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

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.

Tough Clinical Decisions: Experiences of Polish Physicians

“…Most probably, the difference between Polish physicians and healthcare professionals from other countries results from a more hierarchical and authoritarian style of healthcare decision-making in Polish clinical practice. Despite deep political, socio-economic, organizational and regulatory changes in the Polish healthcare system that took place during the last three decades, the subordination and hierarchical dependency between the chief of unit and healthcare professionals working in the unit are still prevalent in Polish hospitals (Łuków & Wrześniewska-Wal, 2007;Krajewska, 2021). Chiefs of units retain substantial power and authority in the decision-making processes, including clinical ones.…”

“…Chiefs of units retain substantial power and authority in the decision-making processes, including clinical ones. Like captains on ships, they usually have the final word on the course of patients' treatment, although formally they are no longer authorized to give professional orders to their unit's staff, only recommendations and guidelines (Łuków & Wrześniewska-Wal, 2007;Krajewska, 2021). The above-mentioned lack of appropriate respect for patients' autonomy and the absence of laws regarding advance directives, including the appointment of healthcare proxy, contributes to the petrification of this situation.…”