The Ethics of Poland’s Reproductive Health System

The Ethics of Poland’s Reproductive Health System
May 26, 2022 No Comments Global Bioethics Liz Khidekel

Access to Autonomy: Examining the Ethics of Polish Reproductive Health Rights

By Elizabeth Khidekel

Religion has played an essential role in determining moral codes and guidelines throughout history. However, conflicting power dynamics often rise when societal influence starts dictating legislation and therefore, individuals’ ways of life. This paper details and analyzes the ethics of an example of this process by discussing Poland’s reproductive health system, as well as access to contraceptives and abortion. The paper provides sufficient background information on religion, contraception, and abortion in the country. It ends with an in-depth ethical analysis of the many factors contributing to this ethical dilemma and shares conclusions and next steps for research.

Table of Contents

Abstract

The current debate over reproductive health rights in Poland has reached global attention. In 2022, Poland was ranked by the European Parliamentary Forum for Sexual and Reproductive Rights as the lowest country in Europe for providing effective contraception methods. This included factors like sexual education, physician avaliability, and religion. Religion in Poland, specifically Catholicism, accounts for nearly 90 percent of the population, and the reasoning of natural law is heavily integrated into the state. Therefore, legislation and funding of public healthcare institutions directly reflect these principles. The result of such a system is reduced contraception access and restrictions on abortion procedures, interfering with bodily autonomy and safety.

The core of this issue is evaluating if it is ethical to use religion within legislation concerning reproductive rights, and examining who has the right to control or influence reproduction in society. A framework of consequentialism is used to weigh the effects of both sides: one wishing for reproductive autonomy, and the other for valuing natural law and hence, life. The ethical analysis includes many factors, including doctors’ autonomy and relationship with patients, a fetus’s right to life, limiting bodily autonomy, and the significance of religion.

Introduction

It is difficult to imagine a world without religion. The ethical and moral codes of different faiths have existed, arguably, since the beginning of structured society, and have been building blocks in developing rules, relationships, and beliefs. Without the ideas of religion, our world would have less influence when setting guidelines and shaping cultural dynamics. However, we as a society must ask ourselves: how can we determine if, or when, religious influence crosses a line? This idea encapsulates the current debate about the modern Polish reproductive health system, where contraceptives and abortions are scarcely accessible and religiously motivated legislation pushes for a fetus’s right to life. Throughout history, the country’s heavy Catholic majority has integrated itself into the government and held up the responsibility of protecting the rights of the fetus, based upon the Catholic principle of life beginning at conception. In 2022, the debate over women’s autonomy within reproductive rights is ever-continuing; medicine is advancing, abortion policies are getting more restrictive, and women who do not believe in the government’s views are getting more frustrated. The choice to carry and birth a child is becoming one of public voice rather than individual choice, with conflicting views asking the question of if the mother’s or fetus’s life should be prioritized. Physicians working in governmentally funded establishments must balance personal views with their responsibility to protect lives. Government officials face the decision of enforcing traditional Polish views while adapting to modern societal responses. Within the realm of medicine and ethics, many factors connect politics, economics, society, and religion together to examine dilemmas and questions concerning reproductive rights. 

This ethical debate of individual medical autonomy versus legislation influenced by widespread religious views will be analyzed through the ethical framework of consequentialism and moral paternalism. Examining the ethical principles and values of autonomy, safety, capacity, and responsibility, this paper aims to investigate the different factors and ultimately answer the difficult ethical question of who should decide and control reproduction in Polish society, and to what extent.

Background on Religion in Poland

Poland’s geographical, political, and social landscapes have made it a powerful nation in Europe in modern day. However, the nation was not always independent. From the time of the Second World War to the early 1990s, Poland was a part of the Soviet Union. The Soviet Union believed that the government’s job was the regulate the growth of the population, and this idea began to be seen as increasingly antinatalist when the state legalized abortion in 1955 (Heer). From 1936 to 1955, abortion had been illegal, unless under strict medical instructions (Heer). This reversal coincided with the USSR’s policy and practices of atheism. The Soviet Union, influenced by the ides of Joseph Stalin, passed laws limiting the influence of the Catholic church, distributed anti-religious propaganda, and was infamously antisemitic and Islamaphobic (Powell). Therefore, after the Soviet Union’s collapse in 1991, countries such as Poland gained their independence not just politically and economically, but religiously as well.

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Poland, historically Roman Catholic, was now free to express the principles of the religion, one of which being natural law. Natural law in Catholicism states that only God introduces and determines new life, and preventing this natural process as a human does not align with the Catholic moral code (BBC Religion). Pope Pius XI, in 1930, objected to contraception in his book Casti Connubii, stating this:

“No reason, however grave, may be put forward by which anything which is intrinsically against nature may become comformable with nature and morally good. Since, therefore, the conjugal act is designed primarily by nature for the begetting of children, those who in exercising it deliberately frustrate its natural power and purposely sin against nature and commit a deed which is shameful and intrinsically vicious” (BBC Religion). 

Along the same principle of natural law, Poland also viewed getting an abortion as going against the moral code, with the Church believing that life starts at conception and should be considered sacred (BBC). With these principles in action, Poland adopted several anti-contraception, anti-abortion policies and an overall shift in public opinion over reproduction, examples of which will be presented later in the paper. 

As religious expression grew, it began intertwining with Polish politics. In 2001, the Law and Justice Party was founded, and it fully rose to power in 2015 through an electoral victory for President, ultimately becoming the majority in the Polish parliament (Traub). The party’s values heavily aligned with those of Catholicism as traditional and conservative ideas were pushed to the public and were integrated into legislation. The effects of this prominent religious influence in Poland has become the core of the ethical issue of reproductive health rights in the country today.

Governmental Restrictions on Contraceptives

Because of the new emphasis on religion, Poland adopted a “pro-natalist” policy in the 1990s to grow its population and encourage parenthood (Harper). Although scarce, birth control clinics did exist in the country. However, the need for scheduled physician visits was prominent because only OB-GYN doctors were permitted to prescribe long term birth control, specifically IUDs or a consistent pill. Contraceptives also included condoms, female condoms, hormonal contraception pills, and family counseling (UN Refugee Agency). Precise medical training in the area of family planning was insufficient, and a qualified, precise system of prescribing contraception did not exist, leaving an unstable method of obtaining birth control (Harper). As time grew and Poland gained access to modern medicine, more patients tried to seek out contraception methods, leading to more controversy in the country.

It is important to note that there are two groups of contraception methods in Poland: emergency contraception, which is typically taken after intercourse, and non-emergency contraception, which is either taken before intercourse or on a daily basis, meaning that the patient has a heavier responsibility to uphold a consistent routine with their contraceptives. Non-emergency contraception can be oral, such as taking a pill every day, but can also consist of a medical procedure like inserting an IUD (Ignaciuk). However, the IUD method is a one time procedure, differing from non emergency contraception such as everyday pills.  This brings up the question of accessible medical treatment, more specifically, which citizens are able to afford and safely reach contraception. Poland is not primarily urban, with 38% percent of citizens residing in rural areas (Witkowski). This causes more money, transportation, and overall effort to be exerted from citizens seeking IUD treatments. In fact, in 2018, Poland was measured as having the lowest IUD rate in Europe at just 0.1 percent, compared to Norway, the highest, showing 23 percent (Statista). The governmental restrictions and low accessibility rates of non-emergency contraception make it immediately less popular with Polish citizens.

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Emergency contraception, or EC, specifically the morning after pill, has also been limited by the government for citizens. The two types of EC pills in Poland consist of the LNG pill, costing $11.25, and the UPA pill, costing $33.75 (European Consortium for Emergency Contraception). These prices are about the same as in the United States, where morning after pills cost anywhere from $11-$50. However, the restrictions for these pills are significantly heavier in Poland, with the government passing a law in 2017 that turned EC into a prescription only medicine (Guardian). Side effects of emergency contraception pills included nausea, vomiting, and fatigue. These symptoms were shown to resolve themselves naturally with no further medication being required (WHO). This means that patients would have to find a physician, secure an appointment, be approved for a prescription, and pick it up in a pharmacy, all in the very scarce time frame allotted for taking emergency contraceptives after an instance of intercourse. Because emergency contraception is a one time dose, it is usually readily available to patients. However, every time a patient chooses to take an EC pill, they have to get a new prescription; emergency contraception is not a consistent medication (WHO). On top of this challenge, which again limits access to those in rural areas and of lower class, emergency contraceptives are also not covered by Poland’s socialized healthcare system, and require parental consent for minors, which presents a slippery slope of the capacity of minors and the ethicality of parental guardianship (ECEC). All of these regulations have led to Poland being ranked the lowest country in Europe for overall guidance and access to contraception, at just 31.5 percent of the population readily having access to it (European Parliamentary Forum for Sexual and Reproductive Rights). Another factor to consider within the access of contraception is the purposes that this medication has for patients who are seeking solutions to other hormonal issues like menstrual cycle regulation and acne regulation. Specifically, hormonal contraception pills and combined contraception pills (COCs) are used to improve these conditions . COCs contain estrogen and progestin, both of which help with inflammation and acne (Arowojulo). Hormonal contraceptives cover a wide range of medical conditions, some of which being menstrual disorders, endometriosis, acne vulgaris, hirsutism, and dysmenorrhoea (Slopien). These medical conditions show that contraception is not just used in society to prevent pregnancy. The hormones and chemical formulas within birth control pills have been scientifically proven to help in other areas. Thus, this widens the scope of people affected by restrictions on contraceptive use. 

An anonymous survey of Polish women in 2019 measured where patients get information about birth control and what methods are most common (Zgliczyńska). It found that the most used sources of information for women were the internet and individual physicians, measuring 82 percent and 73 percent, respectively. Common contraception methods consisted of oral contraceptives, at 38 percent, and condoms, at 24 percent. Along with this, the main factors that women identified as determining contraceptive usage were education, relationship status, frequency of intercourse, and the idea of parenthood (Zgliczyńska). A main outcome of the study showed that Poland lacked sexual education. 8% of the participants had ever taken a sexual education class in school. In addition, participants who learned about sexual education in school were shown less likely to choose reliable contraceptive methods (Zgliczynska). Poland currently has little to no modern programs for sexual education in public schools; rather, citizens say that classes are offered for preparation for family life (Cocotas). 

These heavy restrictions and regulations set forth by the government make many Polish citizens unwilling or unable to properly seek contraception. This has led between one quarter and one third of Polish citizens to obtain an abortion procedure within their lives, which has resulted in even further push back from the government and a severe control over bodily autonomy.

Abortion in Poland

Because abortion is seen as going against natural law, the Law and Justice Party has displayed its beliefs about these procedures, specifically through the country’s two major abortion laws, one directly after the collapse of the Soviet Union, and the second was written into the Polish constitution on January 27th, 2021 (Pawlak). 

As Poland adopted its pronatalist policy, the government passed a law limiting abortion access in 1993. The law stated that in order to have a legal abortion, a patient must either have had a pregnancy caused by a criminal act, three physicians certified that the mother’s life was severely endangered, or the fetus had an irreversible malformation (David). These restrictions led to a dramatic decrease in the number of legal abortions in the 1990’s and reaching an all time low of 138 abortions in 2000 (Chelstowska).

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In 2020, the Law and Justice Party passed a new abortion law, which was written into the Polish constitution in December of 2021. The law kept permitting abortion procedures under the first two clauses of the 1993 law, but outlawed abortions in the cases of fetal malformations (Reuters). An alarming statistic to note is that in 2019, 98 percent of all legal abortions in Poland were on the grounds of fetal malformations (BBC). The government’s justification behind passing this law was calling upon the immorality of determining the quality of one’s life based upon health conditions, correlating with the current worldwide debate about eugenic abortions and prenatal testing, opening up a slippery slope into what it means to have a good quality of life (BBC).

However, this reasoning made many patients who don’t align with the Catholic church’s principles feel that their fetus was being valued by the government and doctors more than themselves. While the church views protecting the life of a fetus as ethical, women who disagree state that they carry their fetus as one unit, and thus,one’s health can directly impact the other.

This idea brings forth a case study about a Polish woman who was a direct example of the ethical dilemma presented by the government choosing to advocate for the life of the fetus, rather than the mother, through religious reasoning. Izabela, a 30 year old Polish woman, made national and international news when she unfortunately died at twenty two weeks pregnant in September of 2021. Izabela died from septic shock because her fetus had an irreversible malformation caused by lack of amniotic fluid to the body. Izabela’s doctors wanted to wait for the natural death of a fetus rather than perform an abortion (ABC). The reasoning used for their decision was the fact that intervening to save Izabela’s life would require the pregnancy to be terminated, and that was illegal based upon the idea of a fetal malformation. As long as they felt a heartbeat, they did not terminate the pregnancy because of their oath to protect life. However, seen clearly here is the idea that the mother and fetus’s health complications intersect. This complicates the laws that the government sets forth: if a fetal malformation classifies the mother’s life as endangered, that would arguably make the abortion legal on the grounds of having a danger to the mother’s life exist. Contradictions such as these were expressed by the public heavily over Izabela’s death as protests broke out all over Poland, breaking Covid protocols and threatening safety of citizens and law enforcement as violence ensued (CNN). Many citizens held signs reading the phrase “Her Heart Beats Too,” sending a message of frustration that the government values and protects the fetus over the mother (CNN): 

Another principle that the Polish public healthcare system practices is the Concience Clause, which states that a physician has the right to refuse to perform an abortion based on personal beliefs as long as they write a referral of care (Human Rights Watch). However, many patients have testified that referrals are rarely written. This intersection of the public healthcare system receiving its funding from the government creates opportunity for the religiously motivated legislation to thus integrate itself into healthcare practices. For patients who can’t afford to seek out and afford private healthcare, they must abide by the rules of the government, even if they don’t hold the same religious beliefs.

This has led to a significant increase in illegal abortions in Poland. In 2016, there were between 10,000 and 150,000 illegal abortions in the country, compared to just 1,000-2,000 legal abortions (Roache, Kacpura).  This connects back to the idea of access for patients wanting to exercise their bodily autonomy: unless a patient is able to abide by all the regulations, travel, pay, and find a physician willing to perform an abortion procedure, they must face consequences of lack of safety, hygiene, and unsterile environments when experiencing an illegal abortion, as well as putting doctors at risk for jail time and fines by performing an unauthorized procedure (BBC).

The impact of limited, and most importantly unsafe abortions has an effect on individual autonomy of patients as well as societal ideals and the Catholic idea of protecting life since the stage of conception. Because of the increasing number of illegal abortions taking place in the country, many patients consider getting an abortion to be the same as taking contraception, which may lead to a slippery slope of intersection between the two (Margolis). There is also the battle of paternalism as the government aims to ensure life for the fetus through religious reasoning, which often conflicts with the mother’s autonomy. A key question comes up of whose life should be valued – the mother’s autonomy versus the fetus’s life as perceived by the government? Keeping this in mind, the paper will explain the various ethical principles, values, and frameworks of the dilemma at hand.

Ethical Analysis

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The ethical dilemmas of Poland’s reproductive healthcare system contain many ethical frameworks and values, all of which can pertain to different subtopics like emergency contraception, abortions, medical tourism, religion, and social responses. The stakeholders consist of patients seeking methods of pregnancy prevention and termination, government and Church leaders, and physicians who work in reproductive health. The fetus, because it is considered alive and functioning by the government, can also be considered a stakeholder, even though it is dependent on an outside source. The mother and father of a fetus are also stakeholders as their autonomy conflicts with the government’s. Men who seek out contraception methods, such as vasectomies, are also impacted by contraception regulation. Patients who use birth control for other uses, such as menstrual cycle or acne regulation, are also stakeholders as they are affected by any restrictions passed. Finally, society as a whole is a stakeholder.

Advocating for a Fetus’s Right to Life

As mentioned previously in the paper, the main ethical dilemma of this paper is examining how the government, through religious reasoning, prioritizes life and autonomy between the fetus and the mother within the field of reproductive rights. For the fetus, the mother, and the government as a paternalistic source, capacity and autonomy are essential.

  • Decisional capacity is defined as “the ability of subjects to make their own medical decisions” (Stanford Encyclopedia of Philosophy). 
  • Individual autonomy is defined as “the capacity to be one’s own person, to live one’s life according to reasons and motives that are taken as one’s own and not the product of manipulative or distorting external forces, to be in this way independent” (Stanford Encyclopedia of Philosophy).

Without the capacity to understand what is happening in one’s environment, an individual’s autonomy cannot be properly exercised. Thus, a fetus does not have capacity or autonomy to make its own decisions medically. Because the fetus is part of the mother, many pregnant patients view their autonomy in regards to both themselves and the fetus they are carrying . However, the government views the fetus as a life, and thus vows to defend that life. Because a fetus is seen as defenseless and vulnerable, the government sees an ethical obligation to protect it. The government’s choice to value the life of the fetus over the mother does not just put her safety in jeopardy, but also sets a dangerous precedent. If paternalistic sources, like the government, can exercise autonomy over a fetus present in a woman’s body, they directly take away bodily autonomy and the right to self govern.

Safety, Responsibility, and Access Within the Doctor Patient Relationship

Returning to the idea of publicly funded healthcare, a key factor that links medicine with legislation is the fact that resources, workers, supplies, and rules in public hospitals are direct reflections of the government’s actions. As of 2018, nearly 60 percent of Poland’s healthcare institutions were public (European Union of Public Hospitals). 

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The alignment of public healthcare with religious and governmental influence affects safety, access, and the overall doctor patient relationship. As previously mentioned, the country’s “conscience clause” for physicians allows doctors to opt out of performing abortions based on their moral or religious views. Combined with the restrictions from the government, public healthcare, although free, does not seem like the most desirable route for women seeking contraception and abortion because the influence of the government directly integrates into public medical establishments. This, once again, connects back to the idea of access to healthcare. On one hand, patients can easily access public healthcare through clinics and hospitals, but face the consequences of not getting a sufficient and supportive doctor-patient relationship and failing to receive quick and accurate medical advice and treatment. On the other hand, patients can choose to seek private healthcare that is not funded by the government, with possibly more willing physicians. However, with private healthcare comes costs, traveling, chances of medical tourism, and most importantly, time. 

Time is of the essence when getting an abortion procedure or taking emergency contraception. Because of the many regulations for reproductive healthcare and many doctors who fear getting punished for performing abortions, safety becomes compromised more than ever before as Poland sees a rise of illegal abortions. Unsterile, unsafe, and sometimes life-threatening secret abortion procedures become the new normal for many women who do not wish to have children/another child because unfortunately, it is the most easily accessible method for many. Not having to face the struggles of seeking out qualified care and waiting for prescriptions, referrals, costs, and other factors seems appealing to many women. The conflict with public health establishments funded by the government are seen as illegal abortions become more prevalent in Polish society.

This brings forth drastic new impacts and consequences: if illegal abortions are normalized, they may be valued as an alternative to contraception. A question arises of whether abortion, a terminating procedure, carries the same ethical burdens of contraception, a preventative procedure. Although the government heavily disapproves of both because they simultaneously violate natural law, normalizing illegal or hidden abortions bears severe consequences for safety, and possibly a whole new definition to what it means to get an abortion. If abortion is seen on the same ethical level as contraception, new societal perceptions could change the course and dynamics of reproductive rights and redefine the terms “termination” and “prevention.”

The Consequences of Limiting Bodily Autonomy

The core dilemma at hand is the ethical analysis of reproductive rights prior to, or in the early stages of pregnancy. However, there are many cases where a pregnancy cannot be terminated successfully in time, and it must be carried to full term. This long process of a nine month pregnancy for an unwilling new mother carries a whole new set of consequences, not just to individual autonomy, but to the dynamic of society. The effects of unwanted births can change population, adoption, and foster care rates. Aside from numbers, there are a plethora of societal factors from unwanted pregnancies and births. The task of being an unprepared or unwilling parent can affect a mother and father’s mental health. A child in a tense family dynamic that lacks parental support may also feel the impacts through their mental health. The economic impact can also be drastic – having to provide for an unplanned child when one is not financially ready can prove to be a big family burden. Lack of proper finances can affect a child’s education, work, and opportunities. Economic and societal factors have the ability to decrease an individual’s overall quality of life. These long term consequences show how the effects of the government’s religiously motivated legislation is inherently bad for Polish citizens who do not align with the principles of the Catholic church. However, the factor of religion is extremely prominent in Poland. 

The Significance of Religious Autonomy Through Moral Paternalism

While this paper has mainly discussed the consequences of limiting the reproductive bodily autonomy of patients because of religious influence in legislation, it is important to note just how crucial religion is as a factor in Polish society. The percent of Catholic individuals in the country has risen in the past few years to 92 percent (Statistics Poland). Poland is considered to be among Europe’s most religious countries, with nearly 70 percent of citizens stating that God plays an important role in their everyday lives (Pew Research Center). The government, upholding this importance of religion, is seen as a paternalistic source towards citizens, specifically one of moral paternalism. Paternalism is defined as “the interference of a state or an individual with another person, against their will, and defended or motivated by a claim that the person interfered with will be better off or protected from harm” (Stanford Encyclopedia of Philosophy).

Moral paternalism specifically occurs when the state or individual in question interferes with someone on the basis of moral differences, and uses the reasoning that the individual’s actions are immoral. In the case of Poland’s ethical dilemma, the government believes that pregnancy is a part of the natural process of life and that the fetus, which is seen as alive from conception, has the right to be born.

The influence of the government on Polish citizens has historically guided the way of life in Poland, not just through individual thinking, but public education, healthcare and government incentives. Seeing how prominent these ideas are presents additional consequences for Poland’s dynamic as a country if this religious aspect was to be completely dismissed by citizens and abolished by governmental systems. The concept of not knowing the future is applied to this dilemma: if the government stopped relying on religious influence, citizens’ ways of life would change on a much larger scale. Churches could lose funding and therefore influence, seeing as they work closely with the government and willing public (Pawlak). A severe lack of culture could take place, international relations with other religious countries could shift, and the slowing of reproduction rates could hurt the population on a long term basis. Although these consequences would have a more gradual shift than the lack of women’s bodily autonomy, they present another side to consider in this ethical issue.

Conclusion

By evaluating abortion and contraception access and examining the religious influence of the Church in Poland, this paper conducted a thorough background and analysis of Poland’s reproductive health system and its ethical issues. The frameworks of moral paternalism and consequentialism were used to evaluate the values and principles of safety, autonomy, and responsibility, and answer the ethical question of whether people who can become pregnant should have the autonomy to decide whether to use contraception and secure legal abortions. Ultimately, patients’ autonomy has to be respected, whether that may contain the decision of getting an abortion or a contraceptive prescription. Because the patients’ bodies are undergoing these situations, the patients themselves should have the right to decide. As Izabela’s case study showed, an impact on the fetus directly correlates with the mother’s health as well, and if the patient cannot make the choice to prevent or terminate for themselves, they could feel the consequences of physical and medical conditions and challenges. Individual bodily autonomy is an essential part to an efficient quality of life, and should not be dictated and enforced by a paternalistic source. Furthermore, the government should not favor the personhood of an unborn fetus through religious influence because its life is being fully supported by the mother. If the mother has a life to support, she should also have the right to decide how to approach her situation and value her own body and health.

Contraception access should first be prioritized in rural sections of the country in order to achieve the value of safety, specifically for emergency contraception. The time needed to obtain certain medication is low, and the stakes are high. Birth control also has many other uses besides pregnancy prevention such as regulating menstrual cycles and acne regulation. Although these cases include patients who may not be trying to prevent a pregnancy, the same restrictions will still apply to patients seeking out this contraception. Based on the data and statistics within the analysis of Poland’s contraception system, it is concluded that the religious influence concerning natural law from the government lowers the quality of life for patients seeking to prevent pregnancy.  

Beneficial governmental incentives to make reproductive healthcare more widespread is to loosen restrictions on abortions and increase bias training for physicians, including stressing the importance of the oath. These actions could contribute to separating religious influence from matters of public health, thus making it not just a safer and consistent system of medical prescriptions and physician visits, but one more accessible to the general public who cannot afford private care. Also, proper sexual education programs in schools would benefit how Polish citizens grow and learn about reproduction, effective contraception methods, and family planning by offering a structured, supportive source for children and teenagers. Finally, while religion would remain a mode of expression in Poland, restrictions and bans surrounding abortion being lifted would destigmatize the subject, showing it as a legal, effective way to terminate an unwanted pregnancy in times of improper or failed contraceptive methods. However, abortion should not be equated with birth control or grouped as the same “medication.” While birth control aims to prevent pregnancy, abortion directly terminates it, meaning that in society the two carry different moral implications. Under the principles of the Catholic church, abortion is seen as terminating a life, which not only comes across as morally wrong in society, but also may have a toll on the patient going through it. Abortion procedures often have lasting psychological effects because of the burden society places on the subject. Contraception, however, is seen as a method of responsible sexual intercourse and prevention. In contrast to abortion, contraception provides a preemptive measure that patients can integrate into their lives. 

Finally, the role of the government should not rely on the teachings of the Catholic church when making legislation. By separation of church and state, the importance of religion can still stay prominent within Polish society, but will not be felt by those who don’t believe it. The framework of consequentialism presents both sides of this ethical dilemma between the government and the individual. However, if the government is not motivated by religious influence and thus does not heavily impact reproductive autonomy, the paternalistic dynamic will decrease and allow for more flexibility within society.

Within every conclusion of this ethical issue, new questions rise up that are difficult to answer in one paper. If given the opportunity to further my research on Poland’s reproductive health system, I would want to examine the intersections of abortion and contraception methods with overarching themes in bioethics; specifically, eugenics, medical tourism, doctor patient relationship dynamics, and the debate over quality of life. In addition, I would like to interview Polish citizens to discover what they think about the situation in their country. Researching a situation in a foreign country where language barriers exist has made it harder to view exact documents set forth by the government and ultimately has led to much of my research examining news articles and interpretations. Having a clearer understanding of the dilemma at hand would provide a better basis for applying an ethical framework as I continue learning about reproductive health, autonomy, and religion in society. 

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