Catholic Medical Quarterly Volume 65(2) May 2015


Conscience, Abortion and the Supreme Court Judgement 2015

Tony ColeFurther to Ian Jessiman`s article on the Supreme Court Judgement, and John Smeaton's comment, (CMQ February) I think there is a danger that doctors may become too influenced by the current belief that the law permits abortion on demand and that a pregnancy can be ended if it is “unwanted”. This may be the popular assumption but it is not the law.

The Abortion Act 1967, gives a defence against the “1861 Offences Against the Person Act”, which criminalises abortion, when two doctors agree that certain conditions pertain, and principal amongst these is an opinion “ formed in good faith”, that the woman’s health is at risk if the pregnancy continues.

Mental health reasons are given in 97% of cases though they are rarely medically assessed or documented. Very few doctors in abortion clinics have training or clinical experience in mental health. Though mental health reasons are cited, they are neither justified nor supported evidentially.

Now there is very good authority in a statement from the RCOG that the risk to the woman’s mental health is the same whether she has an abortion or gives birth[1]. This has recently been repeated by the Academy of Medical Royal Colleges [2], and by Dr M Scott at the Royal Society of Medicine in 2013[3] Indeed there are reports of increases in mental health problems following an abortion. [4]

Therefore, a doctor advising a woman seeking an abortion may say that they will be making their decision entirely on medical grounds. An onward referral to a psychiatrist or obstetrician may be appropriate if there are genuine mental health or obstetric reasons.

It may be advisable to say that other doctors may not take this view and that she is always free to seek another opinion, but that you will act strictly within the wording of the 67 Abortion Act, and come to an opinion “formed in good faith”, as to whether an abortion is medically indicated. A medical risk assessment should be made and documented lest there be any future question. Should there be any future question, the woman can always seek another opinion at any time and this request should be dealt with courteously and swiftly.

In fact, given the present state of medical knowledge there is no need for a G P to have to appeal to the conscience clause. As is often the case, many apparent conscience issues may be resolved by simply applying good medicine.

Dr Tony Cole
Parliamentary and Public Affairs Committee
The Catholic Union of Great Britain


  1. “Systemic Review of Induced Abortion and Woman’s Mental Health”, RCOG, December, 2011
    “When a woman has an unwanted pregnancy, current evidence suggests that the rates of mental health problems will be unaffected whether the pregnancy is terminated or goes to birth”.
  2. Statement of the Academy of Medical Royal Colleges, 2011
    “The rates of mental health problems for women with an unwanted pregnancy were the same whether they had an abortion or gave birth”.
    Prof. Sir Neil Douglas, Chairman of the AOMRC
  3. MEA conference, “Mental Health Reasons for Abortion. are there any?" 21 Nov 2013
  4. Fergusson et al (2008) British Journal of Psychiatry, 193, 444 -451