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The need for two doctors to give consent for a woman to have an abortion before 24 weeks' gestation should be dropped, clinicians have told MPs.
The current legal requirement for a woman to get two signatures from doctors is woefully out of date and inappropriate, MPs on the House of Commons Select Committee on Science and Technology were told last week. Witnesses giving evidence as part of the committee's inquiry into whether the abortion laws in England and Wales need to be updated said that changes were long overdue. They gave evidence days before a conference held in London by Marie Stopes International called for an end to the dual signature requirement.
Tony Calland, chairman of the BMA's medical ethics committee, said that in the case of pregnancies in the first trimester the BMA deemed that it was no longer necessary to have two doctors' signatures because the risks were so low, but this was not so for second trimester pregnancies.
He said, “For the first trimester we feel the risks of that procedure are so small, we ask why do you need two doctors to confirm a procedure or to sanction a procedure that is of very small risk indeed and much less risk than perhaps an operation where you don't need two signatures?”
The committee challenged Dr Calland on why the BMA had offered only a pro-choice motion for its members to vote on at the recent BMA annual conference, given that it was this motion that had led to its current policy in this area.
“There were a series of motions, and the first one was on first trimester abortion, and that was debated,” said Dr Calland. “Time is allowed for certain sections, and after that motion—because there were a lot of speakers—the time on that section ran out.”
MPs asked fellow witness Vincent Argent, a consultant obstetrician and gynaecologist, whether any evidence existed to say that having two doctors' signatures actually improved health outcomes of patients presenting for an abortion.
Dr Argent said no and added: “Sometimes, the clinician [signing] does not actually see the client for consultation. They sign the form on the basis of reading the clinical notes.
“It would be helpful if there were clearer guidelines about such matters as whether the clinician or healthcare professional actually needs to see the client and discuss the situation before signing the form.”
Kathy French, a sexual health adviser at the Royal College of Nursing, also a witness, said, “I think the two doctors' signatures made a lot of sense in 1967, but we've moved on from there. The need for two signatures is very cumbersome. It puts a huge burden on women.”
Anne Weyman, chief executive of the Family Planning Association, added, “There is absolutely no reason why we should have the two doctors' signatures for medical or scientific reasons, and it does seem rather odd that in 2007 we are still bound by an act that was passed in 1861 [the Offences against the Person Act].”
Ms French said the evidence was growing that nurses should have more responsibility in medical abortions.
• A survey carried out between February and September 2007 by Colin Francome, emeritus professor at Middlesex University, and by Marie Stopes International showed that 80% of GPs were broadly pro-choice. But a third of those who were anti-abortion did not believe they should reveal their position when seeing a woman requesting an abortion.
is available from General Practitioners: Attitudes to Abortion 2007 www.mariestopes.org.uk