Management of late gestation abortion of concern in Birmingham Women’s NHS Foundation Trust

Sean Murphy*

According to an inspection report of the Birmingham Women’s National Health Service Foundation Trust, the facility did not consistently provide women seeking abortion with information to prepare them for the possibility of the survival of an infant following a late gestation abortion, including the need to notify the coroner should the infant die. (p. 4, 15)  Apparently the outpatients’ clinic provided patients with this information verbally. (p. 16)

The effect of late term abortions on staff and patients is described as “distressing,”  one of the risks in need of identification, monitoring and mitigation(p.6).  Ward staff felt unprepared to respond to late term abortions involving the survival of an infant (p. 6), several complaining that they “had not received training that would equip them to deal with the physical and emotional aspects of advanced gestation abortions.” (p. 15, 18)

One issue was the need to develop “differential care pathways,” apparently related to decisions about how to manage a surviving or deceased infant based on the reason for the abortion. (p. 16)

Staff involved in what the report describes as a “new complex termination of pregnancy service” were not adequately prepared or engaged before it began, and “continued to express concerns” over a year after its introduction.  Staff had been allowed to opt out of the service, but several (apparently among those who remained) complained about “distress to women and how they felt ill prepared to care for them.” (p. 31)

The report also states, without explanation, “The trust must ensure all HSA1 certificates for termination of pregnancy are fully completed by the registered medical practitioners signing them.” (p. 34)  This may reflect a continuing problem with certification by physicians of the need for abortions, which is a legal requirement.  Among problems previously identified was the practice of signing the forms in advance without actually seeing a patient.

These elements of the report illustrate the practical realities that inform the decisions of some health care personnel who refuse to provide or participate in abortion.




Ontario adds wording to legislation recognizing conscience rights of hospitals

Toronto Sun

Liz Payne

The Ontario government has quietly amended its proposed Patients First Act with wording that appears to strengthen the rights of faith-based hospitals to opt out of assisted death.

The proposed amendment, which was not originally in the act, appeared when it was re-tabled last month after the legislature was prorogued. The act, according to the province, is aimed at improving health care for patients and their families. . . [Full text]

‘Freedom of conscience’ a must, says doctor

Catholic Register

Michael Swan

TORONTO – It’s rare for an hour-long, academic lecture to get a standing ovation, but Dr. Ewan Goligher earned thunderous applause from about 100 people who turned up on a cold, rainy night to hear his defence of medical conscience.

The Toronto intensive care physician and researcher has become one of the leading voices opposing efforts to force doctors to make an “effective referral” for assisted suicide.

Goligher maintains that for the sake of medicine and democratic society, doctors must have a right to conscientious objection — not just for abortion but also for assisted killing.

“Freedom of conscience in the practice of medicine has been seriously eroded in recent years,” Goligher warned at the second annual deVeber Institute lecture delivered at the University of Toronto’s Wycliffe College on Oct. 27. . . [Full text]