As to the suggested safeguarding regulations, there is by no means general agreement in the medical profession concerning their advisability or their value.
The Committee, having investigated the matter very fully, is satisfied that any disability under which the doctor rests in terminating a pregnancy for genuine, accepted therapeutic reasons is only theoretical.
No actual instance was brought before the Committee in which a doctor had been penalized or even subject to question when acting in good faith, nor was any evidence presented to show that any patient had suffered by reason of a doctor refraining from operating through fear of possible legal consequences.
Both medical and legal witnesses competent to speak on these medico-legal aspects were definite in their a.s.surance that, under the existing law, no doctor acting in accordance with the accepted standards of the profession was in any danger.
The only person who need have any fear was one who ignored guidance of the existing standards of his profession, and to this extent the law was, at least in part, a deterrent against laxity of practice.
The Committee considers that, as it stands, the law has shown itself adaptable in practice to all reasonable changes in medical thought.
Further, the Committee was impressed by the possible dangers which might be a.s.sociated with any alteration in the existing law.
While it is undoubtedly true that the majority of doctors are straightforward and honest in their interpretation of the indications for therapeutic abortion, it was made clear that even at the present time there are some who are inclined to terminate pregnancy for reasons which would not be accepted by most.
It would be quite impossible to lay down a hard-and-fast list of indications.
There are definite grounds for fearing that any alteration in the law would lead, in certain quarters, to a widening of the interpretations far beyond the intention of the alteration.
Under any alteration it would be exceedingly difficult to control the merging of the therapeutic into the social and economic reasons.
For these reasons, then, the Committee is not prepared to suggest any alteration in the law regarding therapeutic abortion; the Committee believes, however, that some benefit might accrue from the compulsory notification of all abortions to the Medical Officer of Health.
_Abortion for Social and Economic Reasons._--Having received certain representations in favour of this practice, and having examined a large ma.s.s of evidence on this subject, the Committee is utterly opposed to any consideration of the legalization of abortion for social and economic reasons.
The Committee does not hesitate to state its first objection on moral grounds.
That the deliberate destruction of embryo human lives should be allowed for all the varying and indeterminate reasons suggested by different advocates would lead the way to intolerable license.
We would draw your attention and that of the public to the extreme views which are held by some of the most active advocates of legalized abortion.
In its most blatant form this advocacy is based on the argument of woman"s right to determine for herself whether a pregnancy shall continue or not.
"The right to abortion should be taken quite away from legal technicality and legal controversy. Up to the viability of her child it is as much a woman"s right as the removal of a dangerously diseased appendix."
This is the view of Miss Stella Browne in her essay on "The Right to Abortion"[2] and of others who hold similar opinions.
[2] "Abortion Spontaneous and Induced." Taussig.
Is any comment necessary?
The representative of one of the largest women"s organizations in New Zealand who gave evidence before the Committee advocated the introduction of legislation permitting abortion under certain circ.u.mstances after a woman had had two children, subsequently qualifying the suggestion by the words "if contraceptives fail."
In the case of such ill-considered opinions, the Committee believes that it would be impossible to limit the practice if the law were in any way relaxed.
Of course there are others who confine their advocacy of legalized abortion to cases in which there are elements of real tragedy and which appeal to public sympathy, but, granting that there are many cases in which social and economic conditions create situations of great hardship, nevertheless the Committee is fairly convinced that abortion is not justifiable; the remedies lie in the removal of the causes and the alleviation of these difficult situations by social legislation and other measures, and in the education of the public conscience.
The Committee is also opposed to the legalization of abortion for social reasons on account of the very considerable risks to health which are a.s.sociated with the practice.
Medical witnesses were agreed that, while the immediate risk to life in surgically performed termination of pregnancy was slight, there were very definite possibilities of more remote disabilities, and that such sequelae occurred in a considerable proportion of cases.
In the case of a genuine therapeutic abortion these risks are outweighed by the dangers of the condition calling for the termination of pregnancy, but were the operation to be performed freely for social reasons the effect in the community might be very serious.
World-wide interest has been aroused in the matter through the experience on Soviet Russia, where, for a number of years, abortion for social and economic reasons was legalized and extensively practised.
The operations were performed in special hospitals and by skilled operators.
At first it was claimed that when the operation was done openly and carefully the risk to life was exceedingly small. It was stated, for instance, that in 1926 artificial abortion was carried out on 29,306 women in Moscow with no mortality, and that in a total of 175,000 operations in Moscow there were only nine deaths.
But now come most significant reports of the after-effects to these operations, which state that 43 per cent. of these women suffered from some definite illness as a result of the operation, and that "the most enthusiastic Russian advocates of legalized abortion are appalled at the growing evidence of serious pelvic disturbances, endocrine dysfunctions, sterility, ectopic pregnancy, and other complications following in the wake of artificial abortions."[3]
[3] "Abortion Spontaneous and Induced." Taussig.
A recognition of these remoter dangers has undoubtedly been an important factor in bringing about the complete reversal of the previous policy in Russia, where abortion for social and economic reasons is now illegal.
The opinion of A. M. Ludovici, admittedly an extreme exponent, may well be considered when, in "The Case against Legalized Abortion"[4] he writes:--
"If only the disingenuous propaganda in favour of legalized abortion would cease, and if only those who carried it on refrained from dinning into the ears of an uninformed gallery of women the alleged safety and harmlessness of abortion carried out under the best hospital conditions, there would be less eagerness to face the ordeal of criminal abortion.
"So long as ignorant women are led to believe that abortion, when skilfully performed, is as easy and harmless as having a corn extracted, they will naturally infer that it can be done just as harmlessly in secret as in public, especially if they are a.s.sured that the surrept.i.tious abortionist is skilled, as presumably they always are, and are, moreover, kept in total darkness concerning the kind of operation that is necessary for the interruption of pregnancy.
"If, however, they knew the truth, which is that artificial abortion, even under the best hospital conditions, is a precarious undertaking, so frequently leading to invalidism as never to be "safe"; if, moreover, we spread the truth about Russia"s legalized abortions, and put a stop to the false reports circulated by ill-informed enthusiasts regarding the ease and safety of skilled induced abortion, we should be going a long way towards reducing criminal or surrept.i.tious abortion to vanishing-point."
[4] "Abortion," by Stella Browne. Ludovici and Roberts.
_Sterilization._--Brief mention must be made of _sterilization_--an operation whereby further pregnancy is prevented--which has been put forward by certain witnesses as a method of preventing abortion.
Just as therapeutic abortion is, in certain cases, legitimately performed by medical pract.i.tioners, so has the operation of sterilization a recognized place in medical treatment of exceptional cases in which a woman"s life is likely to be endangered or her health gravely impaired by further pregnancy.
It can, indeed, be reasonably argued that in such cases sterilization is very definitely to be preferred to the very unsatisfactory alternative of repeated therapeutic abortion.
Nevertheless, any general extension of this practice would, in the opinion of the Committee, be open to serious abuse.
The Committee sees a tendency in some quarters to extend the indications for this operation far beyond the bounds of generally accepted medical opinion.
The att.i.tude of the Committee towards this matter is therefore the same as towards more specific legalization of therapeutic abortion.
_The Prosecution of the Criminal Abortionist._--A very disquieting aspect of this problem is the relative immunity of the criminal abortionist from punishment. Conviction for the crime is rare, even in cases where guilt appears to be proved beyond all reasonable doubt.
The Committee has sought to discover the reasons for the failure to obtain conviction.
It is apparent that the police authorities are faced with many difficulties. In the first instance conviction is largely dependent on the evidence of a woman who, in the eyes of the law, is an accomplice to the offence, and corroboration of her evidence may be demanded.
It has been suggested by certain witnesses that, if the woman were legally exempt from penalty, there would be less reticence about giving evidence and a greater fear on the part of the abortionist.
On the other hand, it has been stated to the Committee that where such an indemnity is actually given, this very fact operates against conviction.
The Commissioner of Police gave information that--