GP’s Abortion Discussion at Clinic Front Desk Sparks Controversy

Key Takeaways:

• A doctor was found to have breached the health consumers’ code by failing to provide services with reasonable care and skill in the case of a woman seeking a termination of pregnancy.
• The doctor failed to refer the woman in a timely manner, which potentially hindered her ability to exercise autonomy in her healthcare.
• The doctor discussed the woman’s personal and sensitive information in a busy waiting area, which was deemed a breach of her privacy.
• The doctor was criticized for advising the woman to return to the clinic for a second consultation after lockdown, despite termination services being available during Level 4 lockdown.
• The doctor was recommended to undergo training in privacy around patients requesting a termination and to apologize to the woman.

Introduction to the Case
The Deputy Health and Disability Commissioner, Dr. Vanessa Caldwell, has released a decision regarding a complaint made against a doctor who failed to provide adequate care to a woman seeking a termination of pregnancy. The complaint was referred to the Health and Disability Commissioner (HDC) by the Health and Disability Advocacy Service, after the GP clinic refused to engage with the service despite multiple attempts. The investigation found that the doctor had breached a section of the health consumers’ code by failing to provide services with reasonable care and skill.

The Incident at the Reception Area
During the initial consultation, the doctor took the woman to the clinic’s front desk and discussed the details of the process required for a planned termination with the receptionist in the busy waiting area. This was deemed a breach of the woman’s privacy, as the conversation was held in a public area where other patients and staff could overhear. The doctor claimed that this was necessary for the reception staff to coordinate the next steps, but Caldwell argued that more suitable options, such as a brief written note or a private conversation with the reception staff, could have been used.

The Doctor’s Actions During the Covid Lockdown
The doctor advised the woman to return to the clinic for a second consultation after the Covid lockdown, despite termination services being available during Level 4 lockdown. The doctor acknowledged that he did not know that private sector pregnancy termination services were available during lockdown, but Caldwell argued that this could have been resolved with a simple query or by a practice staff member. The doctor’s actions were deemed unreasonable and inconsistent with accepted practice, as he failed to refer the woman to a private provider or advise her to self-refer after the first consultation.

Failure to Refer in a Timely Manner
Caldwell found that the doctor failed to refer the woman in a timely manner, which potentially hindered her ability to exercise autonomy in her healthcare. While it is reasonable to offer a second consultation to patients who are unsure or need more time to consider their options, the doctor’s decision to postpone the second consultation during the uncertain lockdown period was deemed unnecessary from a clinical perspective. Caldwell recommended that the doctor undergo training in privacy around patients requesting a termination and apologize to the woman.

Conclusion and Recommendations
The HDC’s decision highlights the importance of providing timely and respectful care to patients, particularly in sensitive and time-critical matters such as termination of pregnancy. The doctor’s actions were deemed a breach of the health consumers’ code, and he was recommended to undergo training and apologize to the woman. The GP clinic was also recommended to review its complaint management processes and policies to ensure they align with the HDC’s Code of Rights. The case serves as a reminder of the need for healthcare providers to prioritize patient autonomy, privacy, and dignity in their care.