assisted suicide

Abortion is always a highly charged issue in American elections but it is also dominating the political agenda elsewhere

The  Rebuplicans won both houses of Congress and Trump has said that he would nominate ‘pro-life justices’ [there are likely to be as many as three vacancies] to the Supreme Court. Even one pro-life justice appointment may change the present balance and lead to the over throw of  the court’s landmark 1972 Roe v Wade decision that established a woman’s right to an abortion in the US [in states that allow it].  Trump has also promised to repeal provisions in the Affordable Care Act [nicknamed Obama Care] that require insurers to cover contraceptive services and stop them charging women more than men for insurance [women tend to cost more than men because of contraception, gynaecological and obstetric care]

Abortion in Poland is already illegal except in cases of rape or when the woman’s life is in jeopardy, or if the foetus is not compatible with life once born. Most women wanting an abortion travel to Germany. Last month the ruling party proposed legislation to completely outlaw abortion. Marches and a strike by 30,000 women seem to have led to the legislation being abandoned.

Abortion is a very emotional subject. It is the only procedure that a doctor can opt out off in the UK. When taking about abortion remember that your personal beliefs should not affect your treatment of a patient. Even if you disagree with a patient who requests an abortion the GMC makes it clear that patient should be treated with consideration and empathy. It may be reasonable to ask her to consider other options if she does not seem completely sure  but she has the freedom to make her own mind up and there should not result in any significant delay.The patient should be quickly referred to a colleague who is willing to help her.

The Abortion Act 1967 [UK] makes abortion legal up to 24 weeks gestation,

1 If there is greater physical or mental risk or harm to the mother by continuing the pregnancy.

2. At any stage if there is serious risk to the health of the mother

3. At any stage if the foetus is likely to be born with severe physical or mental abnormalities.

Pregnancy and delivery is more dangerous than a termination so reason number one suggests that provided the pregnancy has not gone far there is effectively abortion on demand. However late terminations, beyond 12 weeks are rare. 90% are before 12 weeks in the UK.

The major organs are formed by 12 weeks. We think that the foetus may begin to feel pain at 20 weeks when the nervous system begins to mature. When recognisably human life truly begins is very controversial.

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