Conscientious objection and the ‘looming crisis’ in abortion care

A recent survey of medical students in the UK has shown that a number of those questioned would object to providing abortion care in certain circumstances. The survey’s author Sophie Strickland believes these findings have worrying implications for the future of abortion care, with fewer future doctors willing to perform terminations. Indeed the dwindling numbers of doctors opting to train in abortion services has been labelled a ‘crisis’ in terms of women’s access as this article attests.

Dr Patricia Lohr, medical director of BPAS, takes a less pessimistic view of the survey findings:

“Importantly, this study suggests that many students surveyed would perform an abortion in a variety of scenarios. For example, just under 16% stated they would not perform a termination for fetal anomaly under 24 weeks gestation, implying that the majority would perform the procedure if necessary. Similarly, less than one quarter stated they would not perform an abortion before 24 weeks for a contraceptive failure suggesting that three-quarters of those questioned would. More research on the medical student attitudes and knowledge about abortion are clearly needed.”

She notes the importance of education and training in this area:

“It’s extremely important that abortion is included in the medical school curriculum. Medical students may not currently engage much with the reasons why a woman may find herself with an unwanted pregnancy and the decision making process women undertake when determining whether to continue or terminate a pregnancy. Abortion is the most commonly performed gynaecological procedure in the country. Regardless of whether a doctor specialises in this area or not, they will during their career come across many women facing an unintended pregnancy and considering abortion.”

The issue is not just with having fewer doctors willing to perform the procedure but also a lack of wider professional support for women’s right to choose abortion. Similar surveys of GPs have shown that almost a quarter refuse to refer women for abortions. (This form of conscientious objection is protected by the General Medical Council guidelines which state that a doctor has a right to refuse referral but is obliged to pass the patient on to a supportive colleague.)

Some doctors have religious or moral objections to abortion, others simply wish to specialise in areas of medicine with more prestige or social support but clearly there is an issue with the numbers willing to refer for or provide abortion versus the number of women requiring terminations. If we look to the States, where abortion doctors have been harassed and even killed for providing medical services we can see a resistant pro-choice medical movement which refuses to take the stigma and abuse lying down. Groups like Medical Students For Choice have been set up to encourage medical students to engage with the importance of reproductive health care and the potential erosion of vital services. Activist groups like Abortion Gang and I Am Dr Tiller write passionate blogs affirming the essential work abortion providers do. At a time of rising anti-choice sentiment in the UK perhaps it’s time we too started to see this work as not only essential but also laudable.

Myth Busting Monday (aka Tardy Tuesday) – ‘Pro-Life = Pro-Women’

Anti-abortion groups are increasingly employing discourse about women’s health to support their arguments against safe, legal abortion. This blog looks at how anti-choice orgs have moved from focusing on fetal rights to a supposed concern for women’s mental and physical health to bolster their campaigns.

Radio 4’s PM show (listen from 43.15) featured a discussion on leaflets being distributed by anti-abortion organisation The Society for the Protection of Unborn Children (SPUC) to GPs across the country. SPUC claim that over 1,000 GPs have requested their ‘Abortion: Your Right to Know’ leaflets and GP Dr Greg Gardner asserts his reasons for stocking the pamphlets. He claims they provide women with useful information on the ‘possible physical complications’ of abortion including an ‘increased risk of breast cancer’.

Before we move on let’s just have a little mini myth-bust on this claim that women need to know about the increased risks of breast cancer following abortion. The myth that abortion causes breast cancer has been debunked by Cancer Research UK, Breakthrough Breast Cancer and The Royal College of Obstetricians and Gynaecologists (RCOG). Which brings us on to the RCOG. During the radio discussion Dr Gardner claims he requested SPUC leaflets because there is a ‘dearth of accurate information for women considering abortion’ and that they need ‘proper information about potential long-term harms’. He doesn’t seem satisfied by the medical guidance put forward by the RCOG – a body dedicated to women’s health, which, in order to produce guidance for medical professionals and patients assesses and evaluates existing research in each relevant field.

Gardner’s claim that he proffers SPUC leaflets to provide women in his surgery with clinical information is, as Ann Furedi of bpas (also on the show) claims, ‘staggering’. Furedi goes on to make a point we really wish didn’t have to keep being made – that there are two separate discussions to be had here. One about the rights and wrongs of abortion; moral issues such as when life begins which are open to debate, and clinical evidence and information on the physical and psychological risks of abortion. As she points out, this medical information would surely be better obtained from reputable health organisations such as the RCOG rather than a campaigning organisation such as SPUC with a politically motivated agenda.

Clearly SPUC wish to dissuade women from having abortions. They have a right to present the viewpoint that abortion is immoral, or discuss their belief that human life begins at conception. However, we object to any obstacle which stands in the way of women’s access to evidence-based information on their health. When anti-abortion organisations make misleading claims related to medical information, those who support evidence based education and healthcare should be alarmed. When SPUC tell young people in schools that abortion causes breast cancer or infertility, ‘facts’ which hold no weight in the scientific/medical community; or when they use family doctors to relay this message, our ability to make an informed choice is compromised. Why can’t SPUC accept that abortion isn’t going to give a woman breast cancer, or make her infertile without relinquishing the belief that it is wrong?

Transcript of EFC presentation on facts and ethics