Abortion and Assisted Dying: Birth and Death on the NHS

Back in 1967, the Abortion Act was passed following a passionate and heated debate in the Commons. Baroness Knight’s speech against the motion was greeted with uproar and derision, when she stated that this bill, if passed, which was framed around compassion and cited difficult cases, would lead to wholesale abortion on demand. Her statement,

“once we accept that it is lawful to kill a human being because it causes inconvenience, where do we end?”

was mocked as being over-emotive and full of exaggeration. The Abortion Act had built-in safeguards, required the signature of two doctors to stop coercion or forced abortion and was only to be applied in limited cases to help desperate women who really had no other choice.

The parallels with the rhetoric surrounding Lord Falconer’s assisted suicide bill are striking. Forty-five years later, the architect of the bill has said that he never envisaged it would lead to abortion on demand, almost 200,000 abortions take place every year and repeat abortions are on the rise with some women having as many as 9 in their lifetime.

The two doctor safeguards have been thrown out of the window, undercover investigations have discovered doctors are not even examining their patients and have pre-signed stacks of abortion forms up to four years in advance and the Department of Health have outsourced the business of aborting babies to private companies, who claim to be charities and yet who receive millions of pounds from taxpayers for the medically awkward and messy task of terminating the lives of babies whose existence would cause an inconvenience to their parents.

The past forty-five years have seen doctors abuse procedures and break the law with impunity and enjoying immunity from prosecution or professional sanctions. In all likelihood thousands of babies have been aborted because they were female, others were aborted because their disability meant that their life was deemed to be of less value or worth, and some have been terminated, way beyond the point of viability. As one report last week pointed out, babies can be and are killed up to the point of birth for easily treatable conditions.

Medical prognoses have often been proven to be incorrect too. Babies predicted to have disabilities have been born perfectly healthy, in some cases a condition has proved easily manageable and no barrier to a good quality of life and some babies with absolutely nothing wrong have been aborted due to a mistaken diagnoses. The problem with any prognosis is that it is always phrased in fairly stark medical terminology with probabilities and scary official-sounding words like co-morbidity, the language often requiring a medical dictionary or interpreter. The language is devoid of joy, happiness or personal fulfilment but replete with potential difficulty and obstacles. There is only ever probability, never certainty and never any existential or metaphysical dimension to any sort of medical or clinical discussion.

Like the abortion laws, the assisted dying bill is backed by a host of rich, powerful and wealthy celebrities. With abortion a host of well-paid self-identifying ‘feminists’ both male and female come out in favour, with the same tropes – rights, compassion, autonomy.

But it isn’t the rich well-paid people who by and large are having abortions. Statistics worldwide demonstrate that is the poorest and most disadvantaged sections of society, especially certain ethnic minorities or immigrants who are resorting to abortion, because they find that they have no other choice.

Thinking about the UK for a moment, Tamara Beckwith, the millionaire trustafarian IT-girl of the 90’s, one of the Tara Palmer-Tomkinson stable, had a baby aged 19. For her, money was no object and she choose life, because she did not have a financial barrier. Equally we have former Spice Girl Geri Halliwell, soap star Clare Sweeney and various other Daily Mail celebrities having babies and enthusiastically embracing and promoting single-motherhood because they can. They have the resources and the lifestyle to accommodate children and the perennial approval of an all-adoring public.

People such as these can argue for a position of choice, because they had the rare luxury of being able to enjoy it. Having a baby would not have been a game-changer for them in terms of money, resources or career.

But this situation is rare for us lesser mortals. We have to limit our family size or resort to abortion because it feels like there really is no other choice and we do not have a celebrity career or have to face the disapproval of friends and family for choosing to wreak havoc upon ourselves for having a baby.

Let me demonstrate how abortion, sold to Parliament as a compassionate choice to be used in limited circumstances with the signature of two doctors has been incorporated into the health care system. I’ve been pregnant once or twice now. The first thing you have to do (in my area anyway) is make an appointment with the GP to ‘confirm your pregnancy’. This entails telling the doctor that you have taken a positive pregnancy test and in my case asking to be referred to the midwife (and thinking that the whole business of saying hey doc I’m up the duff is a waste of everyone’s time and NHS resources).

See that. You cannot just book in directly with the midwife at my practice. No, you have to ‘discuss’ it first with a GP. Why? So that abortion can be discussed with you and offered if necessary or if you are undecided. In some cases, including mine, it has been suggested as a solution, to severe morning sickness and anxiety. This has happened to me with my third and fourth children. I’ve requested to be booked in with the midwife to get the whole ante-natal plan working and been asked whether or not I’m sure and reminded that there is plenty of time.

You offer someone abortion, or assisted death and there it is, straight away, on the table, like the big fat elephant in the room. When a doctor suggests it or even hints at it, it has added gravitas and instantaneously the pressure mounts, no matter how firm you might be feeling in your own mind. The impression is given that somehow you are being demanding, burdensome, irresponsible and reckless.

Since the legalisation of abortion every single pregnant woman now feels keenly aware of her ‘choice’. It’s a decision that hangs heavily in the air, every single day of an unplanned pregnancy, and even sometimes when one is planned, if there is a sudden change in circumstances. When employers become terse and uncooperative, if family or friends are unsupportive, the unspoken question, circles your head “am I doing the right thing”. When someone indicates to you that you are not, the pressure of social affirmation or expectation can prove almost irresistible.

Those diagnosed with a life-limiting condition or who suffer from a number of illness, if this bill is passed will every day have to confront this choice. “Should I just end things here and now? Am I selfish for wanting to stay alive? Am I a burden on family and resources?”. Could a bad day now lead to their premature demise thanks to a bout of depression or despair. I know, I’ve been there in pregnancy, wanting to do anything just to make the sickness end. Composer and peer Andrew Lloyd Weber has said that last year he was on the verge of joining Dignitas thanks to excruciating pain following 14 leg and back operations, but having come through the experience appreciates that to have killed himself would have been reckless and irresponsible.

Just as we see certain sections of the media and press demonise those with larger families on benefits or single mothers, because they didn’t take the option of abortion and now receive state benefits, will we now see the same said about those with multiple disabilities?

It certainly seems likely, when you have writers such as Polly Toynbee cheering on those who might feel that they would be a burden, ‘yes you will’ she says , it’s no bad thing if the terminally ill or medically dependent feel pressurised and Baroness Warnock barking that people with dementia have ‘a duty to die’.

Like abortion, the advocates for assisted dying are rich, famous and well-paid celebrities like Cilla Black, Richard and Judy and even now Lulu, seeping into the nation’s consciousness, introducing and reinforcing misplaced fears about death, dying and burdens.

They won’t have to face a cash-strapped NHS which will offer them euthanasia as a cost-saving and compassionate measure as an alternative to treatment which would prolong life. Like celebrity single mothers they really can choose between life and death without having to face censure or opprobrium for choosing the former. Meanwhile the rest of us are made to feel guilty for wishing to continue our existence.

It’s staggering when you look at the statistics surrounding birth, people are having babies later and later, partly due to financial pressures and partly because they perceive that they need to be a in a perfect chocolate box situation. Hand-in-hand with that, the idea of bodily autonomy (which is specious, no-one truly has this, you can’t force a doctor to chop off your leg) means that now we are all tuned in to the unrealistic idea of the perfect or ideal birth.

The same concept will inevitably creep in to the dying. Death will have to be further clinicalised, managed, perfect and ‘dignified’, and sold as being something which we deserve. Perceived quality of life will determine respect and value given to other people and where do you draw that line?

We are fundamentally treating our existence as passive consumers of an experience in which we are control freaks determining that everything has to be perfect according to our personal dictats and tastes, from relationships, careers, sex, pregnancy, birth, family circumstances and death. It’s hardly surprising that as society has become more prosperous and wealthy, people have become proportionally more selfish and fearful of becoming dependent on others or having others dependent on them.

Life is not perfect, it is fundamentally messy and we have to accept that everything has its season. We are on an unavoidable journey of dependence, independence and dependence once more. The fear and refusal to accept inter-dependence between parent and child now manifests right at the start of life, with parents desperate to put children in child-care and to rush their independence in order that they can be free of the burden of 24/7 child-rearing and resume their previous lives, with the child treated little more than a pet which needs training and in whom the state needs to have a stake. Is it any surprise then, when children similarly treat their parents as the state’s responsibility when they get older or that parents have a fear of intimate dependence?

There is never a perfect time to fall in love, never a perfect time to have a baby and never a perfect time to die. We must not licence doctors to build killing into our heath care system as part of a palliative care approach, but rather enable patients, just as we should pregnant women, to accept and reconcile themselves with what is going to happen, all the while offering comfort and support, rather than a violent way out.

I often muse that a woman is pregnant for 9 months as that period is a time of acceptance, anticipation and growth. The same should be applied to the dying, who deserve more than a validation of their fear, inner turmoil and despair.

Abortion was never intended to be an integral part of a woman’s healthcare needs, promoted in schools and offered as a routine and morally neutral choice. Neither was it believed by parliamentarians that society would promote abortions as desirable amongst certain classes of people, like single mothers , ‘chavs’ or those with chaotic personal lives and/or addictions. What makes Lord Falconer and his chums fool themselves into believing that assisted dying will not be applied to the poor and vulnerable in the same way?