Thursday, 8 September 2011

Mental Injury and Abortion

The British Journal of Psychiatry has published a report of a recent study that investigated the link between abortion and mental health.

I refer to Peter Ould’s summary of the key findings:

‘The broad picture reveals that women who have an abortion have an 81% increased risk of mental health problems when compared with women who don’t. This constitutes “a moderate to highly increased risk of mental health problems after abortion“.

The 1967 Abortion Act provides two mental health grounds for doctors to authorise a termination of pregnancy:

(a)that the pregnancy has not exceeded its twenty-fourth week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family; or

(b)that the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman;

One might concede that doctors may identify specific cases in which the mental health risk is actually reduced by abortion. In the UK, it is even probable that it will take some time to establish that mental deterioration is caused by abortion, rather than just a concomitant. (Although, that is still very worrying).

What amazes me, in the light of this study, is the staggering 97.7% of abortions in 2010 that doctors authorised in the UK to prevent the risk of mental health injury as defined in the 1967 Abortion Act.

Does merely the prospect of increased stress constitute an increased risk to mental health? Where is that defined? How is the type of injury described in section 1(a) distinguished medically from the grave and permanent injury described in section 1(b)?

I read the following about mental injury: ‘To amount in law to “nervous shock” (a.k.a. mental injury), the psychiatric damage suffered by the claimant must extend beyond grief or emotional distress to a recognised mental illness’ (parenthesis mine).

In Rorrison v West Lothian, the Lord Ordinary, in dismissing the plaintiff’s claim for mental injury damages, said this:

‘"Many, if not all, employees are liable to suffer those emotions [frustration and embarrassment], and others mentioned in the present case such as stress, anxiety, loss of confidence and low mood. To suffer such emotions from time to time, not least because of problems at work, is a normal part of human existence. It is only if they are liable to be suffered to such a pathological degree as to constitute a psychiatric disorder that a duty of care to protect against them can arise…"

What this paper should prompt is a thorough review of the process for assessing mental health risk in the case of abortion. Recent calls for an anti-depressant prescription review were prompted by a much smaller sample size and a less comprehensive study.

97.7% of the abortions last year were approved in order to avert recognised pathological mental illnesses, rather than just emotional distress.

Are doctors required to identify the actual illness that might otherwise result? If they are not and merely authorise the abortion on demand, I’m sorry, but that fact alone beggars belief in the current system!

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