Bernard Moran writes on questions hanging over the proposed guidelines on terminations.
Should a doctor be required to offer abortion as an option, to his or her pregnant and distressed patient?
In March, 2009, the Medical Council of NZ published a discussion paper on proposed medical guidelines entitled "Beliefs and medical practice".
Council chairman Dr John Campbell wrote a commentary on the
guidelines in the NZ Doctor.
He observed: "Not surprisingly, it is the doctor's obligations to a woman wishing to discuss a possible termination of pregnancy that provoked the most response and discussion."
The council's guidelines are still under wraps, but it is believed that doctors who have objections to abortion may be required to offer it to patients who have doubts about their pregnancy.
Eight doctors in Wellington recently filed an application in the High Court for a judicial review of these guidelines, presumably as to how binding on doctors they may be.
The draft guidelines acknowledged that some doctors may have a conscientious objection to abortion on religious grounds.
But they omitted to consider that there may be GPs well-versed in recent research carried out in New Zealand and overseas on abortion and mental health - who could object to offering abortion on the grounds that it may adversely harm their patient's mental health.
This would be a case of a GP exercising his or her professional medical expertise and judgment in "duty of care" to the patient.
Abortions approved on the grounds that continuing the pregnancy could be a danger to the mental health of the woman or girl account for 98.7 per cent of all induced terminations in this country.
Let's look at the daily reality of medical practices around New Zealand.
Doctors have told me how difficult it is in a busy surgery to properly counsel a distressed patient with an unplanned pregnancy.
There is a queue of patients waiting outside, and confronted with a patient who clearly doesn't want to be pregnant, it is easy and tempting to write out a referral form for a "termination of pregnancy". That's the allure of abortion. End the pregnancy, problem solved, life goes on as before.
A doctor who knows the medical establishment well (and personally supports abortion on demand) told me that in general they believe abortion benefits women.
However, in 2006 and 2008, there were two landmark research projects carried out by the Otago University Health and Development Team, headed by Dr David Fergusson.
The second study entitled "Reactions to abortion and subsequent mental health" was published in the November 2009 edition of the British Journal of Psychiatry. The key findings were that unwanted pregnancy leading to abortion was likely to be a risk factor for subsequent mental health problems, whereas unwanted pregnancy leading to live birth was not a risk factor for these problems.
This bears out the experience of the late Dr Diana Mason, who looked after thousands of single mothers, most of them initially distressed.
She observed: "I know from my own professional experience that the mother's attitude to her pregnancy will in the normal course of time entirely change."
The 2008 Otago Study, however, found that 90 per cent of the women who experienced subsequent mental health problems, considered that their decision to have an abortion was correct. That would seem cut and dried, but were they encouraged to look at the benefits of other options such as open adoption.
The council has shown no interest in the Otago University research, despite the implications of its findings that there must be many thousands of "invisible" women coping with the after effects of their abortion.
A former chaplain to Queen Mary Hospital alcohol treatment centre at Hanmer Springs told a senior nurse that in his experience most of the women patients had undergone an abortion which led to their alcoholism.
One Wellington single career woman recently wrote of her abortion secret: "It's like an invisible neon sign. I can spot the same experience in other people a mile off and I am terrified that they will recognise it in me. It staggers me that even my closest friends haven't picked it up yet and part of me knows that it is only a matter of time. I once heard someone describe alcoholism like a circling shark and I'd describe carrying the knowledge of my abortion in the same way. It really is like a shark that circles around then goes away again. You know it will be back, each time a bit closer, and because I am trailing blood, it always knows where to find me."
The ironic tragedy in her anguish is that the GP who referred her for the abortion, the counsellors who supported her decision, the surgeon who performed the procedure, all thought what they were doing would be beneficial for her.
Hopefully, the delay caused by this High Court application might lead to an acknowledgement by the Medical Council that this is a much more complex area of medical cause and effect that requires a reappraisal of the guidelines for GPs.
Bernard Moran is communications manager for Voice for Life Inc.
