From triple helix - summer 2010 - Abortion referrals [p21]
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The article summarising four GP members' approaches to abortion 'referrals' (Easter 2010:14-15) stimulated two new contributions and a second bite at the cherry. Philip Davies, an STI training in general practice in Birmingham:More from triple helix: summer 2010
Elections, Christians and the Gospel
The End of Life Assistance (Scotland) Bill
Common call to world mission
The Resistance Campaign
What is the right model of medicine
Is any one of you in trouble? He should pray. (1)
Foundations for Practice - how should Christians teach medicine?
Supporting medical students
Working from home - across the world
Interruptions - how should we respond?
The new atheism
Working from a place of rest
A Different Dream for My Child
Forgiving the impossible?
Growing up ... growing wise
Climate change - debate hots up
Meeting Dr Right part 2
All you need is love
I often look to other Christians both as role models and to seek advice from them. I believe it makes it easier for a Christian GP to make a stand on an ethical issue if many other Christians are taking the same stand. I understand that Christians will disagree on some issues, but abortion should not be one of them. We can make a difference by seeking to love the unborn child.
I was recently shocked to hear that Christian GPs refer patients to abortion clinics to undergo a termination of pregnancy (in medical terminology) or killing of the unborn child (if we want to name sin for what it is). I have always held that abortion is wrong, but have recently come to the decision, after discussion with an older, wiser GP, that it is my duty as a future GP to ensure that I don't make it any easier for a baby to have his or her life ended. This may mean telling a patient that in her case, an abortion is not justified legally, morally or medically. This may mean not telling a patient which colleagues do and do not refer for TOPs (at the same time honouring the GMC's guidance regarding doctor's personal beliefs on the 'right to see another doctor').
I also thought it was wrong ever to write a referral letter to an abortion provider. However, reading your article has changed my mind. The idea of 'referring' to an abortion provider stating that there are no grounds in law for a TOP in this instance is a bold and challenging way of handling a request – this would enable a GP to keep a clear conscience and also challenge the abortion provider's own conscience.
We should be seeking to keep our consciences clear before God, seeking to refuse to participate in evil (eg 1 Thessalonians 5:22) and remembering that we are all personally accountable for our actions. As a junior doctor, I urge more of my seniors to take a stand on this issue.
Salaried GP Jim Newmark, whose initial enquiry stimulated Triple Helix to canvass the views of other GPs, persisted with his supplementary question:
Thanks for allowing me my say. My other point is a plea to Christian colleagues to clarify what the theological (as opposed to practical) difference is between a 'referral' to a colleague and a 'referral' to the hospital? In all the correspondence and discussions I have had the response has always been evasive. And to persist makes the other person characteristically irritable, which is perhaps revealing in itself! This point is alluded to, but not clarified, by Greg Gardner in his statement 'it depends on what your view is of complicity'. Precisely.
I am more than impressed with Mark Houghton's response. A 'referral' letter which effectively states that in his view 'if the abortion is to go ahead it would be illegal' is brave...and startling. I would be fascinated to know what the response has been. This seems to be a completely new take on the subject and deserves much wider publicity in Christian circles. It does the Terms of Service job of putting the woman 'into the process' but also firmly nails the 'referring' doctor's colours to the mast. In addition, by not evoking the wretched conscience clause, it involves no other colleague with all the complications that involves. By doing this Mark is far less complicit (whatever that really means) in the process than anybody who evokes the conscience clause to refer to a colleague and then disappears from sight in a puff of righteous froth.
Hilary Cooling works in sexual health in Bristol and argues that we need more data:
As a statement of scientific fact, Mark Houghton's '...abortion is more dangerous than a delivery' is highly contentious, and deserves a robust reference. He provides only his own submission to the Science and Technology Committee of the House of Commons. This submission itself provides references, but is nowhere near a systematic review. Perhaps he could propose just such a systematic review to the BMJ or another well recognised medical journal? The subject could be 'How does morbidity (physical and psychological/psychiatric) after induced abortion compare with that which follows term pregnancy or spontaneous miscarriage?' It is a subject where the conclusions that people draw continue to be so dependent on their prior position on abortion (pro-choice, pro-life) as to make clarity difficult to achieve. The intellectual integrity of health professionals from any position in the abortion debate deserves to be valued. And this is no more than women affected by abortion deserve, to support respect for their autonomy and wellbeing. Let's all aim for increased intellectual honesty.