Mental Health
ISSUES OF MENTAL HEALTH
THE CURRENT IRISH DEBATE
113 PSYCHIATRISTS OPPOSE ABORTION PROPOSAL
On 24th April 2013 113 psychiatrists have signed a statement saying that legislation, which would allow for abortion as a treatment for threat of suicide, has no basis in medical evidence.
Four leading psychiatrists who carried out the survey of around 300 psychiatrists in the country. They are Dr Martin Mahon, Connolly Hospital, Dr Bernie McCabe, Navan Hospital, Dr Richelle Kirrane, Connolly Hospital and Prof Patricia Casey of the Mater Hospital. Of those who replied, 14 of the doctors disagreed with the statement.
Dr McCabe said: “I am not surprised that so many of our colleagues agree that the proposed legislation is flawed. As members of the medical profession, we have a duty to our patients to adopt best practice and an evidence-based approach to everything we do.
“The fact is that there is no evidence that abortion is a treatment for suicidality in pregnancy and may in fact be harmful to women. The Government must take this into account and reconsider its proposals.”
She said: “In total, 302 letters were sent to consultant psychiatrists there was over a 40pc response. Doctors were given the option to sign their names or reply anonymously. Almost 90pc of respondents agreed with the statement.
Text of the Statment:
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As practicing psychiatrists we are deeply concerned at the Government’s stated plan to legislate along the lines of the X-Case, as this will mean legislating for suicidality.
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We believe that legislation that includes a proposal that an abortion should form part of the treatment for suicidal ideation has no basis in the medical evidence available.
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We as psychiatrists are being called upon to participate in a process that is not evidence based and we do not believe that this should be asked of the profession.
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Any proposal being considered by the Government must be based on a rigorous appraisal of the available psychiatric research and medical evidence.
DEFINITION OF MENTAL HEALTH
The term "mental health," as commonly used, is synonymous with the United Nations' definition of "health," which means social, emotional, and economic well-being, as judged by the person him/herself. This is a broad, sweeping definition which soars far beyond and cannot be equated with "mental health," as medically defined.
As early as 1971, Dr. Louis Hellman, Deputy Assistant Secretary of the Department of Health, Education, and Welfare (HEW), who was strongly pro-abortion, said (at Columbia Women's Hospital, Washington, DC), that the requirement of a psychiatrist's permission for abortion was a "gross sham."
Washington Post, Nov. 25, 1971
This reference was made in spite of (or because of), the fact that, of a total 14,717 hospital abortions performed in California (Nov. '67-Sept. '69), 90% were for mental health purposes.
California Dept. of Public Health, Third Annual Report to California Legislature, 1970
In New York, where the law did not require such a subterfuge, only 2% of the abortions reported for 1970 were performed for "mental health" reasons. Every state or nation that has legalised abortion for "health" has abortion-on-demand.
Requirement of psychological treatment
Although there is undoubtedly a great need for more research on the psychological consequences of induced abortion, it is clear that women experience varying degrees of emotional distress after the procedure.
The evidence outlined below shows that there are particular risk factors associated with the increased likelihood of developing severe and/or prolonged psychological sequelae as a result of having an abortion. Emotional harm from abortion is more likely when one or more of the following risk factors are present: (55)
1. prior history of mental illness
2. immature interpersonal relationships
3. unstable, conflicted relationship with one's spouse
4. history of a negative relationship with one's mother
5. ambivalence regarding the abortion
6. religious and cultural background hostile to abortion
7. single status, especially if no born children
8. adolescent
9. second trimester abortion
10. abortion for genetic reasons
11. coercion to abort
12. prior children
13. maternal orientation
Those features which are likely to be of significance in the Irish clinical situation have been highlighted. Ignorance is no defence where negligence exposes patients to an event which may have life-long implications for her and those close to her. Ultimately, the expectant mother will make the decision, but she has the absolute right to be informed of the likely psychological effects of her decision, with the resultant need for longer-term psychiatric or psychological intervention.
Recognised Effects of Induced Abortion
In a study of post-abortion patients only eight weeks after their abortion, researchers found the following results; (56)
1. 44% complained of nervous disorders
2. 36% had experienced sleep disturbances
3. 31% regretted their decision
4. 11% were prescribed psychotropic medicine by a doctor
A 5-year retrospective study from Canada (57) found significantly greater use of medical and psychiatric services among aborted women. Most significant was the finding that 35% of aborted women made visits to psychiatrists, as compared to 3% of women who had not had abortions.
Danish Study
A large study of all pregnant women throughout the entire population of Denmark was conducted in 1985 and discussed in The Rawlinson Report (1994). (58) The researchers in this study compared women less than three months after an abortion with pregnant women who declined abortion.
They found that psychiatric hospitalisation was higher amongst the post-abortion women than among those who declined abortion and delivered. This very comprehensive study made it quite clear that women who undergo an abortion are very likely to develop psychological complications.
Very little information about the research findings on the adverse psychological effects of abortion is shared with women who are considering the procedure. Again this raises the issue of "informed consent." By withholding readily available information, can the woman's carer be acting in her best interests?
In the Irish context, particularly with our recent history of court-directed abortions for vulnerable young girls, we should pay close heed to the words of the World Health Organization:
"Serious mental disorders arise more often in women with previous mental problems. Thus, the very women for whom legal abortion is considered justified on psychiatric grounds are the ones who have the highest risk of post-abortion psychiatric
disorders." (59)
References
Requirement of Psychological Treatment
55. Zolese G, Blacker CVR, "The psychological complications of therapeutic abortion," British Journal of Psychiatry, 1992, 160,742-9
56. Ashton, "The Psychosocial Outcome of Induced Abortion," British Journal of Obstetrics and Gynaecology, 87:1115-1122
57. Badgley et al, "Report of the Committee on the Operation of the Abortion Law," Ottawa, Canada, Supply and Services, 1977, p 313-321
58. "The Rawlinson Report: The Physical and Psychosocial effects of abortion in Women (1994). A report by the Commission of Inquiry into the Operation and Consequences of the Abortion Act," London, HMSO
59. Official Statement of The World Health Organisation, 1970
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