INTRODUCTION

  Founded in 1852 as the Lawyers' Prayer Union, the subsequently renamed Lawyers' Christian Fellowship (LCF) has a long history of contributing to legal consultations and reviews based on our uncompromising commitment to the Bible's teaching to "Seek justice, love mercy and walk humbly with God" (Micah 6:8).

  From its inception as a prayer union the scope of LCF's work has grown with the support of such renowned patrons as Lord Denning and Lord Mackay of Clashfern. Today LCF has an expanding membership of over 2000 Christian lawyers, with a network of regional groups spanning Britain, and international links which are particularly strong in East Africa. We also provide information to over 20,000 religious groups and individuals through our email bulletins. Many hundreds of those receiving our bulletins run, or are involved in, Christian charities.

  We believe that laws based on Christian truth benefit society and there is a Biblical mandate to share the Bible's teaching on such matters: "I will speak of your statutes before kings" (Psalm 119: 46).

EXECUTIVE SUMMARY AND OVERVIEW

  The LCF is opposed to the legalisation of abortion and nothing in this submission should be taken as an endorsement of abortion or as a concession on this principle.

  The Committee's intention to conduct this inquiry without considering the ethical or moral issues associated with the 24-week time limit is unworkable as:

—  such issues will necessarily play a part in their deliberations, whether consciously or subconsciously, and

—  an inquiry which removed consideration of these issues would become futile because law, science and abortion will always be inextricably linked with ethical and moral issues.

  There are a number of scientific developments that suggest review of the 24-week limit is appropriate, such as the lowering of the age of "foetal viability" and the development of 3-dimensional ultra-sound pictures.

  The LCF do not accept that foetal abnormality can ever justify abortion.

  There are serious concerns about the safety and value of amniocentesis tests, the pressure put on parents of deformed foetuses to have abortions, and the lack of consideration given to current and future treatments for the conditions of foetuses who are being aborted.

  Abortion on demand should not be legalised.

  Studies show that the physical and medical effects of abortion on women are underestimated and can have severe consequences.

  Increased use of the morning after pill is having no positive effect on the rate of abortions and teenage pregnancy, and is having a detrimental effect on the rate of STDs.

  The need for two doctors" signatures should be kept as one of the few safeguards included in the Abortion Act. Rather than reducing the number of safeguards we should be strengthening the safeguards in the Act.

  To remove the need for a doctor to perform an abortion would simply trivialise a procedure that has caused much trauma to women. Instead, steps should be taken to educate and warn the public about the dangers and side effects of abortion.

  It would be irresponsible to allow the second stage of medical abortions to take place at a woman's home, bearing in mind the possible physical dangers involved, as well as the obviously traumatic nature of the procedure.

SUBMISSION

  The LCF is opposed to the legalisation of abortion and believe that a child is a human being from conception, made in the image of God, and deserving of protection and the right to life. Nothing in this submission should be taken as an endorsement of abortion or as a concession on this principle.

Question 1(a)—the scientific and medical evidence relating to the 24-week upper time limit on most legal abortions, including developments, both in the UK and internationally since 1990, in medical interventions and examination techniques that may inform definitions of foetal viability

  1.  For some time now it has been apparent that the 24-week limit no longer accurately defines the so called stage of "viability'. Indeed, it seems unquestionable that as neonatal care improves and develops the age of viability will continue to decrease. This was reflected in the 1990 Human Fertilisation and Embryology Act when the upper limit for most abortions was lowered from 28 weeks (the "foetal viability" age set by the Infant Life (Preservation) Act 1929, and kept by the 1967 Abortion Act) to 24 weeks.

  2.  It is difficult to understand the Committee's intention to consider scientific developments regarding the 24-week time limit without considering the associated ethical or moral issues. Placing such a broad limitation on their inquiry would make it unworkable and futile. The Committee may wish to avoid consideration of the very difficult foundational ethical questions that have always surrounded the abortion debate, such as what is the status of the embryo/foetus. But in doing so they are making two very serious mistakes. Firstly, many scientific developments since 1990 have added invaluable scientific information to that debate. For example, the large, colour three-dimensional ultrasound pictures pioneered by Professor Stuart Campbell are scientific developments that have raised serious questions about the acceptability of aborting foetuses who can be seen stretching, kicking, yawning, sucking their thumbs and opening and shutting their eyes.

  3.  To limit this inquiry so that the ethical and moral implications of such scientific developments cannot be discussed is to severely limit the usefulness of the whole inquiry as a tool for possible law reform in this area. Without including such issues this inquiry cannot hope to inform the wider debate as it lacks any consideration of one of the most important aspects of abortion law.

  4.  Secondly, in stating they will not consider moral or ethical issues associated with abortion time limits the committee is failing to recognise the role that such issues will inevitably play in this inquiry, irrespective of whether the existence of these issues is acknowledged. The committee would be unable to draw any conclusions or make any recommendations based on the evidence they receive about scientific developments without drawing on moral and ethical principles. For example, the age of viability of a foetus is completely irrelevant unless and until moral and ethical questions are asked about the consequences of that information. Whether abortion should be available up to 28 weeks, 24 weeks or 20 weeks is an ethical question which may be informed by science. Another example is that of the growing evidence that abortion causes psychiatric illness. That information does not lead to any useful conclusions, unless and until certain ethical principles come into play, such as the principle of fully informed consent and acting in the best interests of the patient. Such principles are not scientific in nature, but ethical.

  5.  In short, it is not possible to have any meaningful inquiry into abortion law without considering the ethical and moral implications. Law can never be divorced from ethics, science should never be divorced from ethics, and abortion—both for those in favour and those opposed—will always be first and foremost an ethical issue.

Question 1(b)—the scientific and medical evidence relating to the 24-week upper time limit on most legal abortions, including whether a scientific or medical definition of serious abnormality is required or desirable in respect of abortion allowed beyond 24 weeks

  6.  This is an area of abortion law where law and science have not interacted well, and it seems that the law has not been properly applied. Doctors referring women for late abortions due to the baby having "physical or mental abnormalities as to be seriously handicapped" have sometimes interpreted the law in such loose terms as to include conditions that were never intended by parliament; the most famous of these being abortion because of a cleft lip and palate.

  7.  The mere existence of this clause of the Act is highly controversial because of the way it discriminates unashamedly against the disabled and makes sweeping assumptions about quality of life and of the intrinsic value of life. In a full abortion reform inquiry our submission would be that the clause should be repealed. However, even leaving aside those fundamental concerns, there is much to be said with regard to the scientific developments in detecting conditions before birth and treating them after birth.

  8.  In 2002 there were 1836 terminations for foetal disability (1% of the total); 376 of these were for Down's syndrome. Part of the reason for this is that all pregnant women are now offered a nuchal scan, followed by an amniocentesis test if the nuchal scan shows a certain level of risk of Down's syndrome or Edward's Syndrome. However, this "development" in examination techniques is not without its' problems. Dr Hylton Meire, a retired doctor formerly of King's College Hospital, has raised concerns about the value and risk of these tests. Because the initial ultrasound is not very accurate it raises false positives, which means parents may elect to have an amniocentesis test even though their baby is perfectly healthy. The problem with this is that amniocentesis tests carry a one in 200 risk of causing a miscarriage. By Dr Meire's calculations this means 160 healthy babies would be lost for every 50 cases of Down's syndrome or Edward's Syndrome detected.[219] If the Government takes the view that causing the deaths of healthy babies is a price worth paying in order to avoid the birth of children with Down's syndrome, serious questions about eugenics are raised. This also raises serious concerns as to whether the parents of the healthy babies have consented to this risk.

  9.  Many would argue that Down's Syndrome is not something that leads to serious handicap, not least of which are those with Down's and their parents; and yet often parents are actively encouraged to abort if they are told their unborn child has Down's Syndrome.[220] This dismissive attitude to "imperfect" foetuses is held in tension with other scientific developments which improve the treatment options that would be available to the children who are instead being aborted. For example, earlier this year a new treatment with "remarkable potential" was announced which it is hoped will alleviate the learning difficulties caused by Down's syndrome.[221]

  10.  Down's syndrome is just one example that raises some important principles and concerns—scientific developments should not be allowed to take precedence over the safety and health of unborn babies or their mothers; they should not be used as an excuse or tool for eugenics; and they should be used to alleviate, treat and cure illness where possible. Setting out a definitive list of conditions that may or may not constitute a "serious handicap" would be seriously problematic, not least because it could not take into account possible cures and treatments in the future. We do not accept that abortion because of a child's disability can ever be justified. However, if the clause is to remain law, it must be tightened so that (a) it can only be used in the most extreme circumstances, and (b) pregnant mothers are never pressured into having an abortion, but are given balanced and full information about their options and the effect of the condition on their child. It may not be possible for doctors to give adequate information as they may know little or nothing about life with a disabled child, in which case disability groups and/or counsellors with expertise knowledge in this area should be involved.

Question 2(a)—medical, scientific and social research relevant to the impact of suggested law reforms to first trimester abortions, such as the relative risks of early abortion versus pregnancy and delivery

  11.  Some would take a cursory look at the statistics recording pregnancy related deaths and conclude that because the number of deaths attributed to abortion is so low, induced abortion is always safer than continuing with pregnancy. However, there are a number of reasons why abortion related deaths may not be recorded as such, for example, the death may occur after the patient has lost contact with the abortion provider, it may be due to psychiatric illness as a result of the abortion, or the abortion may be wilfully hidden, either by the mother, or by the doctor who does not wish to upset the deceased's family. In addition to this, there is other evidence which paints a very different picture of the medical and psychological after-effects of abortion. Studies from Finland[222] and the USA[223] both showed increased mortality in women who had had an abortion.

  12.  We draw attention to these studies to show that the current approach of many doctors in the way they apply the law is erroneous, as they assume that any pregnancy would pose a greater risk to a woman's physical and mental health than if she had an abortion, and that therefore the Act allows for abortion on demand up to the 24 week limit. The other reason that this approach is incorrect is that this was not the original intent of Parliament. When the Abortion Act was passed it was intended to be applied in a very narrow set of circumstances, and not in every instance that a woman asked for an abortion. The philosophy behind the Act was never one of "pro-choice', but rather one of protecting from a societal problem (ie unsafe backstreet abortions in extreme circumstances). This is yet another instance where law and science have not worked well together, with the medical profession failing to carry out the wishes of Parliament, and Parliament failing to put in place adequate safeguards to ensure its intentions were implemented.

  13.  In fact, further studies into morbidity and mental health after abortions would suggest that in most cases continuing with the pregnancy carries less danger to the mother's physical and mental health than an abortion does. In his article "Are the Majority of UK Abortions Illegal?" Chris Richards compared morbidity rates of those who had an undisturbed pregnancy with those who had an abortion:

"A recent Scottish study estimated the severe morbidity rate from undisturbed pregnancy to be 3.8 per 1,000 [0.38%] but almost all events, including haemorrhage (incidence of 1.9 per 1,000), were treatable with a good long-term outcome. The serious, but usually treatable, acute complications of surgical abortions are haemorrhage (incidence 0.1%) and uterine perforation (incidence 0.4-2%). The risk of infection (incidence 10%) is greatly increased when Chlamydia or Neisseria are present—up to 23% developing pelvic inflammatory disease (PID) within four weeks. With rapidly rising Chlamydia rates this will be an increasingly common complication of abortion... Finally there is growing evidence (though still disputed by some) that abortion—but interestingly not miscarriage—increases the risk of breast cancer (relative risk of 1.3-2). In addition term pregnancy acts as a clear protection against the development of breast cancer".[224]

  14.   In addition to the woman's immediate physical health there are clear dangers to any future pregnancies as a result of having an abortion:

"PID can cause infertility and future pregnancies have a greater risk of placenta praevia (increased by 7-15 times), and pre-term labour (twice as likely). The latter is an important cause of chronic lung disease and cerebral palsy in the child".[225]

  Such consequences of abortion are not reflected in simple mortality rates.

  15.  The other important factor to consider is a woman's mental health either after an abortion or after having an undisturbed pregnancy. There is now ample evidence of the detrimental effect abortions can have on women's mental health. A recent New Zealand study found a significantly higher rate of mental illness in women following abortions than those who kept their pregnancy, even after taking account of their pre-pregnancy mental health. Other studies have found that women who have abortions are much more likely to commit suicide within a year of the event, whereas the suicide risk following birth was half that of the general population.[226] More and more evidence is pointing to the conclusion that abortion is bad for a woman's mental and physical health.

  16.  Some would argue that refusing women an abortion would have a detrimental effect on their mental health. However, the studies do not bear this out:

"An early Swedish study of 4,274 women refused abortion showed that 85.6% completed their pregnancies and only 10% sought an abortion elsewhere. Another similar study followed up 249 such women for 7 to 10 years finding that 73% were satisfied with the way things had turned out; 69% were taking care of the child. Most unwanted pregnancies, if not aborted, resulted in wanted children. Conversely most abused children come from wanted pregnancies. Since the Abortion Act came into force in Britain in 1968 the incidence of child abuse has doubled".[227]

    In addition, representatives of the Royal College of Psychiatry giving evidence to the Rawlinson Commission stated that there are no psychiatric grounds for abortion. This is in spite of the fact that most abortions are carried out on alleged grounds of damage to the mother's mental health.[228]

  17.  Another aspect of early abortion is the increased availability and use of the morning after pill. As a government policy to decrease abortion and teenage pregnancies this is clearly not working. Abortion rates have continued to rise, as have sexually transmitted diseases. It seems that neither abortion nor the morning after pill (itself an early abortifacient) is the answer to increasing teenage pregnancies, and the consequences of failure are high. Teenagers are twice as likely as adult women to attempt suicide after abortion, and the rising rates of Chlamydia could cause a huge surge of infertility in the younger generation. Perhaps it is time the UK stopped being distracted by so-called "reproductive rights" and instead followed the models that have been proven to work. In Uganda the HIV rate was reduced from 35% to 6% with the simple messages "Abstinence until married" and "Be faithful to your spouse". Adopting a policy of encouraging abstinence would also be in line with the WHO's "one partner for life" recommendation, and studies in the USA have shown it can cause teenagers to delay sexual activity. Other factors that can help delay the age of first intercourse are the presence of a father at home and having sex education from parents.[229] Modern scientific and social research is showing that traditional methods and models of family are the best when it comes to reproductive health.

Question 2(b)—medical, scientific and social research relevant to the impact of suggested law reforms to first trimester abortions, such as the role played by the requirement for two doctors" signatures

  18.  All indications suggest that it is not difficult to get referred for an abortion. In fact, it seems that many doctors interpret the Abortion Act in such a broad way that they are in practice offering abortion on demand up to 24 weeks. This is a misuse of the power that has been given to them and is against both the intention and the terms of the Abortion Act. It was never intended as a statute to protect a pro-choice philosophy, rather it was intended to allow for the possibility of a legal abortion in extreme circumstances.

  19.  With hindsight we can see that not enough safeguards were put in place to ensure that the Act wasn't abused and/or misinterpreted. However, one of the safeguards that is present is the need for two doctors to agree that an abortion would be legal in the circumstances. To remove this safeguard would weaken the Act as it would remove the natural accountability that is present when one doctor must have a second doctor agreeing with his decision before it may be acted upon.

Question 2(c)—medical, scientific and social research relevant to the impact of suggested law reforms to first trimester abortions, such as the practicalities and safety of allowing nurses or midwives to carry out abortions or of allowing the second stage of early medical abortions to be carried out at the patient's home

  20.  Taking into account the trauma that has been and is being caused to women through the prolific use of abortion in this country it would be unwise to trivialise this procedure further by no longer requiring doctors to be involved, and even allowing home abortions. Rather than simply trying to make abortion easier the Government should be attempting to educate people about the dangers and side effects of abortions. Similarly, the government's failure to reduce teenage pregnancies, abortions and STDs cannot be swept under the carpet by minimising the seriousness of this procedure. Pro-abortionists have held up a sceptre of "sexual freedom without consequence" which has time and again proved to be fallacious. Rather than covering up this reality both patients and the general public need to be informed of the wider damage that has been done by 40 years of increasingly liberal abortion practices.

  21.  There are other specific concerns about the safety of these proposed reforms. For example, use of the abortion drug RU486 can often involve considerable pain and distress for the woman. To simply send a woman home to deal with the emotional distress as well as any medical complications alone is highly irresponsible. The safety of this drug is also in question, as in the USA at least 5 women have died from septic shock after RU486 abortions.[230] For a law that pro-abortionists would say protects women, it seems that women go through extreme suffering because of it.

Question 3—evidence of long-term or acute adverse health outcomes from abortion or from the restriction of access to abortion

  22. See above.

September 2007

220   Harrison's parents chose his name when he was a 35-week foetus-then they were offered a termination, The Telegraph, 21/05/2006. Back

221   Brain booster "has potential to treat Down's syndrome", By Roger Highfield, Science Editor, The Telegraph, 26/02/2007. Back

222   Gissler M et al. Pregnancy associated deaths in Finland 1987- 1994. Back

223   Reardon D C et al. Deaths associated with pregnancy outcome: a record linkage study of low income women, Southern Medical Journal 2002; 95: 834-841. Back

224   Are the Majority of UK Abortions Illegal? Chris Richards, Triple Helix, Spring 2006 p10-11, CMF. http://www.cmf.org.uk/literature/content.asp?context=article&id=1784 Back

225   Ibid. Back

226   Ibid. Back

227   Deadly Questions on Abortion, Dr Peter Saunders, Nucleus, January 1998 pp31-34, CMF. http://www.cmf.org.uk/literature/content.asp?context=article&id=599 Back

228   Ibid. Back

229   Morning After: the truth comes out, Mark Houghton, Nucleus, Autumn 2006 pp 7-9, CMF. http://www.cmf.org.uk/literature/content.asp?context=article&id=1878 Back

230   RU486-Moves for abortions at home, Triple Helix, Spring 2006 p.4, CMF. http://www.cmf.org.uk/literature/content.asp?context=article&id=1790 Back