Mandatory spousal authorisation for abortion: characteristics of countries in which it exists and the potential for modernisation of the law.

Abstract

Purpose: Spousal authorisation for abortion (SA) does not align with modern thinking on respect for autonomy. The World Health Organization guideline on abortion specifically recommends that abortion should be available on request without third-party authorisation. The objectives of the study were to: a) to determine which countries insist by law on SA, b) describe the characteristics of these countries and c) to assess the impact of such legislation on access to abortion. Methods: Interrogation of known databases on global abortion laws. A literature review of material on how mandatory SA relates to reproductive rights. Results: Fifteen countries were found to require SA. These include 10 which can be described as those with Islamic values and policies and two of predominantly Christian faith. Three South Eastern Asian countries stand out from the rest as modern, progressive and without strong religious influence: Japan, South Korea and Taiwan. These three also have a high degree of freedom in terms of political rights and civil liberties, indicating that there is realistic scope for citizens to influence policymakers. Broader studies on third-party authorisation for abortion show delayed access to abortion and emphasise the general principle that it is the healthcare seeker alone whose consent should be required for a health intervention. A qualitative study from Turkey showed specifically how SA requirements could impair access to abortion. Conclusions: Deeply patriarchal societies will take generations to change. In contrast, Japan, South Korea and Taiwan are prime candidates for liberalisation of abortion law.