Saturday, June 3, 2017

Ethics in Medicine: Termination of Pregnancy

  1. 1.
    moral principles that govern a person's behaviour or the conducting of an activity.

Recently, as part of our 'Ethics and Law' course in clinical school, we have to attend seminars talking about ethically controversial issues. They have been 'bearable', I mean, we attended it as part of a tick-box exercise so we can pass medical school. But the latest 2 sessions have been quite interesting. 

The last 2 sessions were about the Reproductive rights of human and Abortion laws. eg. Should pre-implantation genetic testing be allowed? Is it eugenics? Should IVF be allowed in the NHS on public funds? Who has the right to have unlimited rounds of IVF? Is childlessness an illness that needs to be dealt with by medical professionals? It stirred quite fierce debates among my group. We talked about topics like 'is it absolutely ridiculous that we allow people to terminate unborn babies who have congenital defects?', 'Is any form of contraception or procedures related to human reproductive actually killing a life?' It was definitely very eye-opening, especially the moments when some of my quietest colleagues stood up and spoke strongly for their stance. 

The point of these sessions was not to come to a conclusion. There will never be a conclusion. (That's partly why I dislike these seminars...) If there were a right answer, we wouldn't need to have these debates anymore and things will be done. The point is to just to think about it...

But...I felt very detached and unmotivated to debate about any of these things. I mean...I felt like, it's part of my job, I shouldn't impose my moral judgement on any of my patients. I should do my best to help them from a medical point of view, regardless of what I personally think. With that string of thoughts, I found it pointless to have a debate because...I will do it if that's what my job requires me to do and as long as I am not harming a person. 

'But what is a person?' 
A fetus has no thoughts, no voice and can't say no, even if you try to kill it. Because there isn't a proper definition of 'a person', everyone has a different definition of their own. My view of a person is when the fetus starts having a heartbeat. But that's what I think, not what the patient think. And when in a consultation, what my personal definition is, doesn't matter. Clinically, if the pregnancy is severely harming the person in front of me - a mother, a wife, a woman who is trying very hard to keep her life in one piece and prevent her world from crashing down - I will do my best to relieve that woman's pain. 

'Aren't you a Christian? How can you support something which kills life?' 
I am a Christian, and I try my best to be what my Lord tells me to be in my everyday life. To be loving to everyone, to be kind, to be patient, to be forgiving, to not worry and to fully trust in Him in whatever lies ahead of me. I used to in my mind, judged those people who had a termination, sneered in my mind how heartless these people are. I used to in my mind, judged those parents who chose terminate a pregnancy because there's a serious congenital defect in the unborn baby....until the day I attended the Termination of Pregnancy clinic as part of my O&G attachment. 
I sat in front of these ladies. Every single one of them, feared for their future, scared of what will happen to their body and felt guilty about their past. Even those who had a termination before. Not a single patient was happy when they came into the clinic because 'yay, I can finally get rid of this thing growing inside of me.' 

I chatted to the Consultant who ran the clinic after that session.
'How long have you been doing this?'
'More than a decade.'
'Do you feel bad doing it while all your colleagues shy away from it?'
'Where will these ladies go if I don't do it?'

Sure, as a doctor, I can turn them away under the 'Conscientious Objection' because 'this is killing a life!' But hey, they come to you because you are the only person whom they can turn to, who can help them in a safe manner and who will not judge them. If you judge them as well, they will have nowhere else to go. Perhaps, they will resort to illegal termination or even, suicide. So is that more loving?

Patients have their own stories and their own reasons for having a termination. Doctors have their own stories and their own reasons to object a termination as well. Regardless of what I personally think, I will (hopefully) be their doctor and their colleagues, not their judge.

p/s: If you object TOP, please let me know what would you do to help these ladies if you were in my shoes. 

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