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Why a Pro-life Northern Ireland Depends on a Pro-choice UK
Following my previous post I wrote a shorter, more focused piece, for the medical sociology blog 'Cost of Living.' I reproduce it here:
Over the past couple of weeks or so the abortion debate has once again flared into life. Newly appointed Secretary of State for Health Jeremy Hunt announced his support for halving the legal limit on abortions to 12 weeks. Then, last week, the journalist and political commentator Mehdi Hasan published a piece claiming that ‘Being Pro-Life Doesn’t Make Me Any Less of a Lefty’ prompting many to spend the next few days demonstrating that actually ‘Yes, Being Pro-Life Does Make You Less of a Lefty.’ This week the British Pregnancy Advisory Service (BPAS) launched a campaign titled ‘No More Names’, aimed at reducing the stigma and indeed harassment that many women experience around abortion.
Clearly, abortion is an issue that commands widespread social, and political comment. But it is not simply an issue of pro-choice verses pro-life or left versus right. For example, it is commonly assumed that the UK’s 1967 Abortion Act was the result of the nascent feminist movement. Certainly some feminist campaigners were involved but not all feminists, then or now, agree with abortion. The act resulted from the work of a diverse range of individuals and groups whose interests and concerns generated a complex and sometimes conflicting set of aims and objectives. This included many individuals and organizations that were morally opposed to abortion but could no longer ignore the consequences of prohibition: unsafe backstreet abortions. 45 years later the issues remain just as complex.
In the midst of these debates comes an announcement from Marie Stopes that it will be opening a clinic in Belfast offering termination of pregnancies of up to 9 weeks gestation*. This is a landmark event given the political, social and religious context of Northern Ireland and it is one that merits further consideration. The majority of women living in Northern Ireland who want a termination have to access abortion services elsewhere in the UK and, in some cases, elsewhere in Europe. The associated financial as well as emotional and physical costs involved in seeking an abortion in England, Scotland, Wales and beyond has a direct impact on determining who can (and who cannot) pursue this course of action. Thus, for Northern Irish women abortion appears to be an economic privilege, rather than the political right it is for women in other parts of the UK. The opening of the Marie Stopes Clinic might go some way to redressing this inequality, (but this does not mean that the clinic is being welcomed with open arms).
In this context, the costs associated with seeking a termination are of paramount importance. The NHS does not provide for those who travel from Northern Ireland for a termination and so the women (who are UK citizens) must pay for private treatment. On top of this there is the cost of travel, overnight accommodation, possibly time off work and perhaps childcare – the total bill can easily be upward of £1,000. Many cannot afford this and it is in this context that we see stories of women buying abortificant drugs through online providers as a cheaper alternative to visiting a UK clinic.
The specifics of the Northern Irish situation create a number of paradoxes. Those in Northern Ireland who advocate for the continued restriction of abortion are able to maintain this position precisely because they do not have to fully face the consequences of this position. In the pro-life/pro-choice debate the issue of unregulated abortions does not have a significant bearing, precisely because women can pay to travel elsewhere for a termination. The paradox is that whilst access to abortion is officially severely restricted, in practice, it is widely available to those who can afford it. Northern Ireland’s particular religious characteristics are, of course, also important in this debate. Religious observance is widespread and many of the local politicians are self-avowed Christians, of various denominations, with most parties being avowedly anti-abortion. Nevertheless Northern Irish politicians are charged with representing the views of all their citizens and there is a great diversity of opinion. The current political situation is failing to meet the needs of those women who travel to access abortion services and it is disenfranchising those who cannot afford to do so. The opening of the Marie Stopes Clinic in Belfast provides a legal service some women clearly wish to access, whilst also challenging the Northern Irish government to clarify the legal position on abortion. Whilst the Marie Stopes clinic does not remove all the financial barriers to abortion, it brings the issue of abortion provision in Northern Ireland to wider attention in an unprecedented way. This can only serve to move the social and political debate forward, and for this it is to be welcomed.
About the author: Nathan Emmerich is a Visiting Research Fellow in the School of Politics, International Studies and Philosophy, Queen’s University Belfast. He tweets from @bioethicsuk.
* The legal position on abortion in Northern Ireland remains unclear and there have been demands for the devolved government to clarify the issue for some time. In 2004 the Family Planning Association NI (FPANI) successfully challenged the Northern Irish Department of Health and Social Services’ refusal to issue guidelines on abortion. These finally emerged in 2009 [.pdf] but, on the basis of their provisions for conscientious objection and counselling, they were successfully challenged by a group of pro-life organisations. No further guidelines have been issued since although the Family Planning Association of Northern Ireland have recently been awarded a further legal hearing now scheduled for Jan 2013.
Abortion and its Governance: A Comment on Northern Ireland
In 1986 a group from the Royal Society of Medicine attended a conference in New York billed as: ‘Biomedical Ethics: Anglo-American dialogue.’ Despite the fact that there was clearly a sense in which the British had come to learn the new ‘bioethics’ from its American progenitors The Reverend Professor G.R. Dunstan discussed the strong tradition of ethical reflection found in the UK medical profession in his opening address. Indeed he claimed that with regard to "the involvement of churchmen and philosophers in medical ethics, we in the United Kingdom were about ten years ahead of you in the United States" (1988:5). For support, he draws on the work of the Church of England’s Moral Welfare Council and “its pioneering work on the ethics of sexual relationships in general to specific questions of contraception, sterilisation and abortion in particular, and thence into the prolongation of life and of dying” (1988:6).
It is easy to forget the fact that the Church of England played a positive role in much of the progressive legislation of the 1960s, perhaps most notably in the formation of the 1967 Abortion Act. There is little doubt that some of those involved with the development of the Act thought abortion was, at minimum, ethically questionable. However it was clear that the consequences of criminalisation – primarily backstreet abortions but also women having to continue with pregnancies that put their health at risk – were a sufficiently great moral concern that could no longer be ignored. Certainly the CoE (and, for that matter, the BMA) also had a conservative effect that can still be discerned in the fact that two doctors are required to certify the grounds for an abortion before it can take place. At the time this restriction on a woman’s ‘right to choose’ was sufficient for some feminist campaigners to become disillusioned with the development of the bill and to disengage from the process.
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