Ethics at the Beginning of Life

Question 1

What methods are used to terminate a pregnancy of less than 14 weeks?

Answer 1

Surgical
- Manual or electric vacuum aspiration

Medical

• Mifepristone, followed (24-48 hours later) by misoprostrol
• Note: misoprostrol may be administered at home

Question 2

What methods are used to terminate a pregnancy of 14 weeks or more?

Answer 2

Surgical
- Vacuum aspiration or dilatation & evacuation (D&E)

Medical

• Mifepristone, followed (24-48 hours later) by misoprostrol
• Note: administered in medical facility

Question 3

What are the characteristics of medical abortion procedures according to to WHO (2014) Clinical Practice Handbook for Safe Abortion?

Answer 3

Avoids surgery
Mimics miscarriage
controlled by the woman and may take place at home (at less than 9 weeks of pregnancy)
Takes time (hours to days) to complete the abortion, and timing may not be predictable
Women experience bleeding and cramping and potentially some other side effects (nausea, vomiting)
May require more clinic visits than surgical abortion

Question 4

What are the characteristics of surgical abortion procedures according to to WHO (2014) Clinical Practice Handbook for Safe Abortion?

Answer 4

Quick procedure
Complete abortion is easily verified by evaluation of aspirated products of conception
Takes place in healthcare facility
Sterilisation of the woman or placement of an intrauterine device (IUD) may be performed at the same time as the procedure
Requires instrumentation of the uterus
Small risk of uterine or cervical injury
Timing of the abortion is controlled by the facility and provider

Question 5

When may a medical abortion be necessary over a surgical abortion?

Answer 5

For severely obese women
If the woman has uterine malformations or fibroids or has had previous cervical surgery
If the woman wants to avoid surgical intervention
If a pelvic examination is not feasible or is unwanted

Question 6

When may a surgical abortion be necessary over a medical abortion?

Answer 6

If there are contraindications to medical abortion

If there are constraints for the timing of abortion

Question 7

Why are anti abortion people dumb

Answer 7

because anti abortion laws don’t reduce the number of abortions

Question 8

How many abortions are there every year?

Answer 8

50 million

Question 9

How many of the 50 million yearly abortions worldwide are unsafe?

Answer 9

25 million

Question 10

What effect does restrictive abortion laws have on the number of abortions undertaken per year?

Answer 10

Fuck all

Question 11

Who da man?

Answer 11

Lord David Steel, MP

god what a badass name

Question 12

What did the abortion act 1967 do?

Answer 12

legalised abortions on certain grounds by registered practitioners up to 28 weeks (not in NI tho)

Question 13

Under what conditions could an abortion be administered before the Abortion Act 1967?

Answer 13

If it would leave the woman a “mental or physical wreck”

Question 14

What law were abortions held under prior to 1967?

Answer 14

1861 Offences against the Person Act

Sec. 58 and 59

Question 15

What did section 58 of the 1861 Offences against the Person Act cover?

Answer 15

Administering drugs or using instruments to procure abortion

Abortion was punishable with “penal servitude for life” and was a felony

Question 16

What did section 59 of the 1861 Offences against the Person Act cover?

Answer 16

Procuring drugs, &c. to cause abortion

This was considered a misdemeanour

Question 17

What made abortion not a criminal act when done to save the life of the mother?

Answer 17

The 1929 Act of Parliament

Question 18

What were the statutory defences against ss 58 and 59 of the 1861 Offences against the Person Act ?

Answer 18

if two registered medical practitioners are of the opinion, formed in good faith:

a. ‘social grounds’ (24 weeks)
b. grave permanent injury
c. risk to life
d. fetal abnormality

And this took place on approved premises

Question 19

On what grounds are 98.8% of abortions carried out in Scotland?

Answer 19

Prior to 24th week of pregnancy and risk to mental or physical health of woman

Question 20

What are the key points of law relevant to me that I gotta know about abortion?

Answer 20

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

A doctor can conscientiously object to directly participating in ToPs (but not to associated tasks and patient care)

Conscientious objection exists for some of the grounds (and note that it’s not a yes/no)

AA does not give patients right to demand a ToP
Fetus has no legal right to life

Once fetus is alive outside of the uterus, it acquires legal protection of a newborn

Question 21

Discuss conscientious objection and abortion in UK law

Answer 21

“no person shall be under any duty, whether by contract or by any statutory or other legal requirement” to perform an abortion

“burden of proof of conscientious objection shall rest on the person claiming to rely on it”

Question 22

What counts as evidence that someone is a conscientious objection to performing an abortion?

Answer 22

“In any proceedings before a court in Scotland, a statement on oath by any person to the effect that he has a conscientious objection to participating in any treatment authorised by this Act shall be sufficient evidence “

Question 23

What is the moral status of the embryo?

Answer 23

Fetus does not have legal rights, but may warrant moral consideration

Necessary to understand different views, may encounter in colleagues and patients

Different views focus on the definition of personhood

Question 24

What are the four views of the moral status of the embryo put forward by Hope, Savulescu & Hendrick in Med Ethics & Law, 2009?

Answer 24

Identity is important: the embryo is the same entity as the child will be (note: 14 days & twinning)

The embryo has the potential to be a person

Moral value is accorded when the embryo has the properties of a person

The embryo has value given by others (conferred moral status)