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This bulletin examines access to abortion across the world by focusing on who has decision-making authority and how authorisation takes place in practice. Our focus is on the practical ethical questions that arise after a law, court or other authority has determined that abortion may be available under specified conditions. We examine the factors that influence whether a pregnant person’s 1 informed request is treated as sufficient to proceed, or whether it is overridden, deferred or made conditional on approval from a spouse, parent, committee, clinic or individual healthcare provider.