Select Committee on Science and Technology Minutes of Evidence


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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