy Family Hospital came after you refused to provide an abortion. But did your hospital ever provide abortions? Before I become the director, abortions were carried out at the hospital—a dozen or more a year, mainly due to diagnosed diseases or developmental disorders in the fetus. During my term [as director], abortion was carried out once, in 2006, due to anencephaly in the fetus. I found out about that recently, and it probably took place while I was on vacation. We rarely had patients turn to our hospital with the intention of carrying out an abortion. I usually managed to make them change their intentions. Besides, patients knew that we did not perform abortions at this hospital, and I believe it was accepted. There were no complaints to the authorities, as in the present case.

I would like to add that the next day after I was dismissed and sent on a “compulsory” vacation, another abortion was performed in the hospital.

Some liberals complain about losing abortion access. There is no need for all hospitals in Poland to be forced to perform abortions. We have about 800 legal abortions a year, and about 400 ob-gyn wards: There are two abortions a year per hospital.

Are you appealing Mayor Gronkiewicz-Waltz’s dismissal decision? Yes. I have submitted a claim to the labor court for the annulment of my dismissal from work. The justification of this decision is, in my opinion, very questionable. Moreover, the mayor had publicly announced the intention to dismiss me from work even before I was presented allegations. My comprehensive answer to these charges was rejected with a one-sentence letter.

Tell us your side of the story. What response did you make to the woman who requested an abortion, and what was wrong with her baby? Did you expect the baby to live? A mother applied to the hospital, in writing, to have an abortion carried out after a conversation I had with her. I offered her a continuation of the pregnancy, a delivery at the hospital, psychological assistance at the hospital, and psychological support at the perinatal hospice. Because the mother did not change her mind, the next day I gave her a negative answer. During her pregnancy, an ultrasound examination … and an MRI examination suggested hydrocephalus and craniofacial defects. Prenatal examinations had given the boy a chance for survival, which was confirmed by a child surgeon. After delivery, it turned out that part of the skull was missing and there were severe craniofacial defects.

Officials say you should have offered an abortion referral. I did not direct the patient to another doctor, as I do not know a list of doctors performing abortions: I would have to be calling them using a telephone book. Moreover, by directing the woman there I would actually participate in organizing that abortion—which for moral reasons I could not consider.

What about the accusation you delayed the pregnancy by ordering tests? We were awaiting the results of the cytogenetic test of umbilical blood that was carried out at the Institute of Mother and Child. I did not administer any additional tests.

What motivated you to save a baby that would ultimately die? I decided that I would be guilty of killing a human being, of finishing off an ill child. The value of human life is the same, regardless of the human’s size, place of living (in the mother’s womb or outside it), body shape, or physical appearance.

What does your dismissal mean for other doctors and nurses in Poland who object to performing abortions or giving abortion referrals? I hope my example will encourage them to protect the life of unborn children, to reveal their opinions in this matter, and to use Poland’s conscience clause with more confidence. I am convinced it will awaken the conscience of many people and encourage them to care for the dignity of any human life.