Abortion: stop hiding behind The Science
With anti-abortionists pushing 'scientific evidence' on fetal viability, it is time to restate the moral case for a woman's right to choose.
The Science and Technology Select Committee’s inquiry into Britain’s abortion law, which began on 15 October 2007, considered written evidence from 50 submissions by interested parties. These included the UK Department of Health, abortion providers, pro-choice campaign groups, anti-abortion campaign groups and individuals from both sides of the abortion debate.
It is hoped that the committee’s report will provide a useful summary of where the science of abortion is at: what has changed since Britain’s law was first developed in 1967 and last amended in 1990, and how the legal approach to abortion might best reflect new scientific knowledge and clinical developments. This is likely to have an impact on policy. When prime minister Gordon Brown was asked about his thoughts on abortion as the committee hearings began, his spokesperson replied that ‘his general view was that these were matters that should be guided by scientific evidence’ (1).
But while scientific and medical developments are crucial to the practice of abortion, informing such decisions as how the abortion is performed and who is able to perform it, it remains the case that the principle of abortion is a moral and political question, which cannot be resolved by science.
The tension between science and politics has become clear as the Science and Technology Committee’s (STC) hearing has progressed. On 15 October, the Guardian reported that the clerk of the committee had written to several of those who had submitted evidence to the inquiry, requesting that they disclose their links to any relevant organisations (2).
It was revealed that ‘at least eight submissions of written evidence have come from medical professionals who have not disclosed their membership of Christian groups opposed to abortion on faith grounds’: for example, six of the doctors are linked to the Christian Medical Fellowship (CMF), an organisation that has given its own evidence to the inquiry. Evan Harris MP, the Liberal Democrats’ science spokesperson and a member of the STC, said: ‘This inquiry is specifically about the scientific evidence not moral or religious arguments and our witnesses need to be evidence-led not ideologically or theologically driven. The CMF risk undermining the inquiry by getting people called as expert scientific witnesses when they are not.’
As anybody familiar with the abortion debate knows, whether the issue at stake is fetal pain or breast cancer, fetal viability or women’s mental health, the ‘scientific evidence’ cited by those who disapprove of abortion differs wildly from that cited by respected medical bodies such as the Royal College of Obstetricians and Gynaecologists (RCOG), the British Medical Association (BMA) and the Royal College of Nursing (RCN), and that contributed by pro-choice organisations and abortion providers. The STC inquiry provides a classic example of this clash.
For example, the Daily Telegraph on 16 October reported on a ‘row’ that broke out at the hearing over the 24-week ‘time limit’ for abortion and the question of fetal viability (3). According to Epicure 2, a major ongoing UK study of outcomes for pre-premature babies born at gestations of less than 24 weeks, the chance of survival for such infants lies between 10 and 15 per cent – a rate that has not changed between 1995 and 2006. The Epicure study has also found extremely high levels of disability among the small numbers of pre-prematurity survivors (4). Dr Bryan Gill, honorary secretary of the British Association of Perinatal Medicine (BAPM) which carried out Epicure 2, has clearly stated: ‘Our conclusions to the limits of viability debate is that, if the Select Committee is basing assumptions on the need to lower the limit of viability on improvements to outcome for babies born below 24 weeks, then the present evidence does not support this.’
However, according to evidence given to the committee by John Wyatt, professor of neonatal paediatrics at the University College London, survival rates in centres such as the one Professor Wyatt is involved with may be as high as 42 per cent at 23 weeks’ and 72 per cent at 24 weeks’ gestation. ‘Since 1995, there have been very significant and wide-reaching improvements in the quality of care provided’, he said. ‘The data from recent studies indicate that there has been continuing improvement in the survival of extremely pre-term infants over the last 15 to 20 years with…infants now surviving at 23 and 24 weeks of gestation. Survival at 22 weeks is unusual but has been observed in a number of neonatal centres.’ (5)
As PA reported on 16 October: ‘Professor Wyatt stressed to the committee that he was giving evidence as an individual expert – amid criticisms he failed to declare membership of a Christian group campaigning for a lower limit.’ (6)
The argument that the ‘time limit’ on abortion should be reduced to 22 weeks, or 20 weeks, or whatever gestation takes a particular campaigner’s fancy, has been popular with the anti-abortion lobby for several years. By focusing on the problem of ‘late’ abortions, carried out at a stage where fetuses in the womb (it is argued) look and behave like babies, can feel pain, and are claimed to have the potential to survive outside the womb before accepted thresholds of viability, the anti-abortion lobby hopes to gain more public and parliamentary support than it would if it stuck to its more honest, but less palatable, argument that all abortions are wrong.
The key thing to note is that whatever the science might say to support such arguments – and as the current viability row indicates, not all of ‘the science’ cited in this inquiry says the same thing – the argument to reduce the time limit is a political one, based on a particular moral outlook. The question of abortion cannot be resolved at a scientific level, according to what is more or less bad for the fetus – it is a political issue about women’s need for abortion in a society committed to women’s equality and individual autonomy.
The same can be said about the other examples of competing evidence presented to the STC inquiry. Major studies have shown, and continue to show, that induced abortion does not cause breast cancer, and this evidence is accepted by the Department of Health and in independent evidence-based guidance from the RCOG. Yet individuals associated with the anti-abortion movement persist in claiming that science does show that abortion causes breast cancer – as in the submission to the STC by Dr Joel Brind, professor of human biology and endocrinology at Baruch College of the City University of New York, with a paper titled ‘Scientific Developments Relating to the Effect of Abortion on Risk of Future Breast Cancer’. Brind’s work is an example of a favoured political tactic of the anti-abortion movement in recent years – to claim that ‘science shows’ that abortion is bad for women. Again, this is a moral objection to abortion dressed up in woman-friendly scientific terms; it is not science.
Libby Brooks, writing in the Guardian on 17 October, slams the ‘junk science’ that has been presented to the STC inquiry (7). But the problem is not that political campaigners use bad science to disguise their intentions and further their cause. The problem arises if we assume that abortion is a question that can be resolved by scientific evidence rather than political debate.
To commemorate the fortieth anniversary of the 1967 Abortion Act, the abortion and advice charity BPAS (the British Pregnancy Advisory Service) has re-published Abortion Law Reformers: Pioneers of Change, a book of interviews with the campaigners, doctors and politicians who made legal abortion possible in Britain. As the interviews show, 40 years ago abortion was clearly understood as a political question – an issue of liberty, autonomy and equality. As veteran campaigner Dilys Cossey OBE says in her contribution to Abortion Law Reformers: ‘I embraced the abortion issue as an issue of fundamental importance in a free society. It really moved things forward in terms of women’s expectations and feeling in control of their lives.’
Diane Munday, another key figure in the landmark abortion law reform, recalls that in the 1960s ‘the arguments of the anti-abortion lobby were, I would say, honest. They thought that abortion was wrong and immoral, equivalent to sticking a knife in a two-year-old.’ But as anti-abortion campaigners found that such arguments failed to convince, they shifted their emphasis on to ‘scientific’ claims about how dangerous the operation was for women. As Munday says: ‘[A]ll you have to say to them in the end is, “What if it was clearly shown that abortion was good for women. That their hair grows curly, their skin becomes clear and they feel fantastic, would you agree with abortion then?” And they have to say no, because their real concern is for the fetus.’
There is a great deal of confusion and misinformation about some medical questions surrounding abortion, and the STC inquiry presents a useful opportunity to clear some of these up. Some definitive statements can be made: for example, abortion does not cause breast cancer, or make women mentally ill. Early medical abortion (the ‘abortion pill’) is a very safe method, including when nurses prescribe the drugs and when women take the medication at home. It is to be hoped that the committee can set the record straight on some of these questions, which will help the provision of good information to women requesting abortion.
But as the discussion about reforming the abortion law rumbles on, we should be clear about the balance of science and politics in abortion policy today. Scientific developments are highly relevant to abortion practice – for example, the safety, availability and widespread use of techniques such as early medical abortion, which were not even thought of back in the 1960s, present a clear challenge to certain aspects of the law, such as the insistence that doctors rather than nurses must perform all abortions, and that abortions must be carried out in hospitals or clinics.
But when it comes to the principle of abortion, science can tell us no more than it ever has. Women who need abortions should be able to have them: some people agree with this, and others do not. Scientific evidence, however sound it may be, will never tell us what society should do about abortion.
Jennie Bristow is editor of the BPAS journal Abortion Review. She also writes the monthly spiked column ‘Guide to Subversive Parenting’. She is speaking at the session Demonising parents at the Battle of Ideas festival in London on 27-28 October.
The written evidence for the STC inquiry into ‘Scientific Developments Relating to the Abortion Act 1967’ is available here.
The BPAS publication Abortion Law Reformers: Pioneers of Change is available on the Abortion Review website.
Stuart Derbyshire queried the quality of the debate offered by Channel 4’s Dispatches. Ellie Lee took a look at the history of the abortion debate and made the case for Early Medical Abortion (EMA). Or read more at spiked issue Abortion.
(2) Abortion inquiry asks scientists to disclose links to faith groups, Guardian, 15 October 2007.
(3) Scientists clash over 24 week abortion limit, Daily Telegraph, 16 October 2007.
(4) See ‘Do ‘pre-prematurity’ survivors offer new evidence about fetal viability?’ Laura Riley, Abortion Review, Issue 21, Summer 2007
(5) Scientists clash over 24 week abortion limit, Daily Telegraph, 16 October 2007.
(6) See ‘Abortion row looms after survival study’, PA, 16 October 2007.
(7) British women’s right to choose is under covert attack, Guardian, 17 October 2007
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