I feel myself in broad agreement with the answers given by Mr. Philip Rhodes (2 April, p. 859) to Lord Brain’s points, with the exception of his categorical ” No ” to the question, ” Should the fact that a pregnancy is the result of rape be a ground for its legal termination ? ” . . .I feel that rape per se should be a ground for legal abortion, but at the same time it is important that the flood-gates to abuse should not be opened wide.
I am grateful to Lord Brain (19 March, p. 727) for putting the points in this matter so clearly. Since you ask for wide discussion I put my personal answers to the questions. . . My answers to the questions are necessarily brief for the considerations of your space. A general comment would be that the law needs reform for the sake of the law and not medicine. I have performed abortions for what I and my colleagues have considered to be good reasons. I do not like to perform the operation, and those who assist me like it even less. . .
Extract No doubt we could eventually be so conditioned that abortion, or the destruction of any other life too for that matter, gave no concern to our professional consciences. It is at least debatable whether any such alteration, not to say lowering, of our ethical standards would benefit either our patients or ourselves.
Extract There remain for consideration some general problems to which very little attention has so far been paid. It is necessary to distinguish (1) the law relating to abortion, (2) professional ethics relating to abortion, and (3) individual ethical standards. Hitherto (1) and (2) have coincided, in that an offence against the law relating to abortion has also been treated as an offence against professional ethics. Personal ethical standards, however, may differ from those of the law or of the profession as a whole. If the law is relaxed the General Medical Council will presumably have to consider whether professional ethical standards should be correspondingly relaxed. Individual judgements, however, may well show a much wider range than in the past, when doctors who were not opposed to abortion in principle were usually prepared to accept the standards laid down by the Bourne judgement. . . Doctors will, of course, remain free to exercise their own judgements in these matters, and the same must apply to the nurses and others who have to cooperate with them.
Extract In actual fact we know that many primitive tribes have practised abortion and child destruction for long periods. I suggest that Mr. Mills should examine the cultural origin of his feelings, then perhaps he would come to the conclusion that there are many occasions when termination of pregnancy would prevent many years of suffering, so that neither revulsion nor guilt need be felt.
Extract Nowadays therapeutic abortion is performed relatively rarely for organic disease, and the indications are largely psychiatric with often associated secondary social factors. Whilst some clarification of the old law may be necessary in order that all can understand the situation, we must beware lest in reframing the law this results in the opening of the floodgates in the demand for termination on more liberal grounds.
Extract As you will see this amendment makes a fundamental separation of doctors into two classes, those employed under the N.H.S. in hospitals, and all others. . . it would seem that any fully registered hospital doctor, however junior and in whatever specialty, is able to certify the need for operation, whereas a senior and highly qualified gynaecologist in private practice or possibly just retired from hospital practice would be debarred. . .
Extract It seems reasonable, therefore, to conclude that an increasingly large number of therapeutic abortions will be dealt with privately in the future. I am therefore perturbed that an attempt is being made to limit the activities of medical practitioners who are not in the N.H.S. I refer to the desire of Lord Dilhorne to make it necessary that at least one of the two doctors who will take responsibility for a therapeutic abortion must be in the N.H.S.
Mr. Wilfrid G. Mills was right when he stated (5 February, p. 355) that the present law permits the medical profession to perform all necessary abortions. But I think he was wrong when he inferred that there was no need for reform of the law. . .
. . . Dr. Sim suggests the B.M.A. should press for delay in legislation on this important subject, and a leading article (29 January, p. 248) makes the same point. I do not think it is right to plead for postponement in a matter which so deeply affects the health of a very large number of women. Abortion is not a new condition like some previously unknown virus or unreported drug reaction. . . .
