Intended for healthcare professionals

Editor's Choice

Toward healthier abortion and drug laws

BMJ 2019; 367 doi: (Published 07 November 2019) Cite this as: BMJ 2019;367:l6382
  1. Richard Hurley, features and debates editor
  1. The BMJ
  1. rhurley{at} @rich_hurley

Since Northern Ireland’s law was amended last month, women who want an abortion can be treated as patients rather than criminals, as one doctor puts it in a feature this week (p 224). Previously, abortion in Northern Ireland was permitted only when a woman faced permanent harm, with no exceptions for severe fetal abnormality or after rape or incest. Many women had to travel overseas to receive care considered routine in the rest of the UK. Doctors also risked criminalisation if they did not report a suspected illicit abortion. The law change removes this barrier to open discussions with patients. A public consultation is now under way to determine how abortion services will be introduced.

Meanwhile, throughout the UK many people with drug use disorders remain at risk of criminal punishment. Yet illicit use of drugs such as heroin, methamphetamine, and cocaine persists. Drug deaths in the UK reach a record high year on year. The UN and WHO, the Royal College of Physicians, The BMJ, and many others point out that criminalising people who take drugs not only fails to reduce the harms such use causes but makes drug taking riskier and harm reduction interventions more difficult. The UK government’s independent drug advisers have reached similar conclusions.

Now, after thorough inquiries, two separate committees of MPs join them. They brand UK policy a failure and call for the decriminalisation of possession of small amounts of drugs for personal use (p 215). The chair of the parliamentary Scottish Affairs Committee, SNP MP Pete Wishart, says, “The evidence is clear. Decriminalisation is a pragmatic solution to problem drug use, reducing stigma around drug use and addiction and encouraging people to seek treatment.” Two weeks earlier the Health and Social Care Committee similarly called for “radical change” to tackle this “public health emergency.” Both committees want a health approach rather than a criminal justice approach to drug use and for the Department of Health and Social Care, not the Home Office, to oversee drug policy. Both committees also advise that supervised injecting sites should be trialled.

As Niamh Eastwood, executive director of Release, a charity that advises people on their legal rights about drug use, says on BMJ Opinion, “It appears those with the power to save lives—the UK government—would rather play politics while people continue to die” (

Hopefully, you’re unlikely to be prosecuted for wild swimming. This helps consultant geriatrician Clare Bostock to unwind (p 250). “Challenging myself in the sea,” she says, “means that I feel less fearful of other everyday challenges.” Another challenge might be to enter our 2020 BMJ Awards (p 212), which recognise the inspirational work of UK healthcare teams. Nominations remain open until 17 January (

PULL QUOTE— Northern Ireland women who want an abortion can now be treated as patients rather than criminals

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