Nigel Hawkes, Health Editor
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Nurses can perform surgical abortions, according to a new interpretation of the law.
An analysis of the Abortion Act and subsequent case law suggests that it is legal for a nurse to perform early operations as long as a doctor is in overall charge, but not necessarily present.
At the moment, nurses working as part of a team often administer medications to induce abortions.
But Vincent Argent, a consultant gynaecologist with legal training and Lin Pavey, a nurse and former clinic manager in Brighton with the British Pregnancy Advice Service, argue that nurses should also be able to perform early surgical abortions.
Their analysis is published in the Journal of Family Planning and Reproductive Health Care.
They said: “Our analysis of the Abortion Act 1967 and the RCN v DHSS case shows that registered nurses and midwives could currently perform surgical abortions themselves as long as a medical practitioner is in overall charge even if the medical practitioner is not physically present.”
In an accompanying commentary, Gill Wakley said that the analysis should be examined by the Department of Health, General Medical Council and the Nursing and Midwifery Council. She said: “An expansion of the role of nurses could offer improvements in the quality and access of provision for early termination of pregnancy.”
Madelaine Ward, a family planning nurse and former chairwoman of the Abortion Law Reform Association (now Abortion Rights), said: “In so many areas of health provision, nurses have provided improvements in access to and quality of care.
“The time is now right for nurses to be trained to perform early surgical abortions under the supervision of a registered medical practitioner.
“I hope lobbying by the professions will now happen without delay.” Anthony Ozimic, political secretary of the Society for the Protection of Unborn Children (SPUC), said: “Do nurses really want to perform abortions, the killing of innocent human beings?
“The pro-abortion lobby claim that so-called safe, legal abortion was necessary to safeguard women’s health yet having achieved legal abortion, the pro-abortion lobby now wants to remove safeguards by getting nurses to do doctors’ dirty work for them.
“This proposal would seem to have less to do with women’s health and more to do with an ideological agenda to maximise the numbers of abortions, in the light of fewer and fewer doctors willing to butcher babies in the womb.”
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This is very interesting in light of Europe- and world-wide moves to remove the "conscience" clause from the abortion laws of various countries, whereby medical and nursing students can elect to register a conscientious objection to performing abortions. Presumably if the British conscience clause were removed, doctors would be in a better position than nurses to refuse to perform abortions. And presumable the negative effects on one's career of opting out under the conscience clause would be intensified. I am a nurse. I am well aware that the women and girls who have abortions are often in extreme need of support and compassion, and I am happy to provide those - but I am not participating in any way in the proceedure unless and until a broad scientific and philosophical concensus on when life begins is reached.
Gerry Dorrian, Cambridge, S Cambs
This is clearly part of a concerted attempt by Abortion Rights activists to make abortion available without the consent of a doctor. If they can train nurses and midwives up to do it they can ease the way for making abortion a routine procedure that won't require the 'inconvenience' and, no doubt it will be argued, 'expense' of seeking agreement from a doctor. Madelaine Ward's suggestion that this will lead to an improvement in'quality of care' is sickening. Is she unaware of the irony? A society that accepts as a norm the relentless destruction of its own children cannot, and probably does not deserve to, survive.
Ian Logan, Oxford, UK
This is clearly part of a concerted attempt by Abortion Rights activists to make abortion available without the consent of a doctor. If they can train nurses and midwives up to do it they can ease the way for making abortion a routine procedure that won't require the 'inconvenience' and, no doubt it will be argued, 'expense' of seeking agreement from a doctor. Madelaine Ward's suggestion that this will lead to an improvement in'quality of care' is sickening. Is she unaware of the irony? A society that accepts as a norm the relentless destruction of its own children cannot, and probably does not deserve to, survive.
Mandy, Oxford, UK
We should remember that in this country, fully trained medics can and must be the frontline in keeping women and girls away from untrained lay people who perform such operations. That being said, I am not a supporter of abortion, but I cannot and will not pass judgment on those who have one or who, quite legally, perform one. When you look to the death rates from illegal abortions in other countries, you surely must realise that it is better for this service to be controlled than for it to be driven underground and performed by a greedy, untrained (to use the emotively unnecessary word of Mr Ozimic) "butcher". I would advocate counselling and as much support as a woman or girl needed in order to try and change her mind, but there are obviously some for whom abortion seems the only option, and they cannot be swayed. These women and girls need support and compassion, not condemnation and anger.
Jennifer Hynes, Plymouth, UK
Who carries the can if something goes wrong, nurse or supervising doctor?
Tom Fallowfield, Braemar,