Abortion Flashcards
What is the legal criteria to get an abortion?
- The pregnancy has not exceed 24th week and the continuance of the pregnancy would involved risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman
What are the ethical issues around abortion?
- Woman’s rights vs foetus future rights
- Right to autonomy
- Ethically patient should make their own decision, but legally that decision is made by a doctor
- Beneficence and non-malfeasance
- Important she is given support and ability to make her decision
- Safe options for abortion
Scenario - 15 year old wants an abortion, what are some ethical/legal issues?
- Can she consent to intercourse
- Sex under 16 is unlawful, but 13-15 year olds who have consensual sex with someone of similar age are not prosecuted as would be more harmful
- Does she have capacity to consent to treatment
- Is she at risk of exploitation
Scenario - 15 year old wants an abortion, what are some important questions?
- How old is boyfriend
- Was she being forced
- Who has she told
- What support does she have
Scenario - 15 year old wants an abortion, what framework is used to assess competency to consent to treatment?
- Fraser Guidelines, Gillick Competence
- Lord Fraser states that a doctor could proceed to give contraceptive advice and treatment to a girl under 16 provide he is satisfied on the following matters
- Girl understands advice
- He cannot persuade her to inform parents or inform the parents himself
- She is likely to have sexual intercourse with or without contraceptive treatments
- Physical or mental health will suffer without advice
- Her best interest
What are the different abortion options?
- Medical
- Early medical termination of pregnancy
- Can be done at home allowing more privacy
- Risks include heavy bleeding, incomplete procedure, GI upset
- Early medical termination of pregnancy
- Surgical
- Surgical termination of pregnancy under general anaesthetic/manual vacuum aspiration under local anaesthetic
- Less risk, shorter post-procedure bleeding
- Can fit intrauterine contraception immediately
- LA has shorter recovery time but GA is pain free
- Risks are uterine perforation/cervical damage
- Surgical termination of pregnancy under general anaesthetic/manual vacuum aspiration under local anaesthetic
What is an advantage and a risk of a medical abortion?
Advantage - can be done at home allowing more privacy
Risk - heavy bleeding, incomplete procedure, GI upset
What is an advantage and a risk of a surgical abortion?
Advantage - can fit intrauterine contraception immediately
Risk - uterine perforation/cervical damage
Can doctors refuse to see patients who want an abortion if they do not ethically agree with it?
Doctor cannot refuse to see patient is it is not partaking in abortion treatment, rather acute medical care
What is the GMC guidance to conscientious objection?
- Must explain to patients have conscientious objection to procedure
- Give them information to exercise right to see another doctor
- Not express disapproval of patients lifestyle
- If not practical to see another doctor must make sure arrangements are made for another qualified colleague to take over your role
