Saturday, 31 May 2008

Victoria's abortion law

The Report of Victoria's Law Reform Commission proposing legalization of abortion has finally been tabled:

http://www.theaustralian.news.com.au/story/0,25197,23781307-5006785,00.html

It provides three options:

1. Give a doctor the authority to determine whether an abortion was necessary because pregnancy posed a risk of harm to the woman.

2. Give the woman the authority to make that determination for an abortion up to 24 weeks' gestation, after which responsibility would rest with the doctor.

3. Give women the power to choose an abortion at any stage of pregnancy.

Archbishop Hart has come out condemning the report as coming from an unrepresentative body, and calls for a full Parliamentary Inquiry:

http://www.cam.org.au/abortion/catholic-church-calls-for-parliamentary-enquiry-on-abortion.html

His statement says in part:

"The Commission completely dismisses concerns about proper respect for human life. It seeks to have abortion treated as though it were any other medical procedure. This flies in the face of the fact that the life of a human being is intentionally destroyed. It also flies in the face of community concern for a woman faced with the predicament of abortion.

All three options provided by the Commission reject requirements for making supportive counselling available, requiring an independent medical opinion, reporting adverse events or restricting abortion to places that have adequate facilities for a major surgical procedure."

He is absolutely right of course.

Still, leave aside for a moment issues about protecting life - they convince you and me, but are water off a duck's back to a substantial number of people.

One can make a case even in the terms of the 'pro-choice' movement might understand that the real underlying problem is that abortion isn't treated like any other medical issue.

We know those who have abortions are likely to face severe psychological issues afterwards. Yet there is enormous reluctance to require adequate counselling.

We know there is a high risk of complications, including a risk to subsequent fertility. Yet they don't want to have adverse events reporting.

Most of all, the 'pro-choice' rhetoric around abortion talks about pregnancy as if it were a disease, a condition to be treated because it causes harm to the mother.

But what other drastic medical procedure would be publicly funded for a time-limited 'illness' which can readily be managed by other means?

When the Government decides whether or not to list a drug on the Pharmaceutical Benefits Scheme, the benefits of the drug have to outweigh the costs. In the case of surgical procedures the cost-benefit analysis is less explicit but there.

If being pregnant really is seen as a disease to be treated medically because of the potential 'harm to the woman' (under the current legislation the test is 'a threat to the child or mother's mental or physical health'), then I'd be willing to bet providing more counselling and support during pregnancy could easily be shown to be far more cost-effective than allowing abortion. And that is even before one took into account the costs of the loss of the child. Because of course in a proper cost benefit analysis, any negative impacts on the mother would have to be set against the 'loss of potential productivity' associated with the death of the child.

Taking such an approach would be economic rationalism gone mad at one level. It abstracts from the reality that we are talking about real people, real lives. But sometimes a purely rationalist approach makes the point that the emotion that clouds this issue is all on the 'pro-choice' side.

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