Examination of Witnesses (Questions 120-139)
PROFESSOR PATRICIA
CASEY, DR
ELLIE LEE,
PROFESSOR JANE
NORMAN, DR
CHRIS RICHARDS
AND DR
SAM ROWLANDS
15 OCTOBER 2007
Q120 Dr Spink: Does anyone on the
panel believe that abortion is always safer for the women psychologically
and physically than carrying a pregnancy to term?
Professor Casey: I do not. I believe
that abortion is dangerous for women because of the mental health
problems that we have talked about. I believe that that is true
the later the abortion takes place but that is not in any way
to say that first trimester abortions—
Q121 Dr Spink: Dr Lee?
Dr Lee: I think abortion is psychologically
safer than forcing a woman to carry a pregnancy to term and deliver
a child by denying her access to abortion. In other words, I think
that in so far as we have evidence that compares the outcome of
abortion with the outcome of denied abortion—that is to
say, forcing women to have babies when they have requested abortion—abortion
is psychologically safer.
Q122 Dr Spink: You believe abortion
is always safer for women physically and mentally than carrying
to term?
Dr Lee: No. You are missing the
whole point.
Q123 Dr Spink: That was my question.
Yes or no? Is it or is it not?
Dr Lee: You are missing the entire
point.
Q124 Dr Spink: No. You are missing
the question. Do you believe that having an abortion is always
safer for women physically and mentally than carrying to term?
Dr Lee: In that case, if you properly
wanted to answer that question, you would need to broaden the
scope of the evidence and look at all of the studies that there
are about psychosis following childbirth. We know that the Royal
College of Psychiatrist estimate around 15% of women who have
babies have postnatal depression, so there is your comparator.
Q125 Dr Spink: What Dr Lee appears
to be saying is that she is either not going to answer the question
or she does not know. Dr Lee, in answer to a question to my colleague,
Graham Stringer, when he was asking about the 3,000 20 to 24 week
abortions and suggesting that that was a high figure, you said,
"It depends what one considers to be a large number."
My constituents consider when one is dealing with human life one
is a large number.
Dr Lee: That is their prerogative.
They are allowed to adopt whatever moral position they want. The
point that I was trying to make about the statistics is that if
we are having a discussion about terminations at 20 to 24 weeks
one of the important factors to look at is the occurrence of those
abortions relative to all abortions. I am certainly very interested
in trying to create a framework in which we can reduce the proportion
of later abortions compared to early abortions because early abortions
are better for women than late abortions. If we look at the propensity
for there to be 20 to 24 week abortions, it has not changed over
time and it is important to try and understand why and what can
be done about it.
Dr Spink: It was a very straightforward
question. It is not a trick question. Could I ask for a straightforward,
honest answer, please, from the other members of the panel?
Chairman: All the answers are honest.
Q126 Dr Spink: Of course they are.
Do you believe that abortion is always safer mentally and physically
for a woman than carrying to term?
Professor Norman: On a population
basis in the first trimester it is safer for a woman to have a
termination of pregnancy than to continue with the pregnancy to
term. Whether that is the right thing for an individual woman
is up to the individual woman and her doctor.
Dr Richards: Knowing what I recognise
about the sequelae, earlier on in the previous session we heard
about the risk of prematurity in further pregnancies. We know
about the risks of breast cancer which have not been mentioned
here. One can never guarantee to any woman that it is going to
be safer electively to have an induced abortion than it is to
go to term.
Q127 Dr Harris: Or vice versa.
Dr Rowlands: I agree with Professor
Norman. On a population basis in the first trimester the kind
of figures that you get from the US are surgical abortions up
to nine weeks, mortality one per million; medical abortions up
to nine weeks, one per 100,000 and delivery one per 10,000. You
can see with medical abortion it would be a factor of ten times
safer physically. Psychologically it is difficult and what I said
before I think is true. I do not know that we will ever have studies
that will really prove this one way or the other.
Q128 Dr Spink: Late in the second
trimester, would you vary your judgment on that?
Dr Rowlands: I think it is very
delicate. Those women should be offered counselling and they need
to have enough time but I think that abortion should be available
to them in this country.
Chairman: I want to move on from the
risks to mental health. Obviously you have various opinions on
this particular issue on the panel. Various studies show different
things and the studies which have been quoted by Dr Casey and
yourself, Dr Richards, the panel have agreed have good methodology
within them. You have also pointed out, Dr Rowlands, that there
are also studies which are missing in order to be able to compare
particularly the control groups of women who wanted to have a
termination but were denied and those who had an abortion at that
time. I want to move to the issue of other complications.
Q129 Mrs Dorries: Dr Richards, I
would like to ask you for your opinion on the inference that there
would be a link between breast cancer and abortion. What I am
trying to do is link the consequences of abortion together here.
We have heard about the mental health risks and other problems
associated with abortion. Do you think there is a link between
breast cancer and abortion? We have had a paper from an American
doctor.
Dr Richards: You are well furnished
with good submissions on this subject.
Q130 Mrs Dorries: Do you recommend
adopting the submission by Professor Brind?
Dr Richards: I am absolutely convinced
that, if you compare women who keep their pregnancy with those
who have an induced abortion, those who have an induced abortion
are more likely to get breast cancer later on.
Q131 Mrs Dorries: Is this women who
have had an induced abortion and then go on to have further pregnancies
or women who have an induced abortion and then do not have any
further pregnancies?
Dr Richards: Both. That is true
but there is a question about whether women who have had an induced
abortion compared with those who never have a child have a higher
risk of breast cancer.
Q132 Dr Harris: Can I ask what your
expertise is on this point? Are you a breast surgeon? Are you
an oncologist?
Dr Richards: I am a clinical paediatrician.
Dr Harris: How many breast cancers are
there in your patient group?
Q133 Mrs Dorries: Dr Lee is not a
psychologist.
Dr Richards: I am answering Mrs
Dorries's question. She says do I find the literature which has
been presented to your Committee convincing in that regard and
the answer is I do.
Mrs Dorries: Dr Lee is not a psychologist.
She is a lecturer.
Mrs Dorries: We do not question every
witness on their expertise.
Q134 Chairman: You have answered
the question that was put to you, Dr Richards, and I think Dr
Harris has made his point. In terms of this issue of breast cancer
and abortion, Dr Rowlands, do you have a view on this?
Dr Rowlands: If you look at Professor
Brind's submission and look at his reference list there, you will
notice that he omits Lindefors Harris, 1989, Lazovich, 2000, Lash,
2004, Reeves, 2006 and Michels, 2007 from his reference list.
I just wanted you to note that.
Q135 Chairman: Why, do you think?
Dr Rowlands: I do not know why.
Q136 Dr Harris: Are any of you aware
that Dr Brind runs something called the Breast Cancer Prevention
Institute which sells products to women on the basis of a breast
cancer risk that has been rejected by every respected group—not
individuals, whether they are Chris Richards, Sam Rowlands or
myself—of cancer specialists anywhere in the western world?
Dr Rowlands: I did notice that
Dr Gardener's submission refers to the Breast Cancer Prevention
Institute which is a website reference, which I would not think
was admissible.
Dr Richards: Dr Brind's studies
are well respected. The RCOG said that his method of analysis
in 1996 was well conducted with no major methodological shortcomings
and could not be disregarded. Those are powerful words from the
Royal College, are they not?
Q137 Dr Harris: You are aware that
Dr Brind publishes sometimes in the journal of the American Association
of Physicians and Surgeons? Are you aware of whether that group
has an ideology? Are you aware whether that groups that runs that
journal has a particular—unusually for a journal, may I
say—policy that is American pro-life?
Dr Richards: Dr Harris, is you
being a member of the Human Secular Society an influence on how
you ask questions?
Dr Harris: You are not answering my question,
are you? I do not purport to be an expert witness coming before
my fellow parliamentarians. I would like you to answer.
Chairman: Dr Harris, please respect the
chair.
Dr Harris: I do of course respect you
and your expertise.
Q138 Chairman: I think Dr Richards
has answered the question and I think the answer to Dr Harris's
question is?
Dr Richards: Sorry?
Q139 Dr Harris: Would you accept
therefore that the journal in which Dr Brind publishes has an
actual policy on pro-life anti-abortion in the United States?
Dr Richards: No, I would not.
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