1 March 2012

Open letter of support for doctors who provide abortion services

In the face of the Daily Telegraph’s attempt to entrap and discredit a number of doctors who provide abortions, we would like to express our support for all those doctors who are willing to provide abortion referrals in the UK and all health professionals who provide safe abortion services.

We represent pro-choice organisations that have been working for women’s right to safe abortion for many years. We believe that abortion should be available to every woman who requests it, and that the provision of safe, accessible abortion care is a vital element of health care provision.

The Daily Telegraph‘s interpretation of the 1967 Abortion Act is mistaken. The law does not specify that rape is one of the legal grounds for abortion, but a doctor can provide a referral for abortion if a pregnancy results from rape. Similarly, abortion on grounds of sex selection is neither legal nor illegal in itself. [1] Under the 1967 Abortion Act, it is the effect of the pregnancy on a woman’s health, mental health and life that must be taken into account to determine whether or not she has grounds for abortion. Doctors are not given a shopping list of specific grounds for which abortion is allowed or not allowed. Rather, the law gives doctors the responsibility to decide whether the risk of continuing the pregnancy to the woman’s health and mental health is greater than if the pregnancy were terminated. In making this judgement, doctors are directed by the law to take into account the woman’s personal circumstances. These include, for example, her age, her being unemployed or on low pay, or trying to complete her education, or being single, or having other small children to care for, or feeling strongly that she simply cannot cope with a baby (or another baby) at this particular time because of the negative impact it would have on her life, or because she has fears about the outcome and/or life chances of the child if it were born. The law further allows doctors to authorise an abortion if there is a risk to the woman’s existing children of continuing the pregnancy, or if there is a risk of serious abnormality in the fetus if the pregnancy were to go to term.

The 1967 Abortion Act gave doctors the responsibility for authorising abortions in the belief that women could not be trusted to take this decision for themselves. Yet today, it is clear that women who have babies and women who have abortions are the same women. Today, most doctors and most people recognise that women themselves do know what is best for their own lives and do take responsible decisions. Hence, most doctors are willing to provide an abortion referral for a woman if she requests it because they understand that continuing an unwanted pregnancy is not good for women or their children, and will almost always cause a woman greater distress than having an abortion.

We believe the 1967 Act is outdated because it puts the onus on doctors to be gatekeepers,  rather than providing women with the right to decide what is best for their own lives. We think that abortion should be available on a woman’s request, and not be governed by criminal statute at all.

We are also opposed to gender discrimination, but sex selective abortion is not gender discrimination. Gender discrimination applies only to living people. A fetus does not have rights in the same way as a living person does, and therefore cannot be said to suffer from discrimination. Gender discrimination has its roots in economic, political, social and religious life; sex selective abortion may be one of the consequences of gender discrimination, but it is not a cause of gender discrimination.

The ‘investigation’ reported by the Daily Telegraph was carried out by unidentified persons in the context of concerted attempts by anti-abortion politicians and anti-abortion activists to discredit and frighten abortion providers by characterising them as unprofessional, greedy and wicked. Yet no evidence exists to support this proposition. Hence, they have stooped to using methods that are closer to entrapment than to any semblance of legitimate investigative journalism.

These methods are highly questionable if not downright unethical. In a video taken without the doctor’s knowledge or consent, a short segment of which was screened on ITV’s Granada Regional News on 23 February, a young doctor says to the bogus patient in front of her: “If you want a termination, you want a termination. That’s my job. That’s all. I don’t ask questions,” while the patient tries to insist on divulging her bogus reasons. This is not evidence of illegal behaviour on the doctor’s part. That this doctor has since been suspended and the police asked to investigate her and others is a travesty of justice.

We would have hoped that pro-choice politicians would stand up for abortion providers, and maybe some still will. However, initial reactions have been hasty and heavy-handed, betraying underlying anti-abortion sentiments. Andrew Lansley, the Health Secretary, who otherwise claims he wants doctors to be in charge of all our health care services, said that doctors would face the “full force” of the law if they break the 1967 Abortion Act. This is hard to swallow, especially considering that many of us hadn’t even been born the last time a doctor had to face the full force of the law in relation to illegal abortion. The Health Secretary should know better than most that the 1967 Abortion Act was formulated precisely to allow doctors to exercise their professional judgement. It is shocking that he would threaten them with prosecution for doing so on such flimsy evidence.

Some politicians, Nadine Dorries, for example, would dearly love to turn the clock back. She must be delighted that the Daily Telegraph has boosted her attempts as a woman to curtail other women’s rights. In her blog on Conservative Home, she went one better than Andrew Lansley and threatened doctors not only with prosecution but with being struck off the medical register. She even mentioned life imprisonment, which is ludicrous, but intimidating nonetheless.

The vast majority of heterosexually active people of reproductive age are currently using a method of contraception to the best of their ability, but one in three women in Britain will have an abortion in her lifetime. We will stand up for doctors and other health professionals who support and are willing to provide safe abortion services. We applaud their commitment in the face of unwarranted harassment and condemnation. Even though the public are periodically showered with disinformation on abortion, every poll and every public debate show that most people in Britain are aware of and support the right to use contraception and the right of women to seek abortion when pregnancy is unwanted. We call on everyone who supports family planning, including safe abortion, to express their appreciation for the health professionals who provide them.

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1 As the Chief Medical Officer explained: ‘Sex selection is not one of the lawful grounds for termination. It is illegal for a practitioner to carry out an abortion for that reason alone, unless the certifying practitioners consider that an abortion was justified in relation to at least one of the section 1(1) grounds’. (CMO/CSA letter gateway ref 17305, 23 February 2012, Abortion Act 1967 (as amended): Termination of Pregnancy)

Signed by the following members of Voice for Choice:

Marge Berer, Editor, Reproductive Health Matters

Jane Fisher, Director, ARC (Antenatal Results and Choices)

Ann Furedi, Chief Executive, and Patricia A Lohr, Medical Director, Bpas

Lisa Hallgarten, consultant

Ann Henderson, Chair, Abortion Rights

Lesley Hoggart, Principal Research Fellow, University of Greenwich

Ellie Lee, Co-ordinator, Pro-Choice Forum

Wendy Savage, on behalf of Doctors for a Woman’s Choice on Abortion

Further reading

Reproductive Health Matters’ blog on sex selection.

Education for Choice’s blog on sex selection

Observer editorial calling for moderation.

Granada Television report and video clip.

One of many Daily Telegraph articles, quoting Lansley

Nadine Dorries Conservative MP’s blog