It would be disingenuous to try to suggest that induced abortion has ever been approved by the Medical Council in this State, and it is fair to say that any doctor proven to have undertaken such a procedure in this jurisdiction would have been struck off the register for professional misconduct. From the time of the Hippocratic oath the medical profession generally abjured abortion, although it is worth noting that that oath stated only that the doctor would not give a woman a pessary to procure abortion, was generally flexible and alterable and for 800 years there was never even an implication that its swearing should be a prerequisite for doctors before starting practice. Its successor, the 1948 Declaration of Geneva (also not a prerequisite for doctors entering medical practice) stated that "I will maintain the utmost respect for human life from the time of conception."
But the Medical Council, in the latest edition of its regularly revised guide to ethical conduct and behaviour, states (more baldly than usual) that "the deliberate and intentional destruction of the unborn child is professional misconduct". It is unfortunate that the Council has used the non-medical phrase unborn child when there is a substantial and much more precise medical vocabulary to describe the various phases of human gestation within the womb. And it may prove even more unfortunate that, in effect, the Council could now find itself in direct conflict with the Supreme Court's interpretation of the Constitution in its adjudication on the "X case". In that instance the court ruled that abortion services should exist in this jurisdiction where there is a real and substantial risk to the life of the pregnant mother.
The Medical Council may also find itself in some difficulty with regard to the ethical Declaration of Oslo which was passed by the World Medical Assembly in 1970 (with even the Vatican delegation in assent). That declaration, while asserting that the doctor must have respect for human life under the terms of the earlier Declaration of Geneva, also states, inter alia, that with a diversity of attitudes existing towards the life of the unborn child, the individual doctor's conviction and conscience must be respected. But it also states that "if the doctor considers that his convictions do not allow him to advise or perform an abortion, he may withdraw while ensuring the continuity of care by a qualified colleague". To whom, then, does the conscientious doctor turn in such a situation, sanctioned by the Supreme Court, if all of his qualified colleagues are liable to be struck off the medical register if they attempt to provide such continuity of care?
The fact is - as evidenced by the changing tenets within the Hippocratic Oath in its early centuries and by the subsequent Declarations of Geneva and then of Oslo - that times and technologies change, as do attitudes and aspirations informing the ethical codes for medical practitioners. Senator Mary Henry's opinion piece, published in this newspaper last Wednesday, proffered some other medical dilemmas which the current wording of the ethical guide may present and lamented the Council's failure to stimulate a wider debate at least within the medical profession. This, and a wider discussion, is certainly required. And now is as good a time as any and better than most. The tenor of the abortion debate seems at long last in recent months to have taken a more even and more mannerly tone than it used to manifest. And after discussion there must be some resolution of the current legal and ethical confusion and contradiction within the jurisdiction.