BMA annual meeting: Doctors who carry out abortions should not face criminal sanctions, says BMA
BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j3116 (Published 28 June 2017) Cite this as: BMJ 2017;357:j3116
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Re: BMA annual meeting: Doctors who carry out abortions should not face criminal sanctions, says BMA
I was disappointed by the evident bias in the reporting of this debate and vote by the BMA ARM. It leaves the reader with the impression that there was one line of argument to which all acquiesced. There are quotes from two speakers for the motion, but no quotation from any of those who spoke against it, despite the fact that their presentations received applause at the time. There is no mention that in the 6 days leading up to the debate 1500 doctors and medical students signed a petition urging the ARM to reject the motion. There is no mention of the ComRes poll, quoted by three of the speakers against the motion, which found that which showed that only 1% of women wanted the abortion upper limit of 24 weeks to increase and 70% wanted to see a decrease to 20 weeks or below. http://www.comresglobal.com/polls/where-do-they-stand-abortion-survey/
The outcome of the debate stands. But it is hardly honest or transparent to leave the reader with the impression that the outcome represents the unanimous will of all BMA members. More care please in the tone of reporting on these weighty and sensitive matters.
Competing interests: No competing interests
Re: BMA annual meeting: Doctors who carry out abortions should not face criminal sanctions, says BMA
Drs Jones and Draegar are profoundly wrong and misguided in their advocacy for removing abortion from the criminal law. Draegar's comments are the giveaway when she refers to '...[our] service folding' as being a contributing factor in her thinking. Her self-acknowledged lack of understanding for seeing a difference between the nature of a routine surgical procedure and termination of pregnancy represents a serious misapprehension of the nature of abortion. Abortion is a criminal act, with exceptions created under the 1967 Abortion Act. It involves the termination of the life of a child as an innocent bystander in the affairs of other people, and as such warrants seeing abortion as unusual, and different from other surgical procedures. The passage of motion 50 by BMA representatives in Bournemouth last week represents a blight on our profession.
Apart from the moral dimension, I do not believe the BMA meeting reflects the voice of doctors in the UK, and it’s certainly is not in tune with the voice of the 2008 people surveyed recently by a reputable survey organisation, 99% of whom did not support any relaxation of the present law1. In fact, 70% of 1028 women respondents wanted to see the abortion time limit reduced to 20 weeks or below Table 3 in 1.
The BMA vote, were it to be supported in law, opens the door to sex-selective abortion, to abortion to 28 weeks, and in the ambition of some supporters2, to abortion to term. Not only morally reprehensible, such statements undermine the place of modern medicine with all its potential for good. Any such move would fragment the legal framework surrounding abortion.
Doctors must not sleepwalk into the trap of a vocal liberal elite who see themselves as custodians of the practice of modern medicine. The true voice of modern, caring, doctors needs to be heard opposing the malpractice of private abortion providers3 and purging our part in the 8.5 million abortions which have taken place since 1967. We need to protect our patients and their unborn children from these liberal views. We need to restore our professional integrity, and we need to return to the BMAs position of 1947 in seeing co-operation in abortion as ‘the greatest crime…’4.
The views expressed are my own.
References
1. ComRes. Where Do They Stand Abortion survey 2017 [2 July 2017]. Available from: http://www.comresglobal.com/polls/where-do-they-stand-abortion-survey/.
2. Furedi A. Abortion and disability: pro+choice forum; [2 July 2017]. Available from: http://www.prochoiceforum.org.uk/aad4.php.
3. Care Quality Commission. CQC publishes inspection reports on Marie Stopes International 2016 [2 July 2017]. Available from: http://www.cqc.org.uk/news/releases/cqc-publishes-inspection-reports-mar....
4. BMA. Supplementary annual repport of Council 1946-47; International relations Appendix ii; principles for inclusion in a charter of medicine 1947 [2 July 2017]. Available from: http://www.bmj.com/content/bmj/1/4511/S127.full.pdf.
Competing interests: No competing interests
BMA AGM 2017 On Abortion – A Damning Verdict on My Genetic Defect and Family Members’.
The news published by Abi Rimmer and Rebecca Coombes [1] made me think of those of us born with genetic defects. Pregnancies have been terminated in the UK for extra digits found on Ultrasound Scan. I was born with extra digits (as are 1% of all Ghanaians [2]). Wind forward several decades and, in the UK, you will find the likes of me have been aborted. I joined those who voted Tuesday 27 June to reject Motion 50. I first revealed my Mendelian Dominant extra-digits inheritance in the BMJ July 21 1984 [3] when I protested against aborting sickle cell disease phenotypes after prenatal diagnosis. What I said so impressed Professor Sir David Weatherall FRS of Oxford University that he reproduced my objections verbatim in his priceless book "The New Genetics and Clinical Practice" [4, pages 246-247].
GENETICISTS WITH AN ETHICAL DIMENSION
Sir David and another world famous Human Geneticist Professor George Fraser [5] are among a very few top rate human geneticists with an ethical dimension. As I write today, pregnant women from Africa and Mediterranean countries in the UK are routinely screened for sickle cell disease phenotypes with a view to advising abortion. I can name scores of adult sickle cell disease persons (patients) who are eminently brighter and often more beautiful than siblings without sickle cell disease. Education plus non-intervention Genetic Counselling is the answer [6], not aborting would-be geniuses some of whom though not ever having Hb levels above 9 grams per deci-Litre were yet able to become great Achievers. Sadly too, some doctors do not even know the difference between Sickle Cell Disease and Sickle Cell Trait and have gone on to abort Sickle Cell Traits. My book "The Sickle Cell Disease Patient" [7] which was reviewed in The Lancet by Sir David Weatherall [8] shows the cover photo of a Ghanaian family with a world record: Sickle Cell Disease man marrying a Sickle Cell Disease woman, and producing 13 children (9 alive) none, as expected, with a single normal haemoglobin gene. This book caused anger in some quarters in the UK when I asked: “Should all this family of 13 have been aborted because every one of them had a disease phenotype?”
I myself come from a family with Abnormal Haemoglobin Trait parents who had 11 of us, 3 with sickle cell disease, 4 with Trait, and 4 with normal Hb genes from each parent. My parents would certainly have qualified in the UK now to be advised in each pregnancy for my mother to submit to ante-natal diagnosis and selective abortion of my then immediate elder brother Victor Agbetey, my immediate younger brother Jerry Tei and the fifth of their 11 children beautiful Sussie Koryo all three of whom had sickle cell disease known in the tribe as hereditary cold-season rheumatism (hemikom) [9]
WHO WILL SPEAK UP FOR THOSE WITH THESE GENETIC DEFECTS?
I have written about this matter many times [3 6 7 9-12]. Abi Rimmer and Rebecca Coombes mention Melody Redman at this BMA 2017 AGM as saying: “Fundamentally this motion is about removing the legal safeguards which are currently in place to balance the rights of women with those of the developing fetus. The law had an important role in safe guarding the vulnerable” [1]. Quite so! O for more humane Human Geneticists like Sir David Weatherall and Professor George Fraser in this country that I love so much!.
Conflict of Interest: Ability to discern the vast difference between human rites (renamed “rights”) and Divine Rights is considered now in UK something to be declared as a Conflict of Interest in writing this article even when I am known as a believer in The Lord Jesus Christ.
Felix ID Konotey-Ahulu MD(Lond) FRCP(Lond) FRCP(Glasg) DTMH (L’pool) FGA FGCP FTWAS FWACP Kwegyir Aggrey Distinguished Professor of Human Genetics, University of Cape Coast Ghana and Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies, 9 Harley Street, London WIG 9AL
felix@konotey-ahulu.com Twitter@profkonoteyahul
References
1 Rimmer Abi, Coombes Rebecca – News BMA annual meeting: Doctors who carry out abortions should not face criminal sanctions. BMJ 2017; 357: j3116 June 28.
https://doi.org/10.1136/bmj.j3116
2. Bonney GE, Walker M, Gbedemah K and Konotey-Ahulu FID. Multiple births and visible birth defects in 13000 consecutive deliveries in one Ghanaian hospital. In Proceedings of the Second International Congress on Twin Studies Part C Ed Nance W. Progress in Clinical and Biological Research 1978; 24 Pt B: 105-108.
3. Konotey-Ahulu FID. Ethical issues in prenatal diagnosis. BMJ Clin Res Ed 1984; 289(6438): 185..http://www.bmj.com/cgi/reprint/289/6438/185-a.pdf July 21
4. Weatherall DJ. Ethical issues and related problems arising from the application of the new genetics to clinical practice Chapter 12 (pages 347-348) of The New Genetics and Clinical Practice Oxford University Press Third Edition 1991.
5 Fraser GR. Human Genetics Today: Hopes and Risks. In Fifty Years of Human Genetics – A Festschrift and Liber Amicorum To Celebrate the Life and Work of George Robert Fraser Ed. Oliver Mayo & Carolyn Leach, Wakefield Press South Australia 2007, pages 299-309.
6 Konotey-Ahulu FID. Sickle Cell Disease: The Case for Family Planning. ASTAB Books Ltd. Accra, Ghana 1973.
7.. Konotey-Ahulu FID. The Sickle Cell Disease Patient. Natural History from a clinico-epidemiological study of the first 1550 patients of Korle Bu Hospital Sickle Cell Clinic. The Macmillan Press Ltd 1991/92 London & Basingstoke. Reprinted Tetteh-A’Domeno Company Watford Herts 1996.
8 Weatherall DJ. The Sickle Cell Disease Patient by FID Konotey-Ahulu. Book Review. Lancet Vol. 337, p 1590. June 29 1991.
9.... Konotey-Ahulu FID. Sickle Cell Disease in successive Ghanaian generations for three centuries. In FID Konotey-Ahulu The Human Genome Diversity Project: Cogitations of An African Native. Politics and the Life Sciences (PLS) 1999, Vol 18: No 2, pp 317-322. [Invited Commentary on Professor David Resnik's article: The Human Genome Diversity Project: Ethical Problems and Solutions]
10. Konotey-Ahulu FID. Antenatal diagnosis of haemoglobinopathies March 12 1977. thelancet.com/journals/lancet/article/PIIS0140-6736(82)92572-7 https://doi.org/10.1016/S0140-6736(77)92020-7 Lancet 309 (8011) 597-98.
11.... .Konotey-Ahulu FID. Antenatal screening for sickle cell disease and beta-thalassaemia. BMJ Rapid Response Oct 12 2010 ] http://www.bmj.com/content/341/bmj.c5132/reply#bmj_el_242914
12. Konotey-Ahulu FID. Antenatal sickle cell disease haemoglobinopathy screening. http://www.bmj.com/content/341/bmj.c5243/reply#bmj_el_243447 Rapid Resp Oct 2010
Competing interests: Conflict of Interest: Ability to discern the vast difference between human rites (renamed “rights”) and Divine Rights is considered now in UK something to be declared as a Conflict of Interest in writing this article even when I am known as a believer in The Lord Jesus Christ.
Re: BMA annual meeting: Doctors who carry out abortions should not face criminal sanctions, says BMA
I was left somewhat baffled by this article. Surely if the issue is getting two doctors to see the patient, there are other ways of getting this done? Let's say, in areas where there is a problem, just a register of doctors with no conscientious objections could be given to 111, who could then find any pt an appointment promptly and locally?
As has been pointed out by others, there is little demand for thus among the public. There is also a prompt mechanism for abortions after 24 weeks to be carried out already in place. I am actually concerned that this will restrict the access of women to have a late stage abortion (for those complicated reasons under category E etc of current law). How many doctors would be comfortable being the one left to decide if this degree of nuchal translucency and cleft palate is indicative enough of a microdeletion cause of Down's or Cri du Chat? (something that could easily come back repeatedly negative on amniocentesis gene testing). How many doctors would be comfortable making these assessments by themselves, or performing these late stage abortions without the backing of their colleagues in a panel? How many would refuse, fearing a lawsuit from the woman after or her ex? I believe this would actually leave those most vulnerable women lacking the necessary access. It seems hurried, and ill-considered a topic to vote on. It is an emotive issue so it may well distract the many dissatisfied BMA members from their poor pay and working conditions for a while, but these issues will keep coming up again and again.
Competing interests: No competing interests