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Abortion: Medicine Interview Ethics

Abortion: Medicine Interview Ethics

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

Abortion is just one of those topics that repeatedly comes up both in medicine interviews and in real life.

Being such a contentious issue, with parties holding very strong views on both sides of the picket fence, whenever a new regulatory change is being proposed it’s almost certain to end up on the news.

Considering this, and the fact that it’s simply an interviewer favourite, you need to come prepared to discuss the ethical and legal arguments on the topic in depth at your medicine interview.

In this article, I’m aiming to give you everything you need to know to be able to turn up on your interview day and do just that.

Learn about other medical ethics questions and topics that repeatedly come up here.

What Is Abortion?

The Royal College of Obstetricians and Gynaecologists states that:

“An abortion is a way of ending a pregnancy, either through using medicines (drugs) or through a surgical procedure.”

An abortion is a deliberate termination of a pregnancy, most often carried out in the early stages of foetal development.

It gives the woman the choice as to whether she wants to carry the pregnancy to term or not.

There are lots of reasons why someone might choose to get an abortion:

  • The foetus may be severely disabled and would never have been able to lead a normal life
  • The pregnancy may be putting the mother’s life in danger
  • The pregnancy may be a result of a serious crime such as rape

In addition to a host of other equally valid reasons.

What Are The Different Methods Of Abortion Available?

There are two main methods of abortion that are commonly used in the UK:

  1. Medical abortion (using medications)
  2. Surgical abortion (using a surgical procedure)

Medical abortions generally use a combination of two different drugs: mifepristone and misoprostol.

The mifepristone is taken first and works by blocking the effects of progesterone- one of the hormones that are vital to keeping the pregnancy viable.

The second medication, misoprostol, is then taken 1 to 2 days later. Misoprostol causes the lining of the womb to break down and be expelled from the body- resulting in the loss of the pregnancy.

Surgical abortion essentially uses a small operation to remove the pregnancy from the womb.

It can be used if an abortion is required later on in the pregnancy.

The two methods of surgical abortion are vacuum aspiration and dilatation and evacuation.

Vacuum aspiration can be performed up to 14 weeks and uses a suction tube passed through the cervix to remove the pregnancy from the womb.

Dilatation and evacuation involves a surgeon passing special instruments through the cervix to remove the pregnancy from the womb by hand. This is the method used after 14 weeks.

What’s The Law Regarding Abortion?

Under the Abortion Act of 1967, abortion is legal in England, Wales and Scotland up to the 24-week point and, in special circumstances, beyond.

The law requires two doctors to agree that at least one of the following criteria is met:

  • The pregnancy is not beyond 24 weeks and continuing it would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the woman or any of her children; or
  • The termination is necessary to prevent serious injury to the physical or mental health of the woman; or
  • Continuing the pregnancy would risk the woman’s life; or
  • There is a substantial risk that if the child were born it would be seriously handicapped

So up to the 24-week point in England, Wales and Scotland, the bar for abortion is relatively low.

Every pregnancy carried to term poses a significant risk to any woman’s health (both physical and mental) so the first criterion is not hard to meet.

A group of women protesting for legal abortion

After the 24-week point, abortion is generally only available on serious medical grounds- either the mother has the potential to become seriously unwell and possibly die or the foetus has serious physical or mental abnormalities.

Abortion In Northern Ireland

Abortion laws in Northern Ireland are slightly different to those of the rest of the UK.

Abortion in Northern Ireland is permitted up to the 12-week point on any grounds- not just that the pregnancy poses a risk to the health of the mother or her family.

Up to the 24-week mark is allowed as long as there is a physical or mental risk to the woman’s health greater than the risk of terminating the pregnancy.

Along the same lines as the rest of the UK, abortion after 24 weeks is only allowed in extreme circumstances.

Abortion in Northern Ireland only relatively recently became legal- it was only after a 2018 referendum that led to abortion being decriminalised in October 2019.

There are still significant challenges for women in Northern Ireland seeking an abortion- including serious social stigma and a lack of availability of clinics.

Pro-Life Vs Pro-Choice

Pro-life and pro-choice are the two main opposing camps when it comes to debating the law on abortion.

Pro-life supporters support the life of the unborn foetus; so think abortion is wrong.

Pro-choice supporters support the woman’s right to have a choice; so think the woman should be able to choose whether or not she carries the pregnancy to term or gets an abortion.

Often, this difference in opinion comes down to the differences in when someone thinks that human life begins.

At one end of the spectrum you’ve got people who believe life begins at conception- the moment a sperm meets an egg.

With this being the case, they see abortion as tantamount to murder- as you’re forcibly ending the life of another human without their consent.

At the other end of the spectrum, there are people who believe human life doesn’t begin until the baby is birthed from the mother.

Abortion Ethics Pixel Infographic

In the middle, you have incremental views including people who think the baby is human as soon as it becomes independently viable (i.e. can survive outside the mother’s womb).

An interesting point to note with this opinion is that as modern science advances this point is getting earlier and earlier- so are foetuses becoming human earlier too?

When debating the ethics of abortion, the four pillars of medical ethics can serve as a useful framework for comparing the two viewpoints.

Autonomy

Pro-choice:

  • The pregnant woman should be able to choose what happens to her body- including whether or not she wants to be pregnant.
  • The woman should have the freedom to decide whether she wants to have children- rather than being forced into motherhood by circumstance.

Pro-life:

  • The foetus cannot consent to be aborted and so should have its autonomy respected by not forcibly removing it from the womb.
  • The mother should not be able to make decisions for the unborn child that clearly go against its best interests.

Beneficence

Pro-choice:

  • Women can become seriously unwell during pregnancy and even die. Abortion is sometimes the only thing that will save a mother’s life.
  • Abortion can often be the best thing for the woman’s long-term well-being. For example, caring for the child of your convicted rapist could have a serious impact on a woman’s mental health.

Pro-life:

  • Abortion is never in the best interests of the foetus. Many people believe life is always superior to death.
  • A child may be the only good thing that comes out of an otherwise terrible situation. Carrying the pregnancy to term may be the best thing for the mother even if she doesn’t realise it.

Non-Maleficence

Pro-choice:

  • Forcing a woman through pregnancy and motherhood can do serious harm to her both physically and mentally.
  • Denying a woman a legal abortion may lead her to have a ‘backstreet abortion.’ These are unregulated, unprofessional abortions that can be very dangerous for the patient.

Pro-life:

  • An abortion is a procedure specifically aimed at doing harm to the foetus. Depending on its gestation, there’s also debate about whether a foetus could feel pain during an abortion.
  • An abortion is not a risk free procedure for the mother. Women can bleed, develop infections and in rare circumstances even die as a direct result of an abortion.

Justice

Pro-choice:

  • It’s not fair for women to have to deal with the consequences of an act that takes both a man and a woman to perform. Not being able to have an abortion means women have to look after a child for 18 years while the man can be nowhere in sight.
  • Why should men have a say in what a woman chooses to do with her body? There are very few laws dictating what men can and can’t do regarding their own personal health.

Pro-life:

  • Widespread abortion disincentivises the careful use of contraception, leading to the haphazard termination of pregnancies without an appreciation for the gravity of the situation.
  • If life begins at conception, as many Christians believe, abortion contradicts one of God’s 10 commandments: thou shall not kill, and so can never be fair or just.

Doctors Can Conscientiously Object

Everyone will have their own opinions on abortion- whether that be if they should be allowed at all, to what gestational age they should be permitted or under what circumstances they should be legal.

This includes every practising medical professional; from doctors to nurses to family planning counsellors.

A doctor is legally allowed to conscientiously object to performing an abortion.

This might be because of religious beliefs or personal beliefs. However, if doing so, the doctor must refer the patient to another doctor who could perform the procedure.

An anti-abortion protestor in the USA

Importantly, healthcare professionals are not permitted to conscientiously object if the woman’s life is in danger “or to prevent grave permanent injury to the physical or mental health of a pregnant woman.”

Therefore, in extremis, the doctor must perform the abortion if they have the necessary expertise no matter what their beliefs.

Telemedicine And Abortion

As technology progresses, telemedicine will increasingly become a larger and larger part of our modern lives.

From video call appointments with doctors to e-consultations over a messaging service to prescriptions and treatment plans being instantaneously emailed over to patients.

Over the lockdowns imposed by Coronavirus, the provision of abortions took a big leap forward in this respect.

Normally, a woman would have to attend a treatment clinic to be prescribed and take the first of the two drugs needed for a medical abortion.

However, not wishing to prevent women from having abortions just because they weren’t physically able to attend a health clinic, the government temporarily relaxed this rule.

Following a telephone or electronic consultation with a doctor, a woman was able to take both of the two drugs at home, potentially completing her abortion without ever having stepped foot in a healthcare facility.

While this relaxation of the rules has now been reversed, it does pose an interesting question as to what the future might hold as we progress towards a heavier reliance on ‘virtual’ medicine.

Medical School Interview Abortion Questions

Finally, I’ve written a few example medical school interview questions on the topic of abortion so that you can test your understanding of the subject:

  1. What are the ethical challenges of abortion, considering both the rights of the foetus and the autonomy of the pregnant individual?
  2. In your opinion, under what circumstances is abortion morally justifiable? How do you reconcile your personal beliefs with the ethical considerations surrounding abortion?
  3. Can you discuss a situation where a pregnant patient requests an abortion for non-medical reasons and how you would handle that situation as a medical professional?
  4. How can doctors balance the duty to provide reproductive healthcare, including abortion, with the potential conflict of conscience for those who may have personal or religious objections to the procedure?
  5. What are the responsibilities of a healthcare provider in providing post-abortion care, including physical and emotional support, to patients who have undergone the procedure?

Final Thoughts

The topic of abortion almost beautifully ties together all the different pillars of modern medical ethics- which is undoubtedly why it’s such an interviewer favourite.

Once you’ve got your head around the different laws and rulings, I think it could be a bit of a gift if it now comes up at your interview.

You’ll be able to debate the ethical implications of different regulatory changes or hypothetical scenarios to do with abortion and showcase your knowledge on the topic.

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.