"Doctor has two patients’ in abortion decision

Press, 28 June 1977, Page 25

"Doctor has two patients’ in abortion decision

When deciding on abortion, a doctor had two patients, and not one: this was the fundamental truth pointed up by the Royal Commission on Contraception and Abortion, the president of the Society for the Protection of the Unborn Child (Mr J. D. Dalgety) said in a statement supplied to “The Press." The Royal Commission bad said that “ ... the status of the unborn child is the cornerstone of the abortion debate. If the child has no status, other issues resolve themselves.” Mr Dalgety said in a statment. In fact, the Commission found that the unborn child had a status from implantation and that this entitled it to preservation and protection. The commission had found that it was not a question of dealing with a woman’s body alone, Mr Dalgety said. It found that it was a question of dealing with a new life. The Commission had held that society had a responsibility to preserve and protect that new life unless there were compelling competing interests. The commission had said: “If it is possible to define ‘human’ in any way we wish when referring to pre-natal life, there is no logical reason why we should not define ‘human’ in any way we wish when we are dealing with postnatal life. In this way society could justify the disposal of the chronicallv ill. the senile and the elderly as *non-human’ and attempt to justify the taking of their lives on the grounds of the social good to be obtained.” Some believed that polls had shown that most New Zealanders supported abortion being freely available, but the polls did not show this, Mr Dalgety said. They showed the reverse. In the National Research Bureau poll conducted for the Abortion Law Reform Association in May, 1976, 68.5 per cent declared themselves opposed to “ ... abortion always legal in the first 12 weeks of pregnancy." A study of the 10 public and medical opinion surveys reviewed by the Roval Commission showed

it was only the College of Australian and New Zealand Psychiatrists where a majority supported abortion on request. Details of all of these surveys are contained in Chapter 20 of the commission’s report. With the sole exception of the College of Psychiatrists, all the other public and medical opinion surveys which the commission considered to be reasonably sound showed minority support for abortion on request, Mr Dalgety said. These surveys represented the opinions of more than 13,500 persons. Support for abortion on request was only 7 per cent with the Royal College of Obstetricians and Gynaecologists, 11.7 per cent with the National Council of Women, 15.1 per cent in the Veale survey, 18.2 per cent in the 1976 N.R.B. poll, 15.6 per cent in the 1974 N.R.B. Poll, 31.5 per cent in the Gemmings and Crighton survey. Apart from the response from the psychiatrists, the highest support for any abortion on request or similar proposition was 40.4 per cent when the mother was unmarried in the Gemmings and Crighton survey. Politicians were aware that most New Zealanders were opposed to abortion on request. The commission found that abortion on request virtually existed at the Aotea Hospital. Parliament knows his in the same way that the commmission ascertained it —by listening to people up and down the country, Mr Dalgety said. That politicians views were in step with the majority opinion was borne out by a survey of candidates in the 1975 General Election undertaken by the Women’s Electoral Lobby: 309 of the candidates interviewed, answered the abortion section of their questionnaire. When Values candidates were included, 44.6 per cent supported abortion on social grounds, when Values candidates were excluded support fell to 21.7 per cent. Since the release of the commission’s report, the recommendation to have abortion decisions made

be impartial panels has come under attack, Mr Dalgety said. The commision had found that the unborn child should be preserved and protected, and that the present lad' had been exploited. It found there had been a lack of good faith by some doctors in carrying out abortions, he said. The report said: “In any prosecution, the onus of proving lack of good faith on the part of the doctor concerned rests with the Crown. “Undoubtedly some doctors have been very mindful of this fact and have used it to justify abortions which would not have been accepted if the application for abortion had been decided by a more objective tribunal.” The commission’s findings on this issue in respect of the Auckland Medical Aid Centre showed that “. . . the vagueness of the law has been exploited to the fullest extent by the centre by providing what is virtually an abortion on request service,” Mr Dalgety said. It also found that the centre's counsellors and doctors were abortionorientated and that the centre’s profitability was directly related to the number of abortions performed. It recommended a panel system because it did not want the law exploited again. If Parliament adopted a system of any two doctors being able to make a decision on abortion, abortion on request would be practised in most major population centres in New Zealand within a year of the legislation, Mr Dalgety said. A panel system would work. Such a system had operated successfully at several public hospitals, including, Wellington, Hutt and Invercargill for years. A doctor familiar with the system at Kew Hospital, Invercargill, had described how the system had worked, Mr Dalgety said. He had said that the hospital’s pane] had been set up about 10 years ago. Patients were referred by a general practitioner to a specialist gynaecologist,

who confirmed pregnancy and determined indications for termination. The specialist might decide that, there was no serious risk of physical or mental harm to the patient, and if so would not pass the case for panel decision. If the gynaecologist believed the case legally acceptable, the hospital panel was notified, and a further specialist opinion might be requested. The hospital medical social worker might be asked for a report. The panel comprised the superintendent (or deputy), the referring gynaecologist, the patient’s G.P., and any other specialist (psychiatric, surgical or medical) in the case, and a further gynaecologist, Mr Dalgety said. The Kew doctor had commented: “The patient attends with her husband or de facto or parents or guardians. (if at all possible). The panel discusses the case in detail and endeavours to reach a decision in the absence of the patient. “If a clear cut decision is determined the patient will not be confronted with the panel, but the decision will be explained to the patient by the referring gynaecologist. If the decision is not clear cut the patient and her husband will meet the panel and further details of the case will be elucidated,” the doctor had said. “If the decision for termination is agreed upon, this will be carried out within one week by the referring and approving gynaecologist. If a decision against termination is reached, then this is explained to the patient and her husband. Positive alternatives are given to the patient. The maximum delay from referral to operation is two weeks. “All cases referred are treated with seriousness, gentleness and compassion. The hospital unanimously voted to continue the panel system during 1976. It does work, and it can work quickly, compassionately and within the law,” the doctor said.