Protection of Conscience Project Library
Service, not Servitude
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Already we are finding that the impact of the Abortion Act is making great demands on hospital beds and operating time, and we agree wholeheartedly with Mr. Lewis’s statement to the effect that the whole character of the gynaecologist’s outpatient work has altered because of the numerous requests for termination at almost every session.
Soltau D, Baker W. (Correspondence) Abortions and Gynaecological Practice. Br Med J. 1969 Feb 22;1(5642):506-507.
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. . .at the present rate and with no further increase in demand the annual number of abortions in England and Wales would be at least 35,000. He compared this demand with an estimate from the Ministry of Health and Registrar General’s Office of 1,600 therapeutic abortions in 1958 and 2,800 in 1962. The public have thus endorsed the Act and are asking doctors to implement it in a liberal way. . . . It is apparent that the Abortion Act has brought many people what they wanted-namely, a more liberal attitude towards the termination of pregnancy. . . The number of unwanted pregnancies indicated by the latest figures underlines the need for all doctors working in the National Health Service to provide adequate and accurate advice on contraception.
BMJ. (Editorial) Demand for Abortion. Br Med J. 1969;1(5638):199-200.
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[Notes increase in abortion since change in law. Discusses abortion methods.] “In summary, when the decision has been taken to terminate pregnancy it is best carried out in the first fourteen weeks by a conventional one-stage evacuation or by vacuum suction, and later in pregnancy by abdominal hysterotomy. But therapeutic abortion is not a simple operation. Those who would extend the scope of legal abortion on purely social grounds would do well to remember that no method of terminating pregnancy is entirely devoid of risk. The operation is only as safe as the surgeon who performs it. Mishaps will occur, and they will be kept to a minimum only when operations are performed in well-equipped hospitals by skilled gynaecologists who are well aware of the dangers.”
BMJ. (Editorial) Therapeutic Abortion. Br Med J. 1968;4(5634):786-787.
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[suggests] the establishment of abortion clinics staffed by personnel adept at processing all cases referred. Doctors who claim conscientious objection could be assigned compensatory work in the present infertility clinics.
Seed P. (Correspondence) Requests for Abortion. Br Med J. 1968 Aug 24; 3(5616):499.
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patients requesting abortions are taking up considerable outpatient time, sidestepping our long waiting-lists, and occupying valuable hospital beds-all these at the expense of the genuine gynaecological patients. . . At a recent count, one in five of the patients in our wards are cases for termination of pregnancy. Their increasing numbers have been an embarrassment to many medical and nursing staff who have conscientious objections, especially those working in the operating- theatre.
Bagshaw H, Lee T, McAuley J. (Correspondence) Requests for Abortion. Br Med J. 1968;3(5616):499.
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Although the Royal College of Obstetricians and Gynaecologists considers that most cases will be referred to N.H.S. hospitals and will come under the care of consultant gynaecologists, it is nevertheless probable that some will be admitted to ” a place approved for the purpose by the Ministry of Health or the Secretary of State,” and additionally may not come under the care of a trained and experienced obstetrician. Therein to my mind lies a danger to these women, as the numbers seeking abortion continues to increase and as hospital beds become so severely taxed as to necessitate delay in admission. The difference between the risks of the operation in the early weeks and in the weeks between the ninth and the fourteenth is considerable, and after this point an abdominal approach must be considered. . .
For these reasons, in my earlier letter I feared the possibility of panic measures leading to unethical surgery in inadequate surroundings (apart from authorized units) and stressed the need for the hospital consultant to be directly concerned in all cases.
Bailey KV. (Correspondence) Risks of Abortion. Br Med J. 1968;2(5604):557.
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It is difficult for the ordinary doctor like myself to understand the role of the G.M.C. as regards medical ethics. Its change in attitude over abortion would suggest that the law of the land takes precedence over medical ethics, for the present law permits abortion for non-medical reasons. Does this mean that the G.M.C. will maintain only those medical ethics which do not conflict with the law, and that laws permitting euthanasia and sterilization of the unfit would receive similar sanction ? There is surely a conflict here not only between the G.M.C. and individual doctors but between the G.M.C. and those medical ethics which have international recognition..
Sim M. (Correspondence) GMC and Abortion Act, 1967. Br Med J. 1968 May 4;2(5600):298.
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Surely a decision by Parliament in a democracy cannot be described as sinister ” superior orders” echoing Nuremberg 20 years ago (or rather what ended there and then). The boot could be argued to be on the other foot-namely, that doctors are prepared to dictate to the nation.
Crawford J. (Correspondence) Ethics and Abortion. Br Med J. 1968 Apr 20;2(5598):173.
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[Re: comparison of legal dictation of ethical norms to “superior orders” defense at Nuremberg] “It was a plea of ” superior orders ” in justification of a profession changing an ethical rule which we said would be the ” sinister echo ” not the superior orders themselves (in this case the provisions of the Abortion Act).”
BMJ. (Editorial) Ethics and Abortion (Response). Br Med J. 1968;2(5598):173.
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What the Act does is to make clear beyond doubt that termination of pregnancy is legal and that the decision to terminate or not should be left, as far as possible, to the clinical judgement of the doctors concerned, and that in reaching their decision doctors may take into account the effect of the patient’s total environment on her health.
Baird D. (Correspondence) Ethics and Abortion. Br Med J. 1968;2(5598):173.