Extract Most doctors in practice today can remember when suicide, attempted or completed, was a criminal offence-yet now such a concept seems barbaric. The same incredulity will, surely, soon apply to attempts by the criminal law to control termination of pregnancy in its early weeks. Legal regulation is reasonable later in pregnancy (on the grounds of the duty of the law to respect concepts such as the sanctity of life) but it must be flexible enough to take account of the rapid pace of development in antenatal diagnosis of genetic and developmental disorders.
Extract Abortion for a wide range of indications is, however, now an established part of conventional medical practice in Britain and the committee seemed a little impatient with those who would not recognize that fact. A conscience clause was manifestly essential when the Act came in, since many gynaecologists had sincere moral or ethical objections to abortion on some of the grounds introduced by the new Act. Seven years later the situation has changed. As the committee points out,the number and attitude of gynaecologists are important in determining the level of service which can be provided, so that “it is inevitable that the health authorities should prefer for appointment to certain posts those who see abortion as properly part of clinical gynaecological practice.” What this implies is that a young doctor may find some difficulty in taking up a career in gynaecology in the N.H.S. if he is fundamentally opposed on ethical grounds to abortion in the terms of the Act.
Extract . . .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.
Extract [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.”
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 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.
Extract We have received so many letters on this subject, containing, often, repetitions of arguments already used by other correspondents, that we find it impossible to publish all. We print below abstracts of some of the communications.
The Author of Mona Maclean thinks that not many practitioners of her sex will agree with Miss Kenealy’s views. . . .
Surgeon-Captain O’Callaghan, A.M.S., congratulates Miss Kenealy -on her courage in formulating in written words one of the many questions of conscience that have perplexed many minds. . .
Mr. Lawson Tait (Birmingham), while thinking Miss Kenealy quite wrong in her line of action, finds ” T. C. A.’s” letter inconclusive and not philosophic. . .
E. E. W., writing as a woman, dependent on the honest and straightforward dealing of medical men, asks whether, in the case instanced by Miss Kenealy, it was not wrong to withhold treatment from the mother. . .
Mr. A. G. S. Mahomed (Bournemouth) considers that in the case instanced by her, Miss Kenealy failed in her duty, since, though she thought mercurials would improve the mother’s condition, she failed to prescribe them. . .
Mr. T. E. Constant (Scarborough), writing as one who is not a medical practitioner, is stirred by a perusal of Miss Kenealy’s letter to inquire whether ladies are fit for a profession so severely practical as that of medicine. . .