illuminating science

So, I thought I’d tackle a somewhat controversial issue that’s been going on for a while in Australia, and that’s abortion and the legality of a particular drug called RU486. I wanted to summarise the current state of affairs, and make some comments from a scientist’s point of view. Before I start, however, I should make something clear: contained herein are my personal views as well as the facts, and I am strongly pro-choice (notice that I’m not pro-abortion, I’m pro-choice - there’s a difference). Some of my views are perhaps rather controversial, and a little harsh on religion. I understand that some people may disagree with me, and I’d welcome calm and well thought out comments and discussion. If, however, you get worked up, don’t be surprised if I censor these comments. It’s a bit of a long post, so click “More…” to read on.

So, abortion is legal within Australia, at least on medical grounds (e.g., if there was physiological or psychological danger to the mother to carry the baby to term). There’s a particular drug, RU486, which is able to chemically induce abortion in early term pregnancies, and is available in a number of countries. The appeal of it is that it is a non-surgical procedure which is of benefit to some women who can’t undergo surgery, or who live in outback Australia and don’t have convenient access to a hospital. On the other hand, Wikipedia suggests the fatality rate (1 in 200,000) from the drug is about double that of a comparable surgical procedure, and possible side effects may mean a woman still needs medical care, rendering it less useful for women in remote areas. (Something I didn’t know, though, was that the fatality rate for childbirth in the Western world is 1 in 14,300 - far higher than from an abortion! So there’s one more anti-abortion argument busted.)

There are several other factors which means that there is medical debate about whether the drug is appropriate or not and I’m clearly happy to abide by whatever decision the medical authorities reach. What gets my goat, though, is this: a number of years ago, in order to pass a particular pieceo of legislation, the Australian government bought an independent senator’s vote by guaranteeing that approval or use of the drug would be decided by the Health Minister, not the usual drug testing body. (The senator, Brian Haradine, was a highly-religious and downright nutty guy from Tasmania.) As the Health Minister is also a strong Christian, who flatly disagrees with abortion, the drug has been effectively banned for 10 years, regardless of the opinion of the medical establishment.

Recently, a group of female senators (what’s wrong with you, men?) tabled a bill to hand control of the drug over to the Therepeutic Goods Administration, the main body in Australia for deciding the safety and prescription conditions for drugs. They argue that since abortion is legal in Australia (at least for medical reasons, in most places) if the drug is proven to be safe and effective, it may be a safer and more convient option for some women. Ultimately, the use of the drug should be governed by medical arguments, not religious opinions.

And so it began. Toby Abbott (the Health Minister) has been engaging in a bit of scare mongering, with stories of a black market internet trade in the drug were it to become available. And the Catholic Church has displayed its usual scientific insight by claiming that abortions could rise if the drug is prescribed. Bishop Anthony Fisher said these choice quotes:

What we do know from experience is that there’s plenty of evidence that demand for abortion has followed supply. As abortions become easier and safer, people have been more willing to contemplate that as a possibility and abortion rates in Australia have spiralled as it has become more available.

When challenged, he admitted he did not have “plenty of evidence” of these ridiculous claims. (I’d believe that uptake might follow supply, but there has always been women wanting access to safe abortions.) So, he came back with the argument that

…no one that I’ve heard of suggests it would decrease the abortion rate. Australians are deeply concerned that the abortion rate is already too high and clearly this new direction will not help to decrease abortions.”

So we shouldn’t introduce the drug because it won’t decrease the number of abortions? This statement is so lacking in logic I can’t comment further.

Then there’s a survey survey conducted by an independent company, but for the anti-abortion groups, that showed that just over half - meaning 51% - of people disagree with the use of the drug. The Democrats have voiced concerns over leading questions, but even if the poll was accurate, I’d be very interested in knowing what percentage of women voted against the drug - men can be rather insensitive sometimes. Even if the poll is accurate, I don’t think that this is something that should be decided democratically - if 49% of people approve of the drug, then that’s enough that we should at least consider it. Some people also opposed the drug being subsided by Medicare (the Australian public health scheme, with compulsory contributions) which I sort of agree with - there definitely should be means testing, repeated use checks, etc. - but I suspect “serial abortions” and the like are grossly overexagerated by the pro-lifers.

But worst of all, various Catholic groups are urging doctors to resign the AMA (the Australian Medical Association), even suggesting they form a separate body. The AMA is strongly in favour of the drug being decided on medical grounds, not religious arguments. The Catholic groups, already opposed to abortion, are doing heavy lobbying to sway the vote in their favour.

Which brings me to the title of my post. The majority (although not all) of those lobbying against the drug are religious, anti-abortion groups. The only doctors who have publicly spoken out against it are Christians. This issue aside, if my doctor was a devout Catholic, could I believe that I really was getting the best health care possible? If I were a woman and pregnant, could I be sure that all my options were being presented to me? I have to think: perhaps not. Could I trust someone like the head of the Catholic doctors group who said:

The guild challenges and confronts the current recommendations in favour of RU486, which is truly the human pesticide, toxic to mother and child. The guild rejects the AMA statement on RU486. We strongly urge Catholic doctors and others of good faith to resign from the AMA or else do all in their power to change their unacceptable recommendation.

The “human pesticide”?! They’re not really the words of a competent and rational person. That’s someone who is swayed by emotion, and not what I want in a doctor. And it’s not just Christianity - could I trust a doctor that believes in magnetic healing, or manipulating auras? That’s a little different, though, because suggesting these wouldn’t preclude the use of established techniques.

Of course, every doctor has their own opinions and recommended treatments. But religion has a tendency to blind people to rational reasoning (think of all the recent battles in the U.S. against creationism and its alter ego intelligent design). I hate to say it, but I really wouldn’t want to see a strongly religious doctor for anything important or life changing.

This is just another example of the clash of religion and science (I’ve talked a little before about science and religion and using bad science to promote crazy ideas like in What the Bleep?.) I don’t think it needs to be like this - the two are compatible, but those who are religious need to stop thinking that their views are necessarily more valid than everyone else’s, like a scientist’s who has spent many years studying the issue, and to acknowledge that not everyone shares their beliefs. And particularly in medicine, the doctors should inform their patients as fully as possible, but ultimately it has to be the individual’s choice as to what treatment they receive, and they should have all their options open to them. I’ll look forward to seeing the outcome of parliament later this week.

Anyway, that’s my post for today. Feedback is welcome, particularly if I’ve got any facts wrong or if you can provide some additional references.