Category: Journal Articles

Outpatient management of first trimester therapeutic abortions with and without tubal ligation

JA Collins, HH Allen, AA Yuzpe

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Abstract
In busy hospitals the increasing numbers of abortions must be performed without disturbing other hospital functions. Local anesthesia, vaginal tubal ligation and the use of outpatient beds are the operative and administrative adaptations described. Of 1545 abortions performed in Victoria Hospital, London, in 1971, 428 (32%) were done under local anesthesia; 14 of these patients also had vaginal tubal ligation under local anesthesia. There were 405 sterilizations (26.2%) among this group of patients, of which 390 (96.3%) were vaginal tubal ligations. Of the total number, 891 (57.7%) were dealt with as outpatients and these comprised 62.0% of patients having therapeutic abortion only, and 46.7% of patients having tubal sterilization as well as abortion.

Collins JA, Allen H, Yuzpe A. Outpatient management of first trimester therapeutic abortions with and without tubal ligation. Can Med Assoc J. 1972 May 20;106():1077-1080.

Impact on hospital practice of liberalizing abortions and female sterilizations

A David Clayman, John R Wakeford, John MM Turner,Brian Hayden

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Abstract
The number of therapeutic abortions performed at the Vancouver General Hospital in 1969 was double the average number for the previous four years and in 1970 the total reached 1465. The more liberal attitude towards abortion has resulted in a decided reduction in the number of children available for adoption in the community. This policy has required a streamlining of the duties of the Therapeutic Abortion Committee and an alteration in the pattern of bed and operating-room utilization. By far the greatest number of abortions were performed on psychiatric-social grounds. The complication rate of 17% was influenced chiefly by the advanced duration of the gestation in a high proportion of cases. Gynecologists and hospitals must be prepared to assume their altered role in providing abortion and sterilization in today’s society.

Clayman AD, Wakeford JR, Turner JMM, Hayden B. Impact on hospital practice of liberalizing abortions and female sterilizations. Can Med Assoc J. 1971 Jul 10;105(1):35-41, 83.

Therapeutic abortion in a Canadian city

RM Boyce, RW Osborn

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Author Summary
In a city of 200,000, 119 therapeutic abortions were performed during the period 1962 to 1968. Multiple grounds were commonly given for abortion; these often included depression. Very frequently the absence of support from other people was a factor in deciding to perform abortion. Only five psychiatrists were involved in 82 cases seen in psychiatric consultation. Abortions carried out for more conventional medical reasons, including rubella, decreased in 1967 and 1968 but there was an overall increase beginning in 1967. In the later years of the study (1967-68) a higher proportion of patients were single, younger, had had no previous pregnancy and were aborted later in pregnancy; more were sterilized. A marked increase in abortion rate related particularly to the activity of one of the psychiatrists. One hundred and sixty-six abortions were performed in 1969; a comparable figure (179) was obtained from one other Canadian centre;another centre had performed more (291); two others, 109 and 63; the combined total for 27 other centres from whom replies were obtained was 186.

Boyce R, Osborn R. Therapeutic abortion in a Canadian city. Can Med Assoc J. 1970;103(5):461-466.

Responsibility and Conscience

Lynne Belaief

Philosophy Today
Philosophy Today

Extract
In philosophical ethics, if one asks the question, is ethics possible, it is inconveniently, and, I will argue, erroneously assumed that he has also raised the notorious problem, what is the definition of “the good”? Various confusions attend the latter inquiry, including the remarkably ambiguous insistence that “the good” cannot be defined – implying that one in fact knew a great deal about its meaning in order to know this. I here intend to reject this typical but inconvenient quest principally because all such initial inquiries into the definition of “the good” are potentially important only within a particular ethical perspective, which is already therefore presupposed as true. The logic and ethical value of that perspective, here named legalistic or authoritarian ethics, is to be contrasted with the perspective called creative ethics, and discarded.

Belaief L. Responsibility and Conscience. Philos Today. 1969;13(1):60-79.

The Abortion Act

T.L.T. Lewis

British Medical Journal, BMJ
British Medical Journal

Extract

The part played by the Royal College of Obstetricians and Gynaecologists in the framing of the Abortion Act is familiar. The College aimed to make it legal to terminate a pregnancy only on medical grounds . . . Moreover, we wished to preserve the right of a doctor to refuse to participate in the treatment of any case to which he had an objection on grounds of conscience: hence the famous “conscience clause.” . . . we did not expect a very great change in practice . . . How wrong we were….

Lewis TLT.  The Abortion Act.  Br Med J. 1969 January 25; 1(5638): 241–242

Abortion law reform: memorandum prepared by a sub-committee of the Medical Women’s Federation

R.E. Bowden, A.M. Pantin

British Medical Journal, BMJ
British Medical Journal

Extract

. . .A Bill seeking to reform the law governing abortion is now in the committee stage. The apparently increasing requests for abortion, the legal anomalies, and the practice of abortion by unskilled persons dictate the presentation of this interim report, despite the present dearth of factual information. . .Matters on which the Committee is Agreed . . . (8) No doctor or patient should be required to act against conscience in this matter of termination of pregnancy. . .

Bowden RE, Pantin AM.  Abortion law reform: memorandum prepared by a sub-committee of the Medical Women’s Federation.  Br Med J. 1966 December 17; 2(5528): 1512–1514

Therapeutic Abortion: Report by the BMA Special Committee

British Medical Association

British Medical Journal, BMJ
British Medical Journal

Extract
The Special Committee of the British Medical Association was appointed by the Council on the instruction of the Representative Body, and first met in November 1965.* Its task was to bring up to date the Association’s earlier report of 1936. At the same time as the Committee began its task the House of Lords gave a second reading to an Abortion Bill promoted by Lord Silkin. The Committee therefore prepared, in January 1966, an interim report in the form of comments upon the clauses of this Bill. Simultaneously it sought information from 22 Commonwealth and foreign medical associations on the state of law and practice obtaining in their countries. The replies received have assisted materially in the preparation of the following definitive report on the legislative aspects of the problem. During the early months of 1966 a number of other important statements have appeared, notably the report of the Council of the Royal College of Obstetricians and Gynaecologists, and these too have been considered.

BMA. Therapeutic Abortion: Report by the BMA Special Committee. Br Med J. 1966;2(5504):40-44.