Absence of evidence is evidence of absence?

Here’s the clip of Nadine Dorries and Dr Evan Harris discussing the proposed amendments to the Health and Social Care bill, that gave rise to my intemperate tweet.

When asked whether or not he would support the provision of independent counselling services, Evan Harris evades the question, claiming that Sky’s “script” is wrong and that women are not going to be offered an independent counselling service.

Well, your script is wrong, because they’re not going to be offered — under Nadine Dorries’ plan — an independent service. They’re going to be pushed into the clutches of anti-abortion religious organisations, who are neither trained nor responsible to give the advice and information that’s been approved by the medical royal colleges.

No, Dr Evan Harris, your script is wrong. The text of the Dorries and Field  amendment to the health and social care bill is this:


In this section, information, advice and counselling is independent where

it is provided by either—


a private body that does not itself provide for the
termination of pregnancies; or

a statutory body.”.’.

Absolutely nothing there with regards to compelling women to receive counselling, nor religious organisations. A private body that does not itself provide for the termination of pregnancies, does not have to be religious in nature. There are plenty of private counselling organisations which are not founded upon religious principles or who follow religious guidelines. There is no reason why a local counselling service to whom a patient may be referred for other conditions, may not be able to assist a woman in her decision making process.

Why are the abortion providers deemed as being uniquely able to provide impartial counselling which may not be obtained elsewhere?  Even if, as His Grace points out, BPAS and Marie Stopes did provide objective and impartial counselling, there would still be room for justifiable doubt.

There is nothing in the text of the amendment that renders counselling compulsory or forces women who are seeking counselling to go to a religious organisation. Nadine Dorries seemed to be very clear in that interview that religious organisations would not be included in any Department of Health list of independent organisations. Counselling services are not required to be approved by royal medical colleges, thus referring to them in an attempt to lend the argument weight, is specious.

And that’s why no medical organisation or medical ethical organisation that I know of thinks that it’s a good idea because there’s been no evidence — no evidence of complaints, no evidence of a failure to obtain informed consent — under the current arrangements where women are seen by independent professional counsellors, if they wish to, as part of their visit — their first visit — to an abortion provider, after either having been referred by their GP, whom they could have asked questions of, or indeed, self-referring because they have it in their mind to end their pregnancy. So I think your script is entirely wrong to claim that they’re not getting independent counselling at the moment.

This made my brain hurt. Firstly Dr Harris makes the assumption that the abortion providers’ counselling is impartial, despite the lack of evidence which might indicate that they do overcome any innate bias. Then he presents absence of evidence as being evidence of absence, i.e. the lack of evidence which might prove that BPAS are impartial, proves that they are in fact, impartial. I had to play that clip back a few times to confirm the inherent irrationality.

The point is that it cannot reasonably be assumed that the abortion providers are unbiased. Anyone who has ever done any abortion recovery counselling will tell you an entirely different story. Amongst the piles of leaflets containing soft marketing and social conditioning messages such as 1 in 3 women will have an abortion, nestling on top of waiting room tables, not once does one find any leaflets that may direct women towards services that may be able to provide practical and financial advice and support. There are charitable organisations who will assist women with claiming the relevant benefits or drafting letters to employers or who will provide  baby clothes, equipment and financial grants. Surely any impartial provider should be providing this information? Just as any woman who goes to an organisation such as LIFE, will know exactly where she can procure an abortion, via a GP, surely those providing abortions have a duty to point women towards whether they may be able to access extra help and support if they keep their baby? Give them the whole picture, if they are seeking counselling, not just the medical facts about the abortion.

This was the response to the point made by the interviewer that nothing about Christian or religious groups had been included in the amendment, and that this was a voluntary extra step to ensure that a woman had all the information, instead of being forced in one direction:

They’re not being forced in one direction at the moment. As I say, it’s unlawful to conduct any medical procedure, including termination of pregnancy, without obtaining informed consent, and as far as I’m aware, despite there being many, many abortions every year — hundreds of thousands, in fact — there’s not been a single complaint that someone’s been misinformed by the current professional counselling that exists,

Again he evades the point about independence and denies that women are being forced in one direction. We do know that abortion providers do not give out any literature which might direct women to charitable organisations that could help them, nor do they give out any information regarding government assistance, benefits or employment rights when pregnant, which is what any counsellor should do, help a woman to evaluate all the options before coming to a decision. Informed consent consists of a signature on a piece of paper to say that you understand the medical  nature of the procedure and the potential risks. If there have been no complaints, I would posit that this has as much to do with women’s reticence to come forward and complain about an abortion clinic, the issue is so heavily weighted on both sides. It is possible that a woman might feel guilt both in terms of the procedure, or feel that by complaining she is somehow letting down the  cause of women’s rights. The absence of complaints, is not evidence of satisfactory counselling, remembering that counselling needs to be concerned with helping an undecided woman with a crisis pregnancy  to explore her options. Counselling about whether or not to have the baby should not be conflated with counselling regarding the medical procedure.

Dr Evan Harris uses the volume of abortions carried out every year to support his argument which leaves one with the impression that he views the “many, many”, the hundreds of thousands of procedures as a measure of success. There may not have been any complaints about the medical procedures, but as noted, that is an entirely separate issue to the counselling. Women are not asked to sign to say that they have received satisfactory abortion counselling, simply that they understand the nature of the procedure.

Whilst no medical college that Dr Harris knows of supports this, does that mean that they are agin it? Or does that mean that no royal medical college has publicly expressed an opinion, simply because counselling services are outside of their remit? BACP have expressed support for the idea that women should have access to independent and impartial counselling services. It has also stated that Nadine Dorries has informed them that religious groups will be subject to the same constraints and criteria as the abortion providers. It is unthinkable that any physician would wish to prevent a woman who is undecided from being able to access independent counselling services. Abortion is not simply a physical procedure and any advice should be holistic to ensure that it is the right decision and not relegated to a clinical procedure.

The interview terminates with generic attacks and speculation as to who are the backers and funders of the Right to Know organisation and veering off into the realms of conspiracy theory. Obviously those who care about women having access to all options are right-wing extremists, (note the pejorative use of the word extremist for anyone who might be pro-life), Dr Harris obviously wants to whip up some fear and suspicion that this is all some major conspiracy to stop women from having abortions, when the reality is so much more mundane. It is simply to ensure that those who choose counselling, have access to all information and don’t rush into anything. But by calling everyone extremists, you not-so-subtly introduce the idea that people with perfectly legitimate views, remember that pro-choice views do not require any religious belief, are mentally unsound and prone to irrationality and violence.

As I said, after 9 weeks, the only abortion option on offer by the clinics is surgery. Women who wish to avoid surgery are encouraged to make a speedy decision, which may not be appropriate. Whilst Dr Evan Harris states that there is no evidence of harm, there is certainly a huge question mark over the impartiality of the counselling on offer by the abortion providers and it makes sense to recognise this, not simply turn a blind eye.

Why is this amendment creating controversy and being billed as a massive shake-up?

It recognises the uncomfortable truth that abortion providers turn a profit from providing abortion, it highlights a legitimate concern with regards to their impartiality and they don’t like that one little bit. That is why they are throwing absolutely everything they’ve got into fighting this tooth and nail. And if you’re wondering why the Guardian seem to be quite so concerned by the issue, take a guess who sponsors their international development journalism competition?

Marie Stopes.

One thought on “Absence of evidence is evidence of absence?

  1. There is no such thing ad even informed consent care of Marie Stopes as I discovered. The result for me was awful. It is about time women had the full facts on the table regards abortion. This is a small step in that general direction. That Dr Harris seeks to spin this anyborher way is cheating women out of an honest debate. What a disgrace.

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