The bill on responsible parenthood

LAW

..... 2004

Art. 1.

Each person has the right to self-determination with regards to reproduction in conditions which enable responsible decisions about parenthood.

Art. 2.

Each person has the right to information, education, counseling and access to measures enabling the exercise of the right to responsible parenthood. 

Art. 3.

Whenever the bill mentions:

responsible parenthood - this means freedom to make responsible decisions about having children, their number and the spacing of their births as desired by the parents;

contraceptives - this means medical and therapeutic products, registered for circulation on the territory of the Republic of Poland, which prevent fertilization or the implantation of a fertilized egg in the mucous membrane of the uterus;

prenatal testing - this means a medical examination requested by the woman in order to establish the existence and stage of advancement of the pregnancy, the state and correctness of the development of the embryo or fetus;

termination of pregnancy - this means a medical intervention undertaken with the woman's permission after the implantation of the fertilized egg in the uterus in order to prevent the further development of the embryo or fetus;

assisted procreation - this means actions undertaken by a physician, based on medical knowledge and with permission of the persons involved, the acquisition of gametes, artificial insemination of egg cells in vivo or in vitro and the enabling of the further development of the embryo or its storage with the purpose of transferring it into the woman's body.

Art. 4.

Governmental and local administrative bodies responsible for healthcare issues and social policy ensure access to medical services consistent with the most up-to-date medical knowledge related to responsible parenthood.

Governmental and local administrative bodies responsible for healthcare issues and social policy assist non-governmental organizations in the activities which they carry out with regards to responsible parenthood and cooperate with them.

 

Art. 5.

Governmental and local administrative bodies responsible for healthcare issues and social policy provide a pregnant woman with:

1) healthcare;

2) unconstrained access to prenatal testing and information about such services;

3) indispensable material help during pregnancy, labor and after the birth as specified in other acts;

4) access to detailed information about the rights she is entitled to, services and welfare benefits as well as access to institutions and organizations assisting with psychological and social problems, as well as dealing with issue of adoption.

If a secondary school student is pregnant, the school is required to grant her a leave of absence and provide her with all the help necessary for her to complete her education, if possible without creating delays in fulfilling the requirements for her classes. If the pregnancy, birth or post-labor period make it impossible for the student to pass the required examinations on time, the school is required to assign an additional examination date at a time convenient for the student, scheduled no later than 6 months after the original examination date.

In order to ensure the proper realization of the protection of pregnant women, and especially the accessibility of benefits, the Council of Ministers will issue a regulation clarifying the specific scope, forms and modes of granting benefits and services which are listed in par. 1.

 

Art. 6.

A subject called "Knowledge about human sexuality" is introduced to the school curriculum. The subject, listed in par. 1, accommodates the age, perceptual abilities and needs of the students. The subject is introduced from the first grade of primary school.

The syllabus of the subject listed in par. 1 includes information about rights with regards to responsible parenthood and human sexuality, including methods of preventing sexually transmitted diseases, especially HIV/AIDS and contraceptive means and methods.

The syllabus of the subject mentioned in par. 1 will also include information about the prevention of sexual abuse, creating violence-free partnership-based relationships between men and women and about responsible parenthood.

In order to include the content necessary for the realization of the act the Minister dealing with issues of schooling and education will determine, through issuing a regulation, their scope in the core curriculum for general education and will introduce the subject matter of par. 3 and par. 4 into the system of teachers' training and continuing education.

Art. 7.

Governmental and local administrative bodies responsible for healthcare issues and social policy ensure the availability of contraceptive means and methods.

Governmental and local administrative bodies responsible for health care issues and social policy provide persons who are recipients of social aid with the means listed in par. 1 free of charge.

New generation contraceptives, including post-intercourse contraceptives, are reimbursed according to principles specified by the minister responsible for healthcare.

The proper self-government bodies on the district level create facilities which conduct responsible parenthood counseling and services.

Art. 8.

Governmental and local administrative bodies responsible for healthcare issues and social policy ensure access to assisted procreation health services.

Persons who are covered by social insurance or who are entitled to free healthcare on the basis of separate regulations have the right to take advantage of assisted procreation services free of charge in public heath care facilities or in facilities which have signed contracts for obstetrics-gynecology services.

The right mentioned in par. 2 is restricted to three cycles of treatment. 

Art. 9.

A woman has the right to terminate a pregnancy during the first 12 weeks of its duration.

 

A woman has the right to terminate a pregnancy after 12 weeks of duration if:

1) continuing the pregnancy endangers the woman's life or can affect the deterioration of her health;

2) there exists a probability of grave fetal abnormality or of an incurable disease endangering the life of the fetus;

3) the pregnancy results from a criminal act.

The termination of the pregnancy takes place at the earliest time possible, in accordance with the current state of medical knowledge, including the use of pharmacological methods.

 

In cases described in par. 2 the final decision concerning the continuation or termination of the pregnancy is made by the woman after she is provided with medical information

 

In cases described in par. 2 and par. 3 the termination of the pregnancy is possible until the fetus has reached viability outside of the woman's organism.

 

In cases described in par. 2 the termination of the pregnancy is performed by a physician in a healthcare facility.

 

The physician who terminates the pregnancy provides the woman with information about contraceptive methods and means.

 

Art. 10.

A person who is covered by social insurance or who is entitled to free healthcare on the basis of separate regulations has the right to terminate a pregnancy free of charge in a public healthcare facility or in a facility which has signed a contract for obstetrics-gynecology services.

 

2. The director of the health care facility, who is listed in par.1, is responsible for the realization of the termination of pregnancy.

 

Art. 11.

The right of physicians or of other medical personnel to refrain from the realization of healthcare services which violate their conscience does not extend to the right to refuse services which lead to the prevention of pregnancy.

A physician can use the right to refrain from performing healthcare services which violate his/her conscience as long as the refusal to perform such services includes all forms of his activity as a physician and is reported in writing to the director of the healthcare facility where the physician is employed or the body which keeps a record of individual practitioners.

The director of a healthcare facility and the organ which keeps a record of individual practitioners make the information concerning physicians who use the right to refuse to terminate pregnancies available to interested persons.

 

Art. 12.

Persons performing actions resulting from the act are obliged to keep all information which they have acquired as a result of performing these actions private.

 

If the information listed in par. 1 is revealed, the person who has been harmed has the right to financial compensation.

 

Art. 13.

The following changes are implemented in the law from June 6 1997 " Criminal code (Law Journal Nr 88, pos. 533, Nr 128, pos. 840, from 1999. Nr 64, pos. 729, Nr 83, pos. 931, from 2000. Nr 48, pos. 548, Nr 93, pos. 1027, Nr 116, pos. 1216, from 2001. Nr 98, pos. 1071, from 2003. Nr 111, pos. 1061, Nr 121, pos. 1142, Nr 179, pos. 1750, Nr 199, pos. 1935 and Nr 228, pos. 2255 and from 2004 Nr 25, pos. 219):

1) in art. 152, § 3 words "the conceived child has achieved viability outside of the pregnant woman's organism" are replaced with "the fetus has achieved viability outside of the woman's organism", 

2) in art. 153, § 2 words "the conceived child has achieved viability outside of the pregnant woman's organism" are replaced with "the fetus has achieved viability outside of the woman's organism", 

3) in art. 156 in § 1 after the words "the ability to conceive" the following words are added "with the exception of sterilization used as a voluntary method of birth control",

4) art. 157a is deleted.

 

Art. 14.

The following changes are implemented in the law about the medical profession from December 5 1996 (Law Journal 2002, Nr 21, pos. 76, pos. 691, Nr 152, pos. 1266, Nr 153, pos. 1271 and from 2003, Nr 90, pos. 845):

1) in art. 26:

a) in par. 1 the words "mother and conceived child" are replaced with the words "pregnant woman and fetus",

b) in par. 3 the words "Conceived children, persons" are replaced with the word "Persons",

2) in art. 32 par. 2a is added:

 2a. In the case of a minor a physician can, on request of the minor, provide her with pregnancy prevention or termination services, without consent of the legal representative or of the probate court, if according to the physician's judgment, it is in the juvenile's best interest.

Art. 15.

 Art. 2 is deleted from The Ombudsman for Children act from January 6 2000 (Law Journal Nr 6, pos. 69).

Art. 16.

The Law from January 7 1993 about family planning, the protection of the human fetus and the conditions for the permissibility of the termination of pregnancy (Law Journal Nr 17, pos. 78, from 1995. Nr 66, pos. 334, from 1996. Nr 139, pos. 646, from 1997. Nr 141, pos. 943, Nr 157, pos. 1040, from 1999. Nr 5, pos. 32 and from 2001. Nr 154, pos. 1792) loses its validity.

 

Art. 17.

The law comes into effect three months from the date of its announcement.

 

Justification: 

I. The draft of the responsible parenthood law is supposed to guarantee the compliance of regular legislation with the Constitution of the Republic of Poland. The idea of the originators of the draft is to create a modern system, which ensures the full realization of rights and freedoms in one of the most important areas of life. The current legal and factual state does not meet the requirements of a modern state, which prepares youth to make the most important decisions in life. We are dealing with bad law, a case where a certain outlook on life has caused an increase of adverse social phenomena. The following can be listed among them: lack of preparation of children and youth for coping with the threat of sexual crimes, an increase of the abortion underground and a distortion of the sexual consciousness of citizens and their attitudes towards responsible parenthood. The law which has been in effect since 1993 deprives parents of the possibility of making conscious and responsible decisions about whether, when and how many children they will have. This law hinders the spread of information and use of modern methods of contraception. Most of all, however, the law from 1993 shapes an actual ban on the termination of pregnancy. The official number of procedures performed, not exceeding 200 a year, provides evidence for this claim. In some poorer regions of the country cases of legally terminated pregnancies are not registered at all. This means that the abortion underground, including services performed by persons who do not have the necessary professional qualifications, has dominated the market. Procedures are not performed in hospitals, even in cases of obvious medical indications or circumstances where the pregnancy results from a criminal act. Also, the number of newborns abandoned in obstetric wards has been steadily increasing. In the past years it has exceeded 1,000 newborns a year. The number of illegal abortions cannot be precisely determined. Estimates mention 100-200,000 such procedures a year. Approximately 53 million abortions are performed worldwide, about half of them take place illegally. It has been established that at least 80,000 deaths of women result from mistakes or complications of illegally performed procedures. A lack of medical research makes it impossible to establish with certainty the actual number of deaths resulting from termination of pregnancy procedures performed without obedience of the rules of the medical profession. The danger to the health of women which would result from upholding the current law has been pointed out by i.e. the Committee on Economic, Social and Political Rights (1998, 2002) and the Human Rights Committee (1999) of the United Nations. They have made a recommendation for Polish authorities to take actions leading to the alleviation of the effects of the restrictive anti-abortion law. At the same time the role of access of young people to reliable and free from indoctrination sexual education, as well as the possibility of free choice and easy access to all methods of family planning, have been emphasized. The originators of the draft aim at creating law which would fulfill all these requirements.

II. Making autonomous and responsible decisions about whether to have children, their number and the spacing of their births is every individual's fundamental right. The right is drawn from the Constitution of the Republic of Poland. The Right to dignity, to privacy and the protection of parenthood are important constitutional rights, which are not realized by the current regular legislation.

 

The project creates a base for the realization of these rights through:

ensuring children and youth access to knowledge about responsible parenthood, health and human sexuality,
enabling access to freely chosen contraceptives, also to persons who are in difficult economic circumstances,
social insurance coverage for infertility therapy,
providing pregnant women with proper medical care, also including prenatal testing and material help for persons in difficult economic circumstances,
creating the possibility of safely terminating a pregnancy.

III. The originators of the draft acknowledge that the suggested regulations will not only lead to improvement of the demographic situation of the country, but will also bring about an actual decrease in the number of pregnancy termination procedures, which are now taking place illegally, underground, threatening the life and health of women.

Art. 1 and 2 of the law specify its aims and ensure the protection of responsible parenthood. The originators of the draft suggest an exemplary, open list of actions which can be undertaken by bodies of the public administration in order to achieve this goal. A modern state cannot be silent on such fundamental issues as health, the right to self-determination with regards to reproduction. It is also necessary to create a catalog of rights each citizen is entitled to and the resulting claims. The law will also regulate the possibility of using the rights acknowledged by different legal acts by professions responsible for the sexual health of citizens.

Art. 3 consists of a glossary of legal definitions, indispensable for the correct functioning of the new law. These definitions, partly derived from international legal acts, will stipulate the practical use of the terms. The project defines five terms: responsible parenthood, contraceptives, prenatal testing, termination of pregnancy and assisted procreation.

The normative purpose of Art. 4 is providing citizens with the highest possible standard of responsible parenthood services. Such an idea has been stipulated in constitutional jurisdiction of democratic countries. Traces of this concept can also be noticed in the jurisdiction of the Polish Constitutional Tribunal. In order to realize this goal cooperation with non-governmental organization acting in the field of responsible parenthood is planned.

Art. 5 defines the principles of caring for a pregnant woman. This is the responsibility of bodies of governmental and local administration. The scope of this responsibility is defined by a regulation of the Council of Ministers. Par. 1, in points 1-4, defines the specific forms of assistance to the pregnant woman and the fetus. Par. 2 introduces the right of a pregnant secondary school student to a leave of absence and to assistance necessary to complete her education.

Art. 6 of the law introduces an obligatory subject called "Knowledge about human sexuality". This subject will accommodate the ago of the children and the dangers associated with it. The minister responsible for education will determine the curriculum, which will aim at providing objective knowledge about human sexuality, contraception, violence-free partnership-based relationships between men and women, sexually transmitted diseases and the threat of sexual crimes. The ministry will introduce these themes in teacher training programs.

Art. 7 makes governmental and local authorities responsible for providing the physical and economic availability of contraceptive means and methods. The aim of the originators of the draft is guaranteeing access to modern contraception, also to persons in difficult economic circumstances. Par. 3 obliges the minister dealing with issues of healthcare to add contraceptives, including post-intercourse contraception, to the list of reimbursed medications. According to par. 4 of this article a chain of facilities providing responsible parenthood counseling and services will be created. At least one such facility will be created per district. One of the tasks of such facilities will be supplementing the knowledge of adults about human sexuality.

Art. 8 is a significant novelty in the legal system, because it extends social insurance coverage to infertility treatment. The delegation for the Council of Ministers will determine the scope, forms and modes of infertility treatment at the highest standard possible. Procedures of medically assisted procreation will take place in public health care facilities or in private facilities which sign contracts for such services. It is suggested that the possibility of taking advantage of such procedures should be limited to three cycles. Due to the ineffectiveness of these attempts, further treatment will have to be financed from the private funds of the persons involved.

Art. 9 of the draft has fundamental meaning for the issue of the termination of pregnancy. According to the draft presented the possibility of performing such a procedure will depend on the stage of advancement of the pregnancy. In the first trimester of pregnancy, the procedure will be performed if requested by the woman. Such a solution ensures the liquidation of obstacles which women are faced with in the current legal situation. In par. 2 the right to terminate a pregnancy is restricted after 12 weeks of its duration. The intention of the originators of the draft was to create a closed, restricted list of premises for terminating pregnancy after the first trimester. These premises are those which exist in the current law. Terminating a pregnancy after 12 weeks of its duration is possible after adequate medical or legal procedures. In par. 5 there is a prohibition of the termination of pregnancies after the fetus has achieved viability outside of the woman's organism. This means that the last moment when a termination can take place for medical reasons is determined by physicians who examine the state of the fetus. Par. 3 includes a note ensuring women the possibility of using all the prescribed medical procedures for terminating pregnancies, including the pharmacological method.

A principle resulting from art. 10 is free of charge termination of pregnancy in public health care facilities or in facilities which have signed contracts for obstetrics-gynecology services. Persons who are recipients of social insurance or who benefit from healthcare services on the basis of separate regulations are entitled to this service. Par. 2 of this article makes the director of the healthcare facility responsible for the provision of the service. This corresponds to the contents or art. 11 par. 3 and 4, which stipulates the conditions according to which physicians can refrain from performing termination of pregnancy procedures for personal reasons. The restriction of the physician's freedom is a result of par. 1 of this article.

Art. 12 creates a guarantee of privacy in all cases which fall under the scope of the new law. Par. 2 provides for compensation for all persons who have been harmed by a breach of privacy in cases connected with the prevention and termination of pregnancy and prenatal testing.

Regulations in art. 13-15 adjust the existing law to the changes introduced by the draft. A significant novelty is the decriminalization of sterilization as a voluntary method of birth control.

Art. 16 invalidates the existing law and art. 17 creates a three month-long period of vacatio legis, necessary due to changes in the Criminal Code.

IV. The originators of the draft predict that the introduction of the new law will bring measurable social benefits and significantly improve the situation of women and men planning to have children. The first obvious gain will be the suppression of the abortion underground. The money which is now lost from the legal market of medical services will stay in the possession of persons who will be able to undergo a safe and legal procedure. It is not without importance that the abortion underground functions best in areas which are the poorest ones. Clandestine terminations of pregnancies will become nonexistent, as they are now in all European countries. It is common knowledge that the social security system is now covering the costs of all the negative effects of the activities of persons who, often without necessary qualifications and acting without due care, perform illegal abortion services. The health of women, the possibility of having children at a different time, is a greater value than pretending that the problem does not exist.

It is also noteworthy that the new law will bring about a decrease of child abandonment cases, infanticide and cases of abandoning newborns in obstetric wards.

The assistance of the state to every couple planning responsible parenthood will constitute a considerable improvement. In effect, improvement of the demographical situation of the country should be expected. The reimbursement of infertility treatment will also contribute to this effect.

The introduction to the system of education of a subject called "Knowledge about human sexuality" will play a huge role. The subject will be realized from primary school through all the stages of schooling. The accommodation of the knowledge to the child's age, stage of development and perceptive abilities will be necessary. The originators of the draft predict that the new subject will play a very important role in the prevention of cases of sexual abuse of children and youth. Only schools can consolidate the knowledge which is now partly available through the programs of some non-governmental organizations. Makeshift changes in the Criminal Code, which are proposed by some politicians, will not solve the problem. The originators of the draft want to prevent sex crimes, especially those against children, not just to punish the assumed or actual offenders.

 

V. The draft, if it is accepted by the High Chamber, will reinstate conscious, responsible parenthood, actual and not virtual assistance of the state and, in consequence, will decrease the dangers in the sexual lives of women and men.

 

VI. The implementation of the project will cost.....