In Haec Tempora

CMA writes to BMA with concerns about the new GP contract,
contraception and conscience

The New Contract 2019 for General Practitioners, arising from the document Investment and evolution: A five-year framework for GP contract reform to implement The NHS Long Term Plan is causing grave concerns among a number of our members working in General Practice.

In particular the statement contained in the document on page 90 Annex D on Main Contractual changes and Additional Services states “From April 2019, contraception services will no longer be an Additional Service under the Regulations but will become part of Essential Services. There will be no opt-out or reduction of global sum payments as a result.

The CMA President wrote to the chair of the BMA GPs committee to inform him that ‘this is not acceptable to Catholics working in General Practice. Catholics and some other faith groups cannot, in conscience, provide contraceptive services and they cannot be complicit in asking others to do so on their behalf by sub-contracting of such services or referral. They may provide advice and instruction on natural family planning methods and would be prepared to do so if this was included in the understanding and interpretation of “contraception services”, particularly if the term was altered to “family planning services”.

He continued “It is also a matter of great concern that the statutory provisions relating to conscientious objection in cases of emergency contraception and unplanned pregnancy appear to have been removed from the definition of contraceptive services in the new 2019 Regulations. Clarification as to why these provisions appear to have been removed without any consultation is urgently needed.

In essence, there are three acceptable options that need to be considered to enable Catholics (and I suspect many others from faith backgrounds) to sign a new contract and continue working in General Practice:

  1. Delete the entire paragraph quoted above and accept that contraception services should remain additional and that they are not essential;
  2. Continue to include contraception services as being essential but remove the statement that there will be no opt-out and confirm that doctors who wish to opt out on conscientious grounds may continue to do so in the interest of equality and diversity and respecting minority beliefs;
  3. Continue to include contraception services as being essential but accept and state that such services could include natural family planning services without need to include other contraception methods.

It is also imperative that the statements in the previous contract relating to rights of conscientious objection to ontraception provision and abortion referral / provision be re-instated and respected.

I trust that these comments and concerns will be seriously considered and that the necessary steps will be taken to ensure that Catholic doctors can be reassured and that they may continue to make an excellent contribution to healthcare delivery in General Practice in the UK without compromising their faith.”

We are awaiting a response. But as always, the protection of the rights and duties of conscience is a central issue for the CMA.

Abortion in Northern Ireland

The CMA has also had input to consultation on the legalisation of abortion in Northern Ireland. Of course, we wish to see a continuation of the protection afforded to unborn children which is unparalleled elsewhere in the United Kingdom ad Eire. We hope to publish our submission on the CMQ website along with extracts in the May issue of the Quarterly.

Abortion “not medically necessary to save the life of the mother”

In a statement released in October 19th 2019, the American Association of Pro-Life Obstetricians and Gynaecologists (AAPLOG) stated [1]

Dear ProLife Colleague, Another political candidate has put his head in a meat grinder with a statement about abortion. Republican Rep. Joe Walsh (Ill.) said Thursday that abortions are “absolutely” never necessary to save the lives of pregnant women. “With modern technology and science, you can’t find one instance,” Walsh said. “There is no such exception as life of the mother, and as far as health of the mother, same thing.” The comment was first reported by WGN radio. It came after a debate between Walsh, a House freshman, and his opponent, Democrat Tammy Duckworth, an Iraq War veteran.

So reported THE HILL’S Healthcare Blog “Healthwatch.” (Oct 19). The difficulty stems from the understanding of the word abortion. In benign language, a “spontaneous abortion” is a “miscarriage,” the spontaneous loss of a pregnancy. In common parlance, “abortion” generally refers to an “induced abortion,” the purposeful termination of an otherwise progressing pregnancy, that is, the purposeful killing of the unborn child in the termination of the pregnancy.

AAPLOG believes in “treatment to save the life of the mother.” This is NOT “abortion to save the life of the mother.” We do not believe the purposeful killing of the unborn child is ever necessary to save the life of the mother. But it is, rarely, necessary to end the pregnancy in the course of treatment to save the mother’s life. In this kind of case, we would be trying to save the life of both our patients—the mother and the premature child. And we acknowledge that in some cases, the child would be too premature to have any chance for survival. Both doctors and families sometimes face such painful choices and decisions.

For the AAPLOG statement, go to:

In our letter of Oct 8, we reported on the Dublin Declaration on Maternal Mortality. members/dublin-declaration/ This Declaration deals with the pressure on Ireland to adopt more permissive abortion standards in that country. The Dublin Declaration is identical to the AAPLOG statement, albeit using slightly different language to describe their stance. The Dublin Declaration says: “As experienced practitioners and researchers in Obstetrics and Gynaecology, we affirm that direct abortion – the purposeful destruction of the unborn in the termination of pregnancy – is not medically necessary to save the life of a woman. We uphold that there is a fundamental difference between abortion, and necessary medical treatments that are carried out to save the life of the mother, even if such treatments result in the loss of life of her unborn child. We confirm that the prohibition of abortion does not affect, in any way, the availability of optimal care to a pregnant woman” The AAPLOG Director of Research and Public Policy, Dr. Donna Harrison, was interviewed by CNN today on the statement by Congressman Joe Walsh. She basically made the points above.

[1] The American Association of Pro-Life Obstetricians and Gynaecologists . October 19th 2019

Concern about brain death criteria

The Linacre Quarterly for November2019 highlights concern about the reliability of criteria for brain death. An anaesthesiologist described how conducting an anaesthetic for organ harvest has shaped his understanding of brain death. And Dr Doyen Nguyen, states that “According to the updated standard, the presence of certain brain or spinal cord functions does not invalidate the diagnosis of ‘brain death’. By analyzing these guidelines critically on the basis of scientific realism and Thomistic hylomorphism, this paper demonstrates that the updated ‘brain death’ standard contradicts both the UDDA and the tenets of sound anthropology held by the Catholic Church.” Which is very much the stuff of serious controversy and concern. The contents of the Linacre Quarterly are included in this issue on page 25.