Statement on Cathy Warwicks attempt to involve midwives in late abortions
The Association of Catholic Nurses , which includes midwives amongst its membership , shares and feels the concerns of the many midwives who have opposed Cathy Warwick , both chief executive of the Royal College of Midwives and Chairman of BPAS (British Pregnancy Advice Service ) , in her drive to raise the upper time limit for abortion . Her stance takes no account of the UK legal position on right to conscientious objection for nurses and midwives or the NMC (Nursing and Midwifery Council) guidance on conscientious objection which recommends that nurses and midwives do not work in areas that conflict with personal conscience . Many midwives will feel a gross incompatibility between their vocation of bringing new life into the world and an expectation for them to take on responsibility for killing full term babies selected for abortion as they are delivered. The Association of Catholic Nurses must also support that there is a serious conflict of ethical beliefs between the RCM which is professional organization that supports midwives to prioritise the safety of the pregnancy and safe delivery of a live baby and the BPAS which seeks to legalise a third trimester abortion which in parts of the USA where late term abortions are carried out involves a digoxin induced heart attack or sometimes an illegal partial birth abortion, delivering a baby and then plunging a pair of surgical scissors into the back of the legally viable baby’s neck to kill it before it breathes at the time birth . The Family Planning Association (FPA) currently cites more than 90 % of abortions in the UK to be done before 13 weeks gestation and in its own written information on termination points out that there is a risk to the mother with any termination procedure, medical or surgical , and that this risk substantially increases the more progressed the pregnancy is when the procedure is carried out . As Catholics we believe all life is sacred , both of the mother and the unborn child. Abortion still remains illegal in some countries and is contained and controlled in most European countries with an upper legal time limit of 13 weeks .The argument against late abortions was already debated in 2007 following the 12th Report on the Abortion Act 1967 and as an Association we can recall and support Cardinal Cormac Murphy O’Connor on this that if we cannot change a law which was established to eliminate maternal deaths from back street abortions ‘we can and should work together at least to make abortion much rarer.’ Mary Farnan National Secretary 22/05/2016
The Family Planning Association also provides, in its service delivery, information and advice on benefits and risks and efficiency rates of all types of birth control and includes in its training programme training for professionals to teach natural family planning alongside the Natural Family Planning Teachers Association and Marriage Care.
Cardinal Cormac Murphy-O'Connor on the result of the HFE vote on abortion 2007
Many people of all faiths and none will have been very disappointed by the result of last night’s votes on the abortion time limit. But this issue will not go away. Whilst the law affects attitudes, it does not in itself compel anyone to have an abortion. Even without a change in the law there is much we can all do to change the situation. There are many people on all sides of this debate who agree that 200,000 abortions a year is far too many, and abortion on this scale can only be a source of profound sadness and distress to us all. Abortion is not only a personal choice. It is also about the choices our society makes to support women, their partners and families who face difficult decisions. For the sake of our common humanity, and the lives at stake, we must work to foster a new understanding and approach to relationships, responsibility and mutual support. Even without a change in the law we can and should work together at least to make abortion much rarer.
NMC ADVICE ON CONSCIENTIOUS OBJECTION
1.5 You must adhere to the laws of the country in which you are practising. 2.2 You are personally accountable for ensuring that you promote and protect the interests and dignity of patients and clients, irrespective of gender, age, race, ability, sexuality, economic status, lifestyle, culture and religious or political beliefs. 2.5 You must report to a relevant person or authority, at the earliest possible time, any conscientious objection that may be relevant to your professional practice. You must continue to provide care to the best of your ability until alternative arrangements are implemented.
NURSING AND MIDWIFERY COUNCIL EQUALITY AND DIVERSITY GUIDANCE ON RELIGION AND BELIEF
'All the NMC's functions, policies, strategies and procedures will be screened and assessed to determine their relevance to meeting the General Duties under the Race, Disability and Gender Equality Duties. As part of the NMCs commitment to implementing an inclusive equality impact assessment process, function and policies,etc, will be assessed to ensure they do not discriminate on the grounds of religion or belief.'
HOUSE OF COMMONS SCIENCE AND TECHNOLOGY COMMITTEE 12TH REPORT 2007 ON THE ABORTION ACT 1967
WRITTEN REPONSE OF THE ASSOCIATION OF CATHOLIC NURSES ENGLAND AND WALES TO THE ROYAL COLLEGE OF NURSING ON THEIR STATEMENT TO THE HOUSE OF COMMONS SCIENCE AND TECHNOLOGY INQUIRY 2006/07 INTO THE ABORTION ACT 1967.
To The Royal College of Nursing Ethics Committee
The Association of Catholic Nurses upholds traditional Catholic Church teaching of the sanctity of and the social duty and moral responsibility of all mankind to protect the dignity of all human life particularly when it is weakest and most vulnerable . The most fundamental principles of medical and nursing practice ,beneficence ,to do good and non-maleficence ,to do no harm are known to have been inscribed into codes of professional practice since the time of the Hippocratic Oath around 420BC. The House of Commons Science and Technology recognizes that scientific developments within medicine can 'alter the balance of opinion on ethical and moral issues' (2007,p.3) but has chosen to review only medical ,scientific and other current research in its inquiry into the Abortion Act 1967 forty years after its legalization in the UK. We do not believe such discussion can be divorced from moral and ethical debate.
As nurses we believe our knowledge , skills and expertise should be employed to protect life not to deliberately take life. Article 2 of the Human Rights Act 1998 states 'Everyone's right to life shall be protected by law'. Nurses working in child protection will be particularly aware that maternal health damaging practices during pregnancy that may affect the life of an unborn child are treated as serious in the child protection arena and can result in registration of an unborn child to protect its rights after birth. Under the same legal system within the UK 193,700 terminations of pregnancies were carried out in the UK in 2006. 9.5% of these abortions were performed during the second trimester between 13 weeks and 20 weeks and 1.5% of the terminations were performed after 20 weeks. 1% of abortions were performed on grounds of foetal abnormality and 149 were performed where there was grave danger to the life of the mother if the pregnancy continued. In many European countries such as France, Germany Holland and Italy except in cases of severe foetal abnormality abortion is illegal after 13 weeks. Research in the UK indicates 68% of the UK population and 72% women feel the upper limit of 24 weeks gestation (up to full term for a child with an abnormality) for abortion should be changed and support a legal reduction of the upper limit for abortion to 13 weeks in this country.
Most medical sources agree that dangers of abortion increase to the mother the longer the pregnancy has progressed beyond the first trimester and that there is increased risk of miscarriage or pre-term delivery in subsequent pregnancies. There is also increased possibility that the foetus will experience pain and distress during the surgical process of a second trimester termination. The pregnant uterus has moved higher into the abdominal cavity so that the foetus can have more room to grow as flutters begin to be felt and heartbeats heard.. Whilst some scientific theories argue that development of neural pathways sufficient for foetal sentience or sensitivity to pain does not exist until around 26 weeks the Medical Research Council written evidence (2007) states they have found that there was little direct evidence of the gestational age at which fetuses might feel pain; this would be dependent, inter alia, on the development of the central nervous system. There was no definable stage of fetal life when one set of neurons connected to another. The nervous system matured over many pre- and post-natal months to produce complete pain awareness. The Group concluded that there was still a great need for research into many areas of fetal pain. Invasive procedures such as amniocentesis and more accurate details of foetal growth, development and expressions through 3D and 4D ultra sound scans suggest a foetus can show signs of pain and distress long before 26 weeks. The expectation of trained nurses to handle surgical abortions matched by a continued lack of funding and reduction of essential resources for ordinary everyday work practice situations that often affects nurses more than medical practitioners must create the possibility of unreasonable expectations and grave risk to professional nurse and the patient.
Although the Abortion Act (1967) clearly states 'no person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by this Act to which he has a conscientious objection' and the Department of Health written evidence (2007) to the Scientific and Technology Committee states 'Their conscientious objection should not be detrimental to their careers and appointments' the active promotion of abortion by medical and nursing professional organizations does in fact create a double effect of discrimination that affects non abortion beliefs and choices both of patients and professional nurses and doctors in work practice situations.
As an organization of Catholic Nurses we are saddened and concerned that the Royal College of Nursing ,which as an organization represents the legal interests of a large proportion of nurses in the UK, has chosen in its own written evidence (2007) to the Committee to seek to expand nurse involvement in the provision of existing abortion services and not to consider any support for a reduction of the upper time limit which would seem to be more reflective of the wishes of the general population.
Department of Health (2007) Written Evidence to The House of Commons Science and Technology Committee Inquiry into the Abortion Act 1967
HMSO (1967) Abortion Act ,London,HMSO
HMSO (1998) Human Rights Act ,London,HMSO
House of Commons (2007) Scientific Developments Relating to the Abortion Act 1967,The Science and Technology Committee,House of Commons, London, TSO
Medical Research Council (2007) Written Evidence to The House of Commons Science and Technology Committee Inquiry into the Abortion Act 1967
Royal College of Nursing (2007) Written Evidence to The House of Commons Science and Technology Committee Inquiry into the Abortion Act 1967
DEPARTMENT OF HEALTH WRITTEN EVIDENCE TO THE HOUSE OF COMMONS SCIENCE AND TECHNOLOGY COMMITTEE FOR THE 12TH REPORT 2007 ON THE ABORTION ACT 1967
LEGAL POSITION 2007 ON COSCIENTIOUS OBJECTION
'10. Except where treatment is necessary to save the life of or prevent grave permanent injury to the pregnant woman, "no person shall be under any duty ...... to participate in any treatment authorised by this Act to which he has a conscientious objection". It has been the case that if medical or nursing staff have strong ethical or moral objections to abortion work they should not be obliged to take this on. Their conscientious objection should not be detrimental to their careers and appointments. Further clarity on this clause was provided in a House of Lords judgment in 1988. This found that this exemption does not extend to giving advice, performing preparatory steps to arrange an abortion where the request meets legal requirements and undertaking administration connected with abortion procedures. The General Medical Council (GMC) booklet Good Medical Practice states that doctors views about a patients lifestyle or beliefs must not prejudice the treatment they provide or arrange. If they feel their beliefs might affect the treatment, this must be explained to the patient who should be told of their right to see another doctor.'
THE ABORTION ACT 1967
Conscientious objection to participation in treatment. (1) Subject to subsection (2) of this section, no person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by this Act to which he has a conscientious objection:
Provided that in any legal proceedings the burden of proof of conscientious objection shall rest on the person claiming to rely on it.
(2) Nothing in subsection (1) of this section shall affect any duty to participate in treatment which is necessary to save the life or to prevent grave permanent injury to the physical or mental health of a pregnant woman.
HUMAN FERTILISATION AND EMBRYOLOGY ACT 1990 HFEA
ABORTION LAW IN EUROPE 2013
AUSTRIA :Available up to three months of a pregnancy; afterwards in cases of serious health concerns for the mother or baby.
BELGIUM :Available up to twelve weeks; afterwards in case of serious health concerns for the mother or baby.
BULGARIA:Available up to twelve weeks; beyond that if the life of the mother is at risk, or for severe foetal malformations.
CROATIA:Available up to ten weeks; thereafter for medical reasons or in case of rape.
THE CZECH REPUBLIC :Available up to twelve weeks; after that in case of serious health concerns for the mother or baby or rape.
DENMARK :Available up to twelve weeks. After that the abortion has to be approved by the authorities who take into account exceptional circumstances, like danger to the mother, rape, incest or risk of birth defects.
ESTONIA:Available up to twelve weeks, and beyond that for medical reasons and/or for women younger than 15 or older than 45.
FINLAND:Available up to twelve weeks. A doctor’s authorisation is necessary but in practice is systematic. Beyond that health and social authorities decide on a case by case basis.
FRANCE:Available up to twelve weeks, and beyond that for medical reasons.
GERMANY:Abortion in Germany is permitted in the first 12 weeks upon condition of mandatory counselling, during which counsellors will try to dissuade the woman. Afterwards in cases of medical necessity, but not in case of rape.
GREECE:Available up to twelve weeks, beyond that for medical reasons, rape or incest.
HUNGARY :Available up to twelve weeks; up to 18 weeks if the patient is younger than 18, beyond that for medical or social reasons.
IRELAND:Abortion is allowed in circumstances where there is a real and substantial risk to the life of the mother or where an expectant mother is a suicide risk.
ITALY :Available up to twelve weeks for social or medical reasons; beyond for medical reasons only.
LATVIA:Available up to twelve weeks (up to 16 in case of rape) and after that for medical reasons.
LITHUANIA:Available up to twelve weeks, and beyond that on doctors’ advice for medical reasons.
LUXEMBOURG:Available up to twelve weeks for social and medical reasons or rape; beyond that for medical reasons.
MALTA:Abortion is completely banned. Women found to be having abortions face from 18 months to three years in prison.
NETHERLANDS :Available up to 24 weeks, and beyond for medical reasons. The abortion must take place in one of the 17 abortion clinics or 92 hospitals authorised by the government.
POLAND:Abortion is allowed in case of rape, incest, danger to the life of the mother or the irreversible malformation of the foetus, in the first 12 weeks.
PORTUGAL:Available up to ten weeks on request, and up to 16 weeks in cases of rape. 24 weeks if the child will be born with severe malformations.
ROMANIA:Available up to twelve weeks, afterwards for medical reasons.
SLOVAKIA:Available up to twelve weeks and beyond that for medical reasons or rape.
SLOVENIA:Available up to ten weeks; thereafter for medical reasons.
SPAIN:Available up to twelve weeks; beyond that for medical reasons.
SWEDEN:Available up to eighteen weeks, and beyond that on the authorisation of the health and social services, usually for medical reasons.
UNITED KINGDOM:Available up to twenty-four weeks, and afterwards for medical reasons. In Northern Ireland, the woman’s health must be at risk.