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  • Title: Law: participate or not?
    Author: Finch J.
    Journal: Nurs Mirror; 1983 May 04; 156(18):38. PubMed ID: 6552590.
    Abstract:
    2 separate and important features of abortion law and practice in the UK which are particularly relevant to nurses participating in the procedure are examined: the nurse's participation in an abortion induced by the injection of prostaglandin into the womb; and the nurse's right to refuse to participate in any form of abortion on the basis of reasons of conscience. Focus is on the position of a predecessor of Karen Smith on a female surgical ward in the mid 1970s. It was then that abortions by the use of prostaglandin solution were becoming prevalent. When the Abortion Act became law in 1967 the most usual abortion method involved surgical intervention, and no legal problem was involved for the surgical intervention would always be performed by a physician. Around 1970 the prostaglandin method of inducing abortion began to be written about in the journals. The method was found to have several advantages, including the deployment of medical and nursing staff. The process is initiated by a registered medical practitioner, as it must be according to the Abortion Act. A catheter is inserted through which prostaglandin solution is administered to the patient. From that time the nurse assumes a crucial role. Nurses carry out in whole or in part the subsequent steps in the process. A prostaglandin pump is connected up with the catheter in order to give the patients the abortifacients. Nurses monitor the process, which can last between 15-30 hours. It usually takes about 18 hours for this method to produce the abortion, and the nurses are involved with the patient during this time. Doctors or "registered medical practitioners," are frequently absent. Following questions raised in senior nursing circles regarding the propriety and legality of this process, the DHSS issued a circular to allay fears. The department advised that, providing a registered medical practitioner personally made the decision and initiated the medical induction process and remained responsible for it throughout, it was unnecessary for the medical practitioner to perform each and every action which was required for the process to realize the intended objective. A legal test case was brought against the DHSS to determine the legality of prostaglandin abortion and nurse participation. A High Court judge ruled such participation to be lawful. When appealed, all 3 Lord Justices in the Court of Appeals unanimously reversed the decision. The DHSS appealed, and the law lords by a majority of 3 to 2 overturned the appeal court's ruling and restored the decision reached by the trial judge in the 1st action. Regarding conscientious objection, nurses and other staff, including surgeons and anesthetists, are included in the provision of the Abortion Act which allows refusal to participate on the basis of conscientious reasons.
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