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Health

Too long in gestating: an overdue inquiry into the Abortion Act

Whatever your view of abortion, there are too many abortions, and too many of them are too late. Even abortion’s fiercest advocates don’t pretend that it’s a Good Thing – just the lesser of two evils.

In 2010 there were 189,574 abortions in England and Wales – an 8% increase in a decade. The tightly policed regime envisaged in 1967, when the Act became law, hasn’t existed for ages, if indeed it ever did. There is abortion on demand, whatever the statute book says.

1967 was a long time ago. There have been many medical advances and societal changes since then. It’s time to take stock of the Act.

That’s what a recently announced cross-party commission, to be chaired by Fiona Bruce MP, will do.

It will focus, rightly, on two issues: medical advances and attitudes to discrimination.Read More »Too long in gestating: an overdue inquiry into the Abortion Act

Flu researchers impartially decide dangerous flu research is safe

Flu researchers have looked deeply at their own field, and decided that everything they were doing is all fine. Where the potentially hideously dangerous H5N1 bird-flu virus is concerned, They said that the benefits of the research in preventing and dealing with a future flu pandemic outweigh the risks of an accidental leak of the mutant… Read More »Flu researchers impartially decide dangerous flu research is safe

Abortion and the cognitively impaired mother

It will be interesting to watch the reception of a recent Court of Protection case, as yet unreported, in which a woman with profound learning difficulties was found to have capacity to decide not to terminate her pregnancy.

As so often, the case decided nothing new. But it is a timely reminder of the trite but often overlooked principle that capacity is not an all or nothing thing. The question: ‘Does she have capacity?’ is always dangerously incomplete. The correct question is always ‘Does she have capacity to decide X?’

There was no doubt that she did not have capacity to manage many aspects of her affairs. She was in the bottom 1% of the population so far as intellectual function was concerned. Deputies were appropriately appointed. But, so far as the continuation of her pregnancy was concerned, so what?

It was decided as a matter of fact that she had capacity to decide whether or not to continue with, or to terminate, the pregnancy. And that meant that the Court of Protection had no jurisdiction to decide the matter. No best interests determination could lawfully be made.Read More »Abortion and the cognitively impaired mother

Salt in the Wound, or the Sweetest Thing? On Placing Legal Limits On the Sugar, Salt and Fat Content of the Foods We Eat.

Last week, in the light of the UK’s growing obesity problem, the shadow health secretary Andy Burnham called for a debate on the question on whether a legal limit ought to be introduced on the amount of sugar,salt and fat that manufacturers can put into the foods that we eat, particularly those foods aimed primarily at children. In calling for such a debate, Mr Burnham pointed out that the obesity epidemic can no longer be ignored, given the challenges that widespread obesity will raise for the NHS. Furthermore, he suggested that the current government’s ‘responsibility deal’ , which aims to tackle the obesity problem by collaborating with food manufacturers to improve food content and labelling,  is simply not working.Read More »Salt in the Wound, or the Sweetest Thing? On Placing Legal Limits On the Sugar, Salt and Fat Content of the Foods We Eat.

Informed consent deserves a little less respect

The conclusions of a ‘citizens’ jury’, reported recently in the British Medical Journal [1] shed light on some important weaknesses in the doctrine of ‘informed consent’. The doctrine is commonly thought of as canonical. Be careful about questioning its exalted status: you’ll be branded paternalistic at best, and the indictment may well involve unflattering comparisons with Dr. Mengele.

The ‘jury’, composed of 25 women,  commented on how a leaflet on breast cancer screening should be re-drafted. The jury preferred:

– the term ‘overtreatment’ to ‘over-diagnosis’

-to express benefits in the language of lives saved rather than deaths avoided

– to talk about ‘benefits’ and ‘risks’ rather than ‘pros’ and ‘cons’

– to begin the leaflet by an up-beat reference to the numbers of lives saved by screening, followed by the caveat that a small number of women would be over-treated.

What was the priority: reassurance or accuracy? The majority (15), wanted both; 3 thought that reassurance was most important; 7 thought that accuracy was the priority.

How should one list the benefits and harms? Four thought they should be listed together in the same sentence, 8 that they should be listed separately, and 12 for mentioning them first separately and then together.

The point of all this  is that there are innumerable different ways, all of which would be smiled on by Bolam [2], in which entirely accurate information can be conveyed. And yet tiny nuances are seen by the receivers of the information as significant.Read More »Informed consent deserves a little less respect

Don’t tax the fat!

by Rebecca Roache

Dr Philip Lee, Conservative MP for Bracknell and a practising GP, today suggested that people whose lifestyle choices lead to medical problems should have to contribute towards their healthcare costs. He apparently highlighted type 2 diabetes – which can be brought on by an unhealthy diet, being overweight, and lack of exercise, although some people are genetically disposed to it – and is quoted in the Huffington Post as saying, ‘If you want to have doughnuts for breakfast, lunch and dinner, fine, but there’s a cost’.

At first glance, the idea that those who lead unhealthy lifestyles should bear the burden of their own resulting health problems seems fair. But there are serious problems with this idea. Let us consider two of them.Read More »Don’t tax the fat!

FGM and the Golden Rule

When Binta Jobe [not her real name] was nine, she was taken into the Gambian bush where she suffered female genital mutilation at the hands of an amateur surgeon without anaesthetic. She is now a 23-year-old asylum seeker in the UK, trying to prevent her three-year-old daughter from a similar experience if she is forcibly returned to the Gambia.Read More »FGM and the Golden Rule

The Bad Seed: Facts and Values in the Study of Childhood Antisocial Behaviour

Podcast of Uehiro Seminar given by Gwen Adshead ‘The Bad Seed’ was a popular 1954 novel in which a well brought up young girl begins to manifest behaviour characteristic of a criminal psychopath. As the plot develops, the girl’s mother discovers that her own mother was a serial killer who was executed when she was herself a… Read More »The Bad Seed: Facts and Values in the Study of Childhood Antisocial Behaviour

Abortion and the Senseless Death of Savita Halappanavar

On Wednesday morning, several media outlets, including the Irish Times, the BBC, and the CBC, reported that Savita Halappanavar, a Hindu woman living in Ireland, had died from blood poisoning after doctors in a Galway hospital refused her request to abort the fetus that she was told she was miscarrying.

We do not yet know all of the facts of the case. Several inquires are being conducted. We do, however, learn this much from media reports. Ms. Halappanavar was 17 weeks pregnant. On October 21, she presented at a hospital in Galway complaining of back pain. Upon examination, she was told that she was having a miscarriage, and that it would soon be over. This did not happen. Instead, her ordeal continued for several more days. After a full day of “severe” pain carrying a child that was certain to die, Ms. Halappanavar asked that her pregnancy be terminated. Physicians were reported to have said that since they were in Ireland and the fetus had a heart beat they could not terminate the pregnancy. (In Ireland, the unborn have a constitutional right to life.) Ms. Halappanavar continued to suffer for a further two and a half more days before her fetus died and was removed from her body. By this time she was quite ill. She was then transferred to an Intensive Care Unit but she did not recover, dying some days later on October 28of complications due to septicaemia (blood poisoning.)Read More »Abortion and the Senseless Death of Savita Halappanavar