Abortion raises risk of mental health problems by 81% says major new review

In the largest study of its kind researchers have concluded that women having abortions experience an 81% increased risk of mental health problems.

Published in the prestigious British Journal of Psychiatry, the review also found almost 10% of all mental health problems are shown to be directly linked to abortion.

The Daily Mail, Daily Telegraph and Press Association have published reports but interestingly not the BBC. Amongst the broadcast media CBS and ITN have so far covered it.

A much fuller analysis of the study has been posted on the CMF website. Mary Davenport's review on the American Thinker blog is also worth reading.

Separate effects were calculated based on the type of mental health outcome with the results revealing the following: the increased risk for anxiety disorders was 34%; for depression it was 37%; for alcohol use/abuse it was 110%, for marijuana use/abuse it was 220%, and for suicide behaviours it was 155%. Nearly 10% of the incidence of all mental health problems was shown to be directly attributable to abortion.

Significantly women who had had abortions had a 55% increased risk of experiencing any mental health problem when compared to women who had delivered unintended pregnancies.

This new review, titled Abortion and mental health: quantitative synthesis and analysis of research, was conducted by Priscilla K. Coleman from Bowling Green State University, Ohio, USA, and is based on 22 published studies looking at 36 effects. Only the strongest studies were included, with a combined number of participants totalling over 850,000. Overall the review brings together data on 877,181 participants 163,831 of whom experienced an abortion.

The ‘strongest’ studies are based on a sample size of 100 participants or more, use of a comparison group, and employment of controls for variables that may confound the effects such as demographics, exposure to violence, prior history of mental health problems, etc.

On Tuesday 6th September MPs in the House of Commons are set to vote on an amendment to the Health and Social Care Bill 2011. Tabled by MPs Nadine Dorries and Frank Field it seeks to change the law to ensure women seeking abortion are offered independent advice on their decision to seek a termination.

As MPs prepare to vote on introducing independent counselling for women considering abortion, it’s imperative women are made aware of the real risks of developing mental health problems post-abortion.

Guardian claims Cameron is caving in to appease abortion industry over Dorries amendment – but is it just more spin?

The Guardian newspaper is tonight claiming that Prime Minister David Cameron has decided to vote against an amendment to the Health and Social Care Bill that would give women a right to pre-abortion counseling that is independent from the abortion industry.

In an article titled ‘Downing Street forces U-turn on Nadine Dorries abortion proposals’ the paper, which has been waging a war of words against the amendment, is claiming that ‘No 10 decides to vote against Tory backbench amendment seeking to stop charities offering abortion counselling’.

But how much of the report is actual fact and how much is just spin?

If we look at what Downing Street has actually said (ie. what is in quote marks rather than the Guardian’s interpretation) we might come to a different conclusion altogether.

So what has Downing Street actually said?

‘The prime minister believes that women should have a choice, a proper choice, not any one selective group of organisations,’ the source said.

Well that is no different from what the government has said already. Dorries and Field had asked that women be given an offer of counselling that was independent from the abortion industry which surely rules out the abortion industry alone (BPAS, MSI etc) doing all the ‘counselling’.

‘The discussions currently under way do not represent any moral shift in the government's approach to abortion as an issue, and there are no changes to the Abortion Act involved.’

Well there never was any change to the Abortion Act proposed, just a new duty for GP consortia to provide independent counselling. The actual text of the amendment adds an additional item to a list of commissioning duties/powers to be conferred on GP consortia by the bill as follows:

after paragraph (f) insert a new paragraph as folllows—
“(g) independent information, advice and [sic] couselling services for women requesting termination of pregnancy to the extent that the consortium considers they will choose to use them.”.’.

In this section, information, advice and counselling is independent where it is provided by either—
(i) a private body that does not itself provide for the termination of pregnancies; or
(ii) a statutory body.”.’.

The Downing Street statement concludes:

‘Instead the concern is to ensure that women, in what is an extremely difficult and often traumatic situation, have access to information and counselling that best meets their needs. We will continue to discuss this with all involved in the debate. We plan to consult widely on these proposals later this year.’

So there is going to be a consultation. Well that is what we all expected anyway.

So summing it all up there is still a commitment to give women a proper choice and not leave them at the mercy of the abortion industry with its ideological and financial vested interests. And there is nothing in the statement that indicates the government is committed to allowing the abortion industry to carry on doing any of the ‘counselling’ that has been the subject of so much criticism.

It seems that Cameron is caught somewhat between a rock and a hard place.

If he caves in to the demands of the abortion industry and liberal elite in order to appease his coalition partners he will be leaving women at the mercy of the abortion industry and will lose the support of much of the right wing of his own party along with the Labour Catholics – both sizeable groups.

But if he votes for the Dorries amendment he will arouse the ire of the Liberal Democrats, trade unions and Labour left.

No wonder he is tempted to kick the thing into the long grass for a few weeks with a consultation. What will he decide? And what will be the next step in this intriguing drama? We will have to wait and see. I suspect there are still some fascinating twists and turns to come.

In the meantime let’s not take the Guardian too seriously. In fact I have just heard that Newsnight has said that Downing Street is denying the story.

The abortion industry and its ideologues are clearly rattled by the events of this year and fear they are losing ground. And rightly so. They are. And it’s not over yet. No, this is just the beginning.

Tragic story of Sophie Tyler demonstrates triumph of hope over adversity

The media today carry the tragic story of a teenager left paralysed from the waist down by a hospital error.

An epidural spinal anaesthetic was wrongly left in place after Sophie Tyler, 17, of Risca, near Newport, had a gall stone operation.

Birmingham Children's Hospital has now apologised and admitted liability and a medical law expert is calling for it to ensure lessons are learned from the devastating error.

The hospital’s admission of liability has left the way open for a full settlement, providing Sophie with financial support for the rest of her life.

You can read the details of the case in the Daily Telegraph, Daily Mail and Independent but I was particularly drawn to this young woman’s testimony which is not atypical of young people who suffer these kinds of horrendous injuries.

According to the BBC her initial reaction was not unsurprisingly one of deep despair:

‘When I first came home I was depressed - I wouldn't get out of bed. I would just lay there wishing it had never happened or wishing they had killed me because I had to live with the reality and the consequences of somebody else’s mistake.’

But now she is speaking of her personal battle and her dreams for the future. She has recovered from her earlier depression, although she still has dark days, and is back at school, although cannot attend full time due to ill health:

‘I still go to school, but everything is a lot harder…The money will provide the support and will mean I can look at living on my own without worrying about my mum being there with the other kids. I can look at going to university rather than living at home.’

The case demonstrates how the overwhelming majority of young people, with the proper support, are able to adapt to devastating injuries and find meaning and purpose in a very different life than that they would have chosen for themselves.

Spinal cord injury is actually not uncommon – about 11,000 new cases occur in the US every year and about 250,000 people are estimated to be living with the condition.

On a population basis we would therefore expect about 2,000 new cases a year in the UK and 50,000 living with the condition at any one time. About half of these would involve the cervical spine, with the strong risk of tetraplegia.

It is not unusual for young people immediately after such an injury to suffer depression or even be suicidal – but these feelings almost always are not permanent.

A 1985 British Medical Journal study of 21 people who were paralysed from the neck down and needed ventilators to help them breathe, found that only one person wished that she had been allowed to die. Two were undecided, but the remaining 18 were pleased to be alive.

In other words the number of people with spinal cord injury wanting to kill themselves is very low indeed as a percentage of all those with the condition.

The Guardian reported in 2009 that amongst over one hundred people who had killed themselves at Dignitas over ten years only two had tetraplegia.

I recently blogged about the inspiring story of Matt Hampson, the Leicester rugby player who suffered tetraplegia after a scrum collapsed, and now runs a charity to raise money to support people who he sees as ‘less fortunate’ than himself.

Such stories of triumph over adversity should get many more media column inches and

I wish Sophie every blessing as she adapts to her new life.

Morphine kills the pain, not the patient but some people still just don’t get it

One of the most depressing aspects of campaigning against the legalisation of assisted suicide is dealing with misinformation propagated by the pro-euthanasia lobby and sadly at times even by members of the medical profession.

One of the ‘myths’ used to prop up the failing case for the legalisation of assisted suicide is the false belief that doctors all over Britain are killing people with analgesic drugs like morphine because they need to administer these drugs in lethal doses in order to kill pain effectively.

It is particularly wearying to hear doctors putting this argument as it reveals either that they are ignorant of the medical facts or, even worse, are seeking deliberately to mislead people in order to advance the pro-euthanasia cause: ‘We are killing people anyway with morphine so why not just be honest about it and legalise euthanasia’.

The latest example of this kind of misinformation appears in the Daily Mail this morning in an article by Nick Maes titled ‘I'll always be grateful to the GP who eased Mum's pain - even if it hastened her death’.

Maes relates the story of Dr William Lloyd Bassett, a Shropshire GP, who has been censured by the General Medical Council for giving an overdose of morphine to a man dying with lung cancer. Last week, a GMC hearing decided that Dr Bassett should continue to practise, but issued a warning of serious misconduct against his name.

He then goes on to describe how the same doctor ‘eased his own mother’s passing’ in a similar way.

The fact is that in good hands morphine kills the pain and not the patient. The real need is for better education of doctors in good palliative care – so that they know how to administer the drug effectively and safely – and better education of the public about the facts so that the pro-euthanasia lobby cannot continue to pull the wool to advance their agenda through misinformation and scaremongering.

For those interested in more detail about this issue I would highly recommend the article ‘Morphine kills the pain, not the patient’ published in Medical News Today, which I have reproduced below in full:

Professional and public anxieties about the effects of morphine continue to hinder adequate prescribing of this vital painkiller for genuine pain relief, claims a Comment in this week's edition of The Lancet.

Nigel Sykes, of St Christopher's Hospice, London, UK, says that the notorious Dr Harold Shipman's use of morphine as a murder weapon has further increased disquiet among UK medical professionals.

Dr Sykes claims that the best known fact about morphine among the public and physicians is that it can be addictive, when in fact less than one in 10 000 patients prescribed the drug as part of treatment becomes addicted.

He adds: "For physicians, the second best-known fact is that morphine can precipitate respiratory depression. As a consequence, if offered enough confidentiality, clinicians can be readily found who will confess to having shortened the life of their patients to achieve pain control."

The Comment goes on to say that it is hardly surprising in light of these points that the media view everyday medical practice for severe pain control as increasing the dosage of morphine until the patient dies.

Dr Sykes welcomes the recent study from the US National Hospice Outcomes Project, which studies morphine/opioid use and survival at the end of life - as it provides facts with which to explode the myths about morphine.

The study assessed 725 patients with end-stage cancer, lung disease or heart disease, and found that length of survival was not linked to either absolute or percentage change in dose of morphine or other opioids.

No combination of factors was capable of explaining a variation of more than 8% in survival time, which points to an overwhelming influence of the individual's disease severity.

Only patients who have no experience of opioid treatment are at significant risk of respiratory depression.

Dr Sykes says: "A patient with moderate-to-severe chronic pain, malignant in origin or not, who is given the incremental dose-titration practised in pain and palliative care centres is not at such risk. A physician who truly is killing his or her patient in the name of pain relief is not merciful, just incompetent."

He adds: "This problem matters because underprescribing of opioids remains a major barrier to effective pain control."

Dr Sykes also expresses his concerns for pain relief in developing countries, saying: "If ineffective pain management is still an issue in high-income countries, it is nearly universal in low-income countries where access to morphine is limited or absent, but where most people dying from cancer or AIDS reside."

Amendment giving women option of independent abortion counseling is a step in the right direction

On 6 September MPs will debate an amendment to the Health and Social Care Bill, which seeks to enshrine in law the right of women to have full and free access to independent information, advice and counseling before going ahead with an abortion.

The amendment would also prevent charities such as Marie Stopes (MSI) and the British Pregnancy Advisory Service (BPAS) – which between them carry out about 100,000 abortions a year – from providing advice or counseling to women seeking abortion.

The MPs placing the amendment, Nadine Dorries and Frank Field, argue that because MSI and BPAS carry out and profit from abortions, they are conflicted from offering independent advice at the same time. Nadine Dorries has accused them of having a commercially charged ‘vested interest’ and believes this amendment could reduce the total number of abortions by as much as a third, or 60,000 a year.

The Department of Health, regardless of what happens in the Commons next week, is already promising to ‘develop proposals to introduce independent counseling for women seeking abortion’. In doing so, it has seemingly accepted that the advice given by BPAS, Marie Stopes and others is not independent.

CMF Head of Public Policy Philippa Taylor has written an excellent blog giving an overview of the amendment and explaining why Christians should support it.

In it she urges readers to write to their MPs urging them to support the amendment and points them to the website of the Right to Know Campaign for further information about how to do it.

A fascinating article in the Daily Mail today by Jenny Stocks raises very disturbing questions about the quality of abortion counseling currently available through BPAS and MSI.

CMF has previously highlighted the fact that those countries with laws requiring the offer of counseling or a cooling off period before abortion have abortion rates on average that are a third lower than those, like the UK, which don’t.

It also cites a 2008 Comres survey showing that 51% of British women felt they had no choice but to have an abortion and that 37% wish their decision could have been different.

I have previously outlined how private abortion providers gained a stranglehold on taxpayer funded abortions under the last government. In 1991 the NHS funded 84,369 abortions in total. By 2010 that figure had more than doubled to 181,304. The growth of NHS-funded but privately-provided abortions entirely accounted for this increase.

Women are currently are not given the information, support and time necessary to make an unpressured decision about abortion and this amendment is a small step in the right direction in giving them that opportunity.

At present there are over 2,000 abortions in Britain for every baby adoption. This is a staggering statistic.

I am convinced that given the opportunity to reflect, and with the right support, many thousands more women would choose to give their babies a chance, either by keeping them or offering them for adoption.

This amendment is a good move that deserves our support.

Christian Medical Comment – 12 months, 200 posts, 100,000 page-views – time for a holiday break!

Christian Medical Comment (CMC) was launched in December 2009 with a post titled ‘Goats and kitchen sinks for Christmas’ but I didn’t start regular blogging until September 2010, almost a year ago.

In the last twelve months I have uploaded over 200 individual posts and there have been just over 100,000 page-views – at an average of 450-500 views per post.

Last month CMC finally scraped into the top 500 UK blogs on the wikio rankings and into the top 20 blogs in the Religion and Belief category.

Currently it stands at 17th in Religion and Belief and 438th overall amongst wikio’s 211,354 registered blogs. It also, last November, just snuck into the Jubilee Centre's seven best blogs giving a Christian perspective on social and political issues.

CMC is a specialist blog majoring on issues at the interface of Christianity and Medicine with specific focus on the beginning and end of life. But my broader aim is to bring to the attention of Christians issues that I believe they should be informed and concerned about.

My three most popular posts have been ‘the Chilean Miners’,‘What Terry Pratchett didn’t tell us’ and ‘Homophobic or homosceptic?’ all of which have been reposted several times by other bloggers.

The blog has at times come to wider attention, playing a significant role in exposing Lord Falconer’s sham commission on assisted suicide, and bringing to national media attention the scandal of transplanted organs being taken from Belgian patients after euthanasia. It also counts the Telegraph and the BBC amongst its ten top referring urls.

I’m particularly grateful to those other blogs (especially Euthanasia Prevention Coalition, MercatorNet, Anglican Mainstream and the Official CMF blog) which regularly republish my posts giving them wider distribution and also to the Christian Institute, Christian Concern and Westminster Declaration which frequently link to or quote from them.

Blogging can be a lonely business and the 150,000 or so words on this blog have taken quite a while to write – often late at night at the end of a long day.

But I have been constantly encouraged by readers to keep going – and so I have endeavoured to do so. The readership is wide – with 64% of my readers coming from the UK, 16% from the US and 7% from Canada, Australia, Germany, Ireland, Russia and the Netherlands. The remaining 13% come from all over the world.

So let me take this opportunity to thank all my readers for your support and wish you God’s richest blessing.

This will probably be my last update for a while as we take a family holiday break.

Hopefully I’ll see you next month.

To him who is able to keep you from stumbling and to present you before his glorious presence without fault and with great joy — to the only God our Savior be glory, majesty, power and authority, through Jesus Christ our Lord, before all ages, now and forevermore! Amen. (Jude 24, 25)

What Abdel Al-Megrahi and Ronnie Biggs teach us about the fallibility of ‘safeguards’ in assisted suicide laws

Tomorrow, 20 August, marks the second anniversary of the release from a Scottish prison of Abdel Baset Ali al-Megrahi, the only person convicted for the Lockerbie bombing.

A leading article in today’s Times, ‘Dodging the bullet’, highlights the fact that he was sent home to Libya on compassionate grounds by the Scottish government after medical advice that his advanced prostate cancer would probably kill him within three months.

Al-Megrahi has now lived eight times that long, although the Libyan Government says he is now suffering from a growth in his neck.

When Ronnie Biggs, the Great Train Robber, was released on compassionate grounds in August 2009, his family hoped he’d last until Christmas. But Biggs is also still with us.

The Times suggests we should celebrate the longevity of these two men but their survival is also a reminder of how inaccurate doctors’ forecasts of life expectancy are.

The pressure group Dignity in Dying (formerly the Voluntary Euthanasia Society) champions a change in the law to allow assisted suicide for ‘mentally competent adults who are terminally ill’, but they have recently resisted any specific definition of what they actually mean by ‘terminally ill’.

They have said it again today in relation to the case of ‘Martin’, a 46 year old man with ‘locked-in’ syndrome, who wants his doctor (or lawyer) to be able to help him kill himself.

The US state of Oregon, which legalized assisted suicide in 1997, defines ‘terminally ill’ as ‘six months left to live’ but DID CEO Sarah Wootton has even suggested twelve months on national media, and the organization has run a campaign around multiple sclerosis sufferer Debbie Purdy whose life expectancy probably runs to decades.

Six years ago a select committee of Parliament reported on a bill that would have legalised assisted suicide for those with less than six months to live. They consulted a wide range of experts on how safe such a law would be and commented specifically on the definition of ‘terminally ill’.

The references, unless otherwise indicated, are to House of Lords Report HL 86 (Session 2004-05).

So just how accurate is a prognosis of ‘six months or less’?

Here is what the experts say:

'It is possible to make reasonably accurate prognoses of death within minutes, hours or a few days. When this stretches to months, then the scope for error can extend into years' (Royal College of General Practitioners, HL 86 Vol II, Page 80)

'Prognostication may be better when somebody is within the last two or three weeks of their life. I have to say that, when they are six or eight months away from it, it is actually pretty desperately hopeless' (Professor John Saunders, speaking for the Royal College of Physicians, HL 86 Vol I, Paragraph 118)

'A simple bit of practical evidence is one of the benefit forms that are filled in for patients assigned to a doctor thinking that the patient has six months to live. I would not like to count how many of these forms I have signed in my life for patients still living after a year, eighteen months or even longer' (Dr David Jeffery, speaking for the Association of Palliative Medicine, HL 86 Vol I, Paragraph 119)

'Post mortem research and clinical audit studies performed in the UK, Europe, USA and many other countries consistently show a c30 per cent error in the medically certified cause of death. Significant errors (ie misdiagnosis of the terminal illness resulting in inappropriate treatment occurs in c5 per cent of cases' (Royal College of Pathologists, HL 86 Vol II, Page 730)

The select committee suggested that any 'assisted dying' bill should define terminal illness 'in such a way as to reflect the realities of clinical practice'. This was ignored in the Lord Joffe's 2005 bill, and there is no indication that it has been taken on board by the pro-euthanasia lobby since Parliament's rejection of that bill in 2006. In fact, if anything, they have now dropped reference to any time-scale at all.

Al-Megrahi’s and Bigg’s longevity should remind us of the unreliability of doctors’ prognostic estimates.

A fuller demolition of other so-called ‘safeguards’ arguments can be found on the Care Not Killing website.

Case of man with ‘locked-in syndrome’ may arouse emotions but the law does not need changing

The BBC, Daily Telegraph and most newspapers report today on the case of a 46-year-old man with ‘locked in syndrome’ who is to ask the High Court for permission to allow doctors to help him end his own life. As the Telegraph reports:

‘The man, known for legal reasons only as Martin, suffered a severe stroke three years ago, which left him unable to move. His only method of communication is by using his eyes.

In a highly unusual case, he wants to clarify the law so that medical staff or solicitors who help him to end his life will not be prosecuted. Assisting a suicide carries a potential 14-year jail sentence.

By staring at letters on a computer screen, from his hospital bed in the converted garage at his home, Martin can slowly form words, and has written a statement to the court asking the judges to help him.

Martin’s wife, known as Felicity, respects her husband’s wishes but does not want to play any part in hastening his death. She said she did not want her husband to die.

Martin therefore wants support from professionals to die either by refusing his food and drink, or by helping him to travel to the Dignitas suicide clinic in Switzerland.’

Under the Suicide Act 1961 assisting or encouraging a suicide is a crime carrying a discretionary sentence of up to 14 years. But in each case the Director of Public Prosecutions (DPP) must decide whether there is enough evidence to bring a prosecution and whether it is in the public interest to do so.

The public interest test is decided on the basis of applying a number of criteria published following after a public consultation in February 2010. Two of these criteria are specifically relevant here.

The DPP is less likely to bring a prosecution if he believes that the ‘assister’ was ‘wholly motivated by compassion’ but more likely to do so if the assister is ‘acting in his or her capacity as a medical doctor, nurse, other healthcare professional, a professional carer (whether for payment or not), or as a person in authority...’

Martin’s lawyers, Leigh Day & Co, intend to ask the High Court to afford the same ‘protection’ to doctors and legal staff, who would potentially also face disciplinary action from their professional bodies, as the DPP currently does to those presently sheltering under the (weasel) clause ‘wholly motivated by compassion’. They are essentially trying to force the DPP to amend his prosecution criteria to accommodate Martin. The case is expected to begin next month.

Thus far the DPP’s practice has been not to prosecute those he judges to be ‘wholly motivated by compassion’ but the guidance of medical insurance groups to doctors about not being involved has been very clear.

The Medical Defence Union’s advice to its members remains that ‘doctors approached by patients for advice about suicide should not engage in discussion which assists the patient to that end. Members who are faced with requests for help from patients, including for example the provision of medical reports, should contact us for advice.’

The Medical Protection Society (MPS) – which provides indemnity, legal and professional support to around half of all doctors in the UK – says that ‘doctors who have even the slightest suspicion that their patient may be planning an assisted suicide should proceed with extreme caution and not comply with requests for medical or travel reports’.

Martin’s case will no doubt arouse strong emotions and I see that already Dignity in Dying (formerly the Voluntary Euthanasia Society) are attempting to distance themselves from it by saying that as Martin is disabled but not terminally ill they cannot (publically) back his cause.

What should our reaction be? There are few people who will not feel for Martin in his predicament, but the real issue at stake is whether the law should be changed further to accommodate his wishes. My view is ‘absolutely not!’

The Suicide Act is there to protect vulnerable people from exploitation and abuse by those who might an interest, financial or otherwise, in their deaths. Any further removal of legal protection by creating more exceptions for bringing prosecutions would encourage unscrupulous people to take liberties and would place more vulnerable people – those who are elderly, disabled, sick or depressed – under pressure to end their lives so as not impose a burden on family, carers or society.

We also need to realise that cases like this are extremely rare and that hard cases make bad law. The overwhelming majority of people with severe disability – even with ‘locked-in syndrome’ – do not wish to die but rather want support to live. I have previously highlighted inspiring stories on this blog of people who with good support have been able to get to a position where they can see meaning and purpose in lives even in the face of substantial suffering. It is assisted living they want, not assisted dying.

Finally, we all accept that there are limits to choice. Even in a free democratic society there are boundaries to our autonomy. We are not entitled to exercise ‘freedoms’ that will endanger the reasonable freedoms of others. That is why we have laws. Every law limits choice and stops some people doing what they might desperately wish to do. This is in order to maintain protection for others. The current law is clear and right and does not need fixing or further weakening. On the one hand the penalties it holds in reserve act as a powerful deterrent to exploitation and abuse. On the other hand it gives the DPP and judges some discretion to temper justice with mercy in hard cases. Let’s not meddle with it.

I have argued previously that the DPP is already too lax in his interpretation of the law. He certainly does not need any more encouragement. This case, however it might play on our emotions, needs to be rejected. There is too much at stake – and acceding to Martin’s requests risks making the doctor (or the lawyer) the most dangerous man in the state.

Doctors already have the power to kill. Let’s not make it any easier for them (or for lawyers or anyone else) to get away with it.

How private abortion providers gained a stranglehold on taxpayer funded abortions under the last government

Abortion was legalised in Britain in 1967. However, under the Labour government of 1997 to 2010 abortion became a publicly funded private industry with abortion ‘providers’ gaining a stranglehold.

I have highlighted in a previous blog how tax-payer funded abortions have moved progressively from the public to the private sector over the last two decades.

In 1991 the NHS funded 9,197 abortions carried out by the private sector in England and Wales. By 2010 that figure had risen to 111,775 - an increase of over 1100%.

In 1991 the NHS funded 10% of abortions carried out by the private sector. By 2010 that figure had risen to 93%.

In 1991 the NHS funded 84,369 abortions in total. By 2010 that figure had more than doubled to 181,304.

The growth of NHS-funded but privately-provided abortions entirely accounted for this increase.

The British Pregnancy Advisory Service (BPAS) and Marie Stopes International (MSI), which have a combined income of about £150 million per year, much of it from tax revenues) have carried out the vast majority of these tax-payer funded abortions. However others are also involved.

The list of institutions approved by the Department of Health to carry out private abortions runs to 73!

Of these 13 belong to Marie Stopes and 22 to BPAS. There are also a number of other private hospital chains which profit from abortion. Prominent amongst these are:

Spire - 8 centres doing abortions
Nuffield Healthcare – 8 centres
BMI Healthcare - 8 centres

Of the remaining 14, three are NHS treatment centres and the remainder are miscellaneous hospitals.

Whilst Marie Stopes and BPAS specialise in abortion the remaining hospitals perform other procedures too.

A full list of all private sector abortion centres can be found on the Department of Health website.

The stranglehold these institutions ‘enjoy’ was established by way of two documents produced by the Department of Health in 2001 by the Labour government.

The first of these, ‘Procedures For The Approval Of Independent Sector Places For The Termination of Pregnancy’, was published on 30 November 2001. The 28 page document outlines the various hoops each centre needs to jump through in order to be registered and obtain tax-payers money.

The second, ‘Procedures for the registration of pregnancy advice bureaux’, was published on 23 November 2001. The 15 page document outlines the ‘set of Required Standard Operating Principles’ Pregnancy Advice Bureaux must comply with if they are to become registered.

So which institutions are in the list of approved bureaux?

Well there are 54 of them: 30 run by BPAS, 15 by Marie Stopes, 8 by the Pregnancy Advisory Service and one by the Calthorpe Clinic. The Pregnancy Advisory Service is run by the ‘South Manchester Private Clinic’ (SMPC) which describes itself as supporting ‘the right for people to limit their family size. For over 30 years, we have been providing surgical and medical abortions for thousands of women every year.’ The Calthorpe Clinic is described as a ‘sister clinic’.

The full list is again on the Department of Health website.

So yes, the same people provide both ‘pregnancy advice’ and abortion – the two sides of one ‘abortion industry’ coin.

The DoH document above tells us that ‘Women may obtain advice on pregnancy matters and access to abortion services through a GP, NHS clinic/hospital or a PAB’ and that ‘A PAB may be defined as a “place that provides advice and help to women who may be pregnant”’.

But we are also told that ‘all premises seeking approval as a PAB will be required to confirm that they will comply with a core set of principles (known as “Required Standard Operating Principles” – RSOPs). In particular, every woman must:

• have a pregnancy test as appropriate;
• be fully informed about the choices available to her – including alternatives to an abortion;
• have the opportunity to receive information on pregnancy matters;
• receive impartial advice on the termination options that are available to her;
• be given advice on contraceptive needs.'

So pregnancy testing, ‘counselling’, ‘advice’, abortion are contraception are inextricably linked together. The publicly-funded private abortion providers receive referrals from the formally approved ‘pregnancy advice bureaux’ which they also largely run.

Given that the BPAS and MSI centres, which make up the vast majority, also provide abortions from which the two organisations profit financially, the question can justifiably be asked whether they are capable of ensuring that women are ‘fully informed about the choices available to her – including alternatives to an abortion’.

It is noteworthy that there is not one advice centre run by a pro-life organization on this list – in fact the requirements effectively rule them out of the running.

There are some other interesting things to note from the document on pregnancy advice.

‘All PABx will be required to advise the Department of the aggregated number of referrals for termination that they have made and the number of women whom they are aware of who choose not to have a termination each calendar year. This return should be made by the 1st of February of the following year.’

Well that information should be freely available under the Freedom of Information Act! It will be interesting to see.

‘All PABx must demonstrate that they have effective services providing advice, medical assessment and counselling.’

Well that would be an interesting study! What kind of counseling do they actually provide?

‘There should also be literature and information on alternatives to abortion – for instance adoption and motherhood – from sources independent of the PAB for women who decide to continue with the pregnancy.’

Hmmm. I’d like to see the sort of literature that is available on these alternatives. I wonder if we can get hold of it. And I wonder how available it really is. And finally…

‘The principles of good practice which all registered medical practitioners are expected to follow when seeking patients’ informed consent to investigations, treatment, screening or research are set out in documents prepared by the General Medical Council and sent to all doctors.’

Again it would be very interesting to see what women are really told.

There is lots of fascinating digging to be done here through further research, FOI applications and parliamentary questions.

British Medical Journal publishes my reply to its article on CMF and faith discussions with patients

A couple of weeks ago the British Medical Journal published an article in its Lobby Watch column about Christian Medical Fellowship, focussing on the issue of whether or not Christian doctors should engage in faith discussions with patients.

This week they have published my response which I quote below in full for the benefit of those who do not have direct access to the BMJ website.

BMJ 2011; 343:d5214 doi: 10.1136/bmj.d5214
(Published 16 August 2011)
Cite this as: BMJ 2011; 343:d5214

Christian Medical Fellowship’s chief executive responds to Lobby Watch article
Peter Saunders, chief executive
Christian Medical Fellowship, London SE1 1HL, UK
pjs@cmf.org.uk

The Lobby Watch article on the Christian Medical Fellowship (CMF) is one sided and devotes 412 words to one of our 5000 members, 127 words to one course that we run, and only 111 words to CMF itself(1).

CMF was founded in 1949 following a notice placed in the BMJ and is affiliated, through the ICMDA (International Christian Medical and Dental Association), with about 70 other national bodies of Christian doctors worldwide. We are interdenominational and mainstream and share the same biblical Christian beliefs as other doctors motivated by Jesus Christ’s teaching and example, including Luke the Physician (who wrote Luke and Acts in the New Testament) and such medical pioneers as Paré, Pasteur, Lister, Paget, Barnardo, Jenner, Simpson, Sydenham, Osler, and Livingstone.

CMF’s principal work is to unite and equip Christian doctors, but we also seek to be a voice for Christian values in healthcare. Our commitment to marriage and upholding the sanctity of human life in particular may jar with those pursuing more secular agendas, but the BMA itself referred to abortion as 'the greatest crime' in a 1947 supplement to the BMJ(2).

We welcome the General Medical Council’s recognition that 'all doctors have personal beliefs which affect their day-to-day practice' and that 'discussing personal beliefs may, when approached sensitively, help you to work in partnership with patients to address their particular treatment needs.' We also welcome the recent endorsement by the GMC and Medical Defence Union of “tactful” offers of prayer by general practitioners (3) and the GMC’s confirmation on national radio of the appropriateness of sensitive faith discussions with patients (4). CMF’s new book At a Given Moment by Graham McAll and my recent editorial explore these matters in more depth (5).

Notes
Cite this as: BMJ 2011;343:d5214

Footnotes
Competing interests: PS is chief executive of the Christian Medical Fellowship.

References
1. Cassidy J. Christian Medical Fellowship. BMJ2011;343:d4586. (26 July.)
[FREE Full text]
2. Saunders P. BMA’s 180 degree turn to embrace what it once called 'the greatest crime.' cmfblog.org.uk 25 July 2011.
3.Saunders P. General Medical Council and Medical Defence Union endorse 'tactful' offers of prayer by GPs. cmfblog.org.uk 20 July 2011.
4.Saunders P. General Medical Council confirms the appropriateness of sensitive faith discussions with patients. cmfblog.org.uk 20 June 2011.
5. Saunders P. Faith matters in healthcare encounters. Triple Helix 2011;summer:3.

Social commentators lay blame for riots on Blair government’s policies on schools, jobs and family

Amongst the endless reflections on the riots published this week there was an interesting article in this week’s Sunday Times by Harriet Sergeant based on her 2009 report ‘Wasted - The Betrayal of White Working Class and Black Caribbean Boys’.

In compiling the report she spent a year interviewing black Caribbean and white working-class boys – ‘the very people who have seized our streets’ - for the Centre for Policy Studies. So what were her conclusions on last week’s riots?

Ken Livingstone, the former Labour mayor of London, last week blamed coalition cuts for the riots. He forgets that (these kids) grew up under Labour. They are Blair’s babes and the left’s handiwork. It is not poverty that has stunted their lives but the policies of the previous government in three key areas: schools, work and home.

She unpacks each of these there areas in turn:

Schools

To get an insight into the rage that fuelled the riots, look no further than the statistics on illiteracy that came out the week before. At the age of 14, 63% of white working-class and more than half of the black Caribbean boys have a reading age of seven or less. Almost half of the 16-year-olds marauding our streets lack basic qualifications in English or maths.

Illiteracy is a powerful driver of bad behaviour. The US Department of Justice concluded that failing to learn to read at school ‘meets all the requirement for bringing about and maintaining the frustration level that frequently leads to delinquency’. This ‘sustained frustration’ causes ‘aggressive antisocial behaviour’.

Illiteracy is a life sentence. Half the prison population has a reading age below that of an 11-year-old.

It is not difficult nor expensive to teach a child to read. Countries a lot poorer than ours manage. But they use traditional methods shunned by our educational establishment.

Work

Forty years ago the young men out looting on a weekday would have been in work. They would have left school at 16 and got a job in manufacturing. Now those jobs have gone.

Instead, immigration soared under Labour. Young men like these find themselves in competition with skilled and capable immigrants ready to work long hours for low pay. They lose out every time. According to the Office for National Statistics, of the 1.8m new jobs created under Labour, 99% were taken by immigrants. Since David Cameron came to power the figure is 82%.

The situation is compounded by the benefits system. Far from lifting these young men out of poverty, it bolts them down for good. I went to court with (one boy) for council tax arrears after he got laid off from his temporary agency job. The next time he found work, the adviser in the jobcentre told him not to take it. He would be £30 a week worse off than if he stayed on benefits. After that he gave up.

Home

Politicians are demanding that parents control their children. What planet are they living on? These young men have been left to scramble up any old how. At home and in school, grown-ups are absent or ineffectual.

The lack of male role models was particularly striking. On boy said, ‘All the men I know are in prison or deal drugs. I don’t know one man with a job’.

Nearly every one of the young men I interviewed had a young single mother. Britain has the highest rate of teenage pregnancy in Europe. Despite the huge amount of evidence of the harm this causes children (mothers of children on the ‘at risk’ register, for example, are five times more likely to be single teenage mothers), the Labour government made single motherhood an attractive proposition. Since 1997 a single mother of two children has seen her benefits increase by 85%. We watched the effects of that policy play out on our streets every night last week.

To accuse these young girls of being feckless is unjust. They are merely responding to the economics of the situation. They are as much victims of the crisis in our schools and the perverse influence of benefits as teenage boys. What future is there for a girl who leaves school without a qualification? Whereas boys take to crime, girls get pregnant.

Ministers talk of family breakdown, but there is no family to break down. More than half of single mothers have never lived with a boyfriend. The state has taken over the role of both husband and employer.

She finishes with a raft of measures aimed at rectifying these three areas of deficit.

In another analysis this week, ‘How the liberals ruined Britain’, Melanie Phillips draws very similar conclusions:

The violent anarchy that has taken hold of British cities is the all-too-predictable outcome of a three-decade liberal experiment which tore up virtually every basic social value. The married two-parent family, educational meritocracy, punishment of criminals, national identity, enforcement of the drugs laws and many more fundamental conventions were all smashed by a liberal intelligentsia hell-bent on a revolutionary transformation of society.

Again she focuses on damage to the family as a root cause:

The causes of this sickness are many and complex. But three things can be said with certainty: every one of them is the fault of the liberal intelligentsia; every one of them was instituted or exacerbated by the Labour government; and at the very heart of these problems lies the breakdown of the family.

For most of these children come from lone-mother households. And the single most crucial factor behind all this mayhem is the willed removal of the most important thing that socialises children and turns them from feral savages into civilised citizens: a father who is a fully committed member of the family unit.

You will have to read the whole article to get the full force of it and the way Phillips argues that these changes have played out in work and education.

But I was particularly interested, given that she is not a Christian, in her final conclusion:

Repairing this terrible damage also means, dare I say it, a return to the energetic transmission of Biblical morality. Anyone heard from the Archbishop of Canterbury about the riots? Anyone care to guess what he will eventually say about them? Quite.

When church leaders stop prattling like soft-headed social workers and start preaching, once again, the moral concepts that underlie our civilisation, and when our political leaders decide to oppose the culture war that has been waged against that civilisation rather than supinely acquiescing in its destruction, then - and only then - will we start to get to grips with this terrible problem.

When those outside the church start calling for the church to be doing its job better it is perhaps time that we sat up and listened. I am reminded of St Peter’s words:

‘For it is time for judgment to begin with God’s household’ (1 Peter 4:17)

New pre-natal screening test makes eliminating all people with genetic disease an achievable reality

‘Fetal DNA tests: Are we finally entering an era of eugenics?’ This was the question raised by Nancy Fliesler on the Vector blog last January.

As an Ashkenazi Jew planning to have a baby, Fliesler sought prenatal screening for Tay-Sachs disease, an incurable and lethal condition.

But she asks, ‘What about diseases that don’t severely limit lifespan and aren’t that disabling?’

What should we screen for? Down’s syndrome? Genes associated with bowel or breast cancer? X chromosomes? Where do we draw the line?

Up until now prenatal screening for genetic abnormalities has been carried out using amniocentesis or chorion villus biopsy at eight and twenty weeks gestation respectively. But both tests are invasive carry a risk of miscarriage. Consequently only women at high risk get screened.

Now, however, there is a new non-invasive test that is highly accurate for screening babies early in the first third of pregnancy.

Cell-free fetal DNA is DNA from the baby that has crossed the placenta into the mother’s blood. It makes up about 10% of all free DNA in the maternal blood and can now be examined to determine the baby’s sex and what genetic disorders it carries. It is extremely accurate but currently expensive. However the cost is expected to come down very rapidly in the near future.

This test may mean that every pregnant woman will in the future be tested at an early stage in pregnancy and offered an abortion if their baby carries any genes (including a female chromosome!) that they find undesirable.

The Abortion Act 1967 currently allows abortion up until birth where there is a ‘substantial risk’ or a ‘serious handicap’ – so-called ground E - but this is currently interpreted very liberally indeed.

As I blogged in July, recently revealed statistics showed that between 2002 and 2010 there were 17,983 abortions in this category. The overwhelming majority of these were for conditions compatible with life outside the womb and 1,189 babies were aborted after 24 weeks, the accepted age of viability.

The 17,983 included 26 for babies with cleft lips or palates and another 27 with ‘congenital malformations of the ear, eye, face or neck’, which can include problems such as having glaucoma or being born with an ear missing.

Over the period 2002-2010 there were altogether 3,968 Down’s syndrome babies aborted and now 95% of all babies found to have Down’s syndrome before birth have their lives ended in this way.

As reported recently, fetal DNA blood tests to determine the baby’s gender are already sold privately in the UK and other countries and are extremely accurate fuelling concerns about further sex-selection abortions.

A recent review published in the Journal of the American Medical Association (JAMA), which looked at 57 studies representing 6,541 pregnancies, found that the blood tests gave a genuine result (sensitivity) 95% of the time and that this result was accurate or correct for gender (specificity) 98.6% of the time.

Research last December showed that the entire fetal genome (ie every gene of the baby) can now be identified from the maternal blood using technology already available. So if the price were to come down with further advance the potential is there to identify every baby with a genetic abnormality before birth.

The Sunday Times last weekend quoted a BMJ study saying that fetal DNA tests for Down’s syndrome were 98% accurate and adding that ‘it will be offered initially to parents with private medical cover and others who can afford a fee of £350’. The article claimed that it is also being evaluated for introduction by the NHS in about three years’ time.

The Human Genetics Commission (HGC), a government advisory committee, has already given the green light to preconception genetic tests saying that there are no specific ‘social, ethical or legal’ reasons that stand in the way. The UK National Screening Committee will now consider this advice as it decides whether widespread screening should be introduced in GP surgeries, family planning centres, IVF clinics or pharmacies.

So the only barrier remaining is cost. However, increasingly now, we hear, particularly at a time of economic recession and financial constraint, about the cost of caring for those with disabilities or disease. Cost saving works both ways.

But in reality, because of the very low frequency of genetic disease, the actual cost of prevention, treatment or cure as a percentage of the total health budget is very small indeed.

Furthermore, new preventions, treatments and supportive measures are being developed all the time. In the past PKU universally led to serious brain damage but can now be successfully managed with the right diet after detection. People with cystic fibrosis are living much longer and have a better quality of life as a result of advances in medical technology and palliative care.

Our society’s increasing obsession with celebrity status, physical perfection and high intelligence fuels the view that the lives of people with disabilities or genetic diseases are somehow less worth living.

By contrast the Christian view is that the life of every human individual, regardless of its intelligence, beauty, state of health or degree of disability is infinitely precious. A just and caring society is one where the strong make sacrifices for the weak, or in the words of the Apostle Paul, ‘bear one another’s burdens, and so fulfil the law of Christ’ (Galatians 6:2).

Let’s recognise and resist the eugenic mindset. Our priorities should be to develop treatments and supportive measures for those with genetic disease; not to search them out and destroy them before birth.

Sharp analysis of the real cause of current Western economic instability

A couple of weeks, just before stock markets took a frightening tumble worldwide, I blogged that Merkel and Sarkozy’s ‘extend and pretend’ policies would fail because the real problem was not liquidity but solvency.

I was interested to see in this week’s Times an analysis from Terry Smith, chief executive of Tullett Prebon and of Fundsmith, on the background to our current woes.

Although his solution to the crisis is quite controversial (cutting both government spending and taxes) his analysis of the crisis being indicative of an economic power shift from the Western to Eastern world is bang on. Smith argues first that we have been living in a fool’s paradise:

If we in Britain want to develop the right policies to get us out of our current economic mess, we first need to face up to the cold hard reality that for the past 30 years we have simply been living way above our means.

The West has been outcompeted by the rise of manufacturing and service industries in the developing world. Software programmers in India and Chinese factory workers are willing to work for much less than their Western counterparts. The West’s population has been greying as the baby-boomers pass into old age and advances in medical care have lengthened our lives, increasing the cost of pensions and medical services.

Rather than face the decline in living standards that these fundamental changes entail, we continued to spend so that our standard of living was maintained. More innovative ways were found for people to borrow more and for banks to lend more.

Savings ratios dropped to negligible levels — in the UK from 11.7 per cent of incomes in 1992 to 2.0 per cent by 2008. The size of the public sector swelled to make up for private sector job losses and governments ran deficits as this expansion inflated their costs beyond their tax revenues.

Smith proceeds to show how we have borrowed beyond our means in order to support a lifestyle that we cannot afford, whilst thinking falsely that we can grow our economy to compensate:

This borrowing binge created a housing bubble here, in the US and elsewhere. The ‘solution’ to the banking crisis that broke in 2007-08 when this bubble burst has been for governments to provide capital and liquidity to banks and to guarantee their liabilities. In so doing, Western government finances already in deficit have become unsustainable.

In the UK, government debt is at about 75 per cent of GDP. But if public sector pension liabilities are included, the UK’s debt to GDP ratio would rise to 155 per cent. If the private finance initiative is included and the guarantees given to the banking sector were ever called upon, it would rise to more than 240 per cent.

The situation in the US is worse, with federal debt at 96 per cent of GDP rising to 390 per cent if social security and Medicare liabilities are included. The problem for the US is not political wrangling over the so-called debt ceiling. It is that the US budget deficit has risen continuously since the crisis began and there is no credible plan to check its rise. As in the UK, the spending ‘reduction’ plan relies not upon any actual cuts but upon heroic assumptions about growth that are clearly without foundation in reality.

The eurozone suffers from this same general problem, but it is exacerbated by the single currency. The entry of the peripheral countries into the currency led markets to assume that the credit risk on euro debt issued by them was roughly the same as that of Germany. This bizarre assumption led to the borrowing costs of these countries falling toward those of Germany. Faced with this, these countries went on an orgy of spending, racking up huge government debts. Property prices were inflated, public sector jobs increased, pensions were guaranteed at early retirement ages, and, in some cases, this was coupled with the national pastime of tax evasion.

The consequence has been the bailouts of Ireland, Greece and Portugal, with Italy and Spain now facing a similar prospect.

However, he argues, politicians fail to admit what the real problem is, and for fear of upsetting voters, are unwilling to take the painful steps necessary to put things right:

But politicians continue to deny the painful reality that we have been living beyond our means. So we will probably have more so-called quantitative easing (QE). But ‘printing money’ to fund these growing deficits rather misses the point: if you are spending more than your income, at some point you need to get someone who has money to lend it to you or accept that your currency will be devalued.

Conventional policy responses, such as cutting interest rates to increase demand, are not working. For the past three years, UK rates have been at their lowest level since 1694. Yet despite record low rates, huge government deficits and QE, the economies of the West are still stuttering. Only yesterday the Bank of England cut its growth forecast with Mervyn King saying ‘the imbalances in the world economy are still not being properly tackled and the burden of debt is still there.’

Tuesday’s announcement that US interest rates are expected to remain close to zero until 2013 was greeted with relief by the markets. But these long periods of low rates tell you how bad the crisis is. They are not a solution: look at the Japanese experience of the past two decades.

Smith closes by advocating huge government spending cuts along with tax cuts which is he says are the only way of boosting growth, but he acknowledges that this will cause a huge amount of pain. His best advice is never to get into such a situation:

‘It reminds me of the advice in a manual on seamanship: “Perhaps the worst plight of a vessel is to be caught in a gale on a lee shore. In this connection the following ... rule should be observed: Never allow your vessel to be found in such a predicament . . .”’

I am not an economist but I have always lived by the rule that your expenditure should be less than your income and that you should stay out of debt. It saves a lot of worry.

This basic wisdom seems not to have been grasped by Western governments who seem set on postponing the evil day rather than addressing the real problem.

Rev John Wesley’s famous aphorism was, ‘Earn as much as you can. Save as much you can. Invest as much as you can. Give as much as you can.’

But Western governments instead live by, ‘Borrow as much as you can. Save as little as you can. Spend as much as you can. Give as little as you can.’

As the Good Book says, ‘The prudent person foresees danger and takes precautions. The simpleton goes blindly on and suffers the consequences.’ (Proverbs 22:3)

My advice? ‘Live simply. Save wisely. Give generously. And get out of debt quickly cos the hard rain’s gonna fall!’

Christian pharmacists under threat from new guidelines on morning-after pill provision

Christian pharmacists who object to dispensing the morning-after pill are facing pressure from their professional regulator to recommend other outlets to customers.

Many pharmacists – not just Christians – have moral objections to the morning-after pill because the drug may in some cases act after fertilisation by preventing the implantation of an early embryo. It is thereby technically abortifacient. There is also strong evidence that its ready availability over the counter without prescription does nothing to decreases the number of unplanned pregnancies in a community and actually increases the level of sexually transmitted disease.

Those with moral objections argue there is little difference between being forced to recommend another outlet for the pill and being forced to sell it themselves.

The regulator, the General Pharmaceutical Council (GPhC), has issued ‘non mandatory’ guidance on the matter which they say the guidance will be open to review after one year. ‘Our guidance is advice for pharmacy professionals and explains how our standards might be met, or provide additional suggestions for practice,’ a spokeswoman said.

According to the Daily Telegraph, the guidance was circulated last week. However the latest guidelines on the GPhC website, ‘Guidance on the provision of pharmacy services affected by religious and moral beliefs’, are dated September 2010. They state:

‘If you do not supply Emergency Hormonal Contraception (EHC), (either over the counter or against a prescription) women should be referred to an alternative appropriate source of supply available within the time limits for EHC to be effective.’

The guidance adds that pharmacists should also phone ahead to check that the product is in stock. It also says that conscientious objection on religious grounds must take second place to contractual demands of employers, like the NHS.

As human rights lawyer Neil Addison points out, ‘What many people do not seem to grasp is the fact that if you are refusing to do something because it is morally objectionable you cannot be obliged to recommend someone else’.

And Anna Sweeting-Hempsall a pharmacist in Sunderland said the new guidance ‘forces pharmacists to act against their consciences’ and would cause legal conflicts between staff and employers.

The Telegraph reports her as saying: ‘Now the employers have the right to impose any contractual obligations that take precedence over the right of conscience. The need to notify people beforehand makes you virtually unemployable. Anybody who values the sanctity of life from the moment of conception will be forced from the profession.’

The controversial General Medical Council Guidance, ‘Personal Beliefs and Medical Practice’ leaves doctors with a similar obligation to refer for practices to which they have a conscientious objection:

‘Patients may ask you to perform, advise on, or refer them for a treatment or procedure which is not prohibited by law or statutory code of practice in the country where you work, but to which you have a conscientious objection. In such cases you must tell patients of their right to see another doctor with whom they can discuss their situation and ensure that they have sufficient information to exercise that right. In deciding whether the patient has sufficient information, you must explore with the patient what information they might already have, or need. If the patient cannot readily make their own arrangements to see another doctor you must ensure that arrangements are made, without delay, for another doctor to take over their care.’

These cases rarely come to court and so often the legal precedents are not clear. Although emergency contraception is technically abortifacient, its provision is not covered by the conscientious objection clause in the Abortion Act 1967.

However it may be that equality law might have a bearing on cases like this. In a very recent case a hospital backed down from forcing two Christian nurses to participate in abortion after it received a letter from a lawyer saying that in so doing they could be in breach of the Equality Act 2010.

London hospital backs down from forcing Christian nurses to participate in abortion after receiving lawyer’s letter

A London hospital which tried to force two Christian nurses to participate in abortion has backed down after receiving a letter from a Christian lawyer. The story, which Liverpool barrister Neil Addison of the Thomas More Legal Centre reports on his blog, is also carried today by the Daily Telegraph and LifeSite News.

The two unnamed nurses, who had been employed at the London hospital for ordinary nursing duties, were then allocated to work once a week at an abortion clinic in the hospital. Here they were required to participate in a medical abortions (using the drugs mifepristone (RU486) and misoprostol). When they refused they were told that they had no choice in the matter. One manager in fact commented, ‘What would happen if we allowed all the Christian Nurses to refuse?’

The nurses then approached the hospital’s Catholic chaplain who contacted the Thomas More Legal Centre. Addison then wrote to the hospital on behalf of the TMLC arguing that the nurses had a legal right to refuse to participate under the conscientious objection provisions of s4 of the Abortion Act 1967. He also stated that their belief in the sanctity of life from conception onwards was a philosophical belief protected under the Equality Act 2010 and therefore any attempt to pressure them into participating in the abortion clinic or to suggest that their refusal would affect their career would also be illegal under equality legislation.

The hospital then attempted to tell the nurses that they could be excused from actually administering the abortion drugs but would otherwise have to work in the Clinic. At this point Addison wrote a second letter arguing that this proposal was equally unacceptable because the nurses would still be morally complicit in abortion even if they did not actually administer the drugs. The hospital eventually backed down and the nurses were allocated to other duties.

Addison says he is not aware of the Equality Act ever being used to defend conscientious objection to abortion, but as the courts have already accepted that the philosophical belief in global warming is protected under Equality legislation (see Grainger Plc & Ors v. Nicholson [2009] UKEAT 0219_09_0311) he could see no reason why belief that human life begins at conception should not be equally protected.

Using the Equality Act meant that the Nurses would be able to claim harassment, victimisation or discrimination in an employment tribunal if they were put under pressure at work because of their reliance on the conscientious objection protection in s4 of the Abortion Act.

Section 4 of the Abortion Act 1967,’ Conscientious objection to participation in treatment’ reads as follows:

(1) Subject to sub-section (2) of this section, no person shall be under any duty whether by contract or by any statutory or other legal requirement to participate in any treatment authorised by this Act to which he has a conscientious objection.

The full scope of this clause has not yet been tested in the courts. Whilst it is clear that it covers those directly involved in the abortion itself, the Janaway case ruling (see note below) held that it did not cover a receptionist who refused to type an abortion referral letter.

The current case involving the two nurses did not come to court because the hospital caved in when confronted with the possibility of a legal challenge. However it does raise the question about whether Grainger v Nicholson (the limits of which still have to be explored) may make life easier for some conscientious objectors.

The case is a rare example of equality laws being used to protect the rights of Christians. Previously judges have been criticised for interpreting equality and human rights legislation in ways that allegedly ‘marginalise’ religious beliefs.

Last month, the Equality and Human Rights Commission warned that the courts had failed to protect religious freedom by ruling against Christians who wanted to wear the cross at work.

The watchdog said judges had interpreted the law ‘too narrowly’ and must be more willing to accept that staff who have been prevented from expressing their beliefs have suffered discrimination. However there were hints that it may now be backtracking on this after being put under pressure by members of the gay community.

The victory of the two nurses comes on the heels of a new poll of British medical students that finds them strongly supporting the conscience rights of physicians and medical professionals who don’t want to be involved in doing or referring for abortions.

The new survey, published in the Journal of Medical Ethics found students agreeing that doctors should be allowed to object to any procedure that conflicts with their personal, moral, or religious beliefs. Nearly half of respondents believed in the right of doctors to conscientiously object and refuse to treat a patient who wanted an abortion.

The author contacted 1437 medical students at medical schools in Cardiff, London, and Leeds, and asked them to complete an anonymous questionnaire to canvass their views on conscientious objection to medical practices in 2008.

The current case should encourage Christians exercising conscience on this issue. The two nurses are to be commended for their courage and Neil Addison for his ingenuity. Whilst it doesn’t establish any new legal ground or establish new precedents in law, the case does demonstrate that asking hospitals to make reasonable accommodation for Christians can be successful.

NOTE: For a thorough explanation of the current law on conscientious objection to abortion see ‘Conscientious objection to abortion - ethics, polemic and law’ by Charles Foster in the CMF journal Triple Helix

Ten Point plan to alleviate the riots across England

Christian blogger Adrian Warnock has come up with a ten point plan for quelling the London riots. He adds an eleventh point ‘Pray for London’ and concludes, ‘May God deliver our nation, and use this crisis as an opportunity to call many to himself’.

Here are the ten points – see Adrian’s blog for the details.

1. We must declare a state of emergency and call in the army to the streets of the UK.

2. The rules of engagement must be immediately and publicly changed.

3. RIM Blackberry must immediately and publicly close down their BBM instant messaging service in this country.

4. Arrest anyone who has incited to violence on Twitter, Facebook or elsewhere online.

5. A police website should be set up for members of the public to upload photographs and video of the looters.

6. Sensible Community leaders from all areas such as my pastor should be given opportunities to address the nation via our news channels.

7. Road blocks should be placed around key commercial areas and access to them be controlled.

8. Petrol stations must be immediately required not to sell petrol in cans.

9. A website should be set up for requests for help, and offers of help to be exchanged

10. A clear declaration should be made by the government of who is in charge of the ongoing security operations and how different services will be co-ordinated.

The London riots happened because messages like this blackberry one went viral on smartphone networks

Someone I know received the following message on his blackberry some hours ago. It dispels the narrative that the London riots are simply some sort of reaction to material deprivation and the credit crunch.

Ken Livingstone has taken the opportunity to blame the scale of the rioting on the policies of the current government leading to unprecedented levels of disaffected youth. But this is dangerously simplistic political opportunism.

What we are seeing is primarily opportunist thuggery. The reason all this is happening now with such ferocity is because messages like the following have gone viral on social media networks and are being acted out by people with no internal controls.

It is the social media dimension which enables the culprits to move so fast to start new flash-points and surprise the police.

Blackberry and other outlets must be able to trace the original culprits who sent the messages and those who have passed it on:

'Everyone from all sides of London meet up at the heart of London (central) OXFORD CIRCUS!!, Bare SHOPS are gonna get smashed up so come get some (free stuff!!!) f*** the feds we will send them back with OUR riot!
Dead the ends and colour war for now so
if you see a brother... SALUT!
if you see a fed... SHOOT!
We need more MAN then feds so Everyone run wild, all of london and others are invited! Pure terror and havoc & Free stuff....just smash shop windows and cart out da stuff u want! Oxford Circus!!!!! 9pm, we don't need pussyhole feds to run the streets and put our brothers in jail so tool up,
its a free world so have fun running wild shopping;)
Oxford Circus 9pm if u see a fed stopping a brother JUMP IN!!! EVERYONE JUMP IN niggers will be lurking about, all blacked out we strike at 9:15pm-9:30pm, make sure ur there see you there. REMEMBA DA LOCATION!!! OXFORD CIRCUS!!!
MUST REBROADCAST TO ALL CONTACTS!!!'

China vows crackdown on sex-selective abortion to close gender gap but 160 million Asian girls are already dead

You are unlikely to read this from any British media outlet in the midst of the London riots and falling stockmarkets but China is vowing to strengthen enforcement to prevent sex-selective abortions and close a yawning gender gap. China already has tens of millions more boys than girls as a result of its one-child policy. According to the Associated Press (reported in the Washington Post):

The pledge is in the outline of a plan for childhood development through 2020 but has no specifics. The plan said authorities would increase efforts against the non-medical use of ultrasound tests and abortion of fetuses based on gender.

Spurred by the one-child policy and a traditional preference for boys, sex-selective abortion has created a male-female ratio at birth in China of about 119 males to 100 females, with the gap as high as 130 males for every 100 females in some provinces. In industrialized countries, the ratio is 107 to 100.

The story comes two months after reports of 160 million missing women, mainly in China and India. New York Times columnist Ross Douthat recaps the history of the problem and the changing perceptions of its cause:

In 1990, the economist Amartya Sen published an essay in The New York Review of Books with a bombshell title: ‘More Than 100 Million Women Are Missing’ His subject was the wildly off-kilter sex ratios in India, China and elsewhere in the developing world. To explain the numbers, Sen invoked the ‘neglect’ of third-world women, citing disparities in health care, nutrition and education. He also noted that under China’s one-child policy, ‘some evidence exists of female infanticide.’

Twenty years later, the number of ‘missing’ women has risen to more than 160 million, and a journalist named Mara Hvistendahl has given us a much more complete picture of what’s happened. Her book is called ‘Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men’.

As the title suggests, Hvistendahl argues that most of the missing females weren’t victims of neglect. They were selected out of existence, by ultrasound technology and second-trimester abortion.

The most striking thing about Hvistendahl’s book is where she lays the blame for the 160 million women and the myriad social problems including increased prostitution and sex trafficking which result from the skewed sex ratios. It is not, she argues, a simple case of modern science being abused by patriarchal, misogynistic cultures. That may be part of the story the reality is more complicated. As Douthat explains:

Thus far, female empowerment often seems to have led to more sex selection, not less. In many communities, she writes, ‘women use their increased autonomy to select for sons,’ because male offspring bring higher social status. In countries like India, sex selection began in ‘the urban, well-educated stratum of society,’ before spreading down the income ladder. Moreover, Western governments and philanthropic institutions have their fingerprints all over the story of the world’s missing women.

From the 1950s onward, Asian countries that legalized and then promoted abortion did so with vocal, deep-pocketed American support. Digging into the archives of groups like the Rockefeller Foundation and the International Planned Parenthood Federation, Hvistendahl depicts an unlikely alliance between Republican cold warriors worried that population growth would fuel the spread of Communism and left-wing scientists and activists who believed that abortion was necessary for both ‘the needs of women’ and ‘the future prosperity — or maybe survival — of mankind,’ as the Planned Parenthood federation’s medical director put it in 1976.

In other words, sex selection abortions were originally introduced and fueled by Western liberals as a culturally acceptable means of controlling population growth in developing countries.

‘Unnatural Selection’, argues Douthat, reads like a great historical detective story, and it’s written with the sense of moral urgency that usually accompanies the revelation of some enormous crime.

This places many Western liberals, he says, Hvistendahl included, in a distinctly uncomfortable position. Their own premises insist that the unborn aren’t human beings yet, and that the right to an abortion is nearly absolute. Hvistendahl is describing a holocaust but insists that she hasn’t written ‘a book about death and killing’ and is left struggling to define a victim for the crime that she’s uncovered.

The Chinese, in their crackdown on sex selection abortions, have not had a change of heart about the morality of abortion. They are just, like Vladamir Putin, just desperately concerned about what abortion has done to the demographics of their country.

But the tragedy, Douthat concludes, of the world’s 160 million missing girls isn’t that they’re ‘missing’. The tragedy is that they’re dead.