Spanish Court Orders Madrid to Create Registry of Doctors Who Refuse to Perform Abortions


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Conscientious objection in medicine-the right of clinicians to refuse participation in legally permitted abortions on grounds of personal belief-is a widely recognized concept in modern healthcare, including in Spain. The article centers on Madrid’s attempt to create a public registry of healthcare professionals who object to abortion, a move opposed by the regional government led by Isabel Díaz Ayuso. Ayuso argues that such a registry would force doctors to act against their conscience and could stigmatize them, insisting she will not blacklist medical staff.

Conversely, Spain’s Health Ministry won a provisional court ruling requiring Madrid to initiate the administrative process to establish the registry, citing Article 19 of the national abortion law and a binding coordination protocol approved in December 2024. Supporters say the registry would help coordinate abortion services nationwide while balancing conscience rights with women’s legal access. The dispute has become a political flashpoint,with Ayuso accusing the central government of overreach and criticizing the approach as disrespectful to Madrid’s doctors.


In the modern medical world, there is a rather ubiquitous concept known as “conscientious objection.”

Simply put, it’s the right that medical professionals have to deny legal healthcare actions on the grounds that it would violate their beliefs.

For example, if a Christian doctor simply cannot perform an abortion due to his sincerely held faith, he has every right to refuse the procedure.

It’s a widely recognized right throughout most of the modern world, including Spain.

But, despite the existence of conscientious objection, it appears Madrid is intent on making this privately held right to be as public as humanly possible.

According to The Spain Post, a local court has ordered the regional government of Madrid to begin work on a long-delayed registry of healthcare professionals who refuse to participate in abortions on grounds of conscience.

The ruling came from the Eighth Administrative Litigation Section of the Madrid Superior Court of Justice, which sided with Spain’s Health Ministry.

Judges granted provisional measures requiring the regional government led by Isabel Díaz Ayuso to immediately start the administrative process needed to create and approve the registry.

The dispute stems from Article 19 of Spain’s national abortion law, which requires every autonomous community to maintain a list of medical professionals who object to directly participating in voluntary abortion procedures.

Madrid has been the only autonomous community that has not implemented the system. After repeated refusals by the regional government to comply with the national requirement, the Health Ministry brought the matter to court through an administrative legal challenge.

The issue had already been addressed at the national level in December 2024, when Spain’s Interterritorial Council of the National Health System unanimously approved a coordination protocol to guide the creation of the registry.

Under Spain’s public sector legal framework, that protocol is binding for all healthcare administrations across the country.

Supporters of this move claim that this registry is intended to help health officials coordinate services across the country while balancing doctors’ conscience rights with women’s legal access to abortion.

Ayuso, however, sees things differently.

“I will not force a doctor in the Community of Madrid to act against their conscience and freedom,” she said in October. “I will never make a blacklist of doctors.”

Ayuso’s health officials backed her up by arguing that such a registry creates unneeded “stigma” for healthcare professionals.

As reported by The Irish Times, this entire ordeal appears to have been sparked by the “left-wing coalition government” of Spanish Prime Minister Pedro Sánchez.

Ayuso did not mince words when addressing the push from Sánchez to produce these registries.

“Who does he think he is, speaking for all women,” Ayuso said. “Does he think he is God, speaking for life with that frivolousness?”

She further accused Sánchez of tackling the thorny abortion issue “with the tone of a little chauvinist.”




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