Why we should modernize the abortion law
By Professor Sally Sheldon
17 October 2008

Eighty-five academics with expertise in medical ethics and law have joined together to call on Parliament to modernize the Abortion Act 1967. Their letter is published in The Times.

They explain why modernisation of the Abortion Act is necessary and call on Parliament to update it. An opportunity for reform is soon to be presented by the arrival of the Human Fertilisation and Embryology Bill at report stage in the House of Commons. The signatories represent a sizeable proportion of the total body of academic experts in medical law and ethics and demonstrate a very real strength of opinion within that community that the current legislation is much too restrictive. Given that academics are an independently minded group of people, who generally agree on very little, the unprecedented weight of support behind this letter points to some very real problems with the law and a pressing need for change.

What is wrong with the Abortion Act? The letter points out that it is now over forty years old and reflects the values of 1967, when a 'doctor knows best' model of paternalism was dominant. This is reflected in the fact that, legally, it is two doctors who must decide that an abortion is appropriate for each individual woman. Forty years on, the Abortion Act represents a striking anomaly in the context of the currently widely accepted ethical and legal principles which determine the parameters of good medical practice. Today, respect for patient autonomy is at the very heart of ethical medical practice and the legal framework within which it operates. The law courts have made clear that the right to make one's own health care decisions is not diminished by virtue of being a pregnant woman. Indeed, a series of cases in the 1990s established that a woman is entirely within her legal rights to refuse an unwanted Caesarean section, even where necessary to save her own life and that of a full term fetus.

While many people find these cases difficult, the point is that autonomy isn't worth much if it is only recognised in the context of those decisions with which we agree. And, as is noted in the letter, while achieving fewer earlier abortions is a goal shared by all, there is no evidence that this is best achieved by placing obstacles in the path of a woman wishing to end her pregnancy.

It remains to be seen whether the House of Commons will respond to this call for reform or, indeed, to the recommendations of its own Science and Technology Sub-Committee. That Committee found no basis for the current restrictions contained in the Abortion Act in terms of patient safety but did find that it was possible that the requirement for two doctors' signatures might be contributing to delays, thereby resulting in later terminations. View more information here.