Physicians Offered New Advice on Medically Indicated Termination of Pregnancy

Revised advice to physicians on medically indicated termination of pregnancy has been issued by the World Medical Association.

At its annual General Assembly in Reykjavik, the WMA reiterated that where the law allows medically indicated termination of pregnancy to be performed, the procedure should be carried out by a competent physician. However, it agreed that in extreme cases it could be performed by another qualified health care worker. An extreme case would be a situation where only an abortion would save the life of the mother and no physician was available, as might occur in many parts of the world. This amends previous WMA advice from 2006 that only physicians should undertake such procedures.

The revised policy emphasises that the convictions of both the physician and the patient should be respected. It adds that patients must be provided with necessary medical and psychological treatment along with appropriate counselling if desired.

In another change to WMA policy, the Assembly reaffirmed its view that physicians should continue to have a right to conscientious objection to performing an abortion, while ensuring the continuity of medical care by a qualified colleague. But it added that in all cases physicians must perform those procedures necessary to save the woman’s life and to prevent serious injury to her health.

‘Physicians must work with relevant institutions and authorities to ensure that no woman is harmed because medically-indicated termination of pregnancy services are unavailable’.

The preamble to the revised policy states: ‘Medically indicated termination of pregnancy refers only to interruption of pregnancy due to health reasons, in accordance with principles of evidence-based medicine and good clinical practice. This Declaration does not include or imply any views on termination of pregnancy carried out for any reason other than medical indication’.

WMA President Dr. Leonid Eidelman said that the revised policy was part of the WMA’s procedure to review all policy that was 10 years old and follows two years of discussion and debate.

‘As the document says, termination of pregnancy is a medical matter between the patient and the physician. But attitudes toward termination are a matter of individual conviction and conscience that should be respected.

‘A situation where a patient may be harmed by carrying the pregnancy to term presents a conflict between the life of the foetus and the health of the pregnant woman. Different responses to resolve this dilemma reflect the diverse cultural, legal, traditional, and regional standards of medical care throughout the world and the revised policy recognises this fact’.