Dr. John Neil
Doctors in Conscience Against Abortion Bill
Speech delivered 6 October, 2008
Reproduced with permission
Queen's Hall, Parliament House, Melbourne, Australia
I am an Obstetrician who began training as a specialist in 1969 in the
year of the Menhennit ruling. Issues were black and white in those days, but
the ethics of abortion rapidly became more grey. This has always been a very
difficult issue and these women need a lot of compassion and support in
their choices. I am old enough to have seen maternal deaths from severe
infection after illegal abortion. We are not proposing a return to that
situation. The existing common law is unsatisfactory and needs proper
legislation, which this bill is not. My purpose is to make clearer the
clinical aspects which I find very confused in this bill.
1. The anticonscience clause.
It is ludicrous that a "registered medical practitioner" should have to
perform an emergency abortion. Firstly it is coercive, and others will speak
about this. Secondly, it is based on a false premise that an emergency
abortion actually is ever necessary. Coercion to make an "effective
referral" is also unnecessary and prejudicial.
2. A confused grasp of the clinical. It is important to differentiate
early induction of labour from late term abortion (currently > 20 weeks). I
Example: A woman is admitted to hospital with ruptured
membranes rapidly followed by severe infection of the uterus and
septicaemia. The unborn child is still alive. There is no question
that induction of labour should occur immediately to save the life of the
mother. There is no intent to kill the baby which happens as side effect.
On the other hand, a Down syndrome unborn baby is diagnosed at 21 weeks,
and a late term abortion is carried out, in this case with the intent to
kill the unborn. Under the act, both are abortions but differ because
of the intent. This distinction has been blurred in this Bill. The former
case is of course an emergency, but has not got the same ethical
3. Poor supports for the women in this dilemma.
There is nothing in the Bill, and there
is little support by the Victorian Government currently for women making
these choices, compared to, say, South Australia. These would include
effective counselling about options, and followup. There are some
voluntary supports, and we know that if ultrasound of the unborn is included
in the counselling, then the rate of abortion can reduce from 60% down to
25%. The current low threshold for seeking an abortion would be further
lowered by the current legislation given the lack of support or counselling.
Psychiatrist Professor David Clarke's, statement is important "â€¦distress
and upset may be common when a woman is considering termination, but should
not in itself be an indication for abortion. The correct response is proper
psychological assessment and care."
Support through a pregnancy complicated by abnormality of the unborn
child is rarely offered, but can make for much better resolution of the
grief and closure.
Example. A woman was referred from country NSW to me late in pregnancy.
Her unborn child was diagnosed with an under developed left side of the
heart, in those days incompatible with life. This usually results in
termination. She wanted the chance to keep her baby alive for up to an
agreed 6 weeks at the RCH awaiting a heart transplant. A suitable donor
heart never came. She however was convinced that she had done the best by
her baby and had no regrets about her choice.
Grief together with regret is a potent combination for a woman to deal
4. Poor clinical practice is endorsed.
Great expertise is required to avoid disaster in both early and late
abortion, not available with just any "registered medical practitioner" in
5. Failure of recognition of the unborn child as a person.
- We spend $300,000 for newborn intensive care for a 24 weeks
- We do intrauterine surgery on the 24 week unborn.
- We laser treat the communicating placental blood vessels in twin to
twin transfusion syndrome at 24 weeks and avert disaster for the twins.
In all these case we are treating with great skill the 24 week unborn as
- Then in the case of an unwanted unborn child at 24 weeks we treat it
as a nonperson. This is despite viability of 24 weeks having been
Thus there is a contradictory attitude to the status of the unborn
depending on the mothers wishes, even this late in the pregnancy.
I believe it is important to stick with 20 week as the cut off for
abortion, and not even get close to the issue of viability i.e. 24 weeks.
Late term abortion should be those after 20 weeks and there needs to be an
independent ethics tribunal involved in recognition of the seriousness of
this decision and to provide for accountability.
The privilege and responsibility of parenting and cocreating a human
individual is being very degraded by this Bill. Thus I concur with Jean
Rostan, the French biologist, who said "â€¦I believe that there is no life so
degraded, debased or impoverished that it does not deserve respect and is
not worth defending with zeal and convictionâ€¦.I would measure society's
degree of civilization by the amount of effort and vigilance it imposes upon
itself out of pure respect for life".