Exploring Approach 1: My choice, my right

Thanks @Tasha Waris for being first to pick-up from where we left off at the class workshop. I like the way you have identified some intended 'positive' consequences (which link to what supporters of this approach value about it) and some problems such as mothers/parents having to make difficult decisions when under emotional and time pressure, and fairness issues if there is a user-pays policy. This is a great start and I'm sure other people in your subgroup can build of it.

@Tasha Waris's point about 'knowing what's best for them' raises a very interesting point in terms of 'decision making capacity' -- which I think is a key issue that would need to be worked through for this approach to be successfully implemented. That is, in this approach, does 'My choice, my right' always apply, or are there circumstances in which it does not? And if the answer to the latter is yet, are such circumstances definable (and able to be accommodated within the perspective)?

@Tasha Waris has mentioned the cultural and religious values that is of importance to note when considering the “who gets born” initiative. It is fair to say that different countries react differently to such initiatives, take for example my county, Samoa. The preamble of its constitution states that “Samoa is a Christian nation founded on God” and decisions regarding the running of the country is based on Christian principles and Samoan customs and traditions. Therefore, the government condemns the right to abortion, whether or not there is imperial evidence that can aid a decision.

I think an unintended consequence would come from the accuracy of the test. How likely are for the mother/parent to make a decision based on the results of a test that may or may not be accurately correct?

@Susanna Tuipoloa thanks for sharing the phrase from the Samoan constitution. Its interesting how religion and politics play out in different nations. Im always interested in the disparity between the written documents and how it plays out in practice. The point that intrigues me is how the government can on certain matters take a strong viewpoint such as abortion, due to the way religion are interwoven with documents of significance. Then on the other hand there seems to be a loosening of religion and perspective with other perspectives such as gender diversity in relation to socially accepted norms like such as fa'afafine where even within politics, society and business this is a core part of the social norm.

Hi @Josie Nafatali I absolutely agree with your point. Yes, fa’afafine or transgender is widely accepted within our communities back home and by the government as well like you’ve mentioned however, government resists the legalization of gay marriages and that move is well supported by local religions. So for me, it does not make sense. But whether the government places restriction on abortions, unsafe/backstreet abortions are on the rise, and from my understanding, this lies heavily on unwanted pregnancies. If approach 1 is valued, then giving the chance of life to an unborn fetus can highlight government's role in promoting the reduction of unsafe abortions.

On the other hand, there have been a number of cases from all over the world, not just in Samoa where disabled children are left neglected due to the burden they place on families, particularly parents. This goes back to the ‘my choice, my right’ approach where the parents/families are given the choice based on their abilities to value their unborn’s life and have the necessity to provide absolute care when choosing to bring an unhealthy or disabled child into the world. And instead of offering a choice to the parents to proceed to other options including abortion, I think government should shift its focus to offering support by way of infrastructure and funding for families who find themselves in such difficult situation.

Welcome @Beth Hampton and @Susanna Tuipoloa. One of the things I like about collaborative work is that different people see different things and this is demonstrated by your posts, which include questions about decision-making capacity and the fact that some test results will always be wrong (false positives and false negatives). FYI, NZ's current policies - see the choicebook - include circumstances in which mothers/parents are not allowed to decide.

The tensions or conflicts that would need to be worked through for the “My Choice, My Right” approach to be successfully implemented will require the government to address long-standing and unresolved health inequities that currently exist for our most vulnerable populations in New Zealand (e.g. disadvantaged ethnic, socioeconomic, geographical and gender groups). 

How can the government ensure that mothers/parents with limited income and family support make an informed decision and if desired, access pre-birth testing and screening services in the same manner as mothers/parents who are well-informed, resourced and supported? 

From an equity perspective, I do not believe this approach is viable in our current health system and will require some form of regulation and investment of resources as pointed out by @Wendy Nguyen

I agree with @Janice Hemi. The main role of the government is to ensure that citizens can live prosperously and have an equal access over resources. If this approach is applied, the gap between family with limited resources and sufficient resources will be huge, in terms of accessing health services.

The ‘my choice, my right’ approach is, for me I think is the suitable approach to this initiative. Government steps back and individuals and families are given the freedom to make their own choices, and costs of making a choice lies with the individuals/families themselves, that may also include associated risks of such choices.

A tension / conflict I believe needs to be managed and worked through if this approach was adopted is using this topic as a political football to push a government led agenda. It becomes more challenging if the media jump in to advocate for a particular viewpoint, which could marginalize and create additional pressure and stress for women who chose to not adopt this approach.

When topics like this is aired via media in a public manner, it can easily become emotive reporting and can blur the narrative to help bring greater understanding of both perspectives.

I agree that there has to be clarity about the legislation, policy and views of different groups irrespective of their agenda, beliefs, religion and social norms.