Patient first

From Time magazine, “Healthland”, November 2010:

Warren Hern: [Donald Hertz] called my office on the afternoon of June 23, last year, three weeks after Dr. Tiller was assassinated. Dr. Tiller was a very dear friend of mine and a colleague, and his assassination was not just a personal loss for his family and his friends but very, very frightening because the same group of people that urged his assassination have also urged this to happen to me.

[Hertz] called and he told a person in my office that two Vietnam veterans were leaving Utah to come to Boulder to hurt my family. It scared us to death. My 92-year-old mother was evacuated from her home in the middle of the night because law enforcement authorities were afraid for her safety. They increased the level of protection for me and my family.

The FBI and federal marshals tracked the phone call to Donald Hertz and he was arrested and brought to trial. He terrorized me and my family, and all he got was a slap on the wrist.

Healthland: Are you scared?

Hern: I am a physician. I practice medicine. I have been committed to this work since I started in 1973. I will continue doing it. The people who disagree should leave me alone. It is the clear policy of the American anti-abortion movement to kill every doctor who does abortions. It is not a secret.

Healthland: How are you able to continue your work if that’s the case?

Hern: I show up at my office and see my patients.

Many years ago, when I was young and it felt like I had all the time in the world to dialogue with Jehovah’s Witnesses and other fundamentalist Christians, I used to ask them “Do you believe every word of the Bible is true?”

Abortion

There are a set of moral, ethical, and medical issues around abortion.

[Also about use of Care Quality Commission staff for a politician’s personal prejudices. More of that in the update below.]

The Telegraph does not appear to be interested in any of them, in its latest US-style article about “abortion clinics”.

First and most importantly: Is the person who is having the abortion being coerced in any way? It would be immoral and inethical for a doctor to perform an abortion on anyone unless she wants to have her pregnancy terminated.

Dear Mark Lazarowicz

The worst part about this article is the headline: it calls these damaging attacks on healthcare provision for women “reforms”. The second-worst part is the news that

The government has caved in to calls from anti-abortionists to overhaul existing protocols and strip charities and medics of their exclusive responsibility for counselling women seeking to terminate a pregnancy.

The Department of Health confirmed that it would change the rules to ensure that women are also offered counselling “independently” of existing abortion services. Its announcement was made in advance of an attempt next week led by the Tory backbencher Nadine Dorries to amend the health and social care bill to force such a requirement.

Nadine Dorries lies that the charity-run abortion services – including the British Pregnancy Advisory Service (BPAS) and Marie Stopes – have a “financial conflict of interest” in advising women seeking terminations. (Wrong on both counts. The counsellors employed by these women-centred healthcare charities operate independently of the abortion provision: abortion is not a profitable healthcare service and is frequently provided at a loss to women who could not otherwise afford it.)

Dorries claims that by offering “independent counselling” – of the kind quoted below – 60,000 of the women who get pregnant each year and decide to have an abortion, could be convinced to have a baby instead.

This kind of attack on healthcare provision, justified by these lies taken from the US prolife movement by Dorries (surely the least honest MP in the House of Commons?), is appalling. So naturally, I wrote to my MP:

I am writing to express my concern at proposed changes to abortion counselling arrangements currently under consideration by the Department of Health, based on amendments to the Health and Social Care bill.

The proposals require GPs to make provision for “independent” advice and counselling to be made available to women seeking abortion, stripping abortion providers of responsibility for carrying out this role, apparently with a view to hand this to pro-life charities whose standards of counselling are appalling – see this report from “mystery shoppers” who visited pro-life charities pretending to be considering an abortion:

Centres visited included those run by Life, recently appointed to a panel advising the government on sexual health. That appointment, as well as renewed pressure from socially conservative MPs to tighten abortion laws and strip abortion providers of their counselling role, has sparked alarm among pro-choice supporters.

At a Life centre in Covent Garden, London, the undercover researcher was given a leaflet entitled Abortions – How they’re Done, which said incorrectly that 85% of abortions are carried out using vacuum aspiration. It stated that “the unborn child is sucked down the tube” and that “the woman should wear some protection. She has to dispose of the corpse [in the case of chemically induced abortion].”

The counsellor was said to have focused on mental health issues that she associated with abortion, telling the researcher she was of a good age to have a child, showing her baby clothes and using terms such as “baby” and “grandchild” when referring to the pregnancy.

While a counsellor on Life’s helpline was regarded as being “friendly and non-judgmental”, she was unwilling to answer questions about physical aspects of abortion, saying she was not qualified to do so. When asked whom to talk to about arranging an abortion, the counsellor stated that the organisation was pro-life and could not recommend any service. She claimed not to know the names of abortion providers.

These proposals are at best, unnecessary and misguided. At worst they are a step towards the appalling women’s healthcare provision in the United States. One of the MPs responsible for them is Nadine Dorries, who has close links through the Christian Legal Centre to the US-based Alliance Defence Fund.

Abortion providers in the UK are already obliged to ensure that women receive all relevant information about the procedure, including details of possible risks and side effects and information on alternatives to abortion.

I am concerned that introducing further counselling requirements would delay women from accessing services, at a time when waiting periods are rising across the NHS. Please see this report on waiting times for abortions on the NHS.

The proposals would likewise disrupt care pathways for women who choose to self-refer to abortion providers, rather than approaching their GP.

Women must be trusted to make their own decisions regarding their reproductive health. It is vital that the information they receive remains scientifically accurate and driven by clinical best practice rather than by ideological agenda.

If these amendments are debated at Report Stage of the Health and Social Care Bill on 6-7th September, I urge you please to vote against them, to ensure that women continue to be able to exercise their right to safe, legal abortion without further impediment.

Anti-choice counselling: tell your MP to say NO! (Or use WriteToThem.)