NFZ fined the infirmary for refusing abortion on psychiatric grounds

Institute of parent of Poland wellness Centre (ICZMP) in Łódź was punished by NFZ with a punishment of PLN 350 1000 for refusing to kill a kid conceived on the basis of a certificate of intellectual wellness obtained by the patient by online advice. The scandalous order was challenged to court.

The NFZ imposed a punishment on the hospital, although Article 11(1) of the intellectual wellness Act provides: ‘A decision on the wellness position of a individual with intellectual disorders, opinion or referral to another doctor or scientist or a medical professional may be issued only on the basis of a prior individual examination of that person.’ Interestingly, an additional psychiatric consultation carried out on behalf of the ICZMP shows that a woman's intellectual state was not a threat to her life or health.

Suing the National wellness Fund by a convicted body in this case is simply a very good decision. The court, unlike the NFZ, will analyse the grounds for refusal, following legal, non-ideological grounds as led by the Tusk NFZ people.

The debate on the alleged psychiatric grounds for abortion in Poland reveals a serious problem at the interface of law, medicine and ethics. Referring to a threat to the intellectual wellness of a female became the dominant basis for abortion following the 2020 Constitutional Court judgment. Data show that this category is liable for the vast majority of cases of legal abortion. This raises the question: are we dealing with a real medical category, or are we dealing with a plan to circumvent the law?

From the point of view of psychiatry, it is peculiarly problematic to treat abortion as a therapeutic measure. In current medical knowledge, there is no clear evidence that abortion improves the patient's intellectual state. On the contrary, it is indicated that there is no evidence of affirmative effects of abortion on intellectual health, and any analyses propose a hazard of worsening it. This is simply a fundamental issue: medicine is based on evidence, not on ideological demands or social pressure.

An even more serious problem concerns the logic of the premise itself. If a hard intellectual situation warrants termination of pregnancy, it should be consistently assumed that the elimination of the origin of stress is simply a treatment. Meanwhile, psychiatry as a field never operates with specified logic – it does not remove "causes" by eliminating an object, but treats the patient through therapy, pharmacology and environmental support. Depression, anxiety disorder or adaptive crises in pregnancy are subject to standard treatment, which, as experts emphasize, is possible and effective.

Criticism of psychiatric grounds besides applies to her susceptibility to abuse. intellectual evaluation is mostly subjective, based on a past and patient's declarations. In practice, this means that with appropriate explanation almost all hard situation can be classified as a danger to intellectual health. As a result, this condition ceases to be an exception and becomes a systemic mechanics – a substitute for the previously existing legal bases.

It is besides worrying that psychiatric certificates are issued without in-depth diagnosis, sometimes even without direct contact with the patient, as was the case with Łódź. We are so not only dealing with an ethical problem, but besides with intentional violations of standards of doctoring. The psychiatrist then ceases to service as a therapist and begins to play the function of a formal ‘supplier’ of justification for the decision to discontinue pregnancy. Of course, he does this for ideological reasons, in a pro-abortion spirit.

Supporters of psychiatric reason argue that it protects women in utmost situations. However, critical analysis shows that alternatively of developing a strategy of intellectual and psychiatric support for pregnant women, a simplified solution is being created to destruct the problem by ending pregnancy. This simplification approach, which not only does not meet the standards of evidence-based medicine, but can besides lead to the ridicule and marginalisation of real psychiatric care.

As a result, the “psychiatric message” appears not as a medical category of stricto sense, but as an ideological tool – flexible, hard to verify and prone to instrumentalisation. If it is to stay part of the legal system, it requires much stricter criteria, transparency and solid technological evidence. For this reason, it should be suspended, at least until effective methods have been developed to destruct its abuse by the lobby of kid murderers.

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