I am sorry that Dr. K. S. Jones (23 April, p. 1050) found some of my words potentially offensive. They were not intended to be so, and I agree with him that relations between gynaecologists and psychiatrists should be good, so that patients who need them both shall not suffer. . .
Extract No doubt more intensive social facilities would often be welcome, but to suggest that individual workers need to be forced to ” take up their full responsibilities ” is strongly to be deprecated.
Following the recent correspondence in the B.M.7., I would like to comment on some of the proposed changes in the law with regard to abortion. I feel that too little respect is being shown to the gynaecologist, who will be the person to perform the operation. The concept of ” medical certificates ” is distasteful. . .
Extract Parliament must clearly decide whether they are mainly concerned with preventing the birth of defective children or with accommodating pregnant women. If they intend to move further than they have done in Scandinavia and give ” abortion rights ” to women they will have to set up special abortion clinics staffed by ” committed” gynaecologists. . . the profession, for its part, must devise simpler and more effective means of birth control and of sterilization, and perhaps be willing to offer the latter to all women who have had two or more children.
Extract I should like to question the right of a gynaecologist to refuse to do the work he is employed to do on grounds of moral prejudice. What would be the consequence, I wonder, if a surgeon refused to order blood transfusion on the basis of his beliefs as a Jehovah’s Witness ? It is a well-accepted principle of medical ethics that treatment should not depend on race, colour, or creed of patient or doctor. I maintain, therefore, that it is clearly wrong for a person not prepared to perform abortions to follow a profession which requires him to do so.
I was very interested to read the excellent report on legalized abortion by the Council of the Royal College of Obstetricians and Gynaecologists (2 April, p. 850). Two questions, however, arise. . .
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.