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Monday 22 January 2024

A welcome return to Victorian values

I.e. those Victorian values embodied in Alfred Swaine Taylor's 1879 Manual of Medical Jurisprudence in his discussion of the question of abortion. In discoursing of a case in which, to his distaste. 'the medical man appeared in the capacity of an informer as well as expert', he offered the opinion that the medical man 'should refuse to... lend himself in any way as a detective for the purposes of a prosecution'.

That is, doctors were not in the business of grassing up women who had had abortions, though at that period, they would almost certainly have mainly encountered them when they were at the point of death. Swaine Taylor commented on the frequency of occurrence of miscarriage, both from natural causes and accident.

It was reassuring, in the light of the recent spate of prosecutions of women under the 1861 Offences Against the Person Act for procuring their own abortions, to read that the Royal College of Obstetricians and Gynaecologists has issued a statement that 'it is "never" in the public interest to report women who have abortions, and that they must be safeguarded'.

The organisation says it is "concerned" by the rising number of police investigations following abortions and pregnancy loss, and the effect this might have on "especially vulnerable" patients.

Dr Jonathan Lord, RCOG's medical director, told the BBC: "A law that was originally designed to protect a woman is now being used against her.

"We have witnessed life-changing harm to women and their wider families as a direct result of NHS staff reporting women suspected of crimes, and we just don't think that would happen in other areas of healthcare.

"We deal with the most vulnerable groups who may be concerned about turning to regulated healthcare at all, and we need them to trust us".

Dr Lord said he believed some NHS staff had shared information with police because they were "ignorant" about confidentiality regulations.

The centrality of concern for women's care was manifested in the early twentieth century following complaints by police and the judiciary that medics ought to make more effort to extract information about illegal abortionists from the women they treated. The Royal College of Physicians sought legal counsel and passed a resolution ‘Concerning the Duties of Medical Practitioners in Relation to Cases of Criminal Abortion’: these stated the ‘moral obligation’ to respect the patient’sconfidence. Without her consent a doctor would not be ‘justified in disclosing information obtained in the course of his professional attendance’. However, if a doctor was convinced that criminal abortion had occurred, he should urge the patient, especially should she be likely to die, to make a statement, ‘provided always that her chance of recovery are not therefore prejudiced’. If she refused to make a statement, the doctor was under no obligation to take further action except those to do with his medical attendance upon the patient.