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Abortion guidance ignores gender complexity, says BMA

New government guidance on abortion fails to address the complexities and legalities around gender, the BMA has warned.

Tony CallandThe Department of Health produced updated rules after the CPS (Crown Prosecution service) highlighted a lack of guidance on abortion law as a problem area for doctors.

Guidance in Relation to Requirements of the Abortion Act 1967 states that abortion on the grounds of gender is not lawful.

It adds that the two doctors required to approve abortions must consider women’s individual circumstances and be ready to justify decisions. This is in response to concerns about the use of pre-signed forms.

BMA ethics committee chair Tony Calland (pictured) said that, while overall the new guidance contained helpful clarification of issues concerning abortion law, the association had some concerns about it.

Exceptional circumstances 

Dr Calland said: ‘We feel that it fails to reflect the complexities and full legal situation regarding abortion and gender.’

He said while the BMA believes it is ‘normally unethical’ to terminate a pregnancy on the basis of fetal sex, there could be exceptional circumstances not covered in the guidance.

‘We recognise that in some cases doctors may come to the conclusion that the effects of having a child of a particular gender are so severe to the physical or mental health of the pregnant woman as to provide legal and ethical justification for an abortion,’ he said. ‘This is in addition to the gender-related serious fetal abnormalities referred to in the DH’s guidance.’

In August 2013, the CPS highlighted the lack of guidance when explaining its decision not to prosecute two doctors for certifying abortions based on the gender of the fetus.

It said: ‘There is no guidance on how a doctor should go about assessing the risk to physical or mental health, no guidance on where the threshold of risk lies and no guidance on a proper process for recording the assessment carried out.’

The new guidance does not change the law in relation to abortion, but is intended to provide support for doctors by setting out how the law is interpreted by the DH.

 Read Guidance for doctors on compliance with the Abortion Act

 Read Abortion: BMA views on the law and ethics

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