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Protection of Conscience Project

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Service, not Servitude

1955-1969

 

1969

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

T.L.T. Lewis

  • 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-that is, because of risk to the physical or mental health of the mother, or because of substantial risk that the child would be born deformed. We thought that it was a part of good medicine to take into account the patient's total environment when assessing the risk to her health of the pregnancy continuing. 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 consciencehence the famous "conscience clause." . . .

McRedmond LJ.  The voice of conscience. Ir Med Assoc 1969 May;62(383):189-90 PMID:5770867


1968

Baird D, Crawford JP, Ferguson RS.  Ethics and abortion (Letters). Br Med J. 1968 April 20; 2(5598): 173.

Dugald Baird,  J.P. Crawford, R.S. Ferguson

  • Baird:  I think it most unfortunate that your leading article, Ethics and Abortion (6 April, p. 3), should use such an extravagant and emotionally charged phrase as " sinister echo of something that ended 20 years ago at Nuremberg " in relation to the recent Abortion Act. . .

  • Crawford: As a practising psychiatrist at present who has to face the various dilemmas and new problems in this field so admirably discussed by Sir Roger Ormrod (6 April, p. 7) may I comment on your leading article ? (p. 3). 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). . .

  • Feguson: The word ethics is apparently capable of a number of different interpretations. Your leader writer (6 April, p. 3) uses the arresting phrase, " Medical ethics are the collective conscience of the profession." A generalization of this order makes it obligatory for the profession (B.M.A. ?) to state its moral standpoint. . .

Gerber JC.  A question of conscience. Cathol Nurse 1968 Dec;17(2):23-9 passim. PMID:5188983


1967

Darby P. Abortion and conscience (Letter).  Br Med J. 1967 December 2; 4(5578): 549

Peter Darby

  • Dr. Myre Sim in his letter on. abortion and conscience (4 November, p. 297) complains that doctors have no reliable evidence to guide them in their interpretation of the various clauses of the new Abortion Act. The World Health Organization' defines health as follows: " Health is a state of complete physical, mental, and social well-being' and not merely the absence of disease or infirmity." This definition is surely relevant when one is considering whether or not to advise termination of pregnancy. . .

Fairfield JLD.  Termination of pregnancy bill (Letter).  Br Med J. 1967 January 21; 1(5533): 173

J. Letitia D. Fairfield

  • In view of the approaching reappearance of Mr. Steel's Abortion Law Reform Bill in the House, I would like to draw attention to a very debatable point in the excellent report of the Medical Women's Federation on the Bill (17 December 1966, p. 1512). Their committee gives good reasons for strongly opposing "any rigid codification of indications for terminating pregnancy." . . .

Jolles KE.  Professional freedom threatened.  (Letter) Br Med J. 1967 February 18; 1(5537): 426.

K.E. Jolles

  • I have now spent twenty years in general practice. 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. . . 

Sanderson A.  Abortion and conscience.  Br Med J. 1967 December 9; 4(5579): 621

Alan Sanderson

  • Dr. Myre Sim (4 November, p. 297) exhorts those of us without religious objections to abortion to heed our medical consciences. He is so convinced of the rightness of his views that he brands any doctor who acts differently as lacking in conscience. I do not agree with this assumption. Many highly conscientious doctors favour abortion on social grounds. In the present state of knowledge it is still open to question whether in a particular family the addition of an unwanted child will endanger the health of the other children. . .

Sim M, Lloyd G, Leyton GB.  Abortion Bill (Letters). Br Med J. 1967 May 20; 2(5550): 511

Myre Sim, Gareth Lloyd, G.B. Leyton

  • Sim:  Dr. W. J. Stanley (22 April, p. 247) raises a most important point which has not been sufficiently appreciated by the medical profession. A law which lays down the vaguest criteria for abortion, including the mother's " well-being," and which permits doctors (and presumably nurses) the right to refuse to participate on grounds of conscience makes the decision not to abort on clinical grounds a more actionable one. . .

  • Lloyd:  Dr. W. J. Stanley (22 April, p. 247) raises the question of the legal position of the doctor refusing to accede to the termination of a pregnancy on medical grounds. Let us be clear in our minds that, once the Bill becomes law, any doctor refusing to consider abortion on medical or social grounds could be liable to be prosecuted for negligence. . .

  • Leyton: As a reader of the British Medical 7ournal for more than a quarter of a century I feel compelled to write and say how much I deplore the recent trend in your leading articles of allowing other considerations than the welfare of the patient to influence your reasoning and conclusions. . .

Sim M.  Abortion and conscience (Letter). Br Med J. 1967 November 4; 4(5574): 297.

Myre Sime

  • The Abortion Act has now passed its final stage and is law. Because of the determination of the sponsors to have the law changed before there was a full inquiry into the facts there is still no body of reliable evidence to guide doctors or the public in the interpretation of the various clauses. One point seems clear, and that is the new law will permit a doctor to refuse to recommend or perform an abortion on grounds of conscience. This clause was intended to protect those doctors (and nurses) with strong religious objections to abortion. There are, however, conscientious objections other than religious. . .

Sim M.  Abortion and conscience.  (Letter). Br Med J. 1967 December 16; 4(5580): 684

Myre Sime

  • Dr. P. Darby (2 December, p. 549) puts forward the pregnant woman's " wellbeing " as a medical consideration for abortion. He appears to have forgotten that the " well-being " clause which was included in an earlier stage of the Medical Termination of Pregnancy Bill was withdrawn by its sponsors and is not in the new Abortion Act. That the W.H.O. includes such a phrase 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. . .

Stanley WJ.  Abortion Bill (Letter).  Br Med J. 1967 April 22; 2(5546): 247

  • It appears that, whatever the members of the medical profession feel on the subject, this Bill will shortly become law. Having followed the debates in Parliament one is left with the alarming impression that the protagonists do not have the slightest idea of the serious implications of the Bill, particularly for the medical profession. Until very recently it appears to have been assumed that, provided the grounds for termination of pregnancy laid down in the Bill existed, some doctor would automatically carry out the operation. 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. . .

Thomas JM. Termination of pregnancy bill (Letter). Br Med J. 1967 February 25; 1(5538): 502.

J. Martyn Thomas

  • I wish to support those of my colleagues (28 January, p. 236) who wrote in protest at the rather curt communication which was sent to general practitioners in this area by our three consultant obstetricians stating that they did not recognize either social or psychiatric reasons for termination of pregnancy. It seems to me lamentable that any doctor, in any branch of the profession, should prejudge issues to the extent of refusing to consider cases on their individual merit. . .

Rankin AM, Capper WM. Termination of pregnancy bill (Letters). Br Med J. 1967 February 18; 1(5537): 426.

A.M. Rankin, W.M. Capper

  • Rankin: The B.M.A. Council' was not unanimous in approving the joint B.M.A./ R.C.O.G. report on Mr. Steel's Bill. I for one spoke against and voted against acceptance on precisely the two grounds which Dr. P. A. T. Wood (4 February, p. 299) finds objectionable. . .

  • Capper: Dr. Evelyn Fisher (28 January, p. 236) suggests that the post-abortal guilt complex can be assessed "about six weeks after the abortion." 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. . .

1966

Avellar GR.  Nurses, family planning and conscience. Cathol Nurse 1966 Mar;14(3):38-42  PMID:5182054

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

R.E. Bowden, A.M. Pantin

  • . . .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. . .

 

Brain DM.  Medical issues in abortion law reform. Br Med J. 1966 March 19; 1(5489): 727–729.

D. M. Brain

  • The statement in the leader in the British Medical Journal (5 March, p. 559) that Lord Silkin's Bill on the medical termination of pregnancy was " an example of Parliamentary muddle seldom surpassed" is fully justified. A partial explanation, however, is that a private peer introducing a Bill cannot obtain the help of parliamentary draughtsmen, nor can he get the advice of the Government departments most concerned. He must do the best he can without these aids, and it is generally admitted that Lord Silkin's Bill, as originally introduced, was little more than the embodiment of the aims of the Abortion Law Reform Association. . .

Browne R, Kirk DL. Abortion law reform (Letter).  Br Med J. 1966 June 18; 1(5502): 1541

Robert Browne, David L. Kirk

  • We understand that Mr. David Steel, M.P. for Roxburgh, Selkirk, and Peebles, is to introduce a Bill in the House of Commons to reform the law on abortion.' It will be similar to that already approved by the House of Lords-grounds for legalized abortion being the health of the mother, the results of rape, and the capacity of the mother to care for the child. The B.M.A. has appointed a committee to consider the subject of therapeutic abortion and to prepare a comprehensive report. . .

Campbell J.  Abortion law reform (Letter).  Br Med J. 1966 March 5; 1(5487): 613–614

James Campbell

  • I have read Mr. Wilfrid G. Mills's letter on abortion law reform (5 February, p. 355) with interest, and would like to comment on one statement made in the memorandum. I refer to the assertion that " many gynaecologists feel an instinctive repugnance for the procedure often coupled with some measure of guilt...." I would question the use of the word instinctive, as surely it has now been shown that the human has very little instinctive behaviour, and that in fact he is almost entirely motivated by his cultural conditioning . . .

Clyne DGW.  Abortion law reform (Letter).  Br Med J. 1966 June 11; 1(5501): 1482–1483

D.G. Wilson Clyne

  • In recent weeks there has been a mass of correspondence on this subject, but very little clear thinking, or so it seems to me. A number of contributions, however, merit attention.  First, three important statements were made at the Hastings Centenary Clinical Meeting at Worcester (30 April, p. 1105). Mr. Oswald Lloyd believed that "Many doctors were not clear about the present law on abortion. . . It was enough if he acted in good faith, and similarly any specialist recommending the operation was likewise protected. . . Today there are few cases with physical grounds for therapeutic abortion.". . .

Darby P.  Abortion law reform (Letter).  Br Med J. 1966 February 12; 1(5484): 423

Peter Darby

  • In view of the report which you printed (Supplement, 22 January, p. 19) of the Special Committee on Therapeutic Abortion, the following points may be of interest: (1) The Abortion Law Reform Association strongly opposes any special procedure of notification of medical termination of pregnancy . . .

de Soldenhoff R, Rhodes P, Hewetson SF, Hetherington RJ, Kerslake DM.  Abortion law reform (Letters). Br Med J. 1966 May 7; 1(5496): 1168–1169

Richard de Soldenhoff, Philip Rhodes, S.F. Hewetson, Robert J. Hetherington, D.M. Kerslake

  • de Soldenhoff:  After reading the memorandum on legalized abortion by the council of the Royal College of Obstetricians and Gynaecologists (2 April, p. 850) and also the points put by Lord Brain (19 March, p. 727) and the answer to these by Professor Philip Rhodes, I would like to endorse wholeheartedly the letter which was written by the latter (2 April, p. 859). Without wishing to appear pompous, as a senior obstetrician who has been in charge of an obstetrical service in a large provincial district for 20 years, I think that to bring in legalized abortion would be a terrible mistake. . .

  • Rhodes: I am sorry that Dr. K. S. Jones (23 April, p. 1050) found some of my words potentially offensive. They were not intended to be so, and I agree with him that relations between gynaecologists and psychiatrists should be good, so that patients who need them both shall not suffer. . .

  • Hewetson: I would like to draw attention to two fallacious contentions made by and on behalf of gynaecologists in recent correspondence.  The first is that only gynaecologists can perform abortions, and the second that gynaecologists are the only people in a position to judge the issue in a particular case. . .

  • Hetherington:  The admirable report by the Council of the Royal College (2 April, p. 850) presumes knowledge of the present law, but since Lord Silkin's Bill itself misstates the present law some clarification is needed. . .

  • Kerslake: With regard to the subject of legalized abortion, there are two aspects for decision: (a) what are the indications ? and (b) under what circumstances and with what method is the operation reasonably safe ? The indications may well be considered as social as well as medical. The operation is obviously medical, and here I would cross swords with the Council of the Royal College of Obstetricians and Gynaecologists (2 April, p. 850). . .

Liebeshutetz HJ.  Abortion law refor (Letter).  Br Med J. 1966 May 28; 1(5499): 1359

H.J. Liebeshuetz

  • It is surprising that in the discussion on abortion law reform paediatricians have so far taken only a small part. Yet their work will be profoundly influenced by the change in moral attitudes which is behind the pressure to alter these laws. If it becomes generally accepted that any foetus that has, say, a 20% chance of being abnormal is killed, it may become difficult to defend the preserving of life in very premature babies, where the risk of abnormality is similar. . .

Lushby AF, Jones KS.  Abortion law reform (Letters).  Br Med J. 1966 April 23; 1(5494): 1050

A.F. Lushby, K.S. Jones

  • Lushby:  Following the recent correspondence in the B.M.7., I would like to comment on some of the proposed changes in the law with regard to abortion. I feel that too little respect is being shown to the gynaecologist, who will be the person to perform the operation. The concept of " medical certificates " is distasteful. . .

  • Jones:  Whether or not one agrees with the points made, Professor Philip Rhodes's letter on abortion law reform (2 April, p. 859) is clearly a responsible contribution, and it is therefore particularly unfortunate that the references to psychiatrists in the final paragraph should carry a potentially offensive implication. . .

Marquis RM.  Abortion law reform (Letter).  Br Med J. 1966 April 16; 1(5493): 977

R. M. Marquis

  • I was very interested to read the excellent report on legalized abortion by the Council of the Royal College of Obstetricians and Gynaecologists (2 April, p. 850). TTwo questions, however, arise. . .

McLaren HC, Wright LH.  Therapeutic abortion (Letters).  Br Med J. 1966 July 23; 2(5507): 240

H.C. McLaren, Liam H. Wright

  • McLaren:  The Abortion Law reformers will not be pleased with the moderate proposals put forward by Dr. E. A. Gerrard and his Special Committee (2 July, p. 40), although the proposals will be greeted with relief by most gynaecologists. The recommendations amount to the giving of power over the life of the foetus to two practitioners, one of whom should be a gynaecologist, both, of course, acting in good faith. . .

  • Wright:  Dr. D. G. Withers (16 April, p. 978) questions the right of a gynaecologist to " refuse to do the work he is employed to do on the grounds of moral prejudice." I would question Dr. Withers's knowledge of the current medical status of termination of pregnancy. I would question, too, his use of the words " moral prejudice." . .

Mills W.  Abortion law reform (Letter).  Br Med J. 1966 February 5; 1(5483): 355

Wilfrid Mills

  • The controversy regarding reform of the laws relating to deliberate termination of pregnancy has not yet been resolved within the medical profession, nor does there appear to have been any statement from a body of practising gynaecologists on their personal attitude to this matter. It was in order to test such an opinion that my colleague Mr. G. S. Lester and I circulated the memorandum which appears below to the practising gynaecologists among the Fellows and Members of the Birmingham and Midland Gynaecological and Obstetrical Society asking for their comments. . .

Paintin DB.  Burns R.  Abortion law reform (Letters).  Br Med J. 1966 February 19; 1(5485): 482.

D.B. Paintin, Robert Burns

  • Paintin: Mr. Wilfrid G. Mills was right when he stated (5 February, p. 355) that the present law permits the medical profession to perform all necessary abortions. But I think he was wrong when he inferred that there was no need for reform of the law. . .
  • Burns: Most doctors in the U.K. know that as a result of the large number of resignations from the N.H.S. there will be in the not too distant future an insufficient number of doctors to look after the whole population of this country in the N.H.S. Most doctors also know that an increasing number of patients prefer to have private treatment, and that private medical insurance schemes are being patronized more than ever. It seems reasonable, therefore, to conclude that an increasingly large number of therapeutic abortions will be dealt with privately in the future. . .

Pells D, Diggory P.  Abortion law reform (Letter).  Br Med J. 1966 February 26; 1(5486): 539

Denis Pells Cocks, Peter Diggory

  • Cocks:  As a practising gynaecologist I, like I am sure many of my colleagues, have read accounts of the debate in the House of Lords on Lord Silkin's Abortion Bill (12 February, p. 430) with great interest yet with a good deal of genuine disquiet. Mr. W. G. Mills's letter on abortion law reform (5 February, p. 355) has rightly drawn attention to the fact that the controversy on the deliberate termination of pregnancy has not yet been resolved within the medical profession. . .

  • Diggory: I wish to call attention to a very important and fundamental threat to the liberty of the medical profession which has arisen following amendments to Lord Silkin's Abortion Bill (12 February, p. 430). Lord Dilhome's accepted amendment to Clause 1 now reads that certification of the need for termination of pregnancy has to be made by two doctors who must be "the pregnant woman's regular doctor and a registered medical practitioner employed in a hospital under the N.H.S., or two registered medical practitioners so employed." . .

Potts M.  Abortion law reform (Letter).  Br Med J. 1966 February 12; 1(5484): 422, 423

Malcolm Potts

  • Dr. M. Sim points out (29 January, p. 294) that the report of the B.M.A. Committee on Abortion has been brought forward with " indecent haste " in order to deal with the problems posed by Lord Silkin's Bill. Dr. Sim suggests the B.M.A. should press for delay in legislation on this important subject, and a leading article (29 January, p. 248) makes the same point. I do not think it is right to plead for postponement in a matter which so deeply affects the health of a very large number of women. Abortion is not a new condition like some previously unknown virus or unreported drug reaction. . . .

Rhodes P.  Abortion law reform (Letter). Br Med J. 1966 April 2; 1(5491): 859–860

Philip Rhodes

  • I am grateful to Lord Brain (19 March, p. 727) for putting the points in this matter so clearly. Since you ask for wide discussion I put my personal answers to the questions. . .My answers to the questions are necessarily brief for the considerations of your space. A general comment would be that the law needs reform for the sake of the law and not medicine. I have performed abortions for what I and my colleagues have considered to be good reasons. I do not like to perform the operation, and those who assist me like it even less. . .

Robinson TG, Withers DG.  Abortion law reform (Letters). Br Med J. 1966 April 16; 1(5493): 978

Terence G. Robinson, D.G. Withers

  • Robinson:  I feel myself in broad agreement with the answers given by Mr. Philip Rhodes (2 April, p. 859) to Lord Brain's points, with the exception of his categorical " No " to the question, " Should the fact that a pregnancy is the result of rape be a ground for its legal termination ? " . . .

  • Withers:  With reference to the present discussion on the proposed changes in abortion law, and in particular to the report by the Royal College of Ohstetricians and Gvnaecologiists (2 April, p. 850), I should like to make the following point: Even if more liberal measures were introduced, the individual patient may well be faced with a gynaecologist not prepared to perform the operation because of personal moral misgivings. . .

Scott JT.  Termination of pregnancy bill (Letter).  Br Med J. 1966 December 31; 2(5530): 1654

J.T. Scott

  • The B.M.7. of 17 December shed a welcome ray of hope over what has otherwise seemed a dismal Christmas scene. I refer to the contibutions from the Medical Women's Federation (p. 1512) and Mr. D. Pells Cocks (p. 1531) on abortion law reform. The excellent memorandum of the Medical Women's Federation puts the problem in proper and humane perspective and provides an ideal rallying point for medical opinion. . .

Summary of memorandum by R.M.P.A. Br Med J. 1966 July 2; 2(5504): 44

  • The Royal Medico-Psychological Association issued last month a memorandum on possible changes in the law relating to therapeutic abortion. Emphasizing that it would be opposed to legislation which might bring pressure on an individual doctor to act contrary to his conscience, the memorandum states that the Royal Medico-Psychological Association has approached the problem of therapeutic abortion with the firm view that, in addition to traditionally accepted medical and psychiatric criteria, all social circumstances should be taken into account. If, after considering all these factors, a psychiatrist should form the opinion that the mental health of the mother and the whole family would be promoted by termination, then it should be lawful for him to recommend it.

Taylor RW.  Abortion law reform (Letter).Br Med J. 1966 March 19; 1(5489): 738

R.W. Taylor

  • Mr. James Campbell (5 March, p. 613) makes an important point when he states that the " instinctive repugnance " felt by many gynaecologists for the operation of abortion is a result of our " cultural conditioning." No doubt we could eventually be so conditioned that abortion, or the destruction of any other life too for that matter, gave no concern to our professional consciences. . .

1959

"Jencks and Administrative Proceedings: Conscientious Objectors and Government Employees," Indiana Law Journal: Vol. 34: Iss. 3, Article 4.

  • In this country persons who by reason of religious training and belief conscientiously object to participation in any war are exempted from military service. This immunization, however, is not derived from the constitutional "freedom of religion" right but "arises solely through congressional gTace, in pursuance of a traditional American policy of deference to conscientious objection. ' To understand the problems that arise in this area, it is necessary to be familiar with the procedure by which a person may take advantage of this immunization. . .