The law and abortion

The legal criteria surrounding abortion are specific to the country of practice. The abortion legislation in Great Britain is based on the 1967Abortion Act [4] as amended by the Human Fertilisation Embryology Act 1990 [5]. Before an abortion can proceed, a certificate must be signed by two medical practitioners authorizing the abortion and this certificate requires to be retained for a period of at least 3 years. A notification form, which is forwarded to the Chief Medical Officer (CMO) for the relevant country, must be signed by the doctor taking responsibility for the procedure, although with medical termination it is frequently members of the nursing team who administer the drugs which have been preprescribed by the doctor. Most abortions are undertaken on the statutory grounds C or D which state that the pregnancy has not exceeded its 24th week and where continuance of the pregnancy would involve risks greater than if the pregnancy were terminated or injury to the physical or mental health of the women or of the existing children of her family (Table 33.1). It should be noted that the Abortion Act does not apply in Northern Ireland. A judicial review clarify the legal basis for providing terminations in situations to save the life of the mother or to prevent grave permanent injury to her physical or mental health. An appeal hearing on a judicial review in 2004 directed consultation with professionals, relevant agencies and women to provide clarification about state of current practice and provision of abortion services. Findings from the consultation will inform development of guidance materials for professionals about the provision of termination services in Northern Ireland.

Table 33.1 Statutory grounds for termination of pregnancy

A The continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated B The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman

C The pregnancy has not exceeded its 24th week and the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman D The pregnancy has not exceeded its 24th week and the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, or injury to the physical or mental health of the existing child (ren) of the family of the pregnant woman E There is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped F To save the life of the pregnant woman G To prevent grave permanent injury to the physical or mental health of the pregnant woman

Doctors looking after women requesting abortion care should apply principles of good practice as described in the General Medical Council (GMC) document - Duties of a Doctor [6]. There is a conscientious objection clause within the Abortion Act and the British Medical Association (BMA) have produced a useful overview on the legal and ethical position [7]. Where practitioners have a conscientious objection they should provide advice and organize the first steps for arranging an abortion, where the request meets the legal requirements, and this would usually include prompt referral to another doctor as appropriate. Doctors and nurses can refuse to take part in an abortion but cannot refuse to take part in any emergency treatment.

Before an abortion proceeds, a clinician will certainly wish to be certain that all legal statute is fulfilled but it is also important to be sure that a woman has considered all her options carefully and is sure of her decision and gives informed consent. In recent years, sexual and reproductive health services and abortion providers have become more aware of the specific needs of young women and a competent young person can give her own consent, although encouragement is given for the involvement of parents.

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Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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