ABORTION and the Human Fertilisation and Embryology Bill
Current UK law and practice excluding Northern Ireland
The situation in Northern Ireland is different from the rest of the UK and will be dealt with at the end.
The law:
Under the Abortion Law 1967, as amended in 1990, abortion is permitted provided two doctors certify that the pregnancy is under 24 weeks and “the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family”.
Abortion is also permitted after 24 weeks where the child is “seriously” handicapped or the mother’s life or mental or physical health is in grave danger. There is no obligation in any of these circumstances and regardless of term to preserve the life of the child.
Although the doctors certifying to this effect must weigh up the balance of mental health risks for the woman concerned, no mental health experience or qualifications are required and neither doctor needs to meet her. The woman is not required to receive any counselling nor need she be offered information about alternative solutions or sources of support.
The Courts have now determined that it is legal to provide an abortion for a child under 16 without parental consent or even knowledge.
The practice:
For illustration, I invite you to place yourself in the mind of a woman with an unplanned and unwelcome pregnancy. You are considering abortion as you are in a corner and no-one in whom you have confided (if anyone) has suggested any other way out (very common). You have a look on the net and (perhaps by googling NHS and abortion, say) find your way here:
What choices are you offered? What help to avoid abortion? Note that the only counselling apparently offered (or by implication available) is to help the woman through abortion, not to explore other solutions. Note also the links (what is there and what is not there) and if you are interested follow them. You will find more of the same.
We seem to have reached a point where there is something intrinsically wrong with even inviting a woman who presents considering abortion to explore alternatives. Remember the case of Tamie Downes who was reported to the GMC for doing just that (see: http://www.cmf.org.uk/ethics/tamie_downes.htm). Although she was exonerated the proposed “liberalising” amendments and pressures elsewhere (see for example: http://www.cmf.org.uk/ethics/abortion_law_liberalisation.htm - and the good news is Evan Harris has now been voted off the BMA ethics committee and his replacement is a member of the Christian Medical Fellowship!) are intended to ensure that women are denied the kind of counselling that Tamie, quite properly, provided.
It is difficult to see how this creeping institutional determination to steer women away from seeking alternatives to abortion complies with the law as it stands never mind as it was presented when first proposed. Neither does it serve the real interests of women. In the public debate we are invited to consider the determined, fully informed woman who has considered all the options and made her decision before she crosses the practitioner’s threshold. No doubt there are some such (but even then there is still a duty on the doctor to establish that the conditions of the “social” clause are met). But for many the situation is very different. The law and practice should also acknowledge the reality of the bewildered, frightened, heavily hormonal and therefore extra vulnerable, perhaps bullied, perhaps emotionally or materially abandoned young woman (who may have accepted / absorbed the “woman’s right to choose” mantra without any real thought and) who is bounced through the system and only realises what has been done when it is too late – and is then left to bear alone the burden of the choice she never really had. Do those who assert their championing of “women’s rights” actually care about these women?
[As an aside:
The CMF (Christian Medical Fellowship) website to which I have already provided links is an excellent source of further information and acute observation. The CMF has over 4,500 doctor and 1,000 student members.]
What are the “liberalising” amendments?
Amendments have been tabled to
- Permit abortion in the first 24 weeks of pregnancy provided only that one doctor is of the opinion that it is carried out “in accordance with good medical practice” – no medical justification required.
- Permit abortion after 24 weeks on the same conditions as at present but with only one doctor to certify that the conditions have been met.
- Extend the range of premises where abortions can be performed to include, for example, GP surgeries, polyclinics and possibly school clinics.
- In the first nine weeks of pregnancy permit the completion of a medical abortion (by the administration of drugs to expel the foetus) anywhere (“under the direction of” but not necessarily in the presence of the doctor or nurse).
Amendments have also been tabled which would variously permit nurses or midwives to replace doctors in
- performing early (or all?) medical abortions and
- performing early (or all?) surgical abortions
An amendment has also been tabled which, although ostensibly only curtailing the provision of misleading information, is worded so as to make it more difficult for women to gain access to crisis counselling (aimed at ensuring that her choice is fully informed and that she is provided with details of further sources of information and ongoing support) where such counsellors are not prepared to facilitate abortion.
A further amendment (curiously tabled as an amendment to the Abortion Act, given the claim that these devices are not abortifacients!) proposes to withdraw the right for doctors, nurses, midwives and pharmacists to refuse on grounds of conscience to provide forms of “contraception” which may also destroy the newly-conceived embryo.
What are the implications of the amendments?
The consequences of each would depend on which others were also accepted. But the first amendment would make abortion available on demand up to 24 weeks, regardless of circumstance. The others would, potentially, permit nurses and midwives to carry out abortions which could take place in GP surgeries, polyclinics and even school clinics with medical abortions completed anywhere and unsupervised. Doctors are increasingly opting out of any involvement with abortion and it is this, and the lower cost of nurse-led abortions, which is actually driving the move to dump this on nurses (see: http://www.cmf.org.uk/ethics/nurse_and_gp_surgery_abortions.htm.
As a package, these amendments place a huge threat on GPs, nurses, midwives and pharmacists. In particular the amendment seeking to withdraw the right to conscientious objection with respect to early abortifacients would make it very difficult for “pro-lifers” to function in these professions. [The field of obstetrics and gynaecology is effectively now closed (see final paragraph here: http://careers.bmj.com/careers/advice/view-article.html?id=2926) even though explicit protections were built in to the ’67 Act.] This would mean that these professions, too, would be unrepresentative of society as a whole and many patients would be denied access to like-minded and trusted health care professionals (take a look at this excellent paper if time: http://www.linacre.org/obstetrics.html).
How are these justified?
It is said that women seeking early abortion currently face “delays and obstruction” (see : http://www.abortionrights.org.uk/content/view/270/110/). The amendments are presented as permitting speedy access to early, medical (non-surgical) abortion, in the interests of minimising the physical and psychological impact on the pregnant woman. It is argued that this is a measure which should, therefore, be supported by all MPs regardless of their position on abortion.
What is wrong with this argument?
It is focused solely on a narrow and distorted perception of the needs of the woman. It pays regard neither to the obligation to protect the unborn child within the law nor to the need to protect the woman from the very real risks of abortion.
A conscientious assessment of the balance of risks under the “social clause” must take time and should involve counselling which includes the exploration of alternatives. To characterise this process as causing “delays” or “obstruction” is to deny the reality of and trivialise abortion.
The absence of any requirement for physical or psychological justification establishes a legal right to abortion on demand. This “right” would leave women even more vulnerable to pressure to abort and even less likely to be offered the counselling and support which would help her to continue with her pregnancy. Both the woman and the unborn child are effectively and wholly abandoned.
If current practice is perceived to permit abortion on demand then the response to this should not be to adjust the law to reflect current practice but rather to adjust current practice to ensure, at the very least, that the law is implemented as intended and the assessment of the balance of the risks should have due regard to the psychological and physical risks to the mother from both medical and surgical abortion.
[You may have seen reports that the American Psychological Association has come the conclusion that first trimester, first abortions have no adverse mental health consequences. This has already received widespread and enthusiastic media coverage here as undermining the pro-life case against abortion. Do not be deceived please. See, for starters:
Concern for women with unplanned pregnancies would be better demonstrated by requiring that they be offered real counselling, with full exploration of alternative solutions, and practical support, that consent be properly informed (including full information on risks) and that a “cooling off period” be required so that women have time to reflect
What is the public view?
The same survey found that 57% would oppose permitting early abortion with authorisation from one doctor only and 68% were opposed to nurses performing abortions.
In every case the proportion was higher among women than men.
This survey was conducted before the publication of the latest abortion statistics which showed a further alarming rise - particularly among the young and including a rise of 21% in abortions for girls under 14.
Have any amendments been tabled which are designed to protect unborn life and help women avoid abortion?
Yes. These include amendments to
- restrict abortions over 24 weeks
- reduce the time limit for most abortions from 24 to 20 weeks
- require the expeditious provision of counselling and information on the risks of abortion and sources of support prior to abortion
- require that where the abortion is on mental health grounds (almost all) one of the doctors certifying must have the mental health training and expertise necessary to assess that the risk to the woman’s mental health is genuine and serious.
Please seek support for any amendment which would help to make abortion rarer or help women avoid abortion and provide them with ongoing support. But Parliamentarians should ensure that amendments, however well intentioned, do not have the unintended consequence of increasing pressure on women to decide swiftly when what is required is sufficient time to fully investigate other options and reflect.
Abortion in Northern Ireland
Northern Ireland has always been exempted from the 1967 Abortion Act. Abortion is only permitted to protect the woman from death or real and serious injury to the woman’s physical or mental health. An amendment has now been tabled which would fully extend the Act to Northern Ireland. None of those tabling the amendment represents a NI constituency.
The people of Northern Ireland of all political and religious persuasions and their elected representatives have consistently and firmly opposed the legalisation of abortion and successive UK Governments have provided assurances that they would not legalise abortion against their wishes. The case against this amendment is further strengthened by the commitments under the peace agreement which will see abortion law eventually become the responsibility of the Northern Ireland Assembly. This is already written into legislation. The Government should, therefore, be urged to follow the precedent set in 1990 (prior even to the peace agreement) and call upon its members to oppose this amendment
Someone has started a petition on the Downing Street e-petitions page opposing the extension of the 1967 Act to NI. It is just kicking off and currently has 55 signatures.
You will find it here:
Please sign it and spread the word.
PS (A petition that supports the extension of the ’67 Act to Northern Ireland currently has over 600 signatures.)
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