Catholic Medical Quarterly Volume 70(2) May 2020

Submissions

A new legal framework for abortion services in Northern Ireland - Implementation of the legal duty under section 9 of the Northern Ireland (Executive Formation etc) Act 2019

CMA(UK) Submission regarding changes to abortion legislation in Northern Ireland.

Response ID ANON-YJP1-GVC3-Q

Submitted to A new legal framework for abortion services in Northern Ireland - Implementation of the legal duty under section 9 of the Northern Ireland (Executive Formation etc) Act 2019 Submitted on 2019-12-16

Organisation: Catholic Medical Association (UK)

Section 1 - Legislative Changes

SECTION 2.1, Part 1 - Early terminations of pregnancy

Question 1a: Should the gestational limit for early terminations of pregnancy be up to 12 weeks gestation (11 weeks + 6 days)?

Question 1b: Should the gestational limit for early terminations of pregnancy be up to 14 weeks gestation (13 weeks + 6 days)?

If you answered no to 1a and 1b, what alternative would you suggest?:

At any stage, deliberate termination of a pregnancy involves the deliberate killing of an individual and unique human being. Whether the ending of the life takes place at 1 week, 12 weeks, 14 weeks, 28 weeks or 30 years is immaterial.

Considering that a prime aim of this proposed legislation is to defend the rights of women and girls, it must be remembered that well over 50% of abortions worldwide are carried out on female human beings at their most vulnerable stage in life.

The only truly just solution is to ensure that all unborn human beings, from conception, are afforded protection by the state.

Section 2.1, Part 2 -Early terminations of pregnancy

Question 2: Should a limited form of certification by a healthcare professional be required for early terminations of pregnancy?

If no, what alternative approach would you suggest?:

As medical doctors, we firmly believe that it is the duty of all doctors and healthcare professionals to protect life and to care particularly for the weak and vulnerable in society. Doctors should never become involved in processes that promote or cause the destruction of human life. Deliberate termination of pregnancy (deliberately procured abortion) can never be justified at any stage of pregnancy.

2.2 - Gestations beyond 12 or 14 weeks

Question 3a: Should the gestational time limit in circumstances where the continuance of the pregnancy would cause risk of injury to the physical or mental health of the pregnant woman or girl, or any existing children or her family, greater than the risk of terminating the pregnancy, be 21 weeks + 6 days gestation?

Question 3b: Should the gestational time limit in circumstances where the continuance of the pregnancy would cause risk of injury to the physical or mental health of the pregnant woman or girl, or any existing children or her family, greater than the risk of terminating the pregnancy, be 23 weeks + 6 days gestation?

If you answered ‘no’ to both of the above, what alternative provision do you suggest?:

Medical doctors are trained to carry out thorough clinical assessments when dealing with patients. They make clinical decisions based on personal clinical experience and by reviewing and understanding evidence obtained over periods of research.

There is absolutely no evidence that deliberate procurement of abortion is ever necessary to help the mental or physical health of any woman in pregnancy. Indeed, there is a growing body of evidence that abortion can seriously damage the mental health of many women who undergo abortion procedures. At very best, some studies suggest that procured abortion may have an overall neutral impact on a woman's mental health compared to continuing with pregnancy to term, although women with pre-existing mental health problems are much more likely to suffer more serious mental health issues after abortion.

2.3 - Fetal Abnormality

Question 4a: Should abortion without time limit be available for fetal abnormality where there is a substantial risk that the fetus would die in utero (in the womb) or shortly after birth?

Question 4b: Should abortion without time limit be available for fetal abnormality where there is a substantial risk that the fetus if born would suffer a severe impairment, including a mental or physical disability which is likely to significantly limit either the length or quality of the child’s life?

If you answered ‘no’ to either or both of the above, what alternative provision do you suggest?:

Every foetus in utero is an unborn human being regardless of any perceived or suspected disability or illness. Just as doctors have a duty of care to persons with illnesses and disabilities who have been already born, we have a duty to care for unborn persons, at all stages of gestation, to the best of our abilities. Deliberately taking the life of an unborn human person is not proper care.

It is worth remembering that many of those human beings aborted on the basis of suspected "severe mental or physical disability" have had their lives deliberately destroyed for benign and treatable conditions such as cleft palate, clubbed foot, congenital heart defects. People with Down's syndrome are particularly vulnerable in view of the aggressive attempts to screen for this condition and the promotion of their murder prior to birth.

It is also worth considering that there are many "healthy" people alive whose mothers courageously continued with pregnancy against the advice of "doctors" attempting to persuade them that they should proceed to abortion of the basis of a perceived abnormality determined by pre-natal screening where such information turned out to be incorrect.

2.4 - Risk to the woman or girl’s life or risk of grave permanent injury

Question 5a: Do you agree that provision should be made for abortion without gestational time limit where there is a risk to the life of the woman or girl greater than if the pregnancy were terminated?

Yes

Question 5b: Do you agree that provision should be made for abortion without gestational time limit where termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman or girl?

If you answered ‘no’ to either or both of the above, what alternative provision do you suggest?:

If there is a genuine threat to the life of the mother directly related to the pregnancy, in some very rare circumstances decisions may have to be taken to separate the mother from the placenta and foetus, even if this might cause the foreseen death of the foetus. In these rare cases, every effort should be made to save the lives of both mother and child if possible. If delivery must take place, either by caesarean section or by induction of labour, before the foetus has reached the stage of viability (essentially now at 22 weeks gestation) then it is inevitable that the foetus will not survive despite best efforts to preserve life.

2.5 - Who can perform a termination

Question 6: Do you agree that a medical practitioner or any other registered healthcare professional should be able to provide terminations provided they are appropriately trained and competent to provide the treatment in accordance with their professional body’s requirements and guidelines?

If you answered ‘no’, what alternative approach do you suggest?:

It is not the role of any doctor or other healthcare professional to deliberately end lives.

Attention should instead be given to caring for women in pregnancy, especially those who are pressurised into ending their pregnancy by others.

With increasing numbers of medical abortions, risks to pregnant women have increased due to the inherent dangerous adverse effects known to be associated with the drugs used in medical abortion (Mifepristone and Misoprostol). There have been many reports of deaths of young mothers from the administration of these drugs (in addition to the deaths of their unborn children), as highlighted by the FDA in the USA.

2.6, Part 1 - Where procedures can take place

Question 7: Do you agree that the model of service delivery for Northern Ireland should provide for flexibility on where abortion procedures can take place and be able to be developed within Northern Ireland?

If you answered ‘no’, what alternative approach do you suggest?:

If abortions are to be carried out, the highest standard of medical and nursing care must be provided. Abortion is not simply just another medical procedure despite the claims of some in the abortion provision business. Every year, in addition to the death of the unborn child, some mothers suffer serious morbidity directly associated with abortion.

2.6, Part 2 - Where procedures can take place

Question 8: Do you agree that terminations after 22/24 weeks should only be undertaken by health and social care providers within acute sector hospitals?

Yes

If you answered ‘no’, what alternative approach do you suggest?

Abortion is never safe for either mother or unborn child. To ensure safety for at least the mother the higher risk procedures should only take place in a hospital setting with facilities to deal with complications that sometimes arise. To do otherwise would amount to trivialisation of abortion and its consequences and would also fail to recognise the dignity and worth of the mother involved in the procedure.

2.7, Part 1 - Certification of opinion and notification requirements

Question 9a: Do you think that a process of certification by two healthcare professionals should be put in place for abortions after 12/14 weeks gestation in Northern Ireland?

Yes

Question 9b: Alternatively, do you think that a process of certification by only one healthcare professional is suitable in Northern Ireland for abortions after 12/14 weeks gestation?

If you answered ‘no’ to either or both of the above, what alternative provision do you suggest?:

The requirement that two doctors, having carefully assessed each individual case, agree that an abortion is required for one of the reasons stated in the Abortion Act, was included in the Act for very good reason.

There was a clear recognition that abortion is not an ordinary medical procedure and that it is associated with grave consequences. If properly applied, it should have ensured that abortion would be rare and safe and that women and young girls would be protected from abuse and coercion.

Allowing abortions to be carried out without this minimal safeguard will lead to more widespread abuse of women and young girls. The procedures will also be more dangerous for women.

2.7, Part 2 - Certification of opinion and notification requirements

Question 10: Do you consider a notification process should be put in place in Northern Ireland to provide scrutiny of the services provided, as well as ensuring data is available to provide transparency around access to services?

Yes

2.8 - Conscientious objection

Question 11: Do you agree that the proposed conscientious objection provision should reflect practice in the rest of the United Kingdom, covering participation in the whole course of treatment for the abortion, but not associated ancillary, administrative or managerial tasks?

If you answered ‘no’, what alternative approach do you suggest?:

Conscientious objection should be extended to include a right for objection to any participation in the abortion process, including ancillary, administrative and managerial tasks that might facilitate abortion. There are many doctors, nurses, ward managers, secretaries and others who strongly object to the deliberate killing of the unborn on a variety of religious, moral and ethical grounds. They should all be allowed to opt out of participation in processes such as abortion that they believe to be unjust, immoral and damaging for all those who are involved in such processes. It is a long held tenet in medicine that doctors should not do any harm to patients under their care. The same rule applies to citizens that we should always avoid knowingly causing harm to others. Secretaries, ward managers and others should be allowed to follow their conscience and should be allowed to opt out of participating in abortion when they firmly believe that abortion is harmful to others.

Question 12: Do you think any further protections or clarification regarding conscientious objection is required in the regulations?

Yes

If you answered ‘yes’, please suggest additional measures that would improve the regulations: :

Anybody who objects to involvement in abortion provision should be allowed to opt out if they do not wish to participate on conscience grounds. This should include secretaries, ward managers and other ancillary workers. Their right to opt out must be clearly stated and made known to all who may wish to provide abortion so that no pressure can be applied to those who wish to opt out. Any failure to respect the decision to opt out should be swiftly dealt with.

2.9 - Exclusion zones

Question 13: Do you agree that there should be provision for powers which allow for an exclusion or safe zone to be put in place?

If you answered ‘no’, what alternative approach do you suggest?:

The right to stage peaceful and / or prayerful protest to practices that are considered to be unjust or immoral by large sections of the community should be protected. Abortion providers have the right to know that many people in society do not approve of their actions. Women attending for abortion, especially those who are under pressure from others to have an abortion, have the right to receive information and encouragement from members of society to help them continue with their pregnancy.

Any form of protest or prayerful presence outside abortion centres should be carried out with sensitivity and respect. The suggestion that there have been "incidents where there has been harassment, alarm or distress caused to the people seeking to access the locations and services provided" is simply not true. There was no evidence presented, at any stage, that the peaceful and prayerful protests at Ealing, Richmond or other locations were associated with any harassment or alarm causation. Some may have felt uncomfortable to see that some people object to abortion provision, but that is the nature of protest. Many women are grateful for the help they have received and several women are joyful that they were supported in preserving their pregnancy and in saving the lives of their children.

Question 14: Do you consider there should also be a power to designate a separate zone where protest can take place under certain conditions?

Yes

If you answered ‘no’, what alternative approach do you suggest?:

Protest, provided that it is peaceful and respectful, should be allowed in all areas close to abortion centres and clinics. A 5 metre exclusion zone directly outside such centres might be acceptable.

Further Comments

Question 15: Have you any other comments you wish to make about the proposed new legal framework for abortion services in Northern Ireland?

Enter answer here: It is disappointing and unjust that the people of Northern Ireland have not been consulted about the political decision to impose a liberal abortion programme in their country. It is acknowledged throughout this document that there is a significant degree of opposition to abortion provision by the people of Ulster. The opinion and sincerely-held beliefs of the people have been simply ignored.

It is important to realise that any directions from the UN CEDAW are not binding on any sovereign nation. The United Kingdom, and every other sovereign nation, has the right to make political decisions and laws supporting the values and cultural identities of its people. To use statements from the UN CEDAW to justify extension of abortion provision to Northern Ireland is a dishonest attempt to impose an unjust law on a population that has not expressed any desire to allow abortion to take place within its borders.