Is NHS on Abortion Ethical - Essay Example

?Is NHS on abortion ethical? 3750 Faculty This is a study to explore various issues linked with abortion for NHS. The NHS funds and carries out millions of abortion each year. There are various ethical and social issues linked with the abortions. Over a period of time, the NHS has evolved strategy to deal with the critical issues linked with abortion. The major part of this strategy is communication. The NHS keeps its stakeholders informed regarding different aspects of the abortion and related procedures and risks. Table of Contents Abstract 2 List of Figures 4 Introduction 5 Research Background 5 Research Questions 7 Research Aims and Objectives 8 Research Hypothesis 9 Research Limitations 9 Definition of Terms and Abbreviations 9 Structure of Paper 10 Literature Review 11 Abortion 11 Abortion Rules in the Europe 11 International Standards 12 International Codes of Practice 13 Ethics, Issues and Crisis Management 14 Ethical Issues in Abortion 15 Methodology 17 Primary Research 17 Focus Group Interview 17 Survey 18 Secondary Research 20 Ethical Considerations 20 Research Results 21 Secondary Research Results 21 Primary Research Results 24 Focus Group 24 Survey 25 Analysis and Recommendations 33 Analysis 33 Recommendations 34 References 35 Appendices 37 Stakeholders’ Table 37 Stakeholder map 38 Issues Matrix 38 PESTLE 39 Focus group Questions 39 Online survey questions 40 Relevant Activists map and campaigns 41 Primary research ethical forms signed by interviewees 42 List of Figures Figure 1 NHS Structure 7 Figure 2 Europe Abortion Rules 12 Figure 3 Worldwide rates of unsafe abortions 13 Figure 4 Abortion rate in England and Wales by age, 2005 (after DOH 2005) 22 Figure 5 Age 26 Figure 6 Gender 27 Figure 7 Qualification 27 Figure 8 Views on Abortion 28 Figure 9 Anyone known undergone Abortion 29 Figure 10 Abortion Carried out in 29 Figure 11 Better choice for Abortion services 30 Figure 12 Reason for choosing particular hospital 30 Figure 13 Fetuses’ right to life 31 Figure 14 Religion and Science contradicts on Abortion 32 Figure 15 Stakeholders Map 38 Introduction Research Background Abortion is one of the most controversial aspects in the health care services. It is always linked with rights of two ‘mother’ and ‘foetus’. Abortion is a term used for the termination of pregnancy through procured or induced measures. In UK, Abortion is allowed under certain situations which are within the legal parameters of The Abortion Act, 1967 (Lipp & Fothergill, 2009). In the recent past, there have been various campaigns supporting foetus rights/ rights of unborn or rights of women. There have been certain cases, where father to be demanded for their rights over the unborn. However the issue is still unresolved. There are certain medical conditions where abortions become mandatory to save the life of pregnant women. The activists today are also opposing the use of abortion as a contraceptive measures to get rid of unwanted pregnancy. Abortions put the professionals performing it in ethical dilemma with their motive of medical practice. There have been voices raised for the social and ethical aspects linked with abortion. People supporting abortion as women’s right argue that women have right on their bodies and what happens in their bodies, whereas the others argue that the unborn who can not speak for themselves have right to live. There are various issues of debate over the abortions i.e. women’s health, psychological and emotional well being, support to raise the child and many others. There have been limited studies to understand the long term psychological impact on women who opted for abortions. The fact can not be ignored that even when abortion was not legal, it was being performed and putting women in health risk situations. It is statistically evident that legalising abortion has significantly reduced the number of abortions across the Eastern Europe (WHO, 2008). In such scenario of controversies, it is important how medical service providing organisation like NHS deals with such situations. Organisation’s Background The NHS was established in 1948 to provide good healthcare service irrespective of the wealth of people. It provides free services to the residents of the UK except for dental, optical and prescription medicines. There are more than 1.7 million people working in NHS with nearly half were clinically qualified. The NHS serves eight people per second. This is controlled by the Department of Health. Ten Strategic Health Authorities (SHAs) in England oversee the activities of NHS in England. There are no statistical measures to determine if the health of nation has improved with NHS. However the life expectancy has improved and infant mortality has reduced after the establishment of the NHS. Figure 1 NHS Structure Research Questions There are following research questions for the study: What kind of environmental pressures NHS faces when it comes to its abortion services? What are the opinions and attitudes of people in general for abortion? In what way NHS is ensuring that women/patients take informed decision in favour or against abortion? How the issue management evolved in NHS for abortion? Research Aims and Objectives Research aim is to understand approach of the NHS on the abortion issue and its management strategy. Research objective is to study various aspects of abortion services of the NHS and understand how it has maintained its reputation among people for abortion services from the past. Research Hypothesis Ho1: NHS has established its name for providing abortion services ethically. Ha1: NHS has established its name for providing abortion services ethically. Research Limitations The topic is very vast for the given time frame. There are various aspects of the term abortion and NHS practices. Researcher has tried to cover all the aspects permissible within the given timeframe and resources. However this study can be extended further to explore the issue across depth and breadth of all its sub-issues. Time has been the strongest limiting factor as there are plenty of sources of information available on this topic but it requires time and effort to explore all the reliable and relevant information. Definition of Terms and Abbreviations Abortion: Termination of pregnancy with external or medical help and removal of products of conception from the body of woman. The products of conception are the embryo or foetus, placenta and membranes Foetus: An embryo in later stage of development till birth is foetus Miscarriage: Termination of pregnancy without medical or external help NHS: National Health Service (England) Structure of Paper Literature Review Abortion According to NHS (2010) abortion is a process of ending pregnancy in order to prevent the birth of a baby. This is also known as termination of pregnancy or termination. In UK, abortion is allowed within first 24 weeks of pregnancy under certain circumstances specified under The Abortion Act 1967. According to the law: “abortions must be carried out in a hospital or a specialised licensed clinic two doctors must agree that an abortion would cause less damage to a woman's physical or mental health than continuing with the pregnancy” (NHS, 2010) This law is applicable in the UK mainland excluding Northern Ireland. Abortion Rules in the Europe Abortion rules across the Europe vary on various grounds. In the Ireland, abortion is permissible only in the case where it can save life of mother. In the Poland, Spain and Portugal it is allowed only if it saves life of mother, preserves her physical and mental health. In the Malta it is completely banned. In the Finland and the UK it is also allowed in the cases of economic and social reasons. However in rest of the Europe it is available on request. Figure 2 Europe Abortion Rules Source: BBC International Standards According to WHO the induced abortions have reduced globally from 1995 to 2003 to 2 millions (from 46 million to 44 million). It is evident from the data that there was sharp decline in the abortion rates in those parts of Eastern Europe where abortion is legal and safe. These regions also experienced increase of contraceptive use. In Africa the number of abortions increased but the rate of abortion reduced due to the improvements in the number of reproductive aged women. Figure 3 Worldwide rates of unsafe abortions Source: Ogden, 2007, p. 371 International Codes of Practice There are different norms and practices adopted at various places of the globe when it comes to abortion. There are various methods of abortion available in the present scenario depending on the stage of pregnancy and legally permissible stage for abortion. This can be D& C, suction technique or abortion pill. In the UK abortion is allowed till the first trimester or 24 weeks of gestation. However in rest of the world, abortion rights depend on region to region. Abortion is illegal in Afghanistan, Angola, Bangladesh, Brazil, Chile, Congo, Mexico, Venezuela, Mali, Niger, Nigeria, Uganda, Iran, Egypt, Libya, Syria, Ireland and Malta with an exception of medical situations where it can be threat to the life of a mother (Ogden, 2007, p. 370). Women’s health and emotional well being along with threat to life can be reason for legal abortion in Argentina, Peru, Cameroon, Ethiopia, Malawi, Zimbabwe, Kuwait, Saudi Arabia, Pakistan, Thailand, Poland and Portugal. (Ogden, 2007, p. 370) Ethics, Issues and Crisis Management There are various issues that can lead to a situation of crisis for an organisation providing abortion services. Abortion can be carried out only in first trimester (within 24 weeks), with the signature of two doctors and with the will of pregnant woman. However in the some cases where the doctors fail to identify the signs of abnormality in the early stages can result in the wrongful birth or wrongful life (Rose, 2008). These are the cases in which parents prompt for the abortion. There are various studies that covered the psychological impact on women undergoing abortion. (Lipp & Fothergill, 2009) “An induced abortion may terminate a wanted or unwanted pregnancy. Bolton (2005) highlighted the diverse nature of the stressors involved in pregnancy loss. In an ethnographic study of a gynaecology ward in the UK, one of her participants describes the emotional roller coaster of caring for women terminating an unwanted pregnancy alongside those aborting a wanted pregnancy (Bolton 2005). (Lipp & Fothergill, 2009)” There are different ethical issues of abortion. For the medical practitioner it becomes moral question to carry out an abortion. For parents to be or mother to be, it can be tough choice in a given circumstances. Ethical Issues in Abortion Abortion has various ethical issues linked with it. There are debates going on the Pro-choice and rights of unborn, lowering the term from 24 weeks to 20 weeks, right of foetus as person, religious stand on abortion and others. Harrington (2007) has argued on the disclosure of information as it is determined by the opinion of the medical expert rather than the patient’s right to self-determination. Access to termination in various states depends on the clinical judgement. Factors like women’s rights, social and economic condition, wrongful birth and others are not considered. “There was a further presumption, embodied in a range of legislation, that the human body should not be commodified. (Harrington, 2007)” Cohrane (2007) argued that Britain is facing “an abortion crisis”. There is less training available to the professionals to carry out abortions. The decision of abortion is on the hands of women in first three months without consent of doctors in many European countries. Cohrane further argues that there are certain stereotypes existing in the society who perceive that “Women who seek an abortion are in some way reckless or unnatural, and must potentially be saved from their own folly” (Cochrane, 2007). One of the arguments against abortion comes as foetus’s right as a person. However, the definition of person “conscious human being” outrights this aspect. Methodology A mixed methodology is adopted to explore the topic further. Primary and secondary both data forms has been collected. Qualitative and quantitative method was used in collecting primary data. In this, qualitative was collected from through the focus group interview using set of open ended questions and probes (King, 2004). This method allowed collecting reliable and in-depth data (King, 2004; Lee, 2006). This also allowed collecting information which is rich in personal experience (Chesebro & Borisoff (2007). According to Maxwell, “for qualitative research, different category of questions, descriptive questions ask ‘what’ and explanatory question ask ‘why’ and interpretive questions ask about the meanings of things for the people involved” (Maxwell, 1996:59, as cited by Punch, Keith and Punch, 2006). Primary Research Focus group interview and survey was used for collecting primary data. Focus Group Interview According to Salkind (2006) this allows collecting different data with similarities and differences that can lead to different themes and issues. According to Denzin and Lincoln (2000, p3) “Qualitative researchers study things in their natural settings, attempting to make sense of or interpret phenomenon in terms of the meanings people bring to them.” Survey An online survey was conducted and data was collected from the potential groups. The questionnaires were sent with a request for participation and information on purpose and topic of research. This allowed collecting quantitative data. Quantitative data is easy to analyse and comprehend. “A quantitative approach is one in which the investigator primarily uses post positivist claims for developing knowledge (i.e. cause and effect thinking, reduction to specific variables and hypotheses and questions, use of measurement and observation, and the test of theories). (Creswell, 2003, p.19) A structured questionnaire with closed ended questions was circulated. The questions consist of predefined responses. These predefined responses were included in the form of multiple choices. The data collected was analyzed with the help of data analysis tools. Sampling Definition of Population The population as identified by the researcher is adults of the age group of 18 years and above. Specify Sampling Frame These are the people residents of the England. Specify Sampling Unit Sampling unit consists of the people with experience of NHS services. Specify Sampling method The sampling method adopted in this study was based on convenience sampling. The non probability method was used. Determination of sample Size Time, cost and feedback from academicians were the determinants for sample size thirty. This was very challenging to reach to the women with experience of abortion, researcher tried to explore opinion of people in general. Ott (1994) find 30 to be statistically valid number of respondents for survey. Secondary Research Secondary data has been collected from various online sources like the NHS online information portal, news portals like BBC, The Guardian and others, books, journals and other websites. Ethical Considerations The data collected is sensitive in nature. No personal questions or probing questions were asked to the respondents. Respondents were free to express their views in favour or against abortion, NHS or related matter. Respondents were informed in advance regarding the research process and their consent was taken. Respondents were clarified for the purpose, scope, role of their feedback and other aspects of the study. Respondents were informed that they can restrain from their participation at any stage of the data collection process. Anonymity and confidentiality of information has been maintained from data collection to data presentation. Research Results Secondary Research Results According to the Department of Health almost one third of the British women have had an abortion in their lifetime. The number of abortions has decreased from 198,499 in 2007 to 195,296 in 2008. The peak age for having abortion in the officially recorded data was 19-20 years. 91% of the all abortions were funded by NHS. Highest percent of abortions (90%) were carried out under 13 weeks of pregnancy (Sources: Department of Health, Times database as cited by Bennett, 2010) According to the Ogden (2007) the abortion rate is highest for the women of 20 years of age group. The numbers are as high as 35 abortions per 1000 abortions are of the women within this age group. The abortion rate is high for young girls in their teens and it steadily decreases with the age. There are no cases of abortions of women after in their late forties and above. Figure 4 Abortion rate in England and Wales by age, 2005 (after DOH 2005) Source: Ogden, 2007, p. 370 Researcher when explored the website of the NHS on abortion, following factors were noticed: 1. Information provided covered almost all the related areas like procedures, differences of procedures, potential risks and information on the nearest clinic for carrying abortion. 2. The website contained information in a simple language and empathetic manner. The introduction page of abortion described it as difficult decision. 3. This provided legal information on abortion in the UK. 4. The website clearly states that this is a personal choice of women who undergoes abortion and also informs that doctors ask to involve parents, family members and partners. 5. The circumstances of abortion are listed in the section “Why an abortion may be necessary” 6. The procedures are described in the section “How it is performed” and the risks are in the “Risks” section. 7. The website also provides information on clinical trials on abortion and researches under the UK government initiatives. 8. The issue management strategies of the NHS of abortion are still evolving. There are various developments and research going on various aspects of abortions. The NHS provides information on these through its website and maintains the transparency to provide information to all its stakeholders (See Appendix). 9. It is evident that the NHS is proactively informing the major stakeholder (women seeking abortion) regarding various issues related to it. This also covers the legal aspects in order to avoid any controversial circumstances in future. 10. Women seeking information is clearly notified that abortion can only be carried out on their consent only. Primary Research Results Focus Group The focus group interviews were conducted in the location of researcher where five ladies were casually invited to talk on abortion and related issues. Researcher contacted different women from different backgrounds and informed them regarding the topic of research and asked for their availability. Once all arrived, researcher acted as moderator, posed each question one by one, informally and started taking notes of responses. Views on Abortion The views on abortion differed across the respondents. One out of five respondents was very rigid that abortion should not be carried out except in the cases where life of mother is in threat. Other respondents mentioned various factors such as social and economic condition, pregnancy due to crime against woman like rape cases, emotional well being of women and ability of woman and her partner to take care of a responsibility of child. Interpretation of religion and science contradicts each other on abortion All the respondents agreed that when it comes to abortion, religion and science contradicts each other. Legalisation of abortion has helped reducing death and health complications due to illegal abortion All except one respondent agreed to this statement. One participant argued that it is not legalisation of abortion but the overall improvement of health services, availability of means to detect problems at early stages and increasing awareness among people in general regarding health in general. Cases where abortion should not be legalized Two of the respondents strongly were against for women choosing abortion if they are in the early stages of their careers and in the cases where male partners are ready to take responsibility. One respondent strongly argued that except for the threat of women’s life, abortion should not be devised as a contraceptive measure. Role of NHS on Abortion All except one respondent sounded positive when it came to abortion services of the NHS. They mentioned different aspects like availability of information on the NHS centres or portal, information provided by the health care professionals, quality staff, post abortion services like counselling and others to be important aspects of abortion services. One respondent added that it is availability of the services like NHS that helped dropping the numbers of illegal abortion carried out through unsafe means or untrained professionals risking life of women. Survey Demographics Age 43% of the surveyed respondents were from the age group of 26-35 years; this is followed by 20% of respondents from the age group of 36 to 45 years, 20% respondents from the age group of 18-25 years and remaining 17% 46 years and above. Figure 5 Age Gender Majority of the respondents with nearly 93% (28) were females and remaining 7% (2) were females. Figure 6 Gender Qualification 60% of the surveyed respondents had college level education followed by nearly 33% with post graduate and above qualifications and remaining 7% with high school level of qualification. Figure 7 Qualification Views on Abortion There was very strong support for the abortions in the cases of deformed foetus, failure of contraception, pregnancy due to rape and incest and risk to mothers’ life. However respondents did not agree for the abortions in the cases of unwanted child due to early pregnancy and women considering their career to be more important. Figure 8 Views on Abortion Eleven out of 30 surveyed respondents knew someone who went through abortion, whereas 15 respondents did not know anyone gone for abortion in their social links and four respondents preferred not to say anything. Figure 9 Anyone known undergone Abortion Out of the 11 respondents who knew someone went for abortion, six of their known person went to the NHS for the abortion, two went for private hospitals and remaining three had no idea about where abortion was carried out. Figure 10 Abortion Carried out in 80% of the total 30 respondents agreed that NHS hospitals are better choice for abortion whereas remaining 20% supported private hospitals. Figure 11 Better choice for Abortion services Respondents when asked about the reasons of choosing particular hospital, they selected range of reasons. The top reason was accessibility to the hospital followed by better service, informative, quality staff and others. Figure 12 Reason for choosing particular hospital Respondents when asked the question “What do you think the people against abortion on the basis of "Foetuses’ right to life"?” 39% of the total respondents viewed them to be wrong followed by 37% neutral responses. 10% of the total respondents felt that these people are right. Figure 13 Fetuses’ right to life 56% of the total respondents agreed that religion and science contradicts on abortion, followed by 27% disagreeing and 17% who can not say anything. Figure 14 Religion and Science contradicts on Abortion Analysis and Recommendations Analysis This is evident from the primary data that the NHS has gained reputation for providing quality services among the respondents. The website of NHS provides information related to abortion and clearly indicates that abortion is a personal choice of the women, procedures available and the risks linked to it. The focus group indicated the acceptance of abortion among the respondents for various reasons like saving the life of the mother to social and economic reasons. The views were in favour of women’s right over their body. Majority of the respondents are age group of 18 years to 45 years. The majority of the respondents have college level or higher qualification and one third of the surveyed respondents knew someone who went through abortion. There were no direct question asked if the respondent or the partners of respondents went through abortion process. This indicates that by in large respondents perceived that the NHS provides proper service for abortion and it is preferred over the other service providers. This is very clear that the NHS has developed its positive image among different social group by abiding legal parameters for performing abortions and communicating clearly about various aspects of the process to the major stakeholders. The communication strategy and way of putting information is one of the major part of issue management on abortion services. Recommendations This is clear that the NHS is perceived to be better service providers when it comes to abortion services. It clearly informs the woman regarding various aspects of abortion from available procedures to the anticipated risk on individual cases. However, the consistency of services has been questioned as there are no measures to evaluate the mental and psychological impacts on women undergone abortion as well as other aspects like their reproductive health. There are also limited efforts in order to inform the teenagers and young women regarding the appropriate information on abortion. These are two areas where the organisation can work; teach them avoiding casual sexual relations, unsafe sex that can lead to various risks from sexually transmitted disease to the risk of unwanted pregnancy, use of contraceptives and actual facts regarding abortion. References About the NHS available at http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructure.aspx Andersen, B, Fagerhaug T and Onsoyen, L E (2008) Mapping Work Processes, ASQ Quality Press, Milwaukee Ashdown-Lambert, J. R. (2005). A Review of Low Birth Weight: Predictors, Precursors and Morbidity Outcomes. Perspectives in Public Health, 125(2), 76+. Retrieved January 13, 2011, from Questia database:http://www.questia.com/PM.qst?a=o&d=5044797914 Blakemore, K., & Griggs, E. (2007). Social Policy: An Introduction (3rd ed.). Maidenhead, England: Open University Press. 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Retrieved January 13, 2011, from Questia database:http://www.questia.com/PM.qst?a=o&d=5025247514 Quality and Service Improvement Tools, Stakeholder nalaysis (2011) NHS Institute for Innovation and Improvement available at http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/stakeholder_analysis.html U.S. Abortion Pioneer Seeks Ban, 17 June 2003 available on BBC News http://news.bbc.co.uk/2/hi/americas/2999176.stm Appendices Stakeholders’ Table Stakeholders Expectations Position NHS Hospitals Serving the community in large Free from malpractices and scandals Informs the patients and community Ensures abortion is always informed decision Positive Very demanding Other Hospitals Serving the patients Competition for NHS usually Neutral Primary care physicians NHS takes notes on referrals Positive Local community NHS is a strong healthcare service provider to large base of community. It is expected to practice ethical means and measures and help patients to take informed decisions Positive Abortion patients They are explained about potential risks and problems. Positive but highly concerned Healthcare authority NHS followed the rules, regulations, accepted standards and maintains quality healthcare services. Neutral Suppliers Business is done on the basis of industry norms, acceptable prices and demand of products and services Positive and concerned Media Access to news and information regarding new services, updates, Neutral Anti-abortion interest groups Campaigning against abortion rights Negative, but concerned Interest groups in favor of abortion Campaigning for the right of women for deciding on abortion Positive but concerned Source: Developed on the basis of Andersen, Fagerhaug and Onsoyen () p 34 Stakeholder map Source: Developed on the basis of Andersen, Fagerhaug and Onsoyen () p 35 Figure 15 Stakeholders Map Source: NHS Institute for Innovation and Improvement, 2011 Issues Matrix High Probability Low Probability High Significance Abortion in the case of major risk of women’s life, abortion in the case of damaged foetus Crisis management for women undergone abortion Low Significance Medical experts call on performing abortion Post reporting and consultations Rank Description Diagnosis 1. High Significance High Probability Abortion in the case of major risk of women’s life, abortion in the case of damaged foetus Critical issues 2. Low Significance High Probability Crisis management for women undergone abortion Issues of a lesser critical nature but not major changes are needed 3. High Significance Low probability Medical experts call on performing abortion Issues lesser critical nature requiring more changes 4. Low significance Low probability Post reporting and consultations Issues least critical PESTLE Political The political situation for abortion services is sensitive and critical as this issue has been highly politicised. This has been included in political agenda and is being treated under feminism issue. Economic Most of the abortions carried out in the NHS were funded by it. This has huge economic implications. However the costs of carrying out the pregnancies are never known to evaluate the actual economic impact. Social The social environment for the abortion services are steady as major section of society treats it as one of the women’s right and its legal condition increases the social acceptance. Technological There are various developments in the medical technologies making abortion less riskier and painful. Legal Abortion is legally allowed to be carried out up to the 24 weeks gestation period under specified circumstances. Environmental There are no particular environmental issues linked with abortion except for the disposal of medical wastes or conception wastes. Focus group Questions What do you think about abortion? Do you think interpretation of religion and science contradicts each other on abortion? Do you think legalization of abortion have helped reducing death and health complications due to illegal abortion? In which case you think abortion should not be legalised? What is your opinion on the NHS providing abortion services? Online survey questions Demographics 1. Age 18-25 26-35 35-45 45 2. Gender : Male Female 3. Qualification High School College Post Graduate and above Kindly rate the following on the basis of your opinion (1 for very true and 7 for least true) 1 2 3 4 5 6 7 4. It is ethical in the case of deformed fetus 5. It is ethical in the case of failure of contraception 6. It is ethical if the pregnancy is due to rape or incest 7. It is ethical if the pregnancy can be risk for mother's heath or life 8. It is ethical in the case of unwanted child (Early pregnancy) 9. It is ethical in the case of unwanted child (Women considering her career more important) 10. What do you think the people against abortion on the basis of "Fetuses right to life"? Very right Right Neither right nor wrong Wrong Very wrong 11. Religion and science contradict on abortion Yes Can not say No Thank you for your valuable response. Relevant Activists map and campaigns (Source: Hilpern, 2010, The Guardian) Source: BBC 2003 Source: Platell, 2008, Daily Mail, UK Primary research ethical forms signed by interviewees To Whom It May Concern: I am participating on the focus group discussion carried out by………….. This is a part of research on “Is NHS on abortion ethical?”. This research is part of the course……………. The aim of the study is to understand approach of the NHS on the abortion issue and its management strategy. There are no potential risk for me to provide any data and share information, views and opinion on the abortion and abortion services of NHS. All the information provided will be treated confidential and anonymity of the respondents will be maintained. I will be provided with the copy of complete report if I wish to receive it. I am above 18 years of age and have used services of NHS. (Signature) (Name of the respondent) Date Read More