Tuesday, 3 May 2016

Time limit for abortion

When I was a medical student in Hong Kong, the legal limit for abortion was 24 weeks unless the mother's health was in danger. I assumed that in UK was similar. As I normally opted out of involving in these procedures, I wasn't really aware of any change in the law. Therefore, I was surprised and outraged when I learnt a few months ago about abortion on Ground E in UK.

The 1967 Abortion Act set a time limit of 28 weeks for abortion. However in 1990, Section 37 of the Human Fertilisation and Embryology Act made changed to the Abortion Act to introduced a time limit of 24 weeks to grounds C and D but removed the time limit on Ground A, B and E. So what are Ground A, B and E?

Ground A is when the woman's life is at risk by continuing the pregnancy. Ground B is when grave permanent injury physically or mentally can result if the pregnancy is continued. Ground E is that the child will suffer physical or mental abnormalities as to be seriously handicapped. However, the law did not give a definition for the phrase 'seriously handicapped'.

For years, babies with cleft lips, spina bifida, Down Syndrome and a range of disabilities were aborted beyond the 24 weeks limit and women were offered abortion as late as 38 weeks or even at term. As the foetus can potentially survive outside womb at this stage, the procedure often involves injecting potassium into the foetus' heart in utero before delivery.

I do not understand how someone can offer to take the life of a baby away when he/she can live a healthy and fulfilled life into the 60's or 70's or has something that is surgically treatable. The 24 weeks limit was set for Grounds C and D because babies can survive outside womb beyond this limit and so are considered viable and hence, they are offered rights to survive. The keywords in Ground E include 'suffer' and 'seriously handicapped'. What is suffering? What is seriously handicapped?

The problem with such loose definition is that over the years, there had been babies being aborted for not really serious disability as most would understand such as cleft lip or club foot. In addition, as long as the doctors acted in good faith, they cannot be prosecuted by law. That means it is difficult to challenge the medical profession. I would like to ask, are all doctors perfect and do doctors know everything?

Although BMA laid out a few factors that should be considered while offering late term abortion in a document, it also immediately quoted the case of Rev Joanna Jepson's case about cleft palate and went on to say that it opposes any tightening of the definition of serious handicap. What message is it sending to the doctors who read the guidance? They can continue to advise women to abort at late term on any disability as no one can challenge that in the court?

As for Ground A and B, in most cases, if the pregnancy is beyond 24 weeks and the mother's life is in danger (e.g. pre-eclampsia or cancer requiring treatment), wouldn't most if not all mothers choose to give birth and hope that the baby will survive with all the help in the neonatal unit? That actually make these grounds unnecessary.

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