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Abortion rates hit all-time high

It seems natural to return to a subject I’ve often posted about for my 700th post, and this article allows me to do just that:

The number of legal abortions carried out on women living in England and Wales last year was the highest ever, up more than 3,800 on 2003.

I think I’ve made my abortion views fairly clear over past posts – abortion isn’t something I particularly like, but nor is it something I feel should be criminalised, as this penalises only the most desperate.

What’s shocked me in this case, though, is not the figures themselves, but the Department of Health’s response:

The DoH said: “It is disappointing that the overall level of abortions has increased this year.”

What possible authority does the DoH think it has to pontificate about the decisions desperate people take, and to call them ‘disappointing’? The health service should be about providing unconditional help to the needy, not judging them. Their comments naturally imply that abortions are a ‘bad thing’, without recognising that they are often medically necessary, and that it is really the parents’ decision as to what is a ‘bad thing’ for them.

The DoH would never dream of saying that it’s ‘disappointing’ that suicide levels have increased, or that it’s ‘disappointing’ that poor diets mean diabetes is on the increase. Why is it any different for a parent who feels so desperate that they have to go through the appalling procedure of abortion, often meaning (in the case of later abortions within the legal period) that they have to go through a full birthing process, producing a stillborn foetus. Until the righteous right realise that getting an abortion is rarely as easy as having a tooth removed, then they can’t even begin to understand the mental anguish it confers upon the parent.

Could their be any greater example of the ‘nanny state’ than saying that the result of one of the hardest decisions a person has had to take in their whole life is ‘disappointing’? I think not: It is truly abhorrent that figures relating to the most vulnerable are being given a populist spin to appease Mail readers and secure political gains.

This 698th post was filed under: News and Comment, Politics.

BMA votes against lowering abortion limit

My union has helpfully agreed with my position on the lowering of the 24 week limit on abortions. Whilst I’m sure this will enrage the Daily Mail, it certainly cheered me up because, as far as I can see, there is no logical scientific reason for lowering the abortion limit.

The only scientific reason for doing so is because increasingly premature babies are surviving with medical assistance. But whilst that’s a reasonable scientific point, the logic isn’t present. Increasingly premature babies are going to continue to survive as medical technology improves, until eventually abortions will be impossible – or, more controversially – they will only be available to those who discover their pregnancy suitably early, thus probably disenfranchising those who are not expecting to become pregnant (and may therefore feel that they are in desperate need of an abortion). Very few of the campaigners supporting the idea of lowering the limit would support either of the above situations – and yet that is effectively what they are voting for.

The other popularly posited opinion is that now we have 3D scans, which allow us to see the foetus in greater detail than ever, we shouldn’t allow abortions at this stage of pregnancy. This is a foolish notion. Doctors have for many years seen the real foetus following abortion, and the foetus has always been at the same stage of development, even if it’s previously required a medical degree to interpret the images. Just because something can now be interpreted by the masses doesn’t change the nature of what is actually done.

Therefore, I agree with my BMA colleagues in their decision not to support the lowering of the abortion limit from 24 weeks to 20 weeks. And I will continue to hold that position, until I hear a reasoned logical and scientific reason to change it.

This 650th post was filed under: News and Comment.

Howard urges limits on ‘too easy’ abortions

In what may be a first for this site, I’m actually agreeing with Tony Blair. Don’t worry, I’m not going to be making a habit of it, but if abortion is to become an election issue, then I’ll have to support him on it.

Michael Howard’s position:

I think that what we have now is tantamount to abortion on demand. I believe abortion should be available to everyone, but the law should be changed. In the past I voted for a restriction to 22 weeks, and I would be prepared to go down to 20.

I don’t see what good would be done by reducing the age at which abortion can take place, and I see no scientific evidence for doing so. Mr Howard is responding to the pro-life propaganda pictures of foetuses that look like people. Jelly babies also look a bit like people, but I have no ethical dilemmas when it comes to munching my way through a packet.

Charles Kennedy:

I don’t know what I would do now

That’s not what one would call a well argued thought out position on the issue. And if he doesn’t know his position, how am I supposed to know it? And, indeed, if I don’t know his position on key election issues, how am I supposed to vote for him? Come on Charlie, you can do better than this…

Tony Blair:

However much I might dislike the idea of abortion, you should not criminalise a woman who, in very difficult circumstances, makes that choice. Obviously there is a time beyond which you can’t have an abortion, and we have no plans to change that, although the debate will continue.

I know that this will come as a surprise, but – finally – I agree with Mr Blair on this. I’d perhaps go slightly further than him, because he’s left himself open to attack over women who aren’t in ‘very difficult circumstances’ but still obtain abortions, but he’s in a pretty solid position. For the first time in this not-quite-an-election-campaign, I can say: Well done, Mr Blair!

This 437th post was filed under: Election 2005.

Review: Dirty Work by Gabriel Weston

Dirty Work describes the “Fitness to Practice” investigation into the work of Nancy, a registrar in obstetrics and gynaecology. The investigation is triggered by an operation which goes wrong, and Nancy’s inability to deal with the situation.
The author, Gabriel Weston, is an ENT surgeon, and so is possessed of some insight into how these things work. She also has a remarkable talent for describing aspects of medical life in ways that are both accurate and poetic.

A good doctor needs to know how to spin a yarn. That’s what they teach you at medical school, though no one ever says in in so many words. They prefer to give it a safe sort of name, the powers that be. The call it history-taking, this supposedly natural process in which a patient and doctor collaborate to weave a shape out of what’s gone wrong. They make its sound straightforward. And to the patient it probably feels that way. In reality, though, the competent clinical inquisitor is all the while asserting their own semantic frame, encouraging the patient to dwell on key symptoms, ignoring the white noise of emotion, veering away from anything that has no pathological meaning, doing what is necessary to help a diagnosis emerge. The doctor is rewriting the patient’s story while seeming only to bear witness to it.

If there’s part of that which sounds a little uncaring, perhaps a little too direct, fear not. An epiphany is coming…

I began to see that the words a patient uttered were not always what counted most; that there might be a more important meaning beyond what was being said, a contrary melody, if only I could train my ear to hear it.

This short novel has more characterisation than plot, which feels right for the story it is discussing. It also has a good deal of tension, uncertainty, and occasional confusion.

The work which most affects the protagonist, and the operation in which she makes her mistake, is the provision of surgical abortions. I think this is a shame. There is little in the content of the book that is specific to abortion-related work, and I think it would almost have been more interesting to explore the pressure on Nancy if she were the provider of any other kind of surgery. The subject of abortion – for better or worse – carries a lot of baggage. Weston doesn’t moralise, but the occasional graphic descriptions of the work Nancy carries out weigh, I think, unduly heavily on the mind of the reader. This becomes a novel about the psychological impact of abortion provision, and the myriad other pressures on Nancy are comparatively minimised.

This minimisation feels a bit unfortunate because it removes the focus from Weston’s talent for describing the universal fears and pressures weighing on all doctors, which are less frequently discussed and so possibly more interesting than the specifics of the pressures of an individual line of work:

How on earth will I manage if I am erased, removed, struck off the medical register? I will lose my entire frame of reference. And what would I have to replace it? What is a doctor, if not a doctor? That that title away and there may be very little left over.

I would have liked to have seen these ideas explored further, without the baggage of abortion. Weston’s descriptions and language speak to me.

I have seen that other reviewers have felt that the book fails to emotionally involve the reader with the protagonist, but I couldn’t disagree more strongly. I felt deeply involved with Nancy’s story, and worked through this book in no time.
However, given that I’ve praised the book for its true to life descriptions, I should also caveat by saying that this isn’t consistently true. There are strange lines here and there which ring utterly false. There is a scene in which Nancy – reputedly a registrar – described a consultant “decoding” very common terms like ERPC, D&C, and ToP for her. This is patent nonsense. The terms aren’t even explained to the reader, so there isn’t a clear explanation for why the line exists. These aberrations, while frustrating, are mercifully few.

As a whole, I very much enjoyed this novel. It wasn’t perfect, but there were parts that came remarkably close to perfect. There were some distinctly wrong notes, but they were few and far between. I found the novel made me reflect on my own life and medical practice, and made me reconsider issues I haven’t though about for some years. I found it moving, and somewhat thrilling. I wouldn’t hesitate to recommend it.

Dirty Work is available now from amazon.co.uk in hardback and on Kindle. Many thanks to Bantam Press for supplying a free copy for the purpose of this review.

This 2,076th post was filed under: Book Reviews, .


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