THE OTAGO DAILY TIMES FRIDAY, JURE 12, 1936. A DOCTOR’S RESPONSIBILITY

Otago Daily Times, Issue 22905, 12 June 1936, Page 8

THE OTAGO DAILY TIMES FRIDAY, JURE 12, 1936. A DOCTOR’S RESPONSIBILITY

Two pronouncements this week, arising out of the pertinent observations that were made by Mr Bartholomew, S.M., in his capacity as coroner, at a recent inquest in this city respecting the duly of medical practitioners in regard to notification to the police of the cause of death when it is found to be due to an illegal operation, will have been read with satisfaction. The coroner referred to what he described as the unfortunate and mischievous effect of a ruling of the Director-general of Health bearing on the subject. The matter could hardly rest there. The Minister of Health has recognised the onus cast upon his department to clarify the position and its own general attitude. In a considered statement he declared that the Directorgeneral of Health had not given a ruling for the guidance of the medical profession, but had merely conveyed to the New Zealand Obstetrical Society, in response to a request from it, the opinion of the Crown Law Office on the specific question whether a doctor was under a legal obligation to inform the police of the fact that an illegal operation had been performed. Actually the Director-general did not “ merely convey ” the advice given to his department by the Crown Law Office, for he introduced also the question of moral duty and by doing so seems to have, to some extent clouded the issue. The Minister, it will have been observed, definitely associates himself with the coroner’s view that, where death has been caused by an illegal operation, the doctor should inform the police and withhold a certificate of death. As he stated, it is important that the issue raised should be faced and settled in a way that leaves no room for subsequent misunderstanding. The Minister said further that he was prepared to recommend, if need be, an amendment of the law, but that he preferred in the meantime to believe that recognition of the moral obligation by the medical profession could bo relied on, and that in its hands the matter could safely be left. The Council of the New Zealand branch of the British Medical Association has promptly responded to the Ministerial suggestion, and, expressing itself in general agreement with the Minister

awl the coroner, has undertaken to indicate to its members that they should act in conformity with the rule laid down by the Royal College of Physicians, which was quoted by the coroner at the inquest. The question whether an inquiry should be instituted into all aspects of the problem presented by the prevalence of the offence of criminal abortion is, the Minister has said, being taken into consideration by the Government. It is an unfortunate fact, as the statistics show, that a position exists in this relation which is not creditable to the Dominion. Accordin?, to figures given in the report of the Health Department for last year, the position shown in New Zealand in respect of what is distinguished as " true " maternal mortality, represented in .76 deaths and a rate of 3.12 per 1000 live births, is, considered comparatively, certainly satisfactory. The rate has declined very appreciably of recent years. But the total number of maternal deaths is considerably augmented by deaths from septic abortion. These numbered 42 out of a total of 118 for the year 1934, and they have been an increasing factor. The mortality arising from this cause is characterised as a social and economic problem as opposed to an obstetric problem. There; were three times as many deaths from septic

abortion in 1934. as there were in 1927, definite increases in the rate being noticeable in 1930 and 1934. According to tlic Government Statistician, of eight countries with which a comparison is made, New Zealand had the highest death rate from septic abortion in 1932, and was the only country in which the rate from (his cause was higher than that from other puerperal sepsis. Plainly this comparative prevalence of artificially induced abortion in the Dominion only renders it the more necessary that the obligation of doctors in relation to such cases should be defined as clearly as possible.