Ethico-legal issues in termination of

pregnancy

Dr Carwyn Rhys Hooper

&
Dr Deborah Bowman

T Year

October 2010

Abortion – A Case for Reasoning,

Faith or Intuition?

Please complete the questions below working on your own. When

you have completed all the questions, please discuss your answers
with your neighbour.

1. Do you have definite views about whether abortion is morally

justifiable or not (if not, please go straight to question 4)?

2. If, you do have definite views on whether or not abortion is

morally justifiable, please identify which moral concept(s) you
draw on to support your views:-

a) A woman’s ‘right to choose’

b) The ‘sanctity’ of human life

c) Pregnancy as a ‘morally neutral’ state

d) A balance of risks and benefits

e) Teachings of religion or faith

 f) Other (please state)

3. Using your answer to question 2, please consider the

questions below which corresponds to the moral concept(s) on
which you justify your views (indicated by letter):-

a) Does a woman have an unlimited right to choose to

terminate pregnancies to the extent that she can
terminate pregnancies infinitely as a form of ex post
facto contraception?

b) When does ‘human life’ begin? How do you know? Do

you object to other contragestive forms of contraception
e.g. post-coital hormone treatment or IUDs?

c) How can there be moral equivalence between a choice

to end a pregnancy and the potential for human life that
exists therein and other choices about health e.g. the
removal of an appendix or gall bladder?

d) Why is it appropriate for anyone other than the woman

involved to weigh risks and benefits? If the outcome is
poor, does this make a moral act immoral? Conversely,
if the outcome is good, does this make an immoral act
moral?

e) Is it morally acceptable to subject others to the beliefs

of your religion or faith? If it is, why? If it is not, how do
you reconcile your belief in the immorality of abortion
with accepting that, for society, abortion is acceptable?
 f) What is/are the moral argument(s) on which you base
your views on abortion? How would you explain
choosing this moral position over those described in
questions a)-d) above?

4. If you do not have definite views on abortion, please consider

the following moral concepts that are commonly invoked in
the abortion debate and state which you find most convincing
and why:-

a) All women have a ‘right to choose’ a termination

because of the principles of self-determination and
autonomy

b) An embryo and foetus are living entities and therefore

should be afforded protection because of the
fundamental ‘sanctity’ of human life

c) Pregnancy is a morally neutral state and the choice to

end a pregnancy is not morally different from the choice
to have an appendix or gall bladder removed.

d) Abortion is morally justifiable because the risk of mental

or physical harm to a woman who does not wish to
proceed with a pregnancy ‘trumps’ the harms to an
unborn and undeveloped foetus. The needs of an adult
are not equivalent to those of a foetus.
 e) Religion or faith teachings are clear that all living beings
(of which a foetus is clearly one) must be protected and
not harmed – abortion is morally unjustified.

f) Are there any other common arguments you have heard

in the abortion debate? If so, what were they? Were they
convincing (please explain)?

5. Can the difference drawn in the Abortion Act 1967 between

TOPs performed prior to 24 weeks and those performed after
24 weeks' gestation be morally justified? If so, on what
grounds?

6. Will you, as a clinician, elect to exercise your right of

conscientious objection and not participate in terminations as
provided for under s 4(1) of the Abortion Act 1967? If so, why?
If not, why not?
 It’s All Relative . . . but why?

Consider the following vignettes in small groups and decide

whether some of the requests for terminations from these
patients are more morally acceptable than others. Please explain
your answers.

Case 1

Lisa is 13 years old and is pregnant after having sexual

intercourse for the first time with a seventeen year old at a party.
She requests a TOP at eight weeks.

Case 2

Mary is 47 years old, married and has three teenage children.

She requests a TOP at 22 weeks not having realised she was
pregnant before because she ‘thought the lack of periods and
tiredness was the menopause’.

Case 3

Claire, aged 27, married and requesting a termination at 22

weeks for her first pregnancy because the foetus was diagnosed
with a cleft lip and palate at the 20 week anomaly scan.

Case 4

Maddie, aged 30, in a long-term relationship and requesting TOP

at 31 weeks. The foetus has Down’s syndrome and was
diagnosed by amnio at 18 weeks. Maddie ‘thought I could cope,
but have changed my mind’.

Would it be different if the foetus had been diagnosed with

trisomy 13 ('Edward's Syndrome')?

Case 5
Julie, aged 21, requesting a TOP at 14 weeks after being raped.
Case 6

Stephanie, aged 32, requesting a TOP at 18 weeks because she

is pregnant and her son is only four months old and she ‘can’t go
through all that again so soon’.

Case 7

Helen, aged 22, requesting a TOP at ten weeks because she is in

her final year of medical school and ‘the time just isn’t right’.

Case 8

Polly, aged 40, a single woman, requesting her fifth TOP at 20

weeks because she ‘hasn’t had time to get in to see you before
now. You know children really aren’t my thing’.