Psychologist: Most Abortions in Britain Illegal

Says “Charade” is Operating Around Country’s Abortion Laws

London, December 04, 2013 (Zenit.org) | 249 hits

  • A British psychologist has said the overwhelming majority of Britain’s abortions are “probably illegal” and that a “charade” is operating around the country’s abortion laws.
  • Addressing a London conference Nov. 29th, Dr. Michael Scott said 99 per cent of abortions in Britain performed each year to protect the mental health of the mother could not be scientifically justified.

The consultant psychologist, who often serves as an “expert witness” with the regional police force in Liverpool, said a “charade” is operating around the working of the 1967 Abortion Act that legalised abortion in Britain.

Abortions on mental health grounds were so dishonest, he said, that they were effectively illegal.

He called for the total abolition of Ground C, the section that permits abortion when the “continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated”.

It is under Ground C that nearly all of about 200,000 abortions are performed annually in Britain, most of them for so-called “social” reasons.

Britain’s chief prosecutor caused controversy earlier this year when he said Ground C could also have been used to legally justify the sex-selective abortions of female foetuses because of their gender.

Dr Scott, an expert on post-traumatic stress disorder and author of ten books on psychology, said the bogus mental health reasons for abortions under Ground C also made the law impossible to either police or regulate.

Any attempted justification of abortion on Ground C “should be treated with great suspicion”, he said, adding that the section was not “fit for purpose”.

He noted from experience that whereas assessments for extreme trauma undergo rigorous examination, that is certainly not the case when it comes to terminations. He described both fields as parallel universes, leading him to see most abortions as illegal.

Dr. Scott said he felt there was a “lot of dishonesty” in the area of abortion – a view, he said, shared by people who are pro-abortion. Of the thousands of abortion cases he said he had studied, not one had involved a woman seeking to end her pregnancy on mental health grounds.

“We have de facto abortion on demand,” he said.

“I doubt it was the intent of most of the supporters of the Act,” he said. “How do we move on from abortion being treated like a visit to the dentist to a more appropriate societal response?”

The London conference was organised by the Medical Ethics Alliance.

Read more on the Diocese of Shrewsbury website

(December 04, 2013) © Innovative Media Inc.

With kind permission of Simon Caldwell

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THE MEDICAL ETHICS ALLIANCE

A coalition of six organisations, three faith based, and three dedicated to the Hippocratic tradition

Its purpose is to promote discussion within the medical profession and general public on medical ethics.

The Faiths represented are Islam and Christianity. It also has advisors from Judaism and the Indic Religions

The Hippocratic organisations look to the post war Declaration of Geneva, which brings the Hippocratic Oath into the twentieth century.

Methodology;

We do not seek to unify our belief systems but seek to bring the different world views to bear on specific contemporary questions.

Examples have been the use of the human embryo for scientific research

Organ transplantation

And currently treatment at the end of life. At the moment this has become a big question especially in the media.

Underlying our work is an acceptance that all of medicine is inspired by a belief in the value of human life and the inestimable worth of the individual person whatever their condition or ability.

There is an implicit belief  that all professionals in medicine can have an understanding of what is right and that the truth can be found by reasoning.

It is certain that religious faith is  itself open to reason and that people of faith can enter into conversation with all persons of good will.

In fact when a question arises,  the members of the coalition are asked their views and there is usually a large degree of agreement.

The MEA maintains a web site and publishes on line. It also  holds meetings for health professions.

An example being the conference on the twentieth of June this year entitled  “Natural death – is a pathway needed”

This  questioned one of the current pathways of care give to those thought to be dying in the NHS today. It has generated a great deal of public interest.

For our website.

google   “The Medical Ethics Alliance”

And web journal

“Ethics and Wisdom in Medicine”

Dr A Cole
Chairman

6/11/12

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CONSIENTIOUS OBJECTION IN MEDICAL PRACTICE

M E A response to GMC consultation

There is strong support for a right to conscientious objection in international law and historic ethical declarations. This should be made clear alongside the reference to article 9 of the ECHR in the footnote on page 2.

.The right of conscience has been recognised as a fundamental human right in all of the post-Second World War international human rights instruments (Universal Declaration of Human Rights (1948), article 18; European Convention on Human Rights (1950), article 9; International Covenant on Civil and Political Rights (1966), article 18)

.The International Code of Medical Ethics of the World Medical Association (WMA) (1949) says that ‘a doctor must always maintain the highest standards of professional conduct’ and that it is unethical to ‘collaborate in any form of medical service in which the doctor does not have professional independence’.

The WMA Declaration of Geneva (1948) (Physician’s Oath) states, ‘I will practise my profession with conscience and dignity… I will maintain the utmost respect for human life from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity’

.Article 18 of the Universal Declaration on Human Rights says: ‘Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief, and freedom, either alone or in community with others and in public or private, to manifest his religion or belief in teaching, practice, worship and observance.’

The European Commission has held in 1993 that a right to conscientious objection can be derived from article 18 of the International Covenant on Civil and Political Rights (ICCPR)

The Parliamentary Assembly of the Council of Europe (See ICCPR Article 8 and 18) supports the right to conscientious objection

( Response based on an international summary )

 

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Editorial

There are a number of consultations currently underway but none more contentious than that on mitochondrial donation. The chance to end some of these life threatening diseases which are inherited through mutant  D N A mitochondria in the cytoplasm of ova is not disputed,  but the methods suggested raise some of the most profound questions in medical ethics.

Firstly, what ethical framework is there which can be applied  to changing future generations in perpetuity? What degree of certainty would be required to ensure that errors are not introduced especially as is now clear that babies born from I V F have a higher incidence of abnormalities. The two methods of mitochondrial  donation most favoured by experts, cell nuclear transfer, and maternal spindle transfer, are more invasive than other interventions in I V F and in truth the outcome can only be known after the birth of babies created in this way.

Reading the reports of the expert committees advising government, it is clear that this is the case from their request that children be followed up long term. Their suggestion that there should be a program of primate research also suggests uncertainty and it is not clear how this would shed light on mental health in man.

Unfortunately, Parliament in 2008 made an exception to the law which forbids the alteration of the germ line in the case of mitochondrial disease, and the right of children to know their genetic origins. Thus any child  born will never have the right to know that he or she had more than two parents.

The ethical questions are immense but are unlikely to be asked. The consultation about to open is unlikely to address questions which have such profound medical and social consequences.

27/1/14

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Comment on DJ review for CH

We have recently been emailed a copy of Professor Jones submission to the Liverpool Care Pathway Review which is entitled, “Submission to the Review of the Liverpool Care Pathway (LCP) on behalf of the Department of Christian Responsibility and Citizenship of the Catholic Bishops’ Conference of England and Wales.”

As practising Catholic physicians who have been personally involved with criticism of the LCP, We were rather taken aback by the content of the submission. We have been through the submission in detail, and we would like to highlight three main areas of concern and comment further on two of them.

 

Our main concerns about Professor Jones’ submission are:

 

1. Without apparently directly involving Catholic physicians in this report, he makes several clinical medical conclusions based on a superficial review of the literature alone. As a result, in an area of very difficult clinical decision making, he has almost completely sidestepped important and fundamental issues that make the LCP highly problematical

 

2. He has not included any information from the public cases in which the LCP has been blamed for causing death or suffering, however well documented. The sufferings of patients who have been put on the LCP and their relatives, is the first thing the Church should be reacting to in order to understand the great depth of anguish that this pathway has caused and the reasons for this. This is a major gap in his critique.

 

3. The feeling that comes across in this review is that Professor Jones is a supporter of the LCP and that no available evidence is going to change this. He goes to extreme lengths to align support for the LCP with Catholic teaching and this at times borders on the disingenuous.

 

 

 

 

From the medical academic point of view,

He supports the idea of withdrawal of fluid and sedative management in “dying” patients, without showing he understands how this conflicts with the physiology of thirst and the respiratory and central nervous system depressant effects of opiates and benzodiazepines.

He fails to highlight the pivotal place of the diagnosis that a patient is “dying” in the LCP. He accepts the term “dying patient” with only superficial discussion. He mentions that if the diagnosis of “dying” is wrong, then reduction of fluids could be fatal. He does not see the potential for this to bring about a “self-fulfilling prophesy” in someone diagnosed as “dying” in the LCP, although he says that there is some concern for those “who live longer than expected”.

He is very critical of the views of Catholic physicians who have reported on the LCP and fails to do justice to what they put forward.

 

From the bioethical point of view,

He repeatedly refers to the need to accept death and not flee from the “inevitable”, which is not the way physicians looking after sick patients view the course of disease. To focus on the acceptance of death as a “major good” of healthcare, again detracts from the focus of looking after the sick patient and tends to deter criticism of the LCP.

 

If the Archbishop and Bishops would like to understand Catholic Physicians’ views about the LCP, we would respectfully suggest that they should ask these physicians directly.

 

Yours sincerely,

 

Patrick Pullicino

Anthony Cole

Philip Howard

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Commentary on the Statement supporting the Liverpool Care Pathway

The Statement supporting the Liverpool Care Pathway from the National End of Life Programme was published under multiple signatories. We have a number of serious reservations and questions about the working of the Liverpool Care Pathway.

 

1        The statement says, “it is not always easy to tell whether someone is very close to death”.

The fact is that there is no scientific evidence to support the diagnosis of impending death and there are no published criteria that allow this diagnosis to be made in an evidence-based manner. This is even more true of non cancer conditions. This diagnosis is a prediction, which is at best an educated guess. Predictions have been shown to be often in serious error.

There is no evidence that the diagnosis of impending death can be improved by using “the most senior doctor available “, and an actual misdiagnosis of impending death could result in a wrongful death.

 

2        “The Liverpool Care Pathway …is not a treatment”.

This statement belies what actually happens once a patient is signed up onto the LCP. The fact that morphine, midozelam and glycopyrrolate are prescribed makes the LCP a treatment protocol.

 

3        “The Liverpool Care Pathway …is…a framework for good practice.”

          In the twenty-first century all good clinical practice is evidence based. Good clinical practice has always traditionally involved a close doctor-patient relationship  and the management of symptoms in the best interest of the patient, as and when they arise. The LCP is more than a framework. It is a pathway that takes the patient in the direction of the outcome presumed by the diagnosis of impending death. The pathway leads to a suspension of evidence based practice and the normal doctor-patient relationship.

 

4        “The Liverpool Care Pathway does not….hasten death.”

It is self evident that stopping fluids whilst giving narcotics and sedatives hastens death. According to the National Audit 2010-2011, fluids were continued in only 16% of patients and none had fluids started.

The median time to death on the Liverpool Care Pathway is now 29 hours. Statistics show that even patients with terminal cancer and a poor prognosis may survive months or more if not put on the Liverpool Care Pathway.

 

Your statement fails to mention the relief of symptoms at all. We think this is a serious omission. The question of consent is not mentioned either.

 

If as you say, the LCP does not replace “clinical judgement”, and is a “framework for good”, why is it not endorsed by 28% of senior healthcare professionals?  (National Audit 2010-2011)

 

Patients should receive an individual treatment plan according to best evidence based medicine. They should not be deprived of consciousness, but receive such treatment that is aimed at relieving all their symptoms including thirst. Nothing should be done which intentionally hastens death. An individual care plan based on best evidence is preferable to a rigid pathway.

 

 

Signed

 

Professor P Pullicino

Prof of Neurosciences

 

Mr J Bogle

Chairman Catholic Union of Great Britain

 

Dr P Howard

Chairman Joint Medico Ethical Committee Catholic Union

 

Dr R Hardie

President Catholic Medical Association

 

Dr A Cole

Chairman Medical Ethics Alliance   

 

Dr M Knowles

Secretary First Do No Harm

 

Mrs N  McCarthy

Cathlolic Nurses Association

 

Ms T Lynch

Chairman Nurses Opposed to Euthanasia

 

Mr R Balfour

President  Doctors who Respect Humen Life

 

Dr J Qureshi

Founding Chairman Health and Medical Committee

Muslim Council of Britain

21/10/12

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Draft Parliamentary questions

Written

1        To Sec of State for Health

Can he give an assurance that end of life care given within the NHS is determined only by good evidence based medicine and is not influenced by consideration of age or finance, and will he make a statement?

2        Is the Department of Health collating complaints from families who are distressed by their experience of the Liverpool Care Pathway? Currently the only avenue open to them is the complaints procedure through individual trusts. Given the current public concern is this sufficient and is his department to take an overview, and will he make a statement?

Oral

1        What is the cost of a days care in hospital for a dying person? What savings overall would ensue, if deaths were brought forward by one day and will he make a statement?

2        What amount of funding under Cquins ( Care quality innovations ) is being provided by his department, to extend the Liverpool Care Pathway throughout the hospital service and will he make a statement?

3        What advise is his department giving to commissioners to extend the Liverpool Care Pathway to nursing homes and care homes and general practitioners caring for a person at home and will he make a statement?

4        In connection with the Liverpool Care Pathway, who at present gives consent for this and will he make a statement?

5        Is it the case that the Liverpool Care Pathway may be refused by a competent patient or by a valid and applicable advance directive, and will he make a statement?

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The Gdansk Declaration of the XI th Congress of the European Federation of Catholic Medical Associations

Conscious of the trust placed in us as physicians and defenders of life, of the progress in medical knowledge and technologies, and of the ever better understanding gained into the physical, psychological, educational, spiritual, religious and existential needs of our patients and our society,

  • while aware of the dangers of ethical relativism and of moral permissiveness around us and in our midst;
  • in view of ongoing debates over the permissibility of abortion, euthanasia, the use of human embryos for research and so-called therapeutic purposes, human cloning, the creation of human-animal hybrid embryos, contraceptive and sterilization procedures and artificial reproductive technologies;
  • faced with the silent assumption that those carrying out the above procedures will be doctors;

 

authorized by the Christian traditions and ethos of European and world medicine, in dialogue with all doctors who believe in the dignity and freedom of the human being,

 

  1. We affirm that ethical norms and principles precede enacted laws and should influence their contents in accordance with natural law and the teaching of the Church.
  2. We affirm that in making decision on the medical treatment of the patients who place in us so great a trust, we should be guided above all by our conscience.  Moral evaluation of medical practice must not be based upon superficial opinions or passing trends but on the sensitivity of a conscience formed according to objective ethical norms common to all people and  consistently defended by the Church.
  3. In order to guarantee the freedom of practice of the profession, we have to uphold the right to conscientious objection
  4. We believe that one of the basic demands made of doctors should be ongoing personal development in both practical know-how and in moral stature.
  5. The special vocation of the doctor to serve the life and health of others requires a clear formulation of  the principles of an objective and universal ethics.
  6. We affirm that the source and basis for all ethical norms is the inalienable dignity of the human person throughout the course of his or her life – from conception to natural death.
  7. Just as human dignity requires the protection of human life, it also demands special concern  for its initial phases and respect for human procreation and sexuality.
  8. We promote activities which permits the protection of patients from procedures that violate their human dignity:

●  Decisively rejecting euthanasia, we support the development of palliative medicine;

●  Refusing to agree to abortion, we aim to ensure proper all-round care for the family and the sick child both before and after birth;

●  We choose the treatment of the underlying causes of infertility and not successive techniques of artificial reproduction;

●  We support the development of research into the use of stem cells taken from adults and umbilical cord blood, rejecting the use of human embryos for this purpose.

  1. 9.     We affirm and emphasize that medical practice with respect to matters as genetic manipulation and the end of life has to be realized without intentional loss of human life.

10.We want to protect our children and young people from neglect, abuse and other threats to their health and dignity. We have to ensure proper education for all aspects of life.

11.Aware of the number of people in our midst who are subject to abject poverty or under threats caused by misfortune, we uphold the tradition of the freedom of physicians to offer humanitarian and charitable aid, especially in neglected areas of the world, on the basis of principles and criteria lying beyond economics.

12.Taking into account the responsibility doctors carry for the health and life of patients, we are convinced that medicine must be practiced in dignified conditions, which are due both to patients and to doctors,  and we consistently affirm that in our activities the good of patients should have priority over other obligations.

 

 

 

Signed by:

 

President of the XI Congress of the European Federation of Catholic Medical Associations, prof. Josef Marek (in substitution signed by dr Francois Blin);

 

President of the Catholic Association of Polish Doctors,

dr Anna Gręziak;

 

 

Secretary of the European Federation of Catholic Medical Associations,

dr Hans Stevens

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Child Protection and the GMC

The GMC have asked for submissions in connection with child protection and the role of doctors. Below is a summary of the MEA`s response.

There are a number of  ethical considerations concerning  child protection such as natural   justice, the common good,  and issues of good medical practice and confidentiality.

When putting in place procedures to safeguard children and vulnerable adults it is vital that the requirements of confidentiality do not take precedence over the need to protect their welfare.

Particular difficulties  may arise in the case of suspected fabricated or induced illness. Detailed investigations would be normative and the diagnosis may only emerge over time. An example of good practise would be for the doctor with ultimate responsibility to share the tentative diagnosis with consultant colleagues to see if there is agreement on the diagnosis. It would also be good practice to seek the advice of colleagues in a tertiary centre.

The confidentiality that is required by law in furnishing  reports for prosecutors and the giving of evidence in the civil courts is proscribed. Open evidence will be required in Crown Court and the doctor should not be afforded any anonymity and publicity cannot be avoided. If, however, the doctor has taken the steps outlined above this will afford some protection. Rarely  a doctor may choose to take independent legal steps to protect their interests.

Difficulties can arise when English is not understood or where because of a particular culture, the head of the family is the only person who will speak on behalf of parents and may fail to translate what is said by doctors. There can also be fears that translators may breach confidence in close knit ethnic groups. In Family Proceedings Courts and Criminal Courts accredited translators must be provided by law. In the clinical situation difficulties arise and an independent translator is advisable.

Regrettably many doctors are loath to become involved in child protection as a result of adverse publicity, threats of legal action or complaints to the GMC. Direct threats also occur and many doctors feel that they or their own families are endangered. Ultimately, if many doctors refuse to become involved in the legal process child protection will fail. Fortunately most doctors feel that they are obliged in conscience to do their utmost to protect children.

It has always to be remembered that, especially in cases of possible sexual abuse,  the medical evidence is often only a small part of the evidence upon which the court will rely. Paediatricians should not feel that their evidence is decisive, it is likely to be collaborative at best.

Those who are likely to be front line doctors with children. Paediatricians, accident and emergency doctors and general practitioners in particular need to be trained by their respective colleges using such documents as the RCPCH compendium “ Child Protection  Companion, 2006 which should be used in the annual appraisal of paediatricians.

Clear guidance is required from the GMC which doctors would find helpful and supportive and in which they could be confident that their conscientious work and compliance would protect them from vexatious complaints.

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DYING THE LIVERPOOL WAY

Palliative care has been polluted by politics as governments seek to reduce the cost of health care. Faced with an ageing population and limited resources, end-of-life care is high on the political agenda. Terminal or palliative sedation is potentially dangerous yet it is widely used in hospitals, hospices, care homes and nursing homes. Care homes for the elderly have been targeted to reduce emergency admissions to hospitals at the end of life. The Liverpool Care Pathway for the Dying Patient (LCP) can be lethal. Sick elderly people often present with dehydration. If hydration is withheld they will inevitably die. (1, 2)
  • Palliative carers and geriatricians should try to improve care for the elderly.
  • Community nurses and doctors must be trained to recognise dehydration and should rehydrate the patient as necessary.
  • Anticipatory prescribing of drugs such as diamorphine, midazolam and haloperidol should not be permitted in care homes. If sedation is required a doctor should assess the patient and prescribe as necessary.
References.
  1. No Water- No Life: Hydration in the Dying. Craig GM (Ed) Fairway Folio (2005) ISBN 0 9545445 3 6. E mail: books341@ clara.co.uk. Also available to order from good bookshops in the UK.
  2. Craig GM. Palliative Care in Overdrive: Patients in Danger. American Journal of Hospice & Palliative Medicine, Vol. 25 Number 2, April/May 2008 p155- 160. © Sage Publications 10.1177/1049909107312595
          (Notes by Gillian Craig. MD, FRCP Retired Consultant Geriatrician. UK)
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