Catholic Medical Quarterly Volume 64(2) May 2014
Abortions on mental health grounds ‘probably illegal’.
Report of the Medical Ethics Alliance meeting on abortion and maternal mental health in London , November 2013
The overwhelming majority of Britain’s abortions are “probably illegal”, a senior psychologist has said.
Liverpool-based Dr Michael Scott said that the 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 pyschologist, who is often called as an “expert witness” by Merseyside Police and has worked with the families of the Hillsborough disaster, said a “charade” is operating around the working of the 1967 Abortion Act.
Abortions on mental health grounds were so dishonest that they were effectively illegal, said Dr Scott, a Catholic.
At a conference in London 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. According to Keir Starmer, the outgoing Director of Public Prosecutions, Ground C could also have been used to legally justify the sex-selective abortions of female foetuses because of their gender.
In his speech at the Royal Society of Medicine, Dr Scott, an expert on post-traumatic stress disorder and the author of 10 books on Psychology, said the bogus mental health reasons for abortions under Ground C also made the law impossible to either police or regulate.
He argued that in his view any attempted justification of abortion on Ground C “should be treated with great suspicion.” adding that the section was not “fit for purpose.” “Ground C ought to go,” said Dr Scott. “It is not evidence-based and isn’t based on anything that in my view can stand up to rigorous examination,” he told the conference on abortion and mental health.
“I see about four or five patients a week and perform medico-legal assessments, usually for cases of extreme trauma, in which I have to include if they have post-traumatic stress disorder or whatever, and that can be contested by an expert witness from the other side.
“Occasionally it goes to court where there is great debate about the reliability of my assessment so the methodology is very important. But there is nothing like that with regard to terminations yet they are taking place within this mental health framework.
“You have two universes that don’t meet – the universe of reliable medico-legal assessments and the way abortions are being justified … strictly speaking, to me they seem illegal.”
He said it was also no longer scientifically acceptable simply to allow abortions after two doctors decided “in good faith” that the abortion is necessary, as stipulated by the Act.
“We are at the level of evidence-based medicine and unbridled clinical judgement is not acceptable any longer,” Dr Scott said.
“There has to be the following of an evidence-based protocol. We cannot allow the following of unbridled clinical judgement.”
Dr Scott said the Act was located in a “mental health framework” but “we don’t actually know the mental health status of patients who have terminations under Ground C.”
“We don’t know what we are dealing with because it hasn’t
actually been reliably assessed,” he said.
“So at one level, the terminations under Ground C are probably illegal.”
He said: “The effects on mental health are unproven. If mental health effects are unproven, why is the Act based around mental health criteria? People are playing fast and loose with the concept of mental health.
“There is a charade going on.”
He continued: “I feel there is a lot of dishonesty in the area of abortion. It is not only people opposed to abortion who are saying this. It is also people who are pro-abortion. They are saying exactly the same thing and we need an open discussion.”
‘We have de facto abortion on demand’
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.
“It’s just not a concept that people operate in,” he said, adding that he believed that the real reason most women request abortions is they perceive their pregnancy would permanently and catastrophically harm an important role that they have.
Dr Scott, who works out of Rodney Street and also lectures in Psychology at Manchester University, also suggested that GPs should also be legally obliged to try, as a minimum, to determine if the continuation of a pregnancy may cause harm that might be both catastrophic and permanent before agreeing for the procedure to go ahead.
“We have de facto abortion on demand,” he said. “I doubt it was the intent of most of the supporters of the Act. How do we move on from abortion being treated like a visit to the dentist to a more appropriate societal response?”
He said: “There is a credibility gap between the spirit of the 1967 Act and what actually happens in practice.”
The London conference, organised by the Medical Ethics Alliance, was also addressed by Dr Gregory Gardner, a Birmingham GP who lectures in General Practice at Birmingham University.
He provided latest evidence to show that, rather than protecting the mental health of women abortions might cause psychological harm, especially among women with underlying mental health problems.
Studies reveal that this was true even of women who had
conceived from an act of rape, he explained.
British research includes “Induced Abortion and Mental Health,” a systematic review of the mental health outcomes of abortion which was published in December 2011. A definitive meta-analysis of all the available evidence, it was developed for the Academy of Medical Royal Colleges by the National Collaborating Centre for Mental Health and funded by the Department of Health.
The review concluded that mental health outcomes for women with unwanted pregnancy “were the same whether they had an abortion or gave birth.”
But if the woman had a history of mental health problems, or been under pressure from others to have the abortion or had “negative attitudes towards abortion” then the procedure was more dangerous.
(Photo of Dr Scott by Simon Caldwell)