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NEWS: Clare Dyer Experts clash as committee debates reducing 24 week abortion limit BMJ 2007; 335: 789 [Full text]

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An Ethical Alternative to Late Abortion

Rob Alcock   (29 October 2007)

Viability and the Abortion Debate

Richard J Lyus   (30 October 2007)

An Ethical Alternative to Late Abortion 29 October 2007
Rob Alcock, Graduate Entry Medical Student Swansea University, SA2 8PP Send response to journal: Re: An Ethical Alternative to Late Abortion	The British government Commons Science and Technology Committee has in the last few weeks been reconsidering the issue of whether or not to reduce the legal limit for abortion from 24 weeks[1], the approximate point in gestation that medical intervention can sustain life in vitro. Although the committee has been considering only scientific arguments rather than ones of morality, the subject is fraught with controversy where personal beliefs endanger prejudicing science reason [2].   All sides of the argument would agree that abortion is an unfortunate waste of life. Perhaps then there is an alternative to termination that in some cases could side step many of the ethical issues surrounding the subject. Consider the scenario in which a woman desperately wishes cease her pregnancy at a point in time when the foetus is potentially viable outside the womb. Attending her local hospital obstetrics department, instead of choosing (or being refused) termination she opts for a new opportunity whereby she undergoes a caesarean section delivery, her newborn subsequently being allowed the chance to mature in its development in a specialist unit until it is able to undergo legal adoption by new parents.   There are two clear moral benefits to such a strategy. Firstly, it potentially allows a right to life for the unborn child, and secondly it preserves some significant degree of freedom of choice for the woman, allowing her the escape from the socially binding consequences of continuing the pregnancy beyond the point that it becomes noticeable to her peers. The obvious rebuke is one of limited health service resources, however, the lengths to which childless parents will go to in order to have a child are profound and could be tapped into to resource such an idea.   Whilst the idea does not address the significant moral dilemmas associated with termination of tetragenic pregnancies, and thus is not a panacea for all situations, it is a concept that has received little attention and is thus worthy of greater debate.   Dr Rob Alcock   BSc(Hons) PhD CPhys CSci MInstP Graduate Entry Medical Student, Swansea University Former Research Fellow, Loughborough University Specialist in Instrumentation Physics   References   1. “Scientific Developments Relating to the Abortion Act 1967”, Select Committee on Science and Technology, House of Commons, 2007. 2. Nadine Dorries MP, “Letter: MP seems driven by anti-faith prejudice”, The Guardian, October 23, 2007.   Competing interests: None declared
Viability and the Abortion Debate 30 October 2007
Richard J Lyus, Family Medicine Resident Swedish Cherry Hill, Seattle, WA 91822 USA Send response to journal: Re: Viability and the Abortion Debate	Dear Editor - Arguments to lower the gestational age limit at which abortion may be performed are almost entirely based on the idea of foetal viability; that is, the gestational age at which, if the foetus were born prematurely, it would have a reasonable chance of survival. While I understand the viability argument can be convenient one for both sides of the debate, it does not hold up to rational analysis. Suppose that, by some medical breakthrough, we were able to support spontaneously miscarried pregnancies, even at very early gestational ages. Perhaps by suspending them in some life-sustaining fluid, in which they could fully develop as they would in the uterus. Would this be compelling evidence that we should abolish abortion all together? Conversely, suppose some new virus epidemic sweeps through the nation, becoming endemic in all hospitals and special care baby units in which premature babies are cared for. The virus infects and kills all babies born before 32 weeks, as their lungs are not mature enough to recover from the insult caused. Would this be a compelling argument to increase the gestational age limit on abortion? Both sides of the debate need to realise that viability is probably irrelevant. Yours, Richard Lyus, MD Competing interests: None declared