UN demands to advance abortion and answer by the Tusk Government

On 26 August, the United Nations Committee on the Elimination of Discrimination of Women (CEDAW) published a scandalous study hitting Poland due to the deficiency of universal access to the services of killing unborn children. Before the paper was made public, the committee taken over by eugenics supporters demanded that the Polish authorities respond to many issues which were subsequently included in the report. Donald Tusk's government sent extended and applicable explanations in a letter dated August 21.

Three language versions of the paper are available: English, French and Spanish.

The CEDAW Committee called on the Polish authorities "to recognise abortion as a fundamental right" and "to make the essential legal changes towards the complete decriminalisation and legalisation of abortion". Our country has been accused of violating women's rights by restricting access to this bloody "procurement". Standards consistent with the guidelines of the planet wellness Organisation were called upon to be adopted.

The committee study was released in consequence to information sent by abortion activists, including the Centre for Reproduction Rights. Lobbyists complained that Polish government violated the terms of the CEDAW Treaty, which our state ratified.

It is not known from now on that this committee has been exerting force on countries for years to liberalise their regulations on the freedom to kill conceived children, despite the fact that the treaty neither mentions abortion – straight or even euphemically – and no UN Treaty on Human Rights or the Resolution of the General Assembly contains any internationally recognised human right to abortion.

With the change of power in Poland, global organizations increased force on Warsaw to facilitate access to procedures for killing conceived children. A study by the UN peculiar Rapporteur on force against Women and Girls was published earlier this year. The paper focused on abortion and called on Poland to adapt its abortion rules to “international standards” and to strictly regulate the application of opposition to conscience by wellness professionals.

In fact, any specified report, which indicates that the right to life constitutes "violence" towards women – erstwhile in fact abortion involves utmost violence, and frequently directed against girls – distorts the reality and compromises authors of specified papers or statements.

Responding to the pressures of the CEDAW Committee, the Polish authorities confirmed "their commitment to ensuring equal access to healthcare services provided by national law, including abortion". Tusk's political speech was quoted, promising that under his leadership "women will experience extremist improvement in terms of their rights, dignity, wellness and security." The Polish side did not in any way support the defence of unborn lives. The Committee has not been reprimanded, at least for exceeding its mandate. The Oenzetian body maintains that the provisions limiting access to abortion here constitute "a gender-based force against women" and "may be equivalent to torture or cruel, inhuman or degrading treatment", as defined in the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women.

Responding to proceedings against Poland initiated on the basis of Article 8 of the Optional Protocol to the Convention, the Polish side wrote that "1. First of all, the Government of the Republic of Poland would like to emphasize its unwavering commitment to ensuring and promoting human rights. Poland makes all effort to effectively and in good religion fulfil its work to respect, defend and enforce human rights.

2. Regarding the subject covered by the CEDAW study The Polish Government wishes to emphasise its commitment to warrant equal access to healthcare services provided by national law, including abortion. The importance of this goal was confirmed by Prime Minister Donald Tusk in his first political speech."

Official statistic on the number of abortions performed in Poland between 2010 and 2023 are provided describing the current legal state.

Referring to the allegation of the absence of an authoritative protocol of guidelines for medical personnel on the explanation of the concept of "risk of life or health", misinterpretation of this exception, difficulties in access to abortion due to a threat to the intellectual wellness of a woman, the freezing effect of criminalising abortion for medical personnel and information on cases of death related to pregnancy, it was written what actions the Polish government took or took.

The Polish side indicated that the Act of 7 January 1993 on household Planning, Protection of the Human Fetal and Conditions of Acceptability of Abortion allows doctors to kill unborn children erstwhile pregnancy is the consequence of a forbidden act or threatens the life or wellness of a pregnant woman.

In the second case, it was added that ‘it should be clearly stressed that there are actually 2 independent conditions. erstwhile only 1 of them is fulfilled (i.e. there is simply a hazard of life or health), this provides a adequate legal basis to establish that the circumstances let abortion. The 1993 law does not supply an exclusive list of indications for abortion erstwhile pregnancy threatens the life or wellness of a pregnant woman. Its provisions, referring to the general concept of health, do not in any way find which area of wellness should be subject to specified a risk. The danger may so be in any area of health, whether physical or mental. Furthermore, the 1993 Act does not specify the concept of ‘threat’, leaving it to the designation of a doctor acting on the basis of his medical knowledge. It should be noted that, in accordance with Article 4 of the Act of 5 December 1996 on the profession of doctor and dentist (Journal of Laws of 2023 item 1516, as amended), the doctor must execute the profession on the basis of current medical cognition and available methods and means of prevention, diagnosis and treatment of diseases, in accordance with professional ethics and with due care."

Referring to the protocols of guidelines for medical personnel on how to interpret the concept of "risk of life or health", the Polish side stressed that "the improvement of specified medical guidelines should be left to technological societies. In this regard, the Government of the Republic of Poland wishes to point out that the applicable recommendations in this respect were drawn up by the Polish Society of Gynecologists and Obstetricians, as well as by the Polish Society of Sexual and Reproductive Health".

It is further explained that “the concept of a woman’s wellness hazard concerns all area of health, whether physical or mental. Furthermore, the provisions of the 1993 Act do not specify what should be the specialization of a doctor entitled to find whether there are grounds for abortion. In accordance with Article 4a(5) of the 1993 Law, the existence of specified conditions is determined by a doctor another than the 1 who performs the abortion, unless pregnancy straight endangers the life of a woman. In accordance with the provisions of the Regulation of the Minister of wellness and Social Welfare of 22 January 1997 on the professional qualifications of doctors to interrupt pregnancy and on the uncovering that pregnancy endangers the life or wellness of a female or that there is simply a advanced hazard of severe and irreversible impairment of a foetus or incurable or life-threatening kid (Journal of Laws, item 49), the existence of indications indicating the hazard of life or wellness of a pregnant female is stated by a doctor in the field of medicine appropriate to the kind of illness of a pregnant woman.’

It was further added that “only 1 medical certificate issued by a specialist in the field of medicine applicable to the kind of illness of a pregnant female is required to establish the existence of circumstances indicating a hazard to the life or wellness of a pregnant woman. Therefore, requiring additional opinions or medical certificates as grounds for abortion is in rule unjustified and should be regarded as restricting access to this procedure."

At the same time, it was added that ‘abortion, in cases permitted by the 1993 Act, is simply a guaranteed provision of wellness care, to which all medical entities (hospitals) that have concluded an agreement with the National wellness Fund to supply maternity and gynaecology benefits. In order to guarantee the appropriate implementation of this work in practice, on 30 May 2024 a crucial amendment of the Regulation of the Minister of wellness of 8 September 2015 on the general terms and conditions of wellness care contracts imposed on the supplier with whom the contract was concluded, the work to supply healthcare’. Failure to supply specified benefits shall entail a contractual punishment of 2 per cent of the contractual amount for each breach found.

It was besides explained that "to supply patients with the conditions provided for in the 1993 Act with actual access to abortion in each voivodship, By letter dated 30 January 2024, the Minister of wellness obliged the president of the National wellness Fund to regularly collect information on completed and settled abortion procedures, about the number of refusals to execute abortions, to explain why the patient was denied and how it was made possible to usage this "procurement" etc.

It was added that ‘the aim of the above measures is to guarantee active and effective supervision of the implementation of the contracts in this regard, i.e. to guarantee that, in any case where irregularities occur, the National wellness Fund takes appropriate action not only to clarify precisely the circumstances of the event and to verify the way in which the wellness care is carried out, but besides to draw the breacher to contract liability’.

More than 1 100 points in relation to CEDAW's allegations. Among another things, the investigations that have been conducted in connection with media-wide abortion cases since 2021 have been described. It was indicated that the order of 10 April 2024, in which the lawyer General commissioned a squad of prosecutors of the National Prosecutor's Office to prepare recommendations concerning the conduct of cases concerning the refusal to discontinue pregnancy, as well as recommendations on alleged pharmacological abortion. The guidelines besides address the issue of the handling of pregnancy cases resulting from a crime (especially close supervision).

The issue of the pregnancy registry and the clause of conscience were raised. The Polish authorities acknowledged that "the conscience clause is included in a number of global acts, including the Charter of Fundamental Rights of the European Union, which protects the fundamental rights of citizens of the European Union. Article 10(2) The Charter recognises the right to object to actions which are not in accordance with the national government governing the exercise of that right. The same applies to the Universal Declaration of Human Rights and the global Covenant on civilian and Political Rights. On the basis of global law, Polish government (Article 53 of the Constitution of the Republic of Poland) besides provides that freedom of conscience must be ensured for everyone. The above is besides defined in Article 39 of the Act of 5 December 1996 on the competition of doctors and dentists (Journal of Laws of 2023 item 1516, as amended), hereinafter referred to as the "medical professions Act". It states that doctors can refrain from providing wellness care services that conflict with their conscience, but where hold in providing healthcare could be associated with the danger of failure of life, severe bodily harm or severe wellness disorder. At the same time, the doctor has a work to evidence in the medical records the fact that he has invoked a clause of conscience. In addition, a doctor who performs the profession on the basis of a contract of employment or within the framework of a service shall be obliged to notify the superior in advance in writing."

The Polish authorities keep that "Article 39 of the Medical Competition Act explicitly limits the scope of this law, which in turn obliges any doctor with circumstantial professional qualifications, including specialists in midwifery and gynaecology, to execute all medical activities, including those covered by the conscience clause".

Detailed rules on the work of nurses and midwives have been cited, arguing that they cannot refuse to supply abortion in the event of a direct hazard to the patient's health.

It was besides explained that a hotline was launched, where patients could receive information about abortion.

"It cannot so be argued that the Polish people are denied the right to wellness care benefits covered by the conscience clause. It is essential to separate between the provisions of the Act on Doctor and Dentist Competition concerning the Conscience Clause and those concerning the conditions for abortion contained in the 1993 Act, which defined abortion as a guaranteed provision of healthcare. In this context, it should be noted that Article 4b of the 1993 Law states that "persons covered by social safety and entitled to free healthcare under separate provisions have the right to execute abortion free of charge in medicinal agents".

‘Guaranteed wellness care benefits related to abortion are set out in Annex 1 to the Regulation of the Minister of wellness of 22 November 2013 on guaranteed infirmary care benefits (Journal of Laws of 2023 item 870 as amended). In the light of the laws in force, including in peculiar the Regulation of the Minister of wellness of 8 September 2015 on the general terms and conditions of contracts for the provision of healthcare, all medicinal entities (hospitals) that have concluded an agreement with the National wellness Fund, hereinafter referred to as the ‘Fund’, are obliged to supply the services set out in that agreement to the full degree and in accordance with applicable law.

In order to order and improve the management of contracts with medical institutions, a crucial amendment of the provisions of the wellness Minister's Regulation of 8 September 2015 on the general terms and conditions of wellness care contracts, which requires legal abortions by wellness institutions, was introduced on 30 May 2024, “regardless of the fact that the doctor performing the profession in that healthcare supplier refrained from giving the above-mentioned benefits due to the vocation of a conscience clause”.

The authorities have besides ensured that students undergoing education to get medical qualifications in obstetrics and gynaecology besides learn about artificial reproduction and abortion. "As part of a postgraduate internship, a doctor must have cognition of the legal framework governing the conduct of doctors in the field of artificial reproduction and abortion. On the another hand, specialist training in obstetrics and gynaecology provides for the approval by the manager of the speciality of the cleaning and emptying of the uterus, which is besides performed for most another treatments, i.e. abortions or dead births. With respect to the usage of vacuum procedures, a national midwifery and gynecology consultant indicates that they have been known for decades and are not modern procedures; in addition, their usage is limited in time (up to 8 – 10 weeks of pregnancy) and after vacuum surgery, the uterus cavity in most cases requires additional spooning anyway. It besides points out that expanding the dose of prostaglandin does not destruct pain, but on the contrary, it may increase pain, depending on the individual consequence of patients to systolic pain."

The Polish side announced that the Ministry of wellness is planning to carry out "deep analyses and consultations on improving the procedure for filing complaints about the deficiency of legal abortion. The Ministry of wellness and the Ministry of Justice are presently working on preliminary conceptual work to simplify institutions’ opposition to the opinion or medical certificate and velocity up the procedure. The proposed changes, besides supported by the Ombudsman, include:

• Absence of the request to indicate in the contested legal provision the rights or obligations of the patient afraid by the opinion or judgment. The proposed amendment takes into account the proposals of civilian society organisations that the legislator imposes on persons wishing to exercise the right of opposition besides much on the indication of a legal provision which results in circumstantial rights and obligations of the patient, under the rigour of rejecting opposition for formal reasons without consideration;
• Explanation that the objection is admissible besides in the event of refusal of an opinion or a certificate, and refusal to mention to diagnostic examinations, where essential for specified an opinion or a certificate. In order to be effective, the refusal should be recorded in the patient's medical records and it is so proposed to introduce a statutory work to make appropriate endorsements in this respect;
• Reduction to 10 days after the patient has lodged complete opposition to the opinion or medical certificate. If it is not possible to issue the certificate within the time limit due to the request to examine the patient, the time limit for issuing the certificate shall be extended by the time essential to carry out the examination. The time limit specified in the applicable government (30 days) may in any cases be besides long, which virtually deprives the patient of the anticipation to effectively usage the institution of opposition. This applies, for example, where opposition is raised against a medical opinion or a judgement affecting the right to discontinue pregnancy, given that the 1993 Act sets the time during which abortion is allowed;
• Transfer to the amendment of the provision allowing the patient or its legal typical to attend the gathering of the Medical Commission, with the exception of the part of the gathering during which the gathering and the vote on the certificate are held, and supply information and explanations on the matter. This provision is presently based on the Regulation of the Minister of wellness of 10 March 2010 on the Medical Board of the Ombudsman (Journal of Laws No 41, item 244);
• Make provision for the patient to be able to establish a typical in the proceedings before the Medical Board. In order to simplify the procedure for objecting and to facilitate the exercise of this right by the patients concerned, it is proposed to introduce an chance to object in writing, orally or electronically via the ePUAP. It is besides proposed that the law clearly specify the position of the certificate issued by the Medical Chamber. In order to guarantee the effectiveness of the institutions’ opposition, it is proposed that the opinion of the Medical Board replace the contested opinion or certificate.’

It was pointed out that "The Government of the Republic of Poland besides wishes to emphasise that it has taken applicable action to guarantee that patients have real access to abortion in each state in the situations provided for in the 1993 Act".

Other actions were identified to facilitate access to abortion, namely prosecutorial guidelines relating to the preparation of recommendations concerning the conduct of abortion refusals, and recommendations on alleged pharmacological abortions.

It has besides been ensured that the Government of Poland "regards the circumstantial needs of women with disabilities with appropriate determination". "In 2023 the Ministry of wellness commissioned investigation agency PBS Sp. z o.o. to conduct an analysis of the needs and availability of gynecological and obstetric care for women with disabilities".

It was besides pointed out that forced abortion and sterilisation are prohibited in Poland, and "sterilization without explicit medical indication is prohibited by Polish law and subject to punishment under Article 156(1)(1) of the Criminal Code. In accordance with the above-mentioned provision, for causing severe injury by deprivation of man's ability to procreate, the conviction of imprisonment from 1 to 10 years is punishable."

At the same time, Article 153 of the Penal Code is cited, which states that “any individual who interrupts a pregnancy by applying force to a pregnant female or otherwise terminates a pregnancy without her consent, or causes her to discontinue her pregnancy by force, unlawful threat or fraud, shall be subject to imprisonment for a period of between 6 months and 8 years”. "Therefore, it is written to be reiterated that any specified situation triggers the reaction of law enforcement and justice."

In the case of sterilization promoted by global institutions as a form of contraception, the Polish side warned that it could not be treated in Poland in this way, as it active an irreversible failure of the ability to conceive. However, it was added that ‘medical procedures, specified as bilateral tubal binding and crushing, bilateral endoscopy of tubal light or the cut-out of both tubes, are among the guaranteed procedures listed in Annex 1 to the Regulation of the Minister of wellness of 22 November 2013 on healthcare services guaranteed in the field of infirmary treatment’.

It was indicated that various contraceptives are widely available in Poland. They are subject to a prescription, but not all healthcare professionals have the right to issue specified a prescription. This can be done mainly by doctors, not nurses, midwives and pharmacists. “By its very nature, a pharmaceutical prescription should include emergency contraceptives alternatively than regular ones”.

In the case of ‘day-to-day pills’ from 2 May 2024, entities operating pharmacies available to the public in Poland may apply for a pilot programme based on the Regulation of the Minister of wellness of 29 April 2024 on a pilot programme for reproductive wellness pharmaceuticals (Journal of Laws of 2024 item 662) and an appropriate order of the president of the National wellness Fund, which allows, after an appropriate interview by the pharmacist, to issue a prescription for a post-coital contraceptive (failure) containing 1 of the most commonly utilized substances in specified cases (ulipristal acetate), if this is justified by the hazard to the reproductive wellness of the patient.

In this case, the Polish side showed inconsistency due to the fact that it was previously indicated in the paper that prescriptions for contraceptives cannot be issued by pharmacists due to the fact that they are neither authorized nor able to measure the condition of the patient.

‘As of May 2024 it is so possible to get emergency contraception not only on medical prescription but besides in the case of ulipristal acetate in the pharmacy. As a result, the availability of this substance in Poland remains the same as in almost all another EU associate States. According to data published by the National wellness Fund on 28 May 2024, 468 public pharmacies took part in the pilot programme."

"According to data from 2023, more than 271,000 emergency contraceptive prescriptions were issued in Poland... This is more than in 2020 (over 127,000 recipes of this type), 2021 (nearly 200,000 recipes) and 2022 (nearly 245 1000 recipes). In 2023, about 90% of prescriptions for specified medicines were successfully implemented. A akin percentage, with tiny differences, was besides observed in erstwhile years," we read.

The Polish Government assured that as of September 2025 it would introduce compulsory education on sexual and reproductive wellness and rights in the authoritative curriculum of schools, which would replace the current optional classes of education in the household in all types of schools. "The subject of wellness education will cover intellectual and physical health, as well as wellness nutrition, prevention, addiction and sexual education. It will be a complex subject of human health. It is designed for students of grades IV – VIII primary schools, as well as grades I – III secondary schools, advanced schools, technicians, as well as vocational schools. The teaching content of the fresh subject will include, among others, the legal provisions contained in Article 4(3) of the Act of 7 January 1993 on household Planning, Protection of Human Fetals and Conditions of Admissibility of Abortion, on the basis of which the current Regulation of the Minister of National Education of 12 August 1999 on the method of teaching at school and the scope of content concerning the cognition of the sexual life of a person, the principles of conscious and liable parenthood, the value of a family, prenatal life and the methods and means of conscious procreation included in the programming general education. The Minister of National Education has established a squad of experts, which will include representatives with a advanced level of substantive cognition required, as well as experts who know school practice well. The results of the team's work are to form the basis and content of the fresh subject".

Finally, referring to the recommendations of the CEDAW Committee, it is written that "The Government of Poland wishes to reiterate its unchanging commitment to the protection, respect and implementation of human rights of all persons, including women's rights, and to guarantee equal treatment for women in all areas of life. The Polish Government besides reaffirms its commitment to warrant equal access to healthcare services provided by national law, including abortion. The availability of abortion is 1 aspect of the wellness safety of patients in terms of broad perinatal care and reproductive health. Continuing work on necessary, but frequently up-to-date legislative changes (work in the Polish Parliament on respective draft laws on the admissibility of abortion), The government places the main emphasis on compliance by the participants of the healthcare strategy with the existing rules, ensuring respect for patients' rights and compliance by medical entities with their obligations. applicable and regulatory changes introduced in this respect are described above. The consequence should be a tangible qualitative change in real access to the presently acceptable abortion procedures."

It was clarified that ‘The changes introduced by the Regulation of the Minister of wellness of 8 September 2015 on the general terms and conditions of wellness care contracts should importantly contribute to improving access to abortion procedures. In order to support this, measures have been introduced to guarantee the enforcement of contracts concluded with healthcare providers. In addition, the Polish Parliament is working on changes to the applicable legislation. At the same time, in order to alleviate the uncertainty reported as to the application of the current government and avoid the alleged freezing effect The essential sets of guidelines have been developed by both medical and law enforcement staff."

The government foresees a series of campaigns promoting abortion, in vitro, “day after” pills and sexual education, “as shortly as the applicable government enters into force (laws, regulations)”.

The full version of the answer of the Polish government can be found at this link: https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/Download.aspx?symbolo=CEDAW%2FC%2FPOL%2FOIR%2F1&Lang=en.

Sources: c-fam.org, tbinternet.ohcr.org

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