Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude

South African nurse denied position

Theatre Minutes

Kopanong Hospital

Vereeniging, Gauteng, South Africa

Sean Murphy*

Note:  The following minutes were submitted to the South African Parliamentary Portfolio Committee on Health by John J. Smyth, QC, representing Doctors for Life International.  The committee was considering the Choice of Termination of Pregnancy Amendment Bill.  The minutes are notes, not a verbatim recording, so some interpretation is necessary.  The interpretation supplied by the Project (to the right of the minutes below) is subject to correction by participants at the meeting.

Theatre Minutes
Kopanong Hospital,
Vereeniging, Gauteng, South Africa
Theatre Meeting  28 March 2003
Project Interpretation
(Subject to correction by meeting participants)

Mr Mbule (Medical Superintendent): Open meeting with background of T.O.P. e.g. septic abortions etc. Agenda T.O.P.’s

Interpretation: The meeting is about abortion.  The Medical Superintendent opened with background on abortions.

15yrs old  >  ? T.O.P.:
Come back for Ectopic.
Lost the patient – died

Interpretation: A 15 year old patient is believed to have had an abortion, and returned with an ectopic pregnancy, as a result of which she died.1

Marie Stopes: Training in London 2/52

Interpretation: A reference to training in London.  Marie Stopes was a birth control & eugenics advocate who was active in the first half of the twentieth century in the United Kingdom.

Since abortion Legal:
=   ^ Incomplete abortions
= Legal T.O.P.

Interpretation:  Since abortion was legalized, there has been an increase in the number of patients presenting with incomplete abortions.  This increase must be a result of the legalization of abortion.

Definitions: T.O.P.  > Pre-counseling process
> Administration of tablets (oral or vaginal Cytotec)

Interpretation:  Provision of abortion includes the pre-counselling process, in which abortion is put forward as a legitimate medical/moral alternative. It also includes the use of abortifacient drugs like Cytotec.

Question: PV Bleeding is it a Surgical Emergency i.e.

Patient life threatening surgical TOP
Termination of Pregnancy (T.O.P.)

Interpretation:  Is bleeding from the vagina a surgical emergency?  In other words, does it threaten the life of the patient, so that a surgical abortion is necessary to save her life?  Or is surgical abortion just one available treatment, so that an abortion performed would actually be just for the termination of the pregnancy, and not to save the life of the patient?

Sr Charles:  Breaking it down makes it a different story.

Interpretation:  Distinguishing between these two situations leads to different moral conclusions.

Sr Porter (Scrub sister): Ruptured uterus and Evacuations are the same.

Interpretation:  There is no difference between treating a ruptured uterus and evacuating the uterus to treat bleeding from the vagina. The result is the same.

Mr Mbule:  Try to see it as an emergency.



Interpretation:  Sister Charles, even though it may be difficult for you, you should try to see it as an emergency.

Sr Smith (Area Manager):
Everybody does it, often if they don’t like it. What’s good for one – is good for everybody. No religion or moral believe is superior.


Interpretation: Everybody does this, and often they don't like it.  If it's good for one patient (practitioner?), it's good for everybody.  All religions are the same.  No one religion or moral belief is superior to any other.

Sr De Bruin (Chief Assistant Director):Everybody goes through emotional trauma: Personnel from T.O.P. also experiences problems. What happens if there is an emergency and pro-life sister is suppose to be on duty and must then get a substitute?What happens? Who is responsible for death?Discrimination everybody (personnel) must have the same rules.


Interpretation: Abortion causes an emotional trauma for everyone. Hospital personnel also suffer from this. What happens if there is an emergency2 and a pro-life sister is supposed to be on duty and must then get a substitute?  Who is responsible for a death that occurs while she is trying to find one?  To allow special rules for pro-life personnel is discrimination.  Everyone must operate under the same rules. 

Dr Mbule: What is stabilizing a patient? What does it mean?

When somebody is bleeding
What is your treatment? It will not help to only put on a Line: you have to stop Bleeding : The only way is to Evacuate.

Interpretation:  When patient presents with vaginal bleeding and a possibly viable fetus, and a physician says that he will not do a TOP but will stabilize the patient, what does it mean?  When someone is bleeding, what is the treatment?  It will not help to do only a transfusion.  You have to stop the bleeding.  The only way to do this  is to evacuate the uterus.

Sr Neria (Scrub sister:   What is the final answer? Is everybody scrubbing for evacuation now?

Interpretation:  What is our decision?  Is everybody going to assist with abortions?

Sr Smith: Sr Charles will scrub for T.O.P. evacuation.T.O.P. not to be brought under discussion again.

Interpretation:  Like it or not, Sr. Charles will assist with abortions.  This subject will not be discussed again.

Bosman – Area manager
Smith – Theatre in charge
De Bruin – Chief assistant manager




1.  Not clear if this is a criticism of abortion as having led to the ectopic pregnancy, or a criticism of a response to an ectopic pregnancy. [Administrator]

2.  Still undefined in the discussion. [Administrator]