ALRANZ News

              Thanks to Eileen Slark (Auckland) and Lesley Smith (Wellington) who will be representing ALRANZ at the NCW meeting in Masterton. A remit has been put forward by Voice for Life: “That NCWNZ ask Government to implement the call of Professor David Fergusson of the Christchurch School of Medicine, for further research into the mental health outcomes for women experiencing unplanned pregnancy, by requesting the Health Research Council to initiate further research in this area.” A proposed amendment from the Hamilton Branch is: “That NCWNZ urges further research into the mental health outcomes for women experiencing pregnancies, both planned and unplanned and also during the post-natal phase.” This broader approach will be supported by ALRANZ.

              Thanks to new member Dr Alison McCulloch who has agreed to help ALRANZ with communications. Her involvement in abortion dates back to her time with WONAAC and her reports for Broadsheet under the byline ‘Our Woman in the House’. Since then she has been overseas for a number of years and has had an interesting career in the field of journalism. She was a member of The Denver Post team that won a Pulitzer Prize in journalism for its coverage of the Columbine School massacre in the US in 1999. She was with The New York Times for five years where she was a staff editor on the foreign desk and Sunday Book Review. She also spent time at the International Herald Tribune in Paris.

              President Margaret Sparrow has been invited to speak at a conference in Brisbane on October 17 on “Abortion in Queensland” organised by Children by Choice and Family Planning Queensland. Also speaking will be Professor Caroline de Costa, Professor of Obstetrics & Gynaecology at James Cook University School of Medicine, Cairns, Queensland. She was the first specialist in Australia to be granted prescribing rights for the abortion pill (mifepristone).

              Congratulations to Dr Carol Shand who was awarded the CNZM (Companion of the New Zealand Order of Merit) in the Queen’s Birthday Honours. She is recognised for her pioneering work in the field of sexual abuse and the formation of DSAC (Doctors for Sexual Abuse Care). She is a specialist sexual health physician, an experienced Wellington general practitioner and a long-standing member of ALRANZ. She has always been a champion of women’s health from family planning to obstetrics to abortion care. Since 1980 she has been an abortion provider first at Parkview Clinic and now at Level J Unit. She is a founding Director of Istar Ltd, which imports the abortion pill.

              Dr Henry Morgentaler, Canada’s best known abortion provider and abortion rights crusader, was appointed a Member of the Order of Canada, the country’s highest honour. In announcing the award, on 1 July the Governor-General said the award was in recognition of his commitment to increased health care options for women, his determined efforts to influence Canadian public policy and his leadership in humanist and civil liberties organisations. In the case, R v Morgentaler in 1988, the Supreme Court of Canada found that the abortion provision in the Criminal Code of Canada was unconstitutional, as it violated a woman’s right to security of person.

              Ever since this ruling there have been no laws regulating abortion in Canada. However, it has been a long battle to improve services. Dr Morgentaler led the fight to establish clinics and now runs six clinics across the country. For his cause he served time in jail. As expected, the award was denounced by opponents of abortion, but it was seen as long overdue by his many supporters. He is now 85 and last year suffered a stroke but continues to fight on. He is a Jewish Holocaust survivor and this experience profoundly influenced his secular humanist life values and career choices.

              On 7-9 April 2008 Mr Justice Miller heard legal arguments from Right to Life NZ (RTLNZ) seeking a review of the functions of the ASC and the status of the unborn child. In his judgment (9 June) Mr Justice Miller rejected the claim seeking legal status for the unborn child. He also rejected criticism of the counselling procedures, the lack of independence of counselling services and the method of making appointments at clinics before women have seen a certifying consultant. He did however, question the legality of over 98% of abortions being done on the grounds of mental health, but reached no conclusion on the question whether certifying consultants are complying with the abortion law.

              The Crown Law Office representing the ASC has appealed the judge’s decision for several reasons:

(1) There was no evidential foundation for the finding that ‘There is reason to doubt the lawfulness of many abortions authorised by certifying consultants.’

(2) There was no evidential foundation for the finding that ‘The approval rate seems remarkably high, bearing in mind that under section 187A the consultants must form the good faith opinion that continuance of the pregnancy would result in serious danger to the mother’s health.’

(3) The Court erred in law in concluding that the ASC’s functions under the Act empower it to form its own opinion about the lawfulness of certifying consultants’ decisions.

              RTLNZ intends to cross appeal and re-present its case seeking legal recognition of the status of the unborn child and whether counsellors should be independent from abortion providers.

              RTLNZ had expected Judge Miller to make declaratory orders but this question will now be considered by the Court of Appeal. In the meantime certifying consultants will continue to act in good faith to approve abortions.

              This long drawn out saga commenced over three years ago. On 8 September 2005 Mr Justice Wild heard the case in the High Court in Wellington and released his judgment on 11 October 2005. The ASC had applied to have the case against them struck out. The judge struck out some claims, such as the Attorney-General being second defendant, but allowed others to proceed. An amended claim was filed by RTLNZ on 28 October 2005.

              On 29 November 2006 Associate Judge Gendall heard an appeal by the ASC to disallow seven affidavits, six of them from aggrieved women. The judge, in his opinion released on 21 December 2006, ruled against the ASC.

              The ASC then requested that the case be reheard by a full judge rather than an Associate Judge.    On 28 May 2007 Mr Justice Young heard the case in closed chambers and ruled in favour of the ASC by having the affidavits of the six aggrieved women struck out but the affidavit of psychiatrist Dr Julia Aranui-Faed accepted.  

              On 24 September 2007 Mr Justice France heard arguments on whether affidavits from two paediatricians relating to fetal surgery and fetal diagnosis should be allowed. The judge ruled (3 October) in favour of RTLNZ.

              After all these skirmishes the full case was at last heard by Mr Justice Miller as explained above. In the meantime the composition of the three-member ASC has changed completely. Three years ago Dr Lesley Rothwell was chairperson. The present chairperson Professor Linda Holloway has only been in office since June 2007.

Conferences attended

              Dr Carol Shand attended the 10th Congress of the European Society of Contraception held in Prague from 30 April to 3 May 2008. The theme of the conference was the non-contraceptive benefits of contraceptives. But there was also a significant abortion stream with useful contributions from Dr Christian Fiala, Austria, and Elizabeth Aubeny, France.

              Dr Shand also attended the British Pregnancy Advisory Service Conference in London. The theme was “The Future of Abortion: Controversies & Care”, and it was an opportunity to look at the legal, ethical and clinical debates centering on the provision and delivery of abortion and contraceptive services.

              At both conferences there was frequent reference to the importance of LARC (Long Acting Reversible Contraception) to prevent unwanted pregnancies and especially repeat abortions. In NZ this would be translated as better funding for Mirena and Jadelle as the initial cost of these methods means it is not always an option.

              Mirena is a hormone-releasing IUD that can be left in place for up to five years. Jadelle is a subdermal implant of two rods, that can also be left in place for up to five years. Both release levonorgestrel and are progestogen–only methods.

              In May 2008 Auckland DHB approved a trial of providing the emergency contraceptive pill free to any woman requesting it. When the trial is implemented, the pills will be available in the usual way from pharmacists trained to provide the medication. The trial has been funded to the tune of $300,000 and will be reviewed after the allocation has been used up. ALRANZ regards this as a sensible move if we are seriously trying to reduce unplanned pregnancies.

              Capital & Coast DHB member Helene Ritchie, who has long campaigned for better contraceptive services, then raised the issue with the DHB which agreed to investigate it further.

              Former High Court Judge Sir Graham Speight died in Auckland on 17 July 2008 at the age of 86. In the days when illegal abortionists were frequently before the courts he presided over several notable trials. When the Wall Bill was passed in May 1975 the Auckland Medical Aid Centre sought a declaratory judgment as to the effect of the Act. This was an attempt by the Porirua Labour MP Dr Gerard Wall to close the clinic by restricting abortions to public hospitals. Mr Justice Speight determined that, because of a drafting error, the Act was invalid. He was the judge in the first Woolnough trial in 1975 which resulted in a hung jury. Dr Woolnough was acquitted at the retrial.

              In 1979 he heard an appeal by the Auckland Medical Aid Centre after the ASC had refused to grant the centre a licence to operate. He ruled that the ASC did not have the discretion to withhold the licence and in August 1979 the licence was approved by the ASC.

              In January 1982 he was on the bench in the High Court in Auckland when the case of Wall v Livingston and Roborgh was heard. Dr Melvyn Wall, a New Plymouth paediatrician, was disputing the decision of two certifying consultants Dr Livingston and Dr Roborgh. Mr Justice Speight ruled in favour of the certifying consultants and, even though the abortion took place 48 hours later, Wall took his case to the Appeal Court. His appeal was dismissed.

              Judge Donald Inglis died at the age of 78 on 26 April 2008. He was a Queen’s Counsel, Family Court judge and specialised in family law. In 1975 and 1976 he was engaged by SPUC as one of its lawyers to interrogate people making submissions to the Royal Commission on Contraception, Sterilisation, and Abortion. His adversarial approach, more suited to a court room than a commission of inquiry, hindered greatly the free flow of sensitive information.

              In the 1993 case of ‘Re H’ his clever legal arguments lacked compassion. H was a severely intellectually impaired adult aged 38. She had been institutionalised since the age of six and could not communicate verbally. She became pregnant (nobody knows whether it was another inmate, a staff member, or a visitor responsible for the pregnancy) and her mother requested an abortion and sterilisation. Inglis could not intervene in the abortion decision but he had the authority to rule against sterilisation and did so, on the grounds that less restrictive methods of contraception were available.

Statistics

* There were 18,390 abortions compared with 17,930 in 2006 and the peak of 18,510 in 2003. There is no obvious single reason for the increased numbers.

Submissions to ACART

              The Advisory Committee on Assisted Reproductive Technology (ACART) has called for submissions on two further topics. The first is a “Discussion document on the use of frozen eggs in fertility treatment” and the second is “Consultation on draft guidelines for the use of PGD (Pre-implantation Genetic Diagnosis) with HLA (Human Leukocyte Antigen) testing.” Submissions on both are required by 5 September 2008. Further information on both can be obtained from the ACART website www.acart.health.govt.nz

              On 19 June Hon Nanaia Mahuta released the Bioethics Council report entitled Who Gets Born? The Bioethics Council is an independent advisory committee that provides advice and recommendations to the government on the cultural, ethical and spiritual aspects of biotechnology. The recommendations of the report will now be considered by a Ministerial Group. Most controversial was the suggestion that the ban on using PGD (Pre-implantation Genetic Diagnosis) for sex selection should be lifted. Government already funds PGD for about 40 cycles a year, but only for couples at risk of passing a serious condition to their children. The Council found no compelling reason why sex selection for the purposes of family balancing should be banned, provided the cost is met by parents.

Book Reviews

              Casper, Monica. The Making of the Unborn Patient: A Social Anatomy of Fetal Surgery. New Brunswick: Rutgers University Press; 1998

              This was a benchmark publication 10 years ago and is still a recommended text for anyone wanting to know more about the ethics of fetal surgery. The author is an academic sociologist and ethicist. When researching her book she came to New Zealand to meet those who had worked with Professor Liley, pioneer of fetal transfusions. Anti-abortionists are increasingly using fetal surgery as an argument for greater legal protection of the fetus, (witness the RTLNZ High Court case). Casper favours research into fetal medicine and fetal surgery (which she regards as still largely experimental) but also argues for the protection of women’s rights. In 2002 she took issue with the Bush administration’s proposal to redefine ‘child’ to include unborn fetuses.

              After spending 2003 as the Executive Director of ISNA (Intersex Society of North America) she is now Director of Women’s and Gender Studies and Associate Professor of Sociology at Vanderbilt University, California. In 2007 she reviewed her book in the light of recent developments and published an article in Conscience, the news journal of Catholics for Choice (22 September 2007) entitled Fetal surgery then and now: there is too much emphasis on the fetus and not enough on the woman.

              Smith, Helen. Keep Telling Stories. Wellington: Smith family; 2008.

              Helen Smith QSM married Allan, and they settled in Titahi Bay where Allan was a busy GP and Helen devoted much of her spare time to community affairs. She was the longest-serving councillor on the Porirua City Council from 1973 to 2001. Her contribution to the cultural life of the city was recognised in 2006 by a Community Award for cultural endeavours. They raised a family of three sons and one daughter. Helen was also a mathematics teacher and taught part time at several colleges.

              In 1972 she entered national politics and stood unsuccessfully for the Porirua seat as the Values Party candidate against Dr Gerard Wall. She was a strong feminist and effective speaker. She joined ALRANZ when a branch was formed in Wellington as did her sister-in-law, lawyer Shirley Smith. As mentioned in the February 2008 newsletter, both Helen and Shirley died within a week of each other in December 2007. Helen was 80 years old. When she knew that she was terminally ill she devoted as much time as she was able to recording her memoirs. Thanks to writer Stephanie Drew and the Smith family we now have this very personal history of Helen’s life and times. What shines through most is her strong commitment to family and to the cultural life of her community.

Decriminalisation

              The dictionary meaning of decriminalisation is to cease treating as criminal. NZ examples are homosexuality, which was decriminalised in 1986 and prostitution, which was decriminalised in 2003, but still regulated. When people talk about the decriminalisation of abortion make sure you understand what they mean.

              Some people use the term to mean the repeal of Sections 183, 186, and 187A of the Crimes Act which specifies the grounds for a lawful abortion and the penalties for performing an unlawful abortion. It is significant that self-abortion was removed from the Crimes Act and placed in the CS&A Act with a reduction in penalty from 7 years in jail to a maximum fine of $200. But even though prosecutions are rare it is still an offence.

              The CS&A Act is mainly procedural. The only offences (other than self-abortion) are performing an abortion elsewhere than in a licensed institution and performing an abortion without a certificate from two certifying consultants. The penalty is up to six months’ imprisonment or a fine of up to $1,000.

              From ALRANZ’s viewpoint decriminalisation means abortion would no longer be regarded as a crime and all of the above penalties would be repealed. Regulations to ensure safety and collect statistics do not require an Act of Parliament. Informed consent is part of the Code of Health and Disability Services Consumers’ Rights (1996). There is no need for the complicated procedures in the CS&A Act.

               When Peter Dunne, United Future leader, used the term decriminalisation in an interview with Gordon Campbell in June he acknowledged that the procedures were too complicated and he said that he favoured an informed decision made by a woman and her own doctor. It’s a good start that he used the term decriminalisation as there needs to be much more public discussion about it. But it means different things to different people.

              At a meeting of the United Nations Security Council in June 2008, US Secretary of State Condoleezza Rice, who chaired part of the session, raised the issue of sexual violence against women during conflicts and focused on recent events in Myanmar. Other speakers identified other areas where rape had occurred on a mass scale: former Yugoslavia, Sudan’s Darfur region, the Democratic Republic of the Congo, Rwanda, and Liberia. The meeting unanimously adopted a resolution calling on parties to take immediate measures to protect civilians from sexual violence. The resolution also called for a tightening of procedures to stop sexual abuse by UN peace-keepers.

Overseas News

Australia

              The Victorian State Government has been given three options to modernise abortion laws and remove abortion from the Crimes Act. The Victorian Law Reform Commission has delivered a report at the request of Government. All three options will decriminalise abortion. The most liberal option would give women the right to choose abortion at any stage of her pregnancy. The second option would give the woman that right up to 24 weeks’ gestation. In the third option the decision would be made by a doctor. Later this year a Bill will be put to Parliament and MPs will have a conscience vote. State elections will take place on 25 November 2008.

              Last year an all-party committee of MPs urged the Rudd Government to lift the ban on Australian foreign aid being used to give advice on abortion. The Uniting Church has come out in favour of lifting the ban but more conservative groups and Catholics are opposed. The Foreign Minister Stephen Smith is reviewing the ban.

              The Rudd Government is studying a plan that would enable chemists to prescribe certain drugs, including the oral contraceptive pill, for up to two years without the need for patients to see a doctor for repeat prescriptions. The incentive for this change is the shortage of doctors and the need to shift some duties from doctors to other health professionals.

United Kingdom

              Impassioned speeches were made in Westminster in May 2008 as MPs debated whether to reduce the upper limit for abortions from the current 24 week limit to a figure ranging from 12 to 22 weeks. Prime Minister Gordon Brown and Health Minister Dawn Primarolo saw no evidence to change the present law. Tory MP Nadine Dorries, a former nurse, proposed a 20-week limit. This was defeated 332 to 190. A 22-week limit, supported by Conservative leader David Cameron, was defeated 304 to 233.

              The day before MPs had voted in favour of radical stem-cell research, which will allow scientists to create hybrid human-animal embryos. This came after a three hours’ debate and the vote was 336 to 160. It was argued that such research might lead to breakthroughs in the treatment of various diseases ranging from motor neurone disease to Alzheimer’s.

U.S.A.

              Army scientist Bruce Ivins (62) died after a massive drug overdose, on 29 July 2008, just as the Justice Department was about to charge him with the Anthrax poisonings that occurred soon after the terror attack on 11 September 2001. Letters were sent to various people. Five recipients died, 17 others suffered illness. Two of the recipients were Tom Daschle and Patrick Leahy, pro-choice, Catholic, Democratic senators. Ivins was Catholic and strongly anti-abortion. The motive in other cases was not obvious and now the case will never be heard in a court of law.

              A study from a Texas University found that although the state had the highest amount of federal money ($17million) spent on abstinence-only education programmes, the teen birth rate was also one of the highest. The strategy is clearly not working.

              A study from Harvard Medical School, published in the British Medical Journal in July 2008, showed that a training programme that taught parents how to discuss sex with their children was effective. The researchers took small groups of parents and provided lunch-hour sessions on communicating with their children.

              A study published in the Journal of Adolescent Health found that virginity pledges help some students to delay sexual intercourse but argued for comprehensive education programmes to benefit all students.

China

              Belated recognition for two Shanghai obstetricians, who pioneered the vacuum aspiration technique of abortion, has been strongly supported by Western colleagues. The doctors published their original paper in 1958 in the Chinese Journal of O&G and the first English translation of their paper was published in June 2008 in the British Medical Journal. Australian Roger Short said “There can be few, if any, surgical procedures that have alleviated more human suffering, morbidity, and mortality than vacuum aspiration abortion.” The technique was introduced in NZ by the Auckland Medical Aid Centre in May 1974 and is now the method of choice in NZ.

Italy

              More than 50 Catholic groups in an open letter to Pope Benedict XVI asked for the ban on contraception to be lifted. This came on the 40th anniversary of Pope Paul VI’s encyclical Humanae Vitae. Protests were also made during the Pope’s recent visit to Australia.

Brazil

              In July 2008 lawmakers in Brazil, the most populous Roman Catholic country voted 57 to 4 not to legalise abortion. Abortion is only allowed in cases of rape or to save the life of the woman. However, many septic abortions are treated in hospitals and it is estimated that about 1 million illegal abortions are carried out each year.