Select Committee on Science and Technology Minutes of Evidence

Examination of Witnesses (Questions 300-303)


17 OCTOBER 2007

  Q300  Chairman: And it is the only medical procedure in your view that needs this? Nothing else does?

  Rev Dr Fleming: I am not saying nothing else does. This is a particular kind of procedure. You are talking about a medical procedure often being prescribed for a social reason or a psychiatric reason and that is highly unusual in medicine. Usually a medical procedure is done for a medical reason. This is not being done for a medical reason and in that case, if the professed reason initially is a psychiatric indication you would think that somebody who has psychiatric expertise would be able to do it.

  Ms Quesney: It certainly is one of the only medical procedures that does require two doctors' signatures. I think the other one is sectioning under the 1983 Mental Health Act. I think there is also growing support from medical professionals, the BMA, the RCOG, the RCN, that the two doctors' signatures are unnecessary, that they cause an unnecessary burden on the NHS, but also, I think very importantly, they cause a huge amount of delay in certain cases for women and I think that is totally unfair. That is also not taking into account the fact that some doctors do veto women's decisions. We really need to get into a situation, like most other European countries, where a woman makes the abortion decision in consultation with her doctor but not with the permission of two doctors.

  Dr Saunders: I think we have to understand this in its historical context. Abortion is quite unique because under the Offences Against the Person Act 1861 abortion is still illegal in this country, which means that if you commit an illegal abortion you can go to prison for 14 years. The reason there are two doctors in the Act has nothing to do with medicine or safety but everything to do with legality.

  Q301  Chairman: And you think it should be retained?

  Dr Saunders: It is to confer immunity upon doctors who approve or carry out abortions on the grounds that they have complied with the guidelines in the Abortion Act and therefore are not acting unlawfully. We must not confuse the legal and the medical question.

  Ms Weyman: There is absolutely no reason why we should have the two doctors' signatures, for medical or scientific reasons. It does seem rather odd that in 2007 we are still bound by an Act that was passed in 1861, the Offences Against the Person Act and that really we should have something that does not cause the delays. I think the delay issue is a very serious medical issue, particularly if a woman encounters a first doctor who will not sign the form, will not refer her and does not make that clear. We know that some of the delays that do occur, which then pushes the abortion on, which makes it potentially less safe, the risk increases as gestation increases, are quite harmful to women.

  Q302  Chairman: Finally, we heard from the first panel their views about procedures at home. Do you think there is a case for in fact having procedures in place other than registered premises?

  Rev Dr Fleming: I am persuaded that the safety of the woman is far better guaranteed by abortion procedures being carried out in the current facilities that are provided under the Act.

  Ms Quesney: Very much like in France or in the US, I think there is a case for offering women choice. I think it is really important that when a woman decides to have an abortion she is offered the best possible procedures and the choice to make that a straightforward procedure.

  Q303  Chairman: The patient's choice?

  Ms Quesney: Yes.

  Dr Saunders: I agree with the BMA that there should be no home abortion for the sort of reasons that Nadine Dorries has outlined. I do not think the psychological effects on women, the small number of women who would be upset by the pain and bleeding and the whole process, have been properly researched.

  Ms Weyman: This is common practice in other countries. Certainly the research that we commissioned, which was done in four centres in the UK, showed that most of the women in the study would have found it acceptable to have it at home and indeed there were a significant number who would have preferred it. If you are in an environment where you feel relaxed and happier then you feel less pain. I think it is a question of choice. In many other countries it is not and women only have the second stage at home. Our view is that there should be choice and that women should be able, given the information and advice, to exercise their own judgement about what is going to be best for them.

  Chairman: On that note, could I apologise to the panel for a very swift session and apologise to my Committee because I am sure you wanted to ask 1,001 other things. Dr Fleming, Dr Sanders, Anne Quesney and Anne Weyman, thank you very much indeed.

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Prepared 15 November 2007