Examination of Witnesses (Questions 300-303)
REV DR
JOHN FLEMING,
ANNE QUESNEY,
DR PETER
SAUNDERS AND
ANNE WEYMAN
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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