Differences between Abortion Regulation in the UK and US - Case Study Example

Introduction Abortion is one of the most regulated issues in the UK and US’s health agenda. It has been the subject of controversy in the political arena, religious and even the social one. As a result, medical practitioners have to comply to those regulations as they perform abortions. Abortions can either be done through surgical means or through non-physical forms such as drugs. Due to this reason and many others found in the two regions’ laws, there are significant differences between the UK and US; these shall be examined below.1 Legal grounds that allow abortions In the United Kingdom, abortions are only allowed for two major reasons as stipulated in the 1967 abortion Act, amended in 1990. The first is when a woman’s pregnancy seems to be life threatening. The latter term refers to any significant risks to both the physical and mental health of the patient. The medical risk must be something assessed by two doctors if the pregnancy has exceeded twenty four weeks. In the event that the pregnancy would cause severe medical damage to a mother or that it happens to be a medical emergency, then consent from just one doctor is enough to terminate the pregnancy. 2 The second circumstance that would allow for an abortion in the United Kingdom is in the event that the unborn child will have extreme mental or physical abnormalities. The abnormalities must be certified by a medical practitioner. It should be noted that the above two restrictions apply in Wales, Scotland, and England but not in Northern Ireland. All in all, abortions in the UK are illegal except for medical reasons. In contrast, the United States legalised abortion. However, those legal abortions are regulated by a number of laws and restrictions. These are as follows. Targeted Regulation of Abortion Providers (TRAP laws) Federal bans on partial births and abortion Parental consent laws in cretin Stets In this country, abortion was legalised in the 1970s after the proverbial case of Roe v. Wade. However there are still numerous laws in place to regulate abortions so as to ensure that it is done well; the first among these are the TRAP laws. 3 These are laws are directed towards medical practitioners offering abortions and do not apply to other types pf practitioners. The government introduced this so that there could be greater safety in the process of conducting abortions. These laws mostly dwell on the way the abortion procedure is conducted rather than the choices made prior to the abortion. Consequently, the laws normally affect doctors rather than mothers but the effects are also felt by women. His first requirement in these laws is that doctors offering abortion services need to have a valid licence and failure to do so will result in fines. The other one is that the department of health can check on performance of procedures during any hour of operation, clinics are required to set up quality assurance committees made up of four members and abortion clinics must conduct their procedures in ways that ‘enhance self worth and self esteem of the patient’ This is something highly controversial because it is open to different interpretation by different doctors. Fines will be imposed if an abortion clinic is found to go against best practices of the health department; this means that they may be open to different interpretations by the respective health authorities. One can therefore deduce that the major differences between the US and UK in this regard is the fact that in the US, women are allowed to choose abortions but there may be hidden obstacles to the access of abortions through TRAP laws. These laws discourage health practitioner’s offering abortions since there may be excess restrictions on how to conduct them. Some federal bans also restrict abortions. In the States of South Dakota, Tennessee, Indiana, Louisiana and Georgia, laws have been passed to make abortions illegal. They are only allowed during medical conditions. In contrast to the UK, illegal abortions in the US are rampant in a few countries. This means that most States require that abortions be done legally. 4 Some twenty States in the US adhere to parental consent laws. In those States, any minor who is need of an abortion will require consent from her parent’s in order to proceed with the operation. This was regulated by The Child Custody Protection Act. However, it should be noted that some have complained that girls without parents have a lot of problems especially when their states have other restrictions in this sector. Conscientious objections In the United Kingdom, medical practitioners have the option of not continuing with an abortion if they feel that it goes against their moral principles. But it was found that these were minority of the cases. Most general practitioners would not mind referring patients for abortion. A survey conducted in England found that only one on of twenty four cases felt morally obliged not to perform abortions. However, those same doctors are not allowed to block mothers who may be seeking abortions within the legal limits. They are also required by law to make their objectives known as early as possible during their practise. Doctors should also give patients in need of abortion services suitable alternatives in due time. 5 The United Sates, Objections that may be raised by doctors may not necessarily focus on a doctor’s moral obligations. Most of the time, doctors raise objections to abortions when they fear excess restrictions on their practice through TRAP laws. Sometimes, it may be because of public scorn. Some doctors have been victims of violence since there are extreme anti-abortion supporters who may decide to harm them. Even though abortions are legal in the US, they are yet to receive social backing. 6 Practical aspects of abortion regulations The abortion regulation Act of 1967 in the UK has left a lot of room for anomalies and interpretation consequently bringing about differences in the manner of implementation. First of all, there is a time limit; abortions should take place up to twenty weeks. However, it was found that numerous medical practitioners performed abortions when the pregnancy was twelve weeks and that after those twelve weeks, one would have difficulties trying to perform them. The percentage of practitioners that aided abortions before twelve weeks was eighty six. It should be noted that no time limit is placed in the event that the abortion is life threatening and this was also adhered to in practice. 7 In the 1967 abortion Act (UK), medical practitioners are allowed to continue with abortions if two doctors agree that continuance with the abortion would put some serious risk to the mother with the pregnancy than without it. These is something that was not laid out in detail, consequently, medical practitioners may differ in terms of their interpretations of what ‘medical risks’ means. This is a broad term and leaves a lot of room for differences. Doctors end up depending on their personal judgments than on the legal regulation. In the United Kingdom, there are also some doctors who may perform abortions after requests from mothers. They argue that mothers who are subjected to pregnancy even when they did not want it will be subjected to mental stress and this may pose a risk to their overall well being. Besides that, some doctors continue to add that pregnancies are less safe than abortions as seen in health statistics within the region. They argue that when requested by a mother, they would perform an abortion because is less risky compare to carrying the pregnancy to full term. They believe that the latter would have greater health risks for mothers. The flipside to this argument or the extreme to this debate can seen by doctors who hold the belief that heavy evidence must be given before referring her to abortions. Such doctors are quite hesitant and rarely perform abortions. While on the other hand, certain doctors refuse to perform abortions on ‘conscientious objection grounds’. 8 Some parts of the United Kingdom do not operate under the Act as seen in Northern Ireland. In That country, abortions are only allowed in the event that the pregnancy could be dangerous to a mother’s life. Consequently, most women in that area have been going to England to perform their abortions. On the other hand the United States defers in terms of implementation of these laws. Some Sates make abortion illegal unless it is for medical reasons while others allow them. However, it should be noted that because of the excess restrictions placed on abortions, some legal experts have claimed that women have ‘undue burden’. This is because there is limited access to abortion clinics so most doctors prefer to venture into other aspects of the profession. Therefore a woman in need of an abortion will need to travel for an hour or so in order to locate an abortion clinic. Abortions in the United Sates are mostly conducted in a safe manner and most of them are non-surgical i.e. they use drugs. In this regard, accessibility is the major issue in the US. 9 Underlying factors in abortion regulations (History) Before the 1967 Act was passed in the United Kingdom, minute cases of abortions were performed as a result of medical emergencies after consent from qualified practitioners. On the other hand, wealthy women would get access to certain medical practitioners and pay them to perform abortions. Average women could not afford this and they had to seek help from practitioners who were poorly qualified thus encountering greater risks. Statistics before the regulation Act was passed indicated that about forty women died annually due to unsafe abortions. Politicians, doctors and religious groups then decided that it would be necessary to pass laws that would deal with this serious health problem. There was a lively political campaign at that time and women were protected after the law was passed. 10 The United Sates passed their abortion laws after lively debates on the matter. Most of the sides were extreme with some being pro –life supporters while the others were pro-choice supporters. Women rights movements and the civil and religious movements believed that women should have the right to maintain their pregnancies if they wish or terminate them. Eventually, pro –choice movements carried the day when abortions were legalised so that safety could be ensured. Who holds the upper hand in abortion regulations? In the United Kingdom, it is doctors that hold the upper hand rather than women. It should be noted that the Abortion Act of 1967 was not passed to legalise abortions. Instead, it was passed to make some exceptions in the illegal aspects of abortion. Actually, most of the provisions in the Act are placed in the hands of the doctors. They are the ones which are supposed to determine what ‘greater risk’ to women implies and whether or not they should proceed with the abortion. Some human rights groups within the region have been seen arguing that the abortion regulations of the UK impose unnecessarily long waiting periods. They also assert that there are too many obstacles to abortion and that these should be eliminated in order to give women greater choice in their well being. They believe that abortions should be allowed once a pregnant woman asks for it and not when it is life threatening or risky. A survey conducted by Times revealed that thirty eight percent of all the respondents felt that abortion should be legalised under all circumstances while six percent of those same respondents also asserted that there should be mostly legal circumstances for abortions while a smaller percentage (4%) claim that abortion circumstances should be mostly illegal. 11 In the US, the woman holds the upper hand; this is because she has the ability to choose an abortion since it is legal. However, to every rule, there is an exception; some states consider abortions illegal unless performed for medical reasons and this leaves abortions in the hands of the doctors. Also, in States where parental consent laws apply, then the upper hand rests on parents. Political support for abortions In the United Kingdom, Labour voters support the abortion regulations and even feel that something should be done to improve it while the Conservative Party does not support any further changes to the abortion Act. On the other hand, in the US pro choice activists have been seen in both camps; that is the Democratic camp and the Republican one. This is because one of the Republican candidates Rudy Giuliani was pro choice yet he had considerable support form his party. Also Senator Barrack Osama and Hillary Clinton are both pro choice candidates and both believe in choice. 12 The future in abortion regulations In the United Kingdom, most people support the legal abortion provisions. However, some smaller numbers advocate for greater restrictions. In the future, it is likely that there will be greater reduction of the upper limit of twenty weeks. In the event that this occurs, there will be greater chances of eliminating the need to get consent form two doctors before the abortion is carried out, this may be reduced to one doctor. This is because currently, certain women have to wait unnecessarily when their pregnancies fall below twelve weeks. 13 While the UK will be looking towards making medical abortions less restrictive, The US will be moving towards making legal abortions less restrictive. For example, they might reduce the level of scrutiny that practitioners are subjected to. Besides this, it is also likely that radical elements such as bans will be eliminated. However, some rules such as parental approval might continue because few people have objected to them. Besides this, anti abortion sentiments will not carry lot of weight in the future. 14 Conclusion The major difference between abortion regulation in the US and in the UK is that in the UK, abortions are mostly illegal with exceptions allowed during medical cases. This is the basis for other laws in the region. However, in the US, abortion is mostly legal, regulations centre on provision of safe alternatives. 15 Reference: Kerrilie, Rice (2007): Women’s Health Victoria Regulation of abortion Services, retrieved form http://www.whv.org.au/ accessed on 20th April American Civil Liberties Union (2004): Public Funding for Abortion; New York, NY: American Civil Liberties Union Jones R. et al (2005): Abortion in the United States: Incidence and Access to Services, Perspectives on Sexual and Reproductive Health Journal; 40, 1, 6-16 Wood, M. et al (2005): National Clinic Violence Survey; Arlington, VA: Feminist Majority Foundation Journal Guttmacher Institute (2008): Facts on Induced Abortion in the United States; In Brief. New York, NY; Guttmacher Institute Journal Foster A. et al (2006): Abortion education in nurse practitioner, physician assistant and certified nurse-midwifery programs: a national survey; Contraception Journal, 73,2, 408-414 Royal College of Obstetricians and Gynaecologists (2004): The care of women requesting induced abortion; London, United Kingdom Royal College of Obstetricians and Gynaecologists Journal Medical Practitioners Board of Victoria (1998): Report on Late Term Terminations of Pregnancy (1998) Guttmacher Institute (2008): Counselling and Waiting Periods for Abortion. State Policies in Brief; New York, NY: Guttmacher Institute; retrieved from http://www.guttmacher.org/statecenter/spibs/spib_MWPA.pdf accessed on 20th April, 2008 Eastwood, K. et al. (2006): Abortion training in United States obstetrics and gynaecology residency programs. Obstet Gynecol Journal; 2006; 108(2): 303-308 Kaiser Family Foundation (2003): California Senate Passes Bill Requiring Medical Schools to Teach Abortion Procedures to OB/GYN Residents; Kaiser Daily Reproductive Health Report Read More