Ethics at the Beginning of Life

Question 1

ToP

Answer 1

Termination of Pregnancy

Question 2

State the methods of ToP at < 14 weeks

Answer 2

Surgical : manual/electrical vacuum aspiration

Medical : Mifepristone, followed by misoprostol
(misoprostol can be administered @ home)

Question 3

What is the medical method of ToP ?

Answer 3

Medical : Mifepristone, followed (24-48 hrs later) by misoprostol

Question 4

State the methods of ToP at >= 14 weeks

Answer 4

Surgical : vacuum aspiration or dilation & evacuation (D&E)

Medical : Mifepristone, followed by misoprostol
(misoprostol administered in medical facility)

Question 5

Benefits of medical abortion

Answer 5

Avoids surgery
Mimics miscarriage

Controlled by the woman ad can take place at home (<9 weeks)

Question 6

Cons of medical abortion

Answer 6

May require more clinical visits than surgical abortion

Women may experience bleeding and cramping, and potential other side effects

Takes time to complete abortion (timing may not be predictable)

Question 7

Benefits of surgical abortion

Answer 7

Quick procedure

Complete abortion is verified by evaluation of aspirated products of conception.

Takes place in a healthcare facility

IUD may be performed at the same time

Question 8

Cons of surgical abortion

Answer 8

Requires instrumentation of the uterus

Small risk of uterine/cervical injury

Timing of abortion is controlled by facility and provider.

Question 9

Outline key statistics relating to termination of pregnancy in England & Wales

Answer 9

Over 200,000 abortions - 18.6 per 1,000 women

89% under 10 weeks
87% medically induced

98% for reason (1a), 1.6% for reason (1d)

Question 10

Outline key statistics relating to termination of pregnancy in Scotland

Answer 10

Over 13,500 abortions - 13.4 per 1,000 women

84.3% under 9 weeks, less than 1% over 18 weeks
99% medically induced

98.6% for reason (1a) ; 1.3% for reason (1d)

Question 11

Outline key statistics relating to termination of pregnancy worldwide

Answer 11

73 million induced abortions each year

45% induced abortions are UNSAFE
97% of unsafe abortions are in developing countries.

Question 12

Statistics regarding abortions in countries where illegal/ legal

Answer 12

IN countries where abortion is banned or permitted ONLY to save a women’s life or preserve her physical health only 1 in 4 abortions were safe.

IN countries where abortion is legal on broader grounds, nearly 9 in 10 abortions were done safely.

Question 13

Describe the “Offences against the person act” 1861

Answer 13

Administering drugs or using instruments to procure abortion
(guilty of felony, convicted thereof shall be liable, penal servitude for life)

Procuring drugs &c. to cause abortion
(guilty of misdemeanour, convicted thereof shall be liable)

Question 14

Describe the “Infant life (preservation) act” 1929

Answer 14

Punishment for child destruction

NOTE : Abortion was not a criminal act before 28 weeks if it was performed in order to save the life of the mother.

Question 15

Describe the “Abortion Act” of 1967

Answer 15

David Steel MP

Statutory defences against 58&59 of 1861 act

Abortion allowed:

a) Social grounds (24 weeks)
b) Grave permanent injury
c) Risk to Life
d) Fetal Abnormality

MUST TAKE PLACE ON APPROVED PREMISES

Question 16

1a Social Grounds

Answer 16

• Pregnancy has not exceeded the 24th week
• Continuance in pregnancy would involve risk, greater than if pregnancy were terminated, of injury to physical/mental health of pregnant woman/existing children of her family.

Question 17

1b Grave Permanent Injury

Answer 17

Termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.

Question 18

1c Risk to Life

Answer 18

The continuance of pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated.

Question 19

1d Fetal Abnormality

Answer 19

There is a substantial risk that of the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.

Question 20

Key points in Law surrounding the abortion act

Answer 20

Females under the age of 16 may acquire a ToP without parental consent if competent and able to understand risks and procedures involved.

Abortion Act does not give patients a right to demand a ToP

Pregnant woman can refuse treatment even of it causes harm to unborn child.

Question 21

Abortion Act 1967

Answer 21

Conscientious objection and abortion

NO person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by the act, to which he has a conscientious objection.

Question 22

Moral status of the embryo

Case Study

Answer 22

St George’s NHS Healthcare Trust vs SR vs Collins

S wanted a natural birth, had refused treatment for eclampsia, C-section was carried out against her wishes.

Court ruled her wishes could not be overridden, except if acting without capacity (she was not).

Question 23

Personhood

Answer 23

When does a person become a person ?
What are the necessary qualifications for being a person ?

Question 24

What is moral status ?

Answer 24

What it is morally permissible or impermissible to do to some entity.

To have moral status, an individual must be vulnerable to harm or wrongdoing.

Question 25

Why is abortion of a foetus hard ? (relate to moral status)

Answer 25

The foetus has a full moral status from moment of conception or implantation.

There is a specific time point and change in moral status

It is a gradual process (thus more serious reasons needed as time progresses)

Question 26

State the 4 views about why an embryo may have moral status

Answer 26

1. Identity is important: the embryo is the same entity as the child will be
2. The embryo has the potential to be a person
3. Moral value is accorded when the embryo has the properties of a person
4. The embryo has value given by others (conferred moral status)

Question 27

What constitutes as a serious handicap ?

Answer 27

the probability of effective treatment, either in utero or after birth

the child’s probable potential for self-awareness and potential ability to communicate with others

the suffering that would be experienced by the child when born

Question 28

What is foeticide ?

Answer 28

The act of causing death to a foetus.

Involves an injection through your abdomen to stop the fetal heartbeat

Question 29

Potential Father’s Rights in Abortion

Answer 29

If a father’s pregnant partner seeks to abort an unborn child, having the father’s consent isn’t a legal obligation.

Question 30

What is post-coital contraception ?

Also state the case related to this

Answer 30

Morning after pill

(Jackson) R v Secretary of State for health

Question 31

Ethical concerns with abortion

Answer 31

Responsibilities/obligations of woman to a fetus.

Post-coital contraception