Cape Times

Ter­mi­na­tion of preg­nancy

WMA re­vises ad­vice it pre­vi­ously of­fered

- LISA ISAACS lisa.isaacs@inl.co.za

THE World Med­i­cal As­so­ci­a­tion (WMA) has re­vised its ad­vice on med­i­cally in­di­cated ter­mi­na­tion of preg­nancy, al­low­ing for a qual­i­fied health­care worker, not just a physi­cian, to per­form an abor­tion in ex­treme cases.

At its an­nual Gen­eral Assem­bly in Reyk­javik, Ice­land, the WMA re­it­er­ated that, where the law al­lows med­i­cally in­di­cated ter­mi­na­tion of preg­nancy to be per­formed, the pro­ce­dure should be car­ried out by a com­pe­tent physi­cian.

How­ever, the body agreed that, in ex­treme cases, it could be per­formed by an­other qual­i­fied health­care worker. An ex­treme case would be a sit­u­a­tion where only an abor­tion would save the life of the mother and no physi­cian was avail­able, as might oc­cur in many parts of the world. This amends pre­vi­ous WMA ad­vice from 2006, that only physi­cians should un­der­take such pro­ce­dures, in ef­forts to en­sure that no woman is harmed be­cause med­i­cally-in­di­cated ter­mi­na­tion of preg­nancy services are un­avail­able.

WMA pres­i­dent Leonid Eidel­man said the re­vised pol­icy was part of the WMA’s pro­ce­dure to re­view all poli­cies that are 10 years old.

“As the doc­u­ment says, ter­mi­na­tion of preg­nancy is a med­i­cal mat­ter be­tween the pa­tient and the physi­cian. But at­ti­tudes to­ward ter­mi­na­tion are a mat­ter of in­di­vid­ual con­vic­tion and conscience that should be re­spected,” Eidel­man said.

“A sit­u­a­tion where a pa­tient may be harmed by car­ry­ing the preg­nancy to term presents a con­flict be­tween the life of the foe­tus and the health of the preg­nant woman. Dif­fer­ent re­sponses to re­solve this dilemma re­flect the di­verse cul­tural, le­gal, tra­di­tional and re­gional stan­dards of med­i­cal care through­out the world and the re­vised pol­icy recog­nises this fact,” he added.

The pol­icy adds that pa­tients must be pro­vided with nec­es­sary med­i­cal and psychologi­cal treat­ment along with ap­pro­pri­ate coun­selling if de­sired.

The Assem­bly reaf­firmed its view that physi­cians should con­tinue to have a right to con­sci­en­tious ob­jec­tion to per­form­ing an abor­tion, while en­sur­ing the con­ti­nu­ity of med­i­cal care by a qual­i­fied col­league.

The pre­am­ble to the re­vised pol­icy states: “Med­i­cally in­di­cated ter­mi­na­tion of preg­nancy refers only to in­ter­rup­tion of preg­nancy due to health rea­sons, in ac­cor­dance with prin­ci­ples of ev­i­dence-based medicine and good clin­i­cal prac­tice. This Dec­la­ra­tion does not in­clude or im­ply any views on ter­mi­na­tion of preg­nancy car­ried out for any rea­son other than med­i­cal in­di­ca­tion”.

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