Catholic Medical Quarterly Volume 73(2) May 2023


Forming the Conscience regarding the Issue of Abortion

Fr James McTavish, FMVD

Conscience and its formation

Fr James McTavishThe Second Vatican Council teaches us that conscience is a person's most secret core and sanctuary. There he or she is alone with God, whose voice echoes in his / her depths.[1] To hear God's voice, we need to live with some depth, as only remaining on the surface we may become confused with many competing voices. We are not born with an already formed conscience. In fact, the formation of conscience is a lifelong task. The goal of the Christian conscience is to be able to think, feel, live and love like Jesus of Nazareth, as the Bishops succinctly noted: "Forming our conscience is the work of a lifetime, in which we learn to cultivate the very sentiments of Jesus Christ, adopting the criteria behind his choices and the intentions behind his actions (cf. Phil 2:5)."[2] The Bishops also underlined that to reach the depths of conscience, "it is important to culti­vate the interiority that thrives on periods of silence, on prayerful, attentive contemplation of the Word, on the sustenance gained from the sacraments and from Church teaching."[3]

A healthy dose of humility is required when it comes to decision-making regarding what is right and wrong. St John Henry Newman, in his letter, addressed to the Duke of Norfolk in 1875, remarked, "the sense of right and wrong, which is the first element in religion, is so delicate, so fitful, so easily puzzled, obscured, perverted, so subtle in its argumentative methods, so impressible by education, so biased by pride and passion, so unsteady in its flight" that we need the help of the Church and her teachings.[4]

The issue of abortion

Globally there are approximately 73 million direct abortions every year.[5] This is a staggering amount, which we can easily become rather blasé about, reflecting a numbing of our conscience. In England and Wales in 2021, the latest year for which complete figures are available, there were 214,869 abortions, the highest since records began.[6] The abortion rate in 2021 was highest for women aged 22 years old, and 43% of women undergoing abortions had had one or more previ­ous abortions. In 2021, 98.0% of abortions (209,939) were performed under ground C. Ground C is where the pregnancy has not exceeded its 24th week, and the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the phys­ical or mental health of the pregnant woman. In 2021 in the UK, 859 abortions were carried out for Down's syndrome. Sadly also, forty abortions were performed for cleft lip and cleft palate, conditions which plastic surgeons can nowadays correct after birth with good results.

Catholic Church teaching

The Catholic Church has a long-held teaching regarding the moral evil of abortion. The Catechism of the Catholic Church states, "Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchange­able. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law."[7] With such clear teaching on an issue that even many persons of good will would be in agreement with, how can we explain the seemingly ready acceptance of abortion in British society and worldwide? Pope Francis sheds some light when he underlined that, "We are living in an information-driven society which bombards us indiscriminately with data – all treated as being of equal importance – and which leads to remarkable superficiality in the area of moral discernment."[8] This remarkable superficiality means that it is increasingly difficult to arrive at any depth when it comes to ethical issues. Instead, we can just flounder on the surface, tossed and turned by the changing tides and currents of fads, fashions and popular opinion. In this regard, all believers, but perhaps those particularly in the healthcare professions, have a specific duty to defend the value of life. Pope John Paul II spoke thus, saying that their "profession calls for them to be guardians and servants of human life," not "agents of death."[9]

In front of the vast numbers of abortions being carried out, at times the only reaction it produces is a kind of defence and critique of Catholic thinking, as people in Western society often only focus on the issue of abortion when the life of the mother is at risk. Actually, in our context of the United Kingdom, there are very few such cases as the obstetric care is of such high quality. In many years, there is perhaps only one case per year or even no case recorded. While even one case is of concern, it seems somewhat illogical to ignore the other approximately 199,999 other cases annually and make the one case the base of all criticism of Catholic teaching.

It is important for Catholic teaching to be shared in the public arena, even if said teaching goes counter-cultural. This has long been the case, as even when the Church first pronounced on the immorality of abortion, in a 1st century document called The Didache, abortion and infanticide were rife in the surrounding society.[10] One challenge is that it seems modern society has developed a hardened conscience and seemingly grown a little tired of hearing about the wrongs of abortion. In Matthew's Gospel we hear, "whoever obeys and teaches these commandments will be called great­est in the Kingdom of heaven."[11] It is not suffi­cient to just keep, as we must also teach this doctrine to others. And, of course, being a sensitive topic, it should be done with prudence and respect. But to remain silent about it cannot be a valid option. If we do not speak up, the collective conscience - which is already hardened - will become totally dead.

Perseverance in forming consciences

Pope Francis himself has spoken very clearly about the wrongness of abortion. "So great is the value of a human life, and so inalienable the right to life of an innocent child growing in the mother's womb, that no alleged right to one's own body can justify a decision to terminate that life."[12] Mother Teresa, that other great champion of human life, was not afraid to speak out in the public arena. On receiving the Noble peace prize in 1979, as part of her acceptance speech, she told the world leaders and members of the Nobel com­mittee, "To me the nations who have legalized abortion, they are the poorest nations."[13] And later, at a prayer breakfast in Washington D.C., she told the gathered dignitaries, "I feel that the greatest destroyer of peace today is abortion, be­cause it is a war against the child, a direct killing of the innocent child."[14]

Perhaps each one of us can revise our conscience regarding the issue of abortion. We should not become blasé either, or permit our conscience to become hardened in front of such a devastating loss of life. As the conscience becomes dull, such tragedy apparently becomes more and more normal"." Nor should we forget the great suffering that many women go through following abortion. For this reason, as an extension of God's mercy to them, the Church has organized various initiatives such as "Project Rachel" to help such women.[15]

Like St. Paul, let us ask for the grace to persevere and not get tired of doing good. We need to continue to work patiently to form the collective conscience of our sisters and brothers. This call is a vital part of the mission of the Church, entrusted in a particular way to those working in the field of healthcare: "Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up."[16]

This article is based on a recent formation I gave to Catholic university students in the United Kingdom. I would like to thank John Healy for his expert editorial assistance with this article.

Fr James McTavish, FMVD, is a Scottish missionary priest with the Verbum Dei Missionary Fraternity. Prior to consecrated life he worked as a surgeon, gaining his FRCS (Edinburgh) and specializing in Plastics and Reconstruction. He later studied Bioethics and Moral Theology in Rome, before teaching courses in various theological and medical schools. He is currently based in Rome as a General Counselor of his community.


  1. Gaudium et Spes, n. 16.
  2. Final Document of the XV Ordinary General Assembly of the Synod of Bishops on “Young People, the Faith, and Vocational Discernment,” 27 October 2018, n. 108.
  3. Ibidem.
  4. Cardinal John Henry Newman, “A letter addressed to his Grace, the Duke of Norfolk, on occasion of Mr Gladstone’s recent expostulation,” 1874. Reprint by Kessinger Publications, 60.
  5. Guttmacher Institute, “Global and Regional Estimates ofUnintended Pregnancy and Abortion.”Available at
  6. UK Government, National statistics - Abortion statistics, England and Wales: 2021, Updated 30 January 2023.
  7. Catechism of the Catholic Church, n. 2271.
  8. Evangelii Gaudium, n. 64.
  9. Evangelium Vitae, n. 89.
  10. “You shall not murder a child by abortion nor kill that which is begotten.” Didache. Written between A.D. 70 and A.D. 100.
  11. Matthew 5:19.
  12. Amoris Laetitia, n. 83.
  13. “Acceptance Speech Having Received the Nobel Peace Prize.” University of Oslo, Norway, December 10.
  14. “Speech at National Prayer Breakfast in Washington, D.C, USA.” February 5.
  15. See “Project Rachel” at
  16. Galatians 6:9.