Primum non nocere

All that is necessary for evil to triumph is that good men do nothing.
attributed to Edmund Burke

First, do no harm

Primum non nocere (first, do no harm) is the axiom at the basis of all medical ethics and is taught to all students in medical school. In other words, if there is a risk that a proposed treatment or intervention for a medical problem may do more harm than doing nothing, then it is better to do nothing.

Handmaidens of the law

One has to make an ideological leap, of course, before pregnancy can be defined as a medical problem. That ideological leap has been made and abortion is now widely accepted in the western world as a medical procedure up until the time a baby would be viable outside the womb. What do doctors actually feel about abortion? Presumably, few doctors who perform abortions are totally comfortable about telling people what they do for a living; others, a small minority, feel that abortion violates the wish to protect and preserve life that led them into medicine and refuse to sanction or perform them.

Doctors have stepped outside of the moral and ethical debate about abortion, becoming mere handmaidens of the law. Abortion is legal, women come to them requesting abortions, they satisfy that law… The moral decision is seen as nothing to do with them; it is for the woman to decide, the woman to take the impact of the decision. But performing abortions must take its toll on doctors in terms of trauma and dehumanisation; the denial is rife but the reality must nonetheless hit home on some level.

Anger against doctors

Women who subsequently regret their abortions actually feel tremendous anger towards the doctors who performed them and who gave them no information about the true impact, mental, emotional and physical, of abortion. They come to feel that these doctors were guilty of severe medical negligence. A few doctors have successfully been sued by women for their abortions.

Doctors have abandoned their role of true care of their patients in recommending and performing abortions – because true care would involve getting a thorough history and background rather than just rubber-stamping a woman’s stated desire to have an abortion, something she is often choosing in desperation, under pressure and in ignorance. Interestingly, perhaps, Hippocrates included in his original oath a vow that doctors would not give pessaries to women to induce abortion; many doctors no longer swear the Hippocratic oath, but the ethical duty of a doctor not to harm his or her patients must persist.

Although one can understand why this situation has arisen and why a doctor might feel helpless in the face of what he or she perceives as the massive tide of popular opinion and the fait accompli of legalised, readily available abortion, we believe that if abortion is in fact the destruction of life and harms women, they have a moral duty to do the unthinkable and start swimming against the tide.

A call to doctors

We are calling on doctors to say what they know – and if they do not know, to find out – and to speak out against the almost universal assumption that abortion is a safe, harmless medical procedure that a woman chooses freely. Some women may do; an awful lot do not. They suffer after the event in isolated corners, silenced by shame, and the reality of what abortion does to women does not make it in any convincing way onto the public arena.

The information is there and available, in all the anti-abortion sites on the net, but they are dismissed as pro-life propaganda. There is a powerful lobby invested in ensuring that abortion on demand is not threatened, and we have to be realistic and not naïve about that. Swimming against the tide is a painful and lonely business. But tides can change, eventually, and they do so when people start saying the unsayable.

If the knowledge of all the harmful consequences were suppressed in regard to any other medical procedure than abortion, there would be an outcry. The journey to seeing how abortion is not an anodyne intervention is a long one. We encourage those involved in performing abortions and in referring women for them to take the first step by being open to finding out just what the destruction in the womb of their unborn child does actually do to many women.