This annex is for reference only. It is not intended to be a comprehensive statement of the law or list of relevant legislation and case law, nor is it a substitute for up-to-date legal advice.
Abortion Act 1967
In England, Wales and Scotland the right to refuse to participate in terminations of pregnancy (other than where the termination is necessary to save the life of, or prevent grave injury to, the pregnant woman), is protected by law under section 4(1) of the Act.
This right is limited to refusal to participate in the procedure(s) itself and not to pre- or post- treatment care, advice or management, see the Janaway case: Janaway v Salford Area Health Authority  1 AC 537
The Abortion Act 1967 does not apply in Northern Ireland. Sections 58-59 of the Offences Against the Person Act 1861 were repealed on 22 October 2019 in Northern Ireland
The relevant legislation in Northern Ireland is:
- The Abortion (Northern Ireland) Regulations 2020
- The Criminal Justice Act (Northern Ireland) 1945 (as amended by the Abortion (Northern Ireland) Regulations 2020)
Human Fertilisation and Embryology Act 1990
Section 38 of the Act prevents any duty being placed on an individual to participate in any activity governed by the Act.
Female Genital Mutilation Act 2003
This Act prohibits a range of procedures on female genitalia, except where they are necessary for health reasons or to assist in the birth of a child. Female genital mutilation raises child protection issues.
This Act was amended by the Serious Crime Act 2015, which introduced a duty on doctors in England and Wales to report known cases of FGM in girls and young women aged under 18 to the police. This duty came into force in October 2015.
For further information, see our guidance Protecting children and young people: The responsibilities of all doctors (2012).
Equality Act 2010 (and parallel legislation in Northern Ireland)
The Equality Act and parallel legislation prohibit direct or indirect discrimination or harassment of patients on the basis of a protected characteristic. The protected characteristics are: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation.
Direct discrimination occurs where a person treats another person less favourably than he or she treats, or would treat, others because of a protected characteristic.
Indirect discrimination occurs when a person (A) applies a provision, criterion or practice to another person (B) that appears neutral on its face but which disadvantages B and other people with whom B shares a protected characteristic, and which cannot be shown to be justified.
Harassment occurs where a person’s conduct has the purpose or effect of violating another person’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that person (section 26). For further detail on the application of protected characteristics and discrimination in providing health services, check the Equality Act or seek legal advice.
Gender Recognition Act 2004
The Gender Recognition Act 2004 imposes certain responsibilities to maintain confidentiality. Section 22 of the Act makes it a crime for any individual who has obtained information in an official capacity to divulge that a person has a gender recognition certificate or do anything that would make such a disclosure. The Gender Recognition(Exceptions to Offence of Disclosure) Order 2005 creates an exception to Section 22 for healthcare professionals where:
- The disclosure is made to a healthcare professional
- The disclosure is made for medical purposes, and
- The person making the disclosure reasonably believes that the subject has given consent to the disclosure or cannot give such consent.
Human Rights Act 1998
The Human Rights Act incorporates the European Convention on Human Rights into UK law. Article 9 of the Convention concerns the right to freedom of thought, conscience and religion. It provides an absolute right as far as holding a belief is concerned, but the right to act on beliefs or to oblige others to comply with them is subject to qualification and cannot be used to support an action that infringes the rights and freedoms of others.