Extract 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.
Extract [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).”
Extract 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.
Extract So the B.M.A., representing most doctors in Britain, had clearly stated its views on the ethics of abortion. Parliament then made it legal for a doctor to terminate pregnancy on wider indications than the B.M.A. thought ethically permissible. Should the Association’s opinions on ethics be altered to bring them into line with the law? Posed with that question last week the Council decided that they should not (Supplement, p. 3), and the Representative Body is to be asked in June to ratify this decision . . . The principle at issue is fundamental if doctors are to preserve their right to call themselves professional men. A profession sets a standard of conduct for its members, and the essence of professional freedom for a doctor is his right to act in professional matters uninfluenced by any considerations other than the judgement of his fellows. Medical ethics are the collective conscience of the profession, and a plea of ” superior orders ” would be a sinister echo of some- thing that ended 20 years ago at Nuremberg.
Abstract Dr. Woolley, referring to the Committee’s recommendation on the ethics of termination of pregnancy, said that Lord Cohen had accepted that the General Medical Council’s rulings had to agree with the law of the land, but he (Dr. Woolley) pointed out that any society was permitted to have its own code and standards, and the B.M.A. was one of those soceties. . . Dr. E. A. GERRARD, Chairman of the B.M.A.’s Committee on Therapeutic Abortion, said that if, as it would seem, the General Medical Council was not the guardian of the ethos of medicine in the matter of abortion, the Ethical Committee’s recommendation, backed by the Council, was the correct one. In other words, the British Medical Association must become the guardian of the ethos of medicine.
Extract That the W.H.O. includes such a phrase [“well-being”] in their definition of mental health does not give it legal validity. Neither does it give it medical sanction, for W.H.O. definitions are notoriously unstable and liable to change, as is evidenced by those on alcoholism and drug addiction. There is no agreement on a definition of ” mental health ” in spite of national associations, institutes, and research funds devoted to its cause.
Extract Under the title of Medical Termination of Pregnancy, this Bill would expose to legal action a surgeon who refused to abort on sound clinical grounds, and therefore in good faith, yet his defence would be stronger if he claimed he refused to abort on grounds of conscience.
Extract It has gradually dawned upon the politicians that a doctor might have objections, and at a very late stage a ” conscience clause” has been included, but only against strong opposition. . . . The clause allows for objection on moral or religious grounds, but how does the doctor stand if he objects on clinical grounds ? As a psychiatrist, patients are referred to me for termination of pregnancy, usually the sole grounds for referral being that the patient is depressed as a result of having an unwanted pregnancy. Many psychiatrists consider that there are no, or virtually no, psychiatric grounds for termination of pregnancy, but how will the psychiatrist stand when the new Bill becomes law ? If he does not consider that there are adequate clinical grounds for termination of pregnancy, is he liable to be sued for negligence? The situation must have no parallel in the whole of the history of medicine, and clarification of the doctor’s position is, in my opinion, urgently needed.
Stanley W. (Correspondence) Abortion Bill. Br Med Journal. 1967 Apr 22;2(5546):247.
Extract I have during recent years encountered two patients who when asked about anxiety recalled abortions that had been carried out 20 or more years before. There are few people so miserable as the childless menopausal woman who bitterly recalls the abortion of her first child. Unfortunately the human conscience has a long memory.
Extract During the whole of that time I have proudly shouldered both the duty and the responsibility of being permitted to carry out any medical or surgical treatment needed by any of my patients, even abortion, albeit this latter only subject to certain reasonable legal safeguards. In fact, I have not carried out a single abortion, or even felt tempted to. Under the proposed Abortion Bill, as I see it, I am summarily to be deprived of this professional right for no fault of mine, and only a limited number of certain doctors are to be designated as having a licence to kill unborn babies. But in an emergency, it seems, my right-and duty-to do the necessary are restored to me. Aren’t we back to ” square one “? What constitutes an emergency ?