“depends on the clinical judgment of the medical practitioner”

In October 2001 the Family Planning Association was given leave for a judicial review of the Department of Health’s refusal to issue clear guidelines on how pregnancy terminations are provided under existing law. In October 2004 “three senior judges ordered the Department of Health to draw up guidelines on when abortions can be carried out under existing law.” And finally, today, the Department of Health announced they had, eventually, issued those guidelines.. in draft form.. “to health professionals and interested organisations for comment.” You’d almost think the Department of Health don’t know what the legal position is.. or don’t want to know.. Update Draft guidelines[pdf file]From the Department of Health’s statement

Q What happened after the Court of Appeal Order?

A The Department of Health and Social Services and Public Safety set up a Working Group with representatives from a wide range of professional and specialty backgrounds including nursing and midwifery, obstetrics and gynaecology, public health, psychiatry, clinical genetics, Family Planning doctors and General Practitioners to develop guidance on abortion in Northern Ireland.

The working group developed questionnaires for consultant obstetricians, midwives, GPs and Health and Social Services Trust Chief Executives in Northern Ireland to establish the level and extent of abortion services (including aftercare) available here and to capture views on what they felt should be included in guidance. Feedback from the questionnaires has been used to inform the guidance.

Q What is the current position with regards to abortion in Northern Ireland?

A The Abortion Act 1967 does not extend to Northern Ireland and the grounds on which abortions may be carried out in Northern Ireland are more restricted than those in Great Britain. Abortion law in Northern Ireland is contained in the Offences Against the Person Act 1861, the Criminal Justice Act (Northern Ireland) 1945, the Bourne Judgement case law (1939) and the common law.

Under the law of Northern Ireland, abortion is permitted here where it is necessary to save the life of the mother or where continuation of the pregnancy would involve risk of serious injury to her physical or mental health. The lawfulness of any proposed termination depends on the clinical judgment of the medical practitioner who is to carry out the termination. [added emphasis]

Perhaps the newly uber-empowered Human Rights Commission have a view…? or should the Abortion Act 1967, and the rights it gives directly to individual women, just be fast tracked in Northern Ireland well behind similar legislation in Britain?

Update The condensed version of the draft guidelines[pdf file]

2.6 For that reason, before it would be lawful to perform any operation in Northern Ireland for the termination of a pregnancy, there must either be (1) a threat to the life of the mother, or (2) a risk of real and serious adverse harm to her long term or permanent health. In any other circumstance it would be unlawful to perform such an operation.

While on Moral and Ethical issues

4. Moral/Ethical issues

4.1 Some staff may have a conscientious objection to termination of pregnancy on moral and/or religious grounds. No-one can compel staff to actively participate in performing a termination and the right to object on grounds of conscience should be recognised and respected except in circumstances where the woman’s life is in immediate danger and
emergency action needs to be taken. Health and Social Services Trusts should also have appropriate arrangements in place to accommodate such requests from staff. However staff with a conscientious objection cannot opt out of providing general care for women undergoing termination of pregnancy. The personal beliefs of staff should not prejudice patient care.

4.2 The General Medical Council’s (GMC’s) Good medical practice (May 2001) states that a doctor registered with the GMC is under a duty ‘to make sure that his/her personal beliefs do not prejudice his/her patients’ care.’ A breach of this duty would be a disciplinary offence. This guidance is publicly available on the GMC website – http://www.gmc-uk.org

4.3 The Nursing and Midwifery Council (NMC) Code of professional conduct: standards for conduct, performance and ethics (November 2004) refers to conscientious objection at paragraph 2.5 and indicates that, “you must report to a relevant person or authority, at the earliest possible time, any conscientious objection that may be relevant to your
professional practice. You must continue to provide care to the best of your ability until alternative arrangements are implemented.” This guidance is publicly available on the NMC website – www.nmc-uk.org/

4.4 The British Medical Association (BMA) has published guidance on the law and ethics of abortion in England Scotland and Wales and Northern Ireland. This guidance is publicly available on the BMA website – www.bma.org.uk/.

4.5 The BMA document advises that, “doctors with a conscientious objection to abortion should make their views known to the patient and enable the patient to see another doctor without delay if that is the patient’s wish.” It also states that, “general practitioners with a conscientious objection, who are working in a group practice, may ask
a partner to see patients seeking termination.” The doctor will, however, have responsibility for the woman’s care until someone else takes it over.

4.6 The Royal College of Obstetricians and Gynaecologists (RCOG) has also produced an evidence-based Clinical Guideline, The Care of Women Requesting Induced Abortion (September 2004). Section 3.4 of this guideline provides advice on professionals’ rights in relation to conscientious objection to abortion. This document is publicly available
on the RCOG website – www.rcog.org.uk/