Abortion: time to clarify Australia’s confusing laws

To the Editor: de Crespigny and Savulescu1 criticise legal and media attention given to the abortion of a 32-week fetus with suspected dwarfism in a case in which the expectant mother had become suicidal. At the same time, they appeal to populism to support legislative change in favour of easier access to late-term abortion.

This paradox raises an intriguing point about public opinion and medical ethics. How can members of the public develop opinion unless they are told what is going on? The case was made known to the public (although the patient’s name and face were not shown) because a newspaper editor considered it to be of great interest to many people. The public rightly has an interest in this tragic case, as it relates to at least three controversial themes of significance to public and social health — disability, suicide and abortion. Unfortunately, in recent decades, balanced and informed debate about abortion has been lacking. Instead, the issue has been portrayed simplistically in terms of a woman’s “right to choose”, with little research into the desperate and often coercive circumstances and the harmful consequences of those choices.

That late-term abortions are subject to unclear and complex state laws is testament to the fact that abortion is far from a closed case for the public, healthcare professionals and politicians. de Crespigny and Savulescu acknowledge that the case raises “profound and divisive ethical issues”. Yet, they later assure readers that the case “appears to be ethical”, adding to their overall implication that, if only Australia’s laws were clear, uniform and liberal, the media and the public would not have had any business in the matter.

Many aspects of the doctor–patient relationship are regulated by legislation — an “intrusion” that is accepted in jurisdictions in which democracy and state-funded healthcare coexist, and necessarily so, to protect both doctor and patient. If legislative change is to occur, public consultation must be sought, and the public must be given more, not less, information about abortion.