From ... in Health — Sep 14, 2023

Poland: Abortion Witch Hunt Targets Women, Doctors

(London) – Poland’s government is targeting people for alleged abortion-related activities, intensifying a climate of fear that heightens risks for women and girls, Human Rights Watch said today.

Human Rights Watch released a video highlighting how the government’s dubious use of its powers to chase down alleged abortion-related activity threatens people’s rights to privacy, autonomy, and health, amongst others. Since a near-ban on legal abortion in 2020, Polish officials have increasingly opened investigations on questionable legal grounds against women and girls seeking medical care for miscarriages or after legal medication abortions, as well as against doctors. Polish law does not criminalize having an abortion but rather anyone who provides or assists someone in having an abortion outside of highly restricted grounds.

The government is apparently attempting to find a basis for prosecuting family members, friends, and healthcare providers for illegally providing or assisting abortions. “Polish authorities’ ruthless pursuit of people trying to get or provide basic health care can only be described as a witch hunt,” said Hillary Margolis, senior women’s rights researcher at Human Rights Watch. “The government is misusing police and courts to advance its anti-rights agenda, taking its abusive policies into private homes, hospital rooms, and doctors’ offices.” In interviews with Human Rights Watch, doctors, lawyers, and a woman who had a legal medication abortion described sweeping and speculative investigations, and overbroad searches. Criminalizing those who provide or assist an abortion unjustifiably interferes with the right to health, leading to negative health outcomes and potential persecution of those seeking abortion. Additionally, since January 2021, at least six women are known to have died after doctors did not terminate their pregnancies despite complications that posed a danger to their health or lives, which remain legal grounds for abortion in Poland. Prosecutors opened investigations into all six cases, five of which are ongoing. In the sixth, the prosecutor discontinued the proceedings without providing reasons for doing so. Women and girls have been put under intense scrutiny for alleged abortion-related activity when they seek urgent health care. Joanna, a 32-year-old woman, said that the police demanded to strip search her in April after she had a self-administered medication abortion, which is legal. Two weeks later, she called her psychiatrist for help with symptoms of severe anxiety. During the call, she disclosed her abortion to her psychiatrist, who called an ambulance and contacted the police. Police arrived at Joanna’s apartment alongside a paramedic and escorted her to two different hospitals. At the second one, she was ordered to undress for what amounted to a body cavity search. “They told me to take off my clothes, do squats, and cough,” Joanna said. “I was just standing in front of them, I didn’t take my underwear off.... I tried to take a step back but there was only a wall behind me. I felt I wasn’t a human being anymore.” The lawyer representing Joanna and others subject to invasive searches and interrogation said that such “fishing expeditions” do not have sufficient legal basis. “This is just searching for searching’s sake,” the lawyer said. “It’s not legitimate because the investigation must not be started without grounds for suspicion.... Only for abortion is it done this way.” These actions also constitute degrading treatment in violation of international human rights law, Human Rights Watch said. Cases that Human Rights Watch documented offer evidence that Polish law enforcement authorities have increased their pursuit of women, girls, and healthcare providers since the politically compromised Constitutional Tribunal issued a decision in October 2020 that virtually eliminated legal abortion in Poland.

The decision, which entered into force on January 27, 2021, removed one of only three grounds on which an abortion could be obtained. Evidence consistently demonstrates that laws criminalizing or restricting access to abortion do not eliminate it, but rather drive people to seek abortion through means that may put their mental and physical health at risk and diminish their autonomy and dignity. Since the Law and Justice party (Prawo i Sprawiedliwość, PiS) came to power in 2015, Poland’s government has carried out a sustained attack on sexual and reproductive health rights, particularly access to abortion.

The ruling party brought the abortion case to the Constitutional Tribunal after parliament voted not to adopt legislation effectively banning legal abortion.

The authorities’ crackdown on women’s rights is a symptom of their broader capture of the justice system and dismantling of democratic checks and balances. Under Law and Justice, the government has systematically eroded the rule of law by undermining the independence of the judiciary and establishing effective control over the Constitutional Tribunal, among other institutions. It has sought to silence independent civil society groups, activists, and those who protest against its policies, including through the police and courts. Abortion rights defenders have also come under fire. In March 2023, a Warsaw court convicted Justyna Wydrzyńska, co-founder of the activist group Abortion Dream Team, of helping a woman to procure medication abortion pills. Wydrzyńska, who was sentenced to eight months of community service, is appealing the conviction. Poland’s government should urgently decriminalize abortion and provision of or assistance in procuring an abortion or abortion-related care, and ensure safe and legal access.

The government and authorities should immediately stop questionable investigations and prosecutions related to abortion and ensure that women and girls can access necessary reproductive health care in a dignified and confidential manner, and that healthcare practitioners can provide such care without fear of prosecution.

The authorities should also cease attacks on women’s and reproductive rights defenders. Authorities’ actions – and their use of undemocratic means to pursue their aims – raise serious concerns over breaches of the European Union’s founding values and Poland’s international human rights obligations, Human Rights Watch said. “By going after women and girls who need medical care – and doctors who provide it – Polish authorities are using their powers to terrorize people instead of to protect basic rights,” Margolis said. “As the government ramps up its targeting and harassment of people allegedly linked to abortion, anyone can fall prey to these attempts and have their privacy, dignity, and right to health violat The October 2020 Constitutional Tribunal decision stated that abortion on grounds of “high probability of severe and irreversible fetal impairment or incurable illness that threatens the fetus’ life” is unconstitutional, removing one of few, and the most accessible, legal basis for abortion under Poland’s highly restrictive law. Previously, over 90 percent of the approximately 1,000 legal abortions annually in Poland were on these grounds. Polish law now permits abortion only to safeguard the life or health of the woman or where a pregnancy results from rape or incest. However, in practice multiple barriers severely limit access to care in such cases, as the deaths of pregnant women refused terminations demonstrate.

The Constitutional Tribunal is widely acknowledged, including by the Council of Europe’s legal advisory body, as politically compromised. Between April and September, Human Rights Watch interviewed a woman who was interrogated by police after having a medication abortion, and two gynecologists who said they were targeted for allegedly providing or supporting the right to abortion care. Human Rights Watch also interviewed a lawyer who represented a 17-year-old girl interrogated by police after she took medication abortion pills, and a lawyer representing two women interrogated by police: one after having a medication abortion and one following a miscarriage. In all three cases, police also searched the women’s and girls’ homes and seized belongings including their telephones. Polish media have reported other cases similar to the ones experienced by or within the direct knowledge of the individuals Human Rights Watch interviewed.

The authorities confiscated all patient medical records belonging to one doctor. Human Rights Watch also interviewed three of the patients whose records were taken, and two lawyers associated with the case. Reported by Her Psychiatrist Joanna, the 32-year-old woman who had a legal, self-administered medication abortion at home in Krakow in April 2023, later contacted her psychiatrist over what she felt were anxiety attacks. She told the psychiatrist she was not going to harm herself. Yet a paramedic arrived at her door accompanied by police, whom the psychiatrist had contacted. Two male officers searched her apartment and asked for her phone, saying “it might be evidence in a crime,” without specifying what crime. In the ambulance, the police prevented her from using her phone to inform her sister of her whereabouts. “At that point, I realized that something was going wrong,” Joanna said. “I knew I wasn’t breaking the law in how I got the [abortion] pills, but it didn’t matter.” The police escorted her to a hospital, where they and two additional police officers surrounded her in an examination area. Later, at a second hospital, two female police officers entered the room where a gynecologist had examined Joanna.

They ordered her to strip naked, squat, and cough, without providing a reason. Joanna refused. “They were just repeating, ‘take off your clothes, do squats, cough,’” she said. She removed her shirt and bra but not her underwear. She described feeling like a trapped animal. “I tried to take a step back but there was only a wall behind me. I felt I wasn’t a human being anymore. I didn’t want to take my panties off because I was wearing a [sanitary] pad and it was dirty. It was too humiliating. Something caused me to scream: ‘What do you want from me?!’” Joanna said she gave officers her cell phone to prevent them from searching her physically, which she felt “would break me.” While at the hospital, she realized her laptop had been confiscated. A few weeks later, police called her to give a statement, but did not inform her who or what was under investigation. Kamila Ferenc, a lawyer at the Warsaw-based Foundation for Women and Family Planning who represents Joanna, said that proceedings regarding the crime of assisting illegal abortion are still pending, even though prosecutors cannot charge Joanna with this crime and there are no other potential suspects. Ferenc is also representing Joanna in two cases against the police for a disproportionate and unfounded search that violated her rights, led to inhumane treatment, and erroneously confiscated her belongings, as well as for breach of data privacy regulations due to the publication of personal information.

The cases are ongoing. Interrogated After a Miscarriage In July, a 41-year-old woman spoke publicly about police interrogating her following a pregnancy loss. She said she called an ambulance in June 2022 when she was bleeding heavily after miscarrying at home in Warsaw at 19 weeks pregnant. Police stood outside her hospital room, insisting to doctors that they needed to question her, and then followed her out of the hospital. More police waited outside her house, where they pumped the septic tank and inspected it thoroughly, saying they were doing this on the prosecutor’s orders.

The prosecutor demanded that police strain the septic tank’s contents through a sieve to search for evidence, but police refused. Police took the woman’s bloody clothing, her used sanitary pads, a pair of scissors with which she had cut the umbilical cord after miscarrying, the placenta, and “other biological material” as possible evidence of criminal activity. A Warsaw district prosecutor’s office initiated proceedings for assisting someone to have an illegal abortion, which carries a penalty of up to three years in prison. In October 2022, they discontinued the proceedings due to lack of evidence. Ferenc also represents the woman and plans to bring a case against police for the search and investigation. “[The police] acted like [she] was a criminal and they wanted to find someone to bring charges against,” Ferenc said. 17-Year-Old Interrogated In 2022, police interrogated a 17-year-old girl near Wroclaw and searched her home when she sought health care after taking medication abortion pills.

The girl had had a blood test that confirmed she was pregnant. Rather than consulting a healthcare provider, she interpreted the results herself using online information and believed she was 10 to 12 weeks pregnant. Her friends called an ambulance when she experienced excessive bleeding after taking pills for a self-managed abortion. At the hospital, the girl learned that her pregnancy had been around 20 or 21 weeks, beyond the time frame for which self-administered medication abortion is recommended. Police searched her home and first approached her while she was in the hospital, said Piotr Lech, the lawyer who represented her.

They confiscated her telephone and her mother’s telephone. “My concern is about urgency and the power they used in this case,” Lech said. “Even if [the prosecutor] believed something was wrong ... this urgency was definitely not necessary for a 17-year-old girl still in the hospital.” He emphasized that the state should have prioritized the girl’s health and safety. “The state gave an extra punch to this girl. She needed help first, not questioning,” he said. Soon after the girl’s release from the hospital, Lech accompanied her to the police station for interrogation as a witness to possible infanticide. During the interrogation, police asked for names of people the girl spoke with at Abortion Dream Team, which provides information and aims to destigmatize abortion, as well as where she procured abortion pills. Lech and his client refused to answer the questions. Police did not ask whether she had experienced rape or other sexual violence. Lech noted irregularities in the case: he said that the speed and aggressiveness with which the police pursued it contrasted starkly to his experience in other cases, and that police interrogated his client as a witness to infanticide; however, as only the mother can be guilty of the crime of infanticide under Polish law, there was no suspect she could have “witnessed” committing the crime. Within two days, Lech said, he received notice that the prosecutor had dismissed the case. Pressure on Reproductive Healthcare Providers Dr. Maria Kubisa, a gynecologist in Szczecin, Poland, said that six armed specialist government agents raided her private practice on the local prosecutor’s orders in January 2023.

The agents asked about one patient for whom Kubisa said she had no records.

They confiscated her computer, telephones, and all of her patient medical records dating back to 1996, violating the patients’ right to privacy.

The records included sensitive information and images for about 6,000 patients. Kubisa, who performs gynecological surgery, said the agents forced her patients out of her office. “[A patient] said she had had a serious surgery and needed to have her check-up because she had come from far away,” Kubisa said. “One of the officers said that her health condition is not his problem, it’s not what he cares about.” Kubisa’s lawyer, Rafal Gawęcki, confirmed that the raid was related to allegations that Kubisa had provided a patient an illegal abortion. Kubisa said she has not treated pregnancies since the 2020 Constitutional Tribunal ruling. She said the confiscation of her belongings and patient records left her unable to treat patients for weeks, and that other reproductive healthcare providers could be targeted for similarly overbroad searches. “If they were able to [basically] close my clinic, then they can do anything,” Kubisa said. “They took all of this [documentation] to find something and press charges against me.” About 30 of Kubisa’s patients lodged complaints, including against the prosecutor’s office, for seizing their records. Three of them told Human Rights Watch that they felt the raid violated their privacy and sense of security, and exemplified targeting of women’s sexual and reproductive health rights. As one said, “It’s a matter of control over women and ... controlling our reproductive rights. Nothing like that will ever happen to any male patient who goes to a urologist.... This is not even in the spectrum of [the government’s] interest.” Gawęcki said that in July, a regional court ruled there were legal grounds for the search of Kubisa’s office, but that its execution and the seizure of all patients’ documents were disproportionate and not consistent with the purpose outlined in the search order. Other doctors also said that they have experienced increased pressure since the Constitutional Tribunal ruling. Dr. Dominik Przeszlakowski, an obstetrician-gynecologist in Krakow, said that the Jagiellonian University Hospital, one of Poland’s largest public hospitals, fired him after 24 years following his outspoken opposition to the Constitutional Tribunal’s judgment. Before the judgment, the hospital provided abortions in cases of “high probability of severe and irreversible fetal defect or incurable illness that threatens the fetus’ life.” The day after the October 2020 judgment, the hospital cancelled all scheduled abortion procedures. “[Women] were just completely left alone,” said Przeszlakowski. “They were told to go abroad, by doctors who wouldn’t help them.” At a meeting with doctors from the hospital’s gynecological clinics, Przeszlakowski called for the hospital to reverse its decision. Later that day, the hospital reinstated abortion procedures until the judgment came into force in January 2021. When Przeszlakowski continued objecting to the hospital’s refusal to terminate pregnancies from January, he said the clinic’s director told him to “stop making a fuss.” In November 2021, following the death of a woman who was denied abortion care despite pregnancy complications, Przeszlakowski spoke at a Krakow protest and on a major television station. “[The ruling] was unjust, unfair to women, and nonsense,” he told Human Rights Watch. “We have our medical knowledge, and it is our obligation to use this to do our work as well as we can.” In March 2022, Przeszlakowski left his shift early – something he said other colleagues did regularly – because his mother had an emergency.

The same day, an unscheduled check on the unit led to a letter calling for him to explain his absence, followed by a reprimand. In April 2022, hospital management fired him, allegedly for failure to respond to the letter. When asked whether any other Jagellonian University hospital employee had been terminated for similar reasons, he said that to the best of his knowledge, “No, no one else, never.” “They told me that they don’t have any concerns about my work [as a doctor],” he said. “They knew at what time I left work [on the day in question], they knew I did a handover to colleagues, and despite that, they fired me. It felt like whatever I did or said, they would fire me anyway.” Based in part on off the record conversations with colleagues and doctors from other hospitals, Przeszlakowski believes that the unplanned check on the unit was conducted to create a pretext for his dismissal, with the real reason being his vocal, public critique of the Constitutional Tribunal decision.

The clinic doctors and nurses, including the head of the unit, signed a letter asking the hospital to reinstate Przeszlakowski. He is bringing a case against the hospital for wrongful termination. Additional Information on Increased Targeting of Alleged Abortion-Related Activity The October 2020 Constitutional Tribunal decision stated that abortion on grounds of “high probability of severe and irreversible fetal impairment or incurable illness that threatens the fetus’ life” is unconstitutional, removing one of few, and the most accessible, legal basis for abortion under Poland’s highly restrictive law. Previously, over 90 percent of the approximately 1,000 legal abortions annually in Poland were on these grounds. Polish law now permits abortion only to safeguard the life or health of the woman or where a pregnancy results from rape or incest. However, in practice multiple barriers severely limit access to care in such cases, as the deaths of pregnant women refused terminations demonstrate.

The agents asked about one patient for whom Kubisa said she had no records.

They confiscated her computer, telephones, and all of her patient medical records dating back to 1996, violating the patients’ right to privacy.

The clinic doctors and nurses, including the head of the unit, signed a letter asking the hospital to reinstate Przeszlakowski. He is bringing a case against the hospital for wrongful termination.

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Poland: Abortion Witch Hunt Targets Women, Doctors

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