Revisiting Polish Abortion Law: Doctors and Institutions in a Restrictive Regime

Atina Krajewska

doi:10.1177/09646639211040171

Abstract

This article examines the motivations of doctors operating in restrictive abortion regimes, and it takes Poland as a case study. It places in the foreground institutional and intra-professional factors that determine abortion healthcare, which to date have been accorded little attention. The article compares the impact that criminal, professional, and social sanctions have upon the provision of abortion services. In so doing, its purpose is to refocus debate in this area. It aims to move the emphasis away from legal and political factors, including the criminalisation of abortion, and to place it on medical agency. The Polish case study is examined to test out, in the context of a late-transitional polity, the sustainability of neo-institutionalist approaches to the study of law and organisations and the sociology of professions. The analysis is particularly important and urgent in light of the recent retrenchment of reproductive rights in Poland, and beyond.

Highlights

Writing over 20 years ago about the history of abortion law in the USA, Reagan (1997: 3) noted that ‘[i]t would have been virtually impossible for the state to enforce the criminal abortion laws without the cooperation of physicians’
The analysis presented in this article is urgent in light of the recent legal developments in Poland, where the Polish Constitutional Tribunal issued a judgment (K 1/20), which resulted in the re-criminalisation of abortions performed on grounds of diagnosed risks of severe disorders or incurable illness of the foetus
Despite challenges related to the scarcity of the available data and the bifurcation of views expressed in the interviews, the analysis provided important insights about the processes and structures underlying restrictive abortion practices in Poland

Summary

Introduction

Writing over 20 years ago about the history of abortion law in the USA, Reagan (1997: 3) noted that ‘[i]t would have been virtually impossible for the state to enforce the criminal abortion laws without the cooperation of physicians’. This article extends this research by examining the legal, professional, and employment frameworks shaping the relationships and power dynamics within the medical profession, addressing, in turn, how these affect the development and operation of abortion law It considers the factors determining physicians’ professional autonomy in relation to abortion, that is, their regulatory independence from the state and their decisionmaking power in every-day medical practice (Freidson, 1993). On this basis, the article assesses the role that criminal law, professional regulation and institutional and organisational relationships play in restricting professional autonomy, and it investigates how these restrictions impact upon the provision of abortion services. Understanding the factors determining professional behaviour acquires particular importance as a part of strategy for building alliances for future mobilisation in favour of liberal reforms

Methods

Conclusions

Findings

Ethics Approval