First things first, let me commend Rhetorically Speaking for delivering this first-class commentary on the moral hypocrisy of the ‘pro-life’ lobbies efforts to advance a case for restrictions on access to abortion:

Edward Leigh decides to kick around Liberal Democrat MP Evan Harris, presumably because it’s easier to attack the opposition than to advance a reasoned argument:

Imagine: in one room the doctor might be advising a young mother on her pregnancy and how to breastfeed her baby, while next door a child is being killed in the womb by the nurse, perhaps herself a mother.

But of course, according to Dr Harris and his supporters that is perfectly all right.

What is remarkable here is that Leigh is convinced that the existence of choices taken by different women (living different lives and faced with different decisions in different circumstances) is not all right. It’s a profound rejection of any form of choice that has little or nothing to do with a desire for a reduction of week limits for abortion, and instead articulates a far more stringent position.

All of which leads RS to the following incisive conclusion:

If you take assume Leigh’s position on abortion (or that of Widdecombe, or Dorries, or the Bishop of Brentwood) – that all human life is sacred from fertilisation onwards – then no level of abortion is acceptable. If it’s not all right for the two women in adjoining rooms in Leigh’s imagined clinic to make different decisions, why not campaign on that basis and demand a total ban on abortion where life is not at risk? Voting for a mere reduction might be tactical, but it’s also entirely hypocritical.

In fact, why stop there? There’s also the tremendous failure to follow through with this moral logic: if abortion is murder, morally speaking, should we prosecute women and doctors for that crime? Or would manslaughter be enough?

Exactly.

Let’s be absolutely clear about one thing from the outset, there is, and has been for well over 20 years at least, one ‘constant’ in the abortion debate and that is that base public support for legal access to abortion services, as measured by opinion polls, surveys and other studies, runs consistently at anything from 65-75%, and you will find this figure coming out of any well-constructed and unbiased poll whether it has been commissioned by the government, by a ‘pro-choice’ organisation or even in polls commissioned by the ‘pro-life’ lobby.

In general terms, the British public have made up their minds on the question of whether or not women should have access to legal abortion services and, regardless of whether they are motivated in this primarily by the view that women have the twin rights of sovereignty and self-determination over their own bodies or take the pragmatic view that legal abortion provision is a ‘necessary evil’ in light of the alternative – a return to illegal ‘backstreet’ abortions, with their attendant horrors – there is no sense in which that basic view is changing for all the efforts of the ‘pro-life’ to advance their agenda. One can argue here, quite reasonably, that ‘pro-lifers’ have long since ‘lost’ the general moral argument on abortion and that their, primarily, religious-inspired view of the issue lacks sufficient traction to swing public opinion around to their side.

The answer to RS’s question, ‘why not campaign on that basis and demand a total ban on abortion where life is not at risk?’ is a simple one. They don’t (for the most part) campaign for a total ban on abortion, at least when addressing their efforts towards parliament, because they know that their position doesn’t not have public support – what they do, instead, is focus on a limited range of ‘wedge’ issues by means of which they hope to subject the current abortion law to a form of ‘death by a thousand cuts’.

This we know perfectly well and, as such, the task for those of who oppose this strategy is a simple one, we need both to counter the ‘pro-life’ lobbies deliberate and conscious efforts to support their agenda with misinformation and rhetorical nonsense and, in doing so, expose to public scrutiny the true nature of their real agenda. That’s certainly been my purpose in writing on this issue on previous occasions and it will continue to be my approach – as long as they keep putting up bad arguments I’ll be more than happy to put a bit of time into knocking those arguments down.

All of which brings me neatly to a campaign website called ‘Passion for Life’, which has been set up by the All Party Parliamentary Pro-Life group and which I happened upon from a link at the end of the same article, by Edward Leigh MP, that RS has already neatly eviscerated, and from there to its page on abortion, which it pretty typical of the kind of disingenuous rubbish that this group, and its members, routinely peddle and, which, as you might well expect, is about the get the ‘full treatment’:

More abortion?

How many abortions currently take place?

There are approximately 200,000 abortions in the UK every year – that’s not far off 600 every single day!

Right from the off, the line that’s being peddled here is that there are ‘TOO MANY ABORTIONS’ – which is a view that is logically sustainable only if one starts from a position in which you believe that their should be either no legal right to access abortion services or that access to such services should be severely curtailed and permitted only where continuation of a pregnancy constitutes a clear and present risk to the life of the pregnant woman.

Unless one takes just such a draconian view then one simply cannot argue that there are too many abortions or put a figure on what might reasonably be considered the right number of abortions – there will be, and are, as many abortions taking place each year as there are women who need an abortion, whatever their reasoning behind such a decision might be. What can be argued, quite reasonably, is that there are too many unwanted pregnancies each year and this accounts both for the number of abortions that take place and indicates clearly where we should be focussing our attention – the way to reduce the number of abortions is to reduce the number of unwanted pregnancies NOT restrict access to abortion, all the latter will succeed in doing is turning a number of these unwanted pregnancies into unwanted children.

80% of people in recent surveys believe that the Government should be looking at ways to make abortion rarer, not easier.

That’s a lovely semantic non sequitur, isn’t it?

The opposite of making something rarer is making it more common, not making it easier and the simple fact is that if one makes abortion services easier to access within the current legal limits on when, in terms of the duration of a pregnancy, it in no sense follows that that will result automatically in an increase in the number of abortions – the latter is a function of the number of unwanted pregnancies and not of the availability of abortion services or the relative ease with which such services can be accessed. It is perfectly possible both to make access to abortion easier and reduce the overall number of abortions – one simply has to reduce the number of unwanted pregnancies.

What changes are likely to be called for?

It is almost certain that some MPs will try and get the law changed by putting amendments to the abortion act as part of this HFE bill. This can be done because it is what happened when the original HFE bill was introduced in 1990.
Those amendments are likely to propose;

• Dropping the requirement for two doctors’ signatures to certify abortion

And this is, what? A good thing or a bad thing?

The site doesn’t say, although one presumes that they are against relaxing this requirement, and a reading of the Science and Technology Committee’s report on this aspect of current abortion law is far from illuminating:

85. A range of explanations have been given for the introduction of the requirement for two doctors signatures:

to ensure that the provisions in the legislation were being observed ;

to protect women;

to protect doctors from breaking the law ;

to demonstrate the medico-legal concerns of Parliament, namely that the 1967 Act did not make abortion legal but conferred upon doctors a defence against illegality – the
two doctors are expected to police each other;

to show the seriousness of the decision to terminate; and

to appease the pro-life lobby.

In the same report, so far as arguments for retaining the ‘two signatures’ requirement go, the only one the committee consider worth mentioning is this one:

96. Abortion is not like other kinds of procedures. The Society for the Protection of Unborn Children (SPUC) points out that abortions are typically performed on healthy women and foetuses, and Rev Dr Peter Fleming, from SPUC, told us that:

This is a particular kind of procedure. You are talking about a medical procedure often being prescribed for a social reason or a psychiatric reason and that is highly unusual in medicine. Usually a medical procedure is done for a medical reason. This is not being done for a medical reason and in that case, if the professed reason initially is a psychiatric indication you would think that somebody who has psychiatric expertise would be able to do it.

Prescribing medical procedures for social/psychiatric reasons is hardly that unusual these days – what is cosmetic surgery if its not a medical procedure that is carried out for social/psychiatric reasons.

That said, the real problem here is that of the over-medicalisation of the process.

Yes, the vast majority of abortions are carried out for fundamentally social reasons, reasons that have little or nothing to do with any direct substantive risks to the physical or psychological well-being of the majority of women who do use abortion services. You know it. I know it. The government knows it – and the general public knows it… and support for legal access to abortion services still runs, as I’ve already said, at a solid 65-75% of the adult population.

Yes, its also true that there have to be safeguards within the system, both clinical safeguards – the one overriding reason why at least one doctor should be required to sign off on abortion is stupidly obvious, if they do nothing else they need to ensure that the woman is medically fit to undergo the procedure itself – and social safeguards of a kind that seek, as far as is possible, to ensure that the decision to go ahead with an abortion is taken under the woman’s own volition and on the basis of informed consent.

What is, however, not at all clear is why there should be a requirement for a second opinion on all such decisions – notwithstanding the assertion that abortions are qualitatively ‘different’ to other medical procedures, the argument provided by SPUC is not justification for a requirement that two doctors should sign off on all abortions its simply an argument that doctors should employ sound clinical judgement in determining whether there are grounds for seeking a second opinion, particularly a psychiatric opinion.

The distinction here is an important one. We know that in the vast majority of cases abortions are carried out for social reasons and not because there is clear clinical evidence to show that continuation of a pregnancy would actually place women at a significant risk of either physical or psychological harm, i.e. that the legal grounds under which these are conducted (and recorded) are, in reality, nothing more than a medico-legal artifice. In such cases, what needs to be established for the abortion to go ahead is only that the woman seeking the abortion is medically fit to undergo the procedure and that she is making her decision of her own volition under conditions of informed consent. The first condition is one that a competent doctor is, of course, entirely qualified to render judgement on, the second condition is one that could be assessed by someone other than a doctor, a counsellor for example, but which its also generally considered that a doctor is sufficiently competent to assess without the requirement for a second opinion.

Where a second opinion would reasonably be called for here is not where a women simply cites psychological grounds as the legal grounds for abortion, as I’ve already noted in the majority of cases this is not more than a medico-legal artifice, but where a doctor considers, from talking to the woman and based on their knowledge and understanding of her clinical history, that there may be a significant risk to the woman’s long-term well-being should the abortion go ahead or suspects that the woman may not be capable of (or be) acting of her own volition and making her decision under conditions of informed consent. What is under consideration, therefore, is not whether there may be psychological grounds which justify an abortion going ahead but whether there may be reasonable grounds to deny access to abortion by reason of duress/lack of capacity to consent or because of undue risk to the women’s health and well-being – and that is a very different thing, indeed, from what is currently set out in law.

Not only is there a clear argument for removing the requirement for two signatures, and a second opinion in cases where there are no significant long-term risks to health or concerns as capacity and consent but there is, even in the argument put forward by SPUC, a ‘pro-life’ organisation – a very clear and obvious argument for the ‘de-medicalisation’ of the vast bulk of abortions, i.e. for permitting abortions to be carried out, in law, on the basis of purely social grounds.

Regardless of the issue of whether the requirement for two signatures in all cases results in undue, unnecessary and unhelpful delays in obtaining access to abortion services, what is clear here is that the law as stands, specifically the manner in which its set out the legal grounds for abortion, is massively out of step with reality and needs, therefore, to be altered to more accurately acknowledge and reflect the real grounds on which abortions are carried out.

Moving on, the next assertion is utterly tendentious:

• Allowing practitioners who are not medically qualified to perform abortions

The actual proposal is that suitably trained and qualified nurses should be permitted to conduct a limited class of early-stage non-surgical abortions (i.e. those taking place before 9 weeks gestation which use drugs to terminate the pregnancy) which acting under the jurisdiction/supervision of a doctor.

In short, while there is much to debate, in clinical terms, about the advisability of this proposal the manner in which it is presented here, on a website run by a all-party parliamentary group, substantially misrepresents the nature of what is being proposed. It’s scaremongering, and scaremongering of a kind that exhibits a clear contempt for the intelligence of the general public – if you really want to know what some of your elected representative think of you then this is pretty good example.

• Extending the Abortion Act to cover Northern Ireland without a mandate from the people of Northern Ireland or their elected representatives (currently the Abortion Act does not apply in Northern Ireland).

The primary reason why the current Abortion Act does not extend to Northern Ireland is, of course, that religion and religious belief plays a considerably larger part in the public and political culture of the province than it does in the rest of the UK and with that clearly in mind one has to ask how this differs, in principle, from the recent suggestion made by Rowan Williams, the Archbishop of Canterbury, that the law of the United Kingdom should somehow accommodate religious ‘law’ (specifically Shar’ia law, of course) as a form of ‘supplementary jurisdiction’, a suggestion for which the Arch-Bish was roundly and all-too publicly pilloried

Is that not, in principle, exactly the position that currently exists in relation to the Abortion Act and Northern Ireland?

• Removing the right of doctors to conscientiously object to arranging or performing an abortion

So far as I’m aware, no one has suggested that doctor’s should not be permitted to opt-out of performing an abortion as a matter of conscience, not would this be either reasonable or ethical.

That said, doctors do, quote rightly, operate under a clear ethical duty to act in the interests of their patients and that reasonably extends to a requirement that doctors must act upon the legitimately expressed wishes of patients provided that it is legal for them to do so – in short it is a unethical for any doctor to act in such a way as to disregard or act against the legitimately expressed wishes of a patient seeking access to a legal medical procedure as it would be for that same doctor to carry out a medical procedure on a patient without that patient’s consent.

A doctor may reasonably recuse themselves from administering a particular treatment or procedure on grounds of conscience but not from the duty to refer a patient on to another doctor who harbours no such objections and if it is found that some doctors are acting in such a way, if they are responding to a patients’ requesting access to abortion service by actively putting up barriers to such requests then, at the very least, it is a disciplinary matter, if not grounds for a legislative measure that makes it absolutely clear where their duty lies.

Conscience is a basis on which a doctor may decline to personally provide a particular treatment but not one on which they may act to deny a patient access to that treatment from an alternative source – it is a simple and straightforward as that.

At the present time the law allows abortion up to twenty-four weeks. But in some cases it is allowed up to birth, if there is a ‘substantial risk’ that the unborn child is disabled.

This is a complex debate in its own right – one that hinges on the question of how one defines not only ‘substantial risk’ but also what one means by ‘disabled’ – few people, but for the most religiously blinkered in outlook, would argue that it is wrong to abort a foetus, even up to the point of birth, if its discovered that the foetus has a severe and manifestly life-limiting disability – there are simply some genetic disorders you would not wish on even your worst enemy let alone consider it reasonable to prevent a women from aborting a foetus found to have such a disorder.

Where it becomes rather more difficult is when one comes to less severe conditions such as Downes Syndrome, where it is certainly possible for a someone born with that condition to live a full (if typically shortened) and active life – these are difficult questions because what has to be considered is not just the quality of life that the foetus may experience once born in terms of their personal capacities and limitations but also the impact of caring for such an individual may have on their family and how this, in turn, affects the quality of their lives.

The birth of a disabled child may, for some families, prove ultimately to be a rich, reward and life-affirming experience. For other families it may come to destroy the family unit and the lives of those within it and knowing that one cannot, in all conscience, treat the question of whether or not it is right to permit abortions up to the point of birth where there is a significant risk of disability as a matter of crude moral absolutes. To do so is to forfeit not only all claim to the moral superiority of one’s position but to forfeit all claim to humanity – there is something inescapably inhuman in the proposition that one should put abstract and unverifiable beliefs ahead of human considerations of compassion.

What do pro-abortionists believe?

Those who wish to see abortion made easier, say that the child in the womb, particularly in the first eight or nine weeks, is not fully developed therefore is not yet a human baby as it isn’t ‘viable’.

And the reason we say that an embryo isn’t ‘viable’ at eight to nine weeks gestation is easily explained by mere reference to a dictionary:

Viable (adj)…

2.    Physiology.

b. (of a fetus) having reached such a stage of development as to be capable of living, under normal conditions, outside the uterus.

As to the question of whether a foetus is a ‘human baby’ at that stage, that is in itself a complex philosophical question and not one I intend to explore in detail here, suffice to say that no one, however much they support a woman’s right to choice, denies, even at such an early stage in development, that an embryo is biologically human – what is open to question is whether, when and to what extent a foetus acquires notional ‘human rights’ as it develops and, particularly, at what point in its development it may reasonable to suppose that its right to continue its biological development comes to outweigh a women’s right to self-determination and sovereignty over her own body, hence:

They emphasise that it should be the mother who should make the decision as she is most immediately affected, and that she should have freedom of choice.

As noted, there is rather more to this than mere ‘choice’. How one views abortion, if one does not subscribe to an absolute moral position, is of necessity a complex balancing of notional rights, one that is inextricably bound up in questions of what it is and what it means to be human.

They sometimes allege that opposition to abortion is purely a matter of religious belief and that this should not be imposed upon others.

There are some who arrive at a moral objection to abortion by routes other than religion, true, but this in no way should obscure the fact that in the vast majority of cases it is religion which forms of the basis of individual and collective objections to abortion. However, how one arrives at such a view is a much less important question than that of what one does with one’s view once one arrives at them and it here where there is a fundamental difference between the ‘pro-choice’ and ‘pro-life’ outlook.

The pro-choice outlook is one that is fundamentally rooted in and supportive of personal liberty, one that in no material sense impinges on the rights and liberties of those who harbour moral objections to abortion – if you disagree with abortion on moral ground then you are quite within your rights not to have one and no one from the ‘pro-choice’ side is going to tell you otherwise.

By way of complete contrast, the ‘pro-life’ view is, quite obviously, one that is entirely inimical to personal liberty, one that asserts that we are all to live our lives in terms of a moral viewpoint that we don’t all share whether we wish to do so or not, in fact what polls consistently tell us is that a majority of people in this country do not share in this absolutist moral outlook.

Some people argue that access to abortion ought to be recognized as a human right.

Actually, as you may have already figured out, it is self-determination and personal sovereignty that are – rightly – considered human rights, the right of access to abortion is but a by-product of those fundamental rights.

What changes will the P4L campaign be arguing for?

Those MP’s, supportive of the principles of the Passion for Life campaign are likely to put forward proposals which would help to make abortion rarer. These may include;

• Lowering of the twenty-four week upper limit for abortion for social reasons as a result of much clearer evidence now available that a child born at or before 24 weeks has a good chance of survival.

What utter nonsense. Just as making abortion easier to access in no way guarantees that there will be more abortion, so reducing the upper limit for legal, elective, abortions offers no guarantee that it will make abortion ‘rarer’.

And so another set of piss-poor arguments bite the dust – next…