Chapter 2
Evidence in support of the Bill
Introduction
2.1
This chapter covers evidence supporting the Bill and is structured to
address each of the terms of reference. Submitters supported the Bill on the
grounds of the lack of support for gender selective abortion, the associated
discrimination by gender, the infringement of human rights of unborn children,
particularly female children, and problems arising from imbalanced sex ratios
caused by gender selective abortion.[1]
2.2
Submitters argued that the occurrence of gender selective abortion in
other countries, and in immigrant communities in other western countries, means
there is a reasonable likelihood that it also occurs in Australia. Mrs Rita
Joseph submitted that the lack of data from the Medicare funding is central to the
gender selective abortion debate in Australia. Mrs Joseph explained that this
lack of data prevents the determination of the prevalence of gender selective
abortion in Australia:
...Medicare funding is provided indiscriminately, without any
legal restrictions or requirements for medical establishments to ascertain and
record those terminations that are being carried out on the grounds of gender
'preference'. ('Gender preference' of course is a euphemism for lethal
discrimination against an unborn child on the grounds that it has been
prenatally determined that the child is of the 'wrong gender'.)[2]
The unacceptability to Australians of the use of Medicare funding for gender
selection abortions
2.3
Submitters supporting the Bill argued that studies and surveys conducted
in Australia had identified the unacceptability of gender selective abortion.
Surveys and studies
2.4
The results of one survey cited[3]
in submissions suggested that although there was a high percentage of
respondents strongly in favour of abortion generally, that group considered
that gender selective abortion was morally unacceptable (85 per cent) and should
be illegal (82 per cent). The research also showed that of the group that was
'somewhat pro-abortion', the majority were opposed to sex selection abortions
being legal, holding the view that the practice is morally unacceptable.[4]
2.5
A February 2013 Galaxy poll of 300 Tasmanians cited by submitters showed
that 92 per cent of respondents disapproved of gender selective abortion.[5] A further study noted in
evidence was the December 2010 study released as part of the Australian Survey
of Social Attitudes. This showed that 80 per cent of respondents disapprove of
gender selective abortion.[6]
Information from other surveys and studies also showed that gender selective
abortions are not considered acceptable to Australians:
- a survey by the Sexton Marketing Group in 2007, found that only
seven per cent of Australians approved of abortion as a way to choose a child's
sex;[7]
-
the Australian Federation of Right to Life Association's survey
found that 82 per cent of respondents did not support late term (after 20
weeks) abortions for non-medical reasons;[8]
and
- an Adelaide Now media survey also found that 82 per cent of
Australians felt that parents should not be given the right to choose the gender
of their baby.[9]
2.6
Submitters concluded that the above study and survey findings indicate
that gender selective abortions are unacceptable to most Australians.
Submitters therefore argued that, Medicare funding of gender selective
abortions would also be unacceptable to most Australians.[10]
Providing a clear signal regarding
gender selective abortion
2.7
Submitters supporting the Bill considered that for as long as Medicare
funding is available for gender selective abortion, it gives the practice 'legitimacy'.[11]
It was argued that gender selective abortion is discriminatory in essence and
hence should not be allowed:
Medicare funding of gender-selective abortion is an
inappropriate way of spending the money of taxpayers. The Medicare system is
set aside specially for health reasons. Funding of sex-selective abortions can
reinforce a value judgement based on antiquated prejudices, which devalue the
life of female babies based on inheritance and property ownership laws and the
ability to work and support the family.[12]
2.8
Submitters contended that it was important for the Bill to be passed, in
order to send a clear signal that gender selective abortions were not
acceptable and should be discouraged.[13]
2.9
There were mixed views on whether banning Medicare funding would be
effective in substantially deterring gender selective abortion.[14]
It was argued however that even if the Bill did not have a direct practical
effect on the number of gender selective abortions, it was important to provide
a clear signal that the practice is unacceptable.[15]
2.10
Submitters argued that the Bill's symbolic importance will shape
community attitudes, and serve notice on anyone who seeks to pressure a woman
toward a gender selective
abortion.[16]
It was also noted that the ban set out in the Bill should be part of a broader
package of measures to address gender selective abortion.[17]
The prevalence of gender selective abortion
2.11
This section addresses evidence from submitters supporting the Bill on the
second term of reference for the inquiry–the prevalence of gender selection, with
preference for a male child, amongst some ethnic groups present in Australia
and the recourse to Medicare funded abortions to terminate female children.
Prevalence in other countries
2.12
Many submitters drew attention to large numbers of girls and women (up
to 200 million) that are 'missing' from the world population due to gender
selective abortion.[18]
For example, it was noted that in China, the sex ratio is estimated to be 1.06.[19]
Although this is within the 'normal' range there are still over 30 million more
men than women in China. In India, the sex ratio is 112.[20]
Despite being illegal in both India and China, the sex ratios at birth in these
countries suggest the occurrence of gender selection.[21]
Other places where gender selection appears to be affecting the sex ration at
birth include Vietnam, Pakistan, Taiwan and Southeast Europe.[22]
Occurrence in western countries
2.13
Submitters also pointed to evidence for gender selective abortion in
western countries.[23]
Research in England and Wales
shows that among India-born women, the sex ratio at birth for all third
children was 114.4 boys per 100 girls for births between 2000 and 2005.[24]
A 2008 US National Academy of Science report found that sons outnumbered
daughters by 50 per cent for third children if there was no previous son in US-born
children of Chinese, Korean and Asian Indian parents.[25]
FamilyVoice Australia submitted information from studies of Canadian and United
States' birth rates that indicated some evidence of gender selective abortion
occurring in some communities including immigrate communities from India,
China, Korea and Vietnam.[26]
2.14
The Catholic Women's League Australia Inc. provided information collated
by the UK in response to the request from the Council of Europe to collect data
on the sex ratios at birth:
While the overall United Kingdom birth ratio is within normal
limits, analysis of birth data for the calendar years from 2007 to 2011 has
found the gender ratios at birth vary by mothers’ country of birth.
For the majority of groups, this variation is the result of
small numbers of births and does not persist between years. However, for a very
small number of countries of birth there are indications that birth ratios may
differ from the UK as a whole and potentially fall outside of the range
considered possible without intervention.[27]
Prevalence in Australia
2.15
Submitters argued that the evidence that gender selective abortion is
occurring in immigrant communities in western countries indicates that it is
therefore likely to also be occurring in Australia.[28]
Cherish Life Queensland went further and argued that the ideas about gender
selective abortion may be picked up by the wider community.[29]
2.16
The Office for Justice and Peace of the Catholic Archdiocese of
Melbourne commented that the number of gender selective abortions is not the
key issue, rather, any occurrence of gender selective abortion is an attack on
human rights:
...it is difficult to determine the extent to which any of the
estimated 80,000 abortions which occur annually in Australia are carried out
for the purpose of gender selection.
Notwithstanding, it is clear and undisputed that this
abhorrent practice is being carried out in Australia and that under the current
legislative framework, the procedure is funded by Medicare.
It must be emphasised that all current human rights
instruments make no distinction between human rights abuses of the few and
human rights abuses of the many. Any denial of human rights is an attack on the
Common Good.
The attack on the human rights of unborn females amongst
certain ethnic groups within Australia is an attack on the human rights of all
Australians.[30]
2.17
Submitters also commented that there is some evidence from doctors that
gender selective abortions are occurring, noting a case that has been referred
by a Victorian doctor to the Medical Board of Australia. It was submitted that the
same doctor had been approached twice for gender selective abortion. In both
instances the preference was for a male child.[31]
2.18
It was acknowledged that as Australia does not collect data which
identifies and records the reasons for Medicare funded abortions, the actual
prevalence of gender selective abortions in Australia cannot be quantified. In
addition, there is limited regulatory scrutiny of abortions as statistics are generally
not collected or collated by states and territories, although South Australia
and Western Australia maintain some data.[32]
2.19
Submitters suggested that relevant data should be collected on the
reasons for abortion, so that the frequency of gender selective abortion can be
determined.[33]
The Catholic Archdiocese of Sydney also argued for the collection of such data
and noted that past federal inquiries had recommended that this data be
collected.[34]
2.20
Mrs Joseph submitted that:
Objections to this Bill that rely on the facile claim that
that gender prenatal selective terminations do not occur here in Australia have
no substance in fact. For many years now those in the abortion industry who are
involved in gender selection have successfully stymied the introduction of even
the most minimal requirements to enable the gathering of statistics on this
appalling practice. Such resistance to transparency on this human rights issue
should no longer be acceptable, especially in the light of the promises made by
our Australian Government to introduce protective legislation against this
inhumane practice.
Australian domestic law provides no human rights protection
for children at risk of termination for such discriminatory reasons as the
unborn child’s gender and this results in the terrible and fundamental
injustice of arbitrary deprivation of human life. Such violations should no
longer be permitted to remain hidden behind doctor-patient confidentiality.[35]
The use of Medicare funded gender selection abortions for the purpose of family
balancing
2.21
In addressing this term of reference, submitters supporting the Bill
strongly disapproved of abortions for family balancing and pointed to restrictions
on the use of technology for family balancing and state and territory laws
relating to abortion.
Abortions for family balancing
2.22
Submitters argued strongly against the use of Medicare funded
gender selective abortions to
achieve family balancing. For example, Dads 4 Kids submitted
that:
Every child, whether male or female, should have the chance
to live. Gender Selective Abortion or 'family balancing' is known to take place
in Australia, as disclosed informally by doctors, but is a detestable practice.
It should not be supported by taxpayer funding. Terminating unborn boys or
girls depletes our society of potential fathers and mothers, leaders, doctors,
teachers, parliamentarians, trades people and the list goes on. No child should
be discriminated against because of its sex and no government should condone or
support terminations on the basis of gender.[36]
2.23
The use of Medicare funding for such services was considered by
submitters to be improper and abhorrent as it did not constitute a health
service and violated the child's human rights.[37]
FamilyVoice Australia submitted that:
Given the availability of ultrasound technology for
determining the gender of an unborn child, the ready availability of abortion
on demand in several Australian states and the known existence of a social
phenomenon of Australian couples desperate to have children only of a certain
sex either for 'family balancing' or, in some sense, to 'replace' a deceased
child of that sex it would be naïve to assume that sex selection abortions for
these reasons were not occurring in Australia.[38]
Evidence for family balancing by
gender selective abortion in Australia
2.24
The evidence for the use of gender selective abortions for family balancing
was thought to be largely anecdotal.[39]
Submitters asserted that abortions undertaken for gender selection to achieve
family balancing are not appropriate and should be banned.[40]
2.25
One case was cited by submitters as purporting to show that gender selective
abortion for family balancing may be occurring in Australia. Submitters claimed
that twin boys were aborted because the parents already had three sons and
wished for a girl.[41]
However, no evidence was submitted to the committee that substantiated the
claim that the abortion had been undertaken on the basis of gender selection.
2.26
The Rabbinical Council of Victoria took the view that abortion as a
method of family balancing is abhorrent and should not be subsidised by the government
under any circumstance. The Council submitted that:
Even in such case where there is a clear medical indications
for gender selection, such as X-linked recessive disorders, we would submit
that offering pre-implantation genetic diagnosis (PGD) would offset the demand
for so drastic a step as abortion.[42]
Restrictions on gender selection
2.27
The Australian Family Association submitted that the twins case cited
above highlights the anomaly with the Assisted Reproductive Technology Guidelines
of the National Health and Medical Research Council (NHMRC) of Australia. The
guidelines restrict the use of gender selection through pre-implantation
genetic diagnosis while there is no scrutiny of Medicare funding.[43]
The NHMRC guidelines state that 'sex selection (by whatever means) must not be
undertaken except to reduce the risk of transmission of a serious genetic
condition'.[44]
2.28
Submitters noted that the NHMRC guidelines also state that:
Sex selection is an ethically controversial issue. The
Australian Health Ethics Committee believes that admission to life should not
be conditional upon a child being a particular sex.
Therefore...sex selection (by whatever means) must not be
undertaken except to reduce the risk of transmission of a serious genetic
condition.[45]
2.29
However, while these restrictions are in place for invitro fertisation (IVF),
there is no legal scrutiny of taxpayer funding, via Medicare, of gender
selective abortion of naturally conceived children.[46]
2.30
In addition, the committee heard of cases where Australians have travelled
overseas to access Prenatal Gender Diagnosis (PGD) for gender selection.[47]
The Coalition for the Defence of Human Life submitted that:
In order to circumvent this ban couples are travelling to
places such as Thailand that provide preimplantation genetic diagnosis (PGD) of
gender allowing gender selection of embryos for ART [Assisted Reproductive
Technology] procedures. In 2011 some 72 couples travelled to Thailand to have
PGD and ART at Thai Superior ART in Bangkok 2012. In 2012 this increased 30% to
106 couples.[48]
State and territory abortion laws
2.31
The Commonwealth has responsibility for Medicare funding. The Australian
Catholic Bishops Conference noted that 'there is a variety of laws and
restrictions on abortion in Australia, depending on state or territory'.[49]
Knights of the Southern Cross (NSW) submitted that:
Abortion is the subject of criminal law in all Australian
States and Territories, except the ACT. Abortion is legal in the ACT up to full
term if it is provided by a medical doctor.
Victoria, South Australia, Western Australia, Tasmania and
the Northern Territory have legislation in place that provides a statutory
explanation of when an abortion is not unlawful.
In NSW and Queensland, lawful abortion is available under
common law interpretations of the Crimes Act or Criminal Code. An abortion is
legal when the doctor believes a woman’s physical and/or mental health is in
serious danger.[50]
2.32
The Australian Catholic Bishops Conference questioned the effectiveness
of the state and territory laws stating its opinion that there is 'little
inclination from the states and territories to enforce what laws there are'.[51] The Catholic
Archdiocese of Melbourne submitted that:
In most Australian jurisdictions, access to abortion is now
available without the need for supporting medical oversight up until at least
26 weeks of gestation. The position adopted by most State legislatures is that
abortion is afforded the status of most other medical procedures. Despite this
position, the collection of data on this one particular medical procedure,
(including the reason or reasons occasioning the termination) is almost
non-existent. As such, it is difficult to determine the extent to which any of
the estimated 80,000 abortions which occur annually in Australia are carried
out for the purpose of gender selection.[52]
Withholding gender information
2.33
One of the suggestions put to the committee was that where gender-linked
genetic disorders were not found, information on the gender of a child could be
withheld until 20 or 30 weeks gestation when it was less likely that gender selective
abortions would occur.[53]
2.34
The Catholic Archdiocese of Sydney noted that the Canadian
Medical Association has published evidence that gender selection is taking
place in Canada and called for gender information to be withheld until 30 weeks
of pregnancy. However, the Catholic Archdiocese of Sydney noted that such a
restriction was problematic:
Although we recognise the good intentions behind such a
proposal, withholding legitimate information from parents is problematic and
such a response does not address the underlying issue. The principal problem is
not the sharing of the knowledge of the baby's gender, but the ready acceptability
of abortion as a 'response' to that knowledge. Discouragement of abortion,
community education and the changing of parents’ hearts and minds are the keys
to encouraging a more welcoming attitude towards life and baby girls.[54]
2.35
While the National Association of Specialist Obstetricians and
Gynaecologists did not support or oppose the Bill in their submission, they echoed
suggestions that it may be worth considering withholding gender information
until after 20 weeks if there are no gender linked genetic disorders.[55]
Support for United Nations Campaigns
2.36
This section addresses evidence from submitters supporting the Bill on
the fourth term of reference for the inquiry: 'support for
campaigns by United Nations agencies to end the discriminatory practice of
gender-selection through implementing disincentives for gender selective
abortions'.
2.37
The campaigns against gender selective abortion by UN agencies were
supported by many submitters.[56]
Gender selective abortion was seen as a very significant human rights issue and
was described as abhorrent, a crime against humanity, cruel and inhumane,
morally unacceptable, and evil.[57]
2.38
Several submitters indicated that by implementing the policy proposed by
the Bill, Australia would be supporting the UN campaigns.[58]
Introfish Inc, for example, noted that both the WHO and the UNPFA are working
toward eliminating gender selective abortion and stated:
Both of these Organisations call for legislation, amongst
other measures, to be enacted to eliminate the discriminatory practice.
Australia must eliminate deadly discriminatory gender selection abortion by
enacting legislation, including the Health Insurance Amendment (Medicare
Funding for Certain Types of Abortion) Bill 2013.[59]
2.39
Similarly, The Australian Family Association stated:
The present bill if passed would certainly implement a
disincentive for sex selection abortion and would protect girls from the
violence of prenatal selection, thus honouring Australia's obligation to do so.[60]
2.40
The Coalition for the Defence of Human Life noted that Australia had
shown some support for UN campaigns, by banning gender selection through other
reproductive technologies such as prenatal genetic diagnosis and assisted
reproductive technology.[61]
2.41
Real Talk Australia submitted its view on finding an appropriate balance
between the rights of the child and the rights of parents, stating that:
All human beings are the 'subject' of rights not the 'object'
of rights. Parents do not have the right to
choose what child they get, or terminate pregnancy based on desires for a
'type' of person. If this becomes a widespread practice parents will become
more like owners of children not caregivers. On the issue of gender selection,
our focus can be shifted ever so slightly from the rights of a child, to
upholding the wishes of a parent. In doing that the rights and the welfare of
children get relegated to second place.
Society
expresses respect for the dignity of each person, by recognising him or her as
a person and not as an object.[62]
Concern from medical associations
2.42
The last term of reference for the inquiry sought consideration of the
concern from medical associations about gender selective abortion in developed
countries such as Canada, the United States and the United Kingdom. Submitters
noted that the Society of Obstetricians and Gynaecologists of Canada, the
American College of Obstetricians and Gynaecologists, the Chief Medical Officer
of the UK, Professor Dame Sally C. Davies, and the British Medical Association
generally opposed gender selective abortion except for preventing serious
sex-linked genetic diseases.[63]
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