The Medical Profession and the Abortion Controversy

A 1974 study in America, reported that 'almost all professionals involved in abortion work, reacted with more or less negative feelings.'
  • Staff find that they cannot cope with prostaglandin abortions, particularly when done for "non-medical reasons."
  • The Abortion Supervisory Committee admitted to continuing concerns about workforce recruitment and retention.
  • Abortion is surgically unchallenging work that hardly fits within the classic bounds and aspirations of young physicians in training.
  • 'As the pregnancy advances, the idea of abortion becomes more and more repugnant to a lot of people, medical personnel included'
  • British medical schools have started to restrict the number of Muslim students, because they refuse to learn about abortion.
In New Zealand, as elsewhere, hospital staff are reluctant to perform second trimester abortions.

Dr M.G.Laney, Clinical Director of Gynaecology Services at Christchurch Women's Hospital, sent a letter dated 10th May, 2001, to Christchurch and Canterbury GPs, advising of problems with late referrals:
"A higher than acceptable percentage of patients are being referred late, when the pregnancy is quite advanced. These women are more difficult to operate on, and some are too advanced and require prostaglandin termination of pregnancy (PGTOPS). This is an unpleasant procedure for staff and patients alike.

"As a result of the increased number of PGTOPS that we are being asked to carry out, we are losing competent and highly regarded nursing staff. They find that they cannot cope with these PGTOPS, particularly when done for non-medical reasons."

The Abortion Supervisory Committee's Report for 2003, admitted to continuing concerns about workforce recruitment and retention.

Why doctors are moving away from abortion
In the United States, most of the abortionists are reaching retirement age and there is concern among providers about the emerging shortage of younger doctors prepared to be involved.

Abortion is surgically unchallenging work that hardly fits within the classic bounds and aspirations of young physicians in training.
Abortion is seen by younger doctors as surgically unchallenging work that doesn't meet the aspirations of young physicians in training. Residents in obstetrical training programs have made it known to their mentors that they prefer not to waste their valuable training time, carrying out a procedure that is now largely confined to abortion clinics.

One Obstretician-Gynaecologist who supports abortion rights but has chosen not to perform abortions said bluntly what he says others were probably thinking: "It [abortion] is seen as the dirty work of our field. "

Previous research on abortion staff
Rachel MacNair is the director of the Institute for Integrated Social Analysis in Kansas City, and author of Perpetration-Induced Traumatic Stress: the Psychological Consequences of Killing (Paeger, 2002), which examines several groups that kill, including war veterans and executioners.

She found that very little study has been done on the doctors, nurses, counsellors and other staff in abortion facilities. Only two scientific studies that look at a large number of people have been carried out by researchers who do not work in abortion: M.Such-Baer's in Social Casework 1974, and K.Roe in Social Science and Medicine in 1989.

"Both studies were done by people in favour of legal abortion, yet they both note the high prevalence of symptoms that fit the condition now called Post-Traumatic Stress Disorder. The 1974 study (before the term was adopted) noted: "obsessional thinking about abortion, depression, fatigue, anger, lowered self-esteem, and identity conflicts were prominent." The symptom complex [group of related factors] was considered similar to combat fatigue.

According to MacNair, the other study listed similar symptoms: 'Ambivalent periods were characterized by a variety of otherwise uncharacteristic feelings and behaviour, including withdrawal from colleagues, resistance to going to work, lack of energy, impatience with clients, and an overall sense of uneasiness. Nightmares, images that could not be shaken, and preoccupation were commonly reported. Also common was the deep and lonely privacy within which practitioners had grappled with their ambivalence."

Symptoms of Post-traumatic Stress Disorder summarised from the official definition (American Psychiatric Association, 1984) are as follows:
    A. Traumatic event

    B. Re-experiencing the trauma
    1. Recurrent, intrusive recollections
    2. Dreams
    3. Sudden acting or feeling the event is recurring
    4. Intense distress at cues that resemble the trauma
    5. Physical stress reactions to cues of the trauma

    C. Numbing
    1. Avoiding anything associated with the trauma
    2. Avoiding things that remind about the trauma
    3. Inability to recall something important about the trauma
    4. Markedly diminished interest in significant activities
    5. Feeling detached or estranged from others
    6. Constricted affect
    7. Sense of foreshortened future

    D. Increased arousal
    1. Sleep problems
    2. Irritability, outbursts of ange
    3. Trouble concentrating
    4. Hypervigilance
    5. Exaggerated startle response

Degrees of negativity
"Such-Baer's 1974 study in America, reported that 'almost all professionals involved in abortion work, reacted with more or less negative feelings.' Those who have contact with the fetal remains have more negative feelings than those who do not, and their response varied little: 'All emotional reactions were unanimously extremely negative.'

Discomfort with abortion clients or procedures, was reported by practitioners who strongly supported rights and expressed strong commitment to their work.
"The largest published study involved interviews with 130 abortion workers in San Francisco between January 1984 and March 1985. The authors did not expect to find what they found. 

'Particularly striking was the fact that discomfort with abortion clients or procedures, was reported by practitioners who strongly supported rights and expressed strong commitment to their work. This preliminary finding suggested that even those who support a woman's right to terminate a pregnancy, may be struggling with an important tension between their formal beliefs and the situated [actual] experience of their abortion work.'

"The stress seems to grow as the unborn child develops. Dr Don Sloan, an abortionist, noted in a book that vigorously asserts the need for legal abortion, 'As the pregnancy advances, the idea of abortion becomes more and more repugnant to a lot of people, medical personnel included'. In attempting to cope with abortion, clinicians try to divorce themselves from the method.

Late-term abortions
Warren Hern, an abortion specialist, in a paper given to the Association of Planned Parenthood Physicians, said that late-term abortions pose 'an unusual dilemma.' The doctors and nurses who do it have 'strong personal reservations about participating in an operation which they view as destructive and violent.'

An abortion doctor admitted that he was sometimes surprised by the anger a late-term abortion can arouse in him. On the one hand, the physician said, he is angry at the woman. "But paradoxically," he added, "I have angry feelings at myself for feeling good about grasping the calvaria [the top of the baby's head], for feeling good about doing a technically good procedure which destroys a fetus, kills a baby."

Dreams about abortion
According to Rachel MacNair, reports vary about the numbers of clinic staff who suffer from abortion-related nightmares. Many of those who have stopped doing abortions, became convinced that it was wrong through experiencing harrowing dreams. Read more

Allegations of discrimination in some British medical schools
British medical schools have started to restrict the number of Muslim students, because they refuse to learn about abortion.
The Times (17 February, 2003) reported that British medical schools have started to restrict the number of Muslim students, because they refuse to learn about abortion. The proportion of medical students from ethnic minorities had risen from 10% to 33% over the last 20 years. 

The Council of Heads of Medical Schools expressed concern that tutors are unable to teach the full syllabus because Muslim students refuse to participate in certain courses that run counter to their faith. 

Many Muslim and Christian hold to the principles of the Hippocratic Oath and the 1948 Declaration of Geneva, which forbid abortion. It appears this may work against them in 21st century Britain.

At a June 2001 conference in Rome, Dr T. Everett Julyan of Glasgow, stated:

"In March 2000, I was interviewed for an O&G training post. When the interview panel learned that I was unwilling to perform abortions, and also prepare women for them, I was denied a job, solely on that basis.

"Discrimination against those who refuse to end human life as part of their job description, serves neither doctors nor patients and is a symptom of a relativist view of medical ethics. Its detrimental effects are far-reaching, affecting individuals, the medical profession and society in general"

The case for discrimination
When O&Gs and nurses chose to opt out on the grounds of conscience, the workload is increased for the other staff.
British medical selection panels in general, regard the provision of abortion services as a primary health service and a woman's legal right. NHS hospitals usually roster staff for a daily schedule of abortions, and when O&Gs and nurses chose to opt out on the grounds of conscience, the workload is increased for the other staff.

New York's Mayor makes abortion training mandatory
In June 2002, New York City Mayor Mike Bloomberg, a financial contributor to the National Abortion Rights Action League (NARAL), alarmed by evidence that medical students were choosing not to take abortion as an elective, required mandatory training in abortion techniques at New York City public hospitals.
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