Binning R, Miller JC, Chisholm NA.
Attitudes to abortion (Letters). Br Med J. 1974 May 25; 2(5916): 441.
Rex Binning, J.C. Miller, N.A. Chisholm
- Binning: You have been taken to task by a number of correspondents (4 May, p. 276; 11 May, p. 329) concerning your leading article "Attitudes to Abortion" (13 April, p. 69). They are mainly concerned with only one emotive aspect of the problem. There are others. . .
- Miller: I am sure that there are many doctors who share my great anxiety for the future of gynaecological departments and even possibly for the Royal College of Obstetricians and Gynaecologists itself if the Lane Report is accepted by the Government and implemented.For doctors generally it would mean that there could be no prospect of specializing in gynaecology for Roman Catholics or for those who hold similar views on the subject of abortion. . .
- Chisholm: Professor H. C. McLaren (11 May, p. 329) is surely overstating his case when he tries to imply any parallel between the state atrocities of the Nazis and official recognition here of the reality of the need for abortion and the essentially humanitarian nature of the service it provides when abortion is inevitable. Conscience must be seen to have its positive face. The "conscience clause" cannot be regarded as merely a negative one allowing only the right of abstention from helping the distressed. . . .
Attitudes to abortion
(Letter). Br Med J.
1974 May 18;
- Your are right to emphasize, in your comments on the report of the
Lane Com mittee (13 April, p. 69), that doctors should exercise a
humanitarian approach to women seeking advice within the terms of the
Abortion Act. But it is not a new situation for doctors to be required to
treat illness or injury which has resulted from human folly. Road
traffic accidents and voisoning have a much higher mortality and
morbidity among women of childbearing age than pregnancy and its
sequelae. . .
- Jane Doe is in the first trimester of pregnancy. She has consulted
her doctor who agrees that she needs an abortion. Jane Doe's doctor
judges that he can safely perform the abortion only in a hospital,
but the hospitals where he practices will not allow him to use their
facilities for the abortion. Jane Doe and her doctor apply for an
injunction to require Bellin Memorial Hospital, a private sectarian
hospital, to provide its facilities for the abortion. The hospital
has received Hill-Burton funding' and is subject to state
regulations. . .
Eugene L. Berl
- . . . While Roe and Doe guarantee a woman's right to choose to
terminate her pregnancy free of state interference within the
guidelines set by the Court, they do not guarantee her an absolute
right to an abortion. To the extent that states do not subsidize
abortions, a woman's ability to obtain an abortion is limited by her
ability to pay.6 Financial considerations aside, the freedom from
state interference is of little consequence unless facilities
suitable for the performance of abortions are located within a
reasonable distance of the woman's place of residence and are willing to
perform such operations.7 The Court's abortion decisions do not require
the states to provide abortion facilities. States need only refrain
from "interfering" with a woman's decision to obtain an abortion
before their interest in maternal health or unborn life becomes
compelling. . .
Attitudes to abortion.
Br Med J.
1974 April 13;
- Pressure groups supporting one or
other attitude to abortion have given doctors and the public little
peace since the first drafts of the Abortion Bill appeared nearly ten
years ago. Perhaps the most useful result of the exhaustive inquiry
by the Lane Committee published last week could be the fading away
of so much shrill and emotional argument, for it is now clear that no
major change will be made in abortion law in Britain in the
foreseeable future. The report is not a whitewashing exercise,
however; while the legal changes it recommends are relatively minor
(see p. 128) it calls for changes inattitude that are much more
fundamental. . .
Denis J. Horan
- The abortion controversy is currently in the coercive stage. The hard
core proponents of legalized abortion are now busy opposing
abortion'legislation that keeps abortion in the criminal code, or that
seeks to regulate abortion other than through the medical practice act.
Their aim is the psychological satisfaction of making abortion not only
legal, but morally acceptable to all but the cranky Catholics. Part of
the plan includes opposition of conscience clauses. Obviously this latter
stance smacks of a betrayal of their promise that their wish was only
freedom now, and thus they are somewhat at a disadvantage before the
courts, at least as far as the conscience clause is concerned. . .
Hypher TJ, Gill CGE, Rawson P.
Attitudes to abortion
(Letters). Br Med J.
1974 May 25;
T. J. Hypher, C.E.G. Gill, P. Rawson
- Hypher: Your leading article (13 April, p. 69) is indeed disturbing,
for its attitude is one of uncritical approval of insidious value changes.
It accepts unquestioningly that . . . priority in certain appointments will
go to those who see abortion as properly part of clinical gynaecological
practice and that a young doctor may find difficulty in taking up a career
in gynaecology if he is fundamentally opposed on ethical grounds to
abortion. . .
- Gill: If, as you surmise
(leading article, 13 April, p. 69), despite the "shrill and emotional
argument" of pressure groups" abortion for a wide range of indications is
. . . now an established part of conventional medical practice,"
nevertheless some provision should be made in British medicine for dedicated
aspirants to gynaecological and obstetric practice who can never take
part in an abortion programme. . .
- Rawson: I was truly appalled by your
irresponsible leading article (13 April, p. 69). By its very terms of
reference the Lane Committee was care fully emasculated beforehand so
that, what ever the findings, there would be no mention of the real
result of the Abortion Act-namely, the wholesale destruction of human lives,
nearly 400 a day . . .
McLaren HC, Scott JS, Miller IM, Nolan JR. Jenkins DM.
Attitudes to abortion
(Letters). BMJ 1974 May 11;2(5914):329-330 PMID:11664331
Hugh Cameron McLaren, J.S. Scott, Ita M. Miller, J.R. Nolan, David M.
- McLaren: . . . Already the Department of Health and Social Security has chits
to be handed to prospective consultants called "job descriptions"
which, of course, require a prospective consultant to abort. The
Guardian this month also spelt out the warning to trainee consultants in
stating that the committee recommended "a more careful watch by
hospital authorities on the religious beliefs and ethics of
gynaecologists when making consultant appointments.". . .
- Scott: In your leading article "Attitudes to Abortion" (13 April,
p. 69) you sadly misunderstand the present situation. The Lane
Conmittee which has recently reported was precluded by its terms of
reference from considering the underlying principles behind the
Abortion Act-rather in the position of a group inquiring into the
Factory Act of 1833 but excluded from considering the principle of
child labour. . .
- Miller: It is hardly surprising that the Lane Committee found
regional disparities in the number of abortions carried out within the
N.H.S. The number of abortions in any individual centre must be inversely
proportional to the number of doctors with conscientious objections to
performing the procedure. . .
- Nolan: In your leading article (13 April, p. 69) you state that
"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." How has the situation changed? . . .
- Jenkins: In your leading article (13 April, p. 69) you report that the
Lane Commmittee "clearly understood the dislike felt by many doctors
and nurses for abortion procedures and sympathized with it" and you
continue "abortion is indeed distasteful to many people." However, you
feel that though "a conscience clause was manifestly essential when
the Act came in ... seven years later the situation has changed." You do
not consider it important to ask why this antipathy exists. . .
Martin F. McKernan
- I'd like to talk about four areas: the first is the New Jersey case,
Doe v. Bridgeton Hospital Association,' the second is an analysis of the
twin opinions of the Supreme Court in Roe v. Wade2 and Doe v. Bolton,3
vis-dvis the compulsion of health care facilities to provide abortion
services, the third is the concept of state action in this particular
area, and the fourth is a suggestive preventive matter for health care
facilities which desire not to permit the performance of elective
abortions. . .
Joseph J. Minattur
Michael Morris, P. Golding
- Morris: Your leading article (13 April, p. 69) is a sad reflection of
the confused thinking in current medical and national ethics. From
the time of Hippocrates until 1967 abortion was unaceptable to the
majority of doctors. You admit yourself that it "is indeed distasteful
to many people" (you do not suggest why this should be). . .
- Golding: In your leading article (13 April, p. 69) on the Lane
Committee Report you state: "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." . .
Joan Mahoney Neff
- . . . This legislation was presumably intended to allow medical
professions to act in accordance with their conscience and without fear of reprisals.
Few people would disagree with the protection of the right to conscience,
especially with regard to a topic as controversial as abortion. However,
problems arise when one person's right to conscience interferes with the
exercise of another person's constitutional rights. It seems obvious that
a doctor or nurse should not be forced to perform an abortion. But if all
the nurses or doctors in a public hospital avail themselves of their
right to conscience, the women unable to afford private hospitals will be
unable to avail themselves of their right to terminate a pregnancy. . .
Nancy B. Shuger
John Stallworthy, Madeleine Simms
- Stallworthy: The light is amber and may soon be red. It is sad
to read in a leading article (13 April, p. 69) in a responsible journal
with a world-wide distribution that conscience which "was manifestly
essential" in 1967 to the clinical application of the Abortion Act is
no longer just as important. . .
- Simms: Like Professors H. C. McLaren and J. S. Scott (11 May, p.
329), the Nazis thoroughly disapproved of abortion and were
determined to stamp it out. Consequently, one of the first laws they
passed when they came to power in Germany in 1933 was one increasing
the penalties against abortion. . .
Margaret S. White
- Miss Madeleine Simms, having bracketed by implication Professors H. C.
McLaren and J. S. Scott with the Nazis (1 June, p. 501), proceeds to make
a series of statements which have little relation to the truth. Let
us consider the facts: Among the first Acts the Nazis passed was one
permitting mass sterilization of the congenitally abnormal. This was
subsequently expanded by scret decrees which permitted the abortion,
sterilization, and liquidation of the Jews and the Reich's other
"enemies." . . .
Becker W. Schwest [Duty to loyalty and conscience] Rev 1972 Oct
[Article in German] PMID: 4485498
Mildner T. [A question of conscience for
Maimonides] Med Klin 1972 Aug 25;67(34):1091-3 [Article in German] Publication Types: Biography
Historical Article Personal Name as Subject: Maimonides PMID: 4561058
Issues of conscience. Am J Nurs 1972 Jan;72(1):61 PMID:
Thelma M. Schorr
- A nurse called us recently to say she had accompanied a patient who
was admitted to a small private New York hospital for an abortion. "I
was appalled and ashamed," she said, "to see how some of the nurses
treated those kids, many of them only 14 or 15 years old, from all over
the country. It was like Bedlam. They were herded like cattle, given no
counseling, no support at a time of such crisis in their young lives." . . .
- The injustice caused to patients by the
present interpretation of the abortion law has been brought to the
attention of the profession and the public. However, the injustice
inflicted on a minority of the profession has been given scant attention.
In the eight years since graduating from a London teaching hospital I
have managed to do the "right jobs," get the required fellowship and
membership, and even obtained the B.T.A. (Been To America). However, I
now discover that to have a conscientious objection to abortion on demand
precludes one from continuing to practise in the specialty in this
country. . .
[The prolonged pain of moral conscience after an euthanasia during Hitlerian
persecutions.] Ann Med Psychol (Paris) 1971 Mar;1(3):405-7 (Medicolegal study) [Article in French] PMID: 5558673
Conor J. Carr
- As one who left Britain after training there as a gynaecologist, I
read with interest the letters of Mr. C. K. Vartan (26 June, p. 767)
and the replies (10 July, p. 108). Having been a senior registrar in
Oxford, I can substantiate Professor J. A. Stallworthy's statement (10
July, p. 108) that it is possible for men to work in his department
without having to perform duties contrary to their conscience. However,
it was noticeable that all three replies came from teaching units,
where the staffing is such that the presence of one or two people with
religious convictions against abortion does not put an undue amount of
work on one or two other individuals. . .
- Mr. C. K. Vartan's question (26 June, p. 767) "should not those who
will not terminate train for some other branch of medicine?" carries
serious implications for doctors and society. Uniformity of practice
would be administratively convenient but man's right to live and work
according to the dictates of conscience is an asset precious to him
and medicine itself. . .