Abortion: A Comprehensive Guide for Medical School Interviews

Introduction

Abortion is one of the most complex and debated topics in medicine, law, ethics, and society. It is particularly relevant for medical school interviews because it demonstrates an applicant’s ability to handle sensitive, ethical, and socially impactful issues. For medical school interviews, it is vital to understand the legal, ethical, social, and cultural dimensions of abortion. This tutorial will provide an in-depth exploration of the topic, equipping you with knowledge and arguments to engage in a balanced and thoughtful discussion. Abortion is one of the most complex and debated topics in medicine, law, ethics, and society. For medical school interviews, it is vital to understand the legal, ethical, social, and cultural dimensions of abortion. This tutorial will provide an in-depth exploration of the topic, equipping you with knowledge and arguments to engage in a balanced and thoughtful discussion.

Definitions

• Abortion: The termination of a pregnancy by removing or expelling the embryo or foetus from the uterus before it can survive outside the womb. For example, this can be performed medically through the administration of drugs like mifepristone and misoprostol, or surgically through procedures like vacuum aspiration or dilation and evacuation (D&E).

• Viability: The stage of foetal development at which the foetus could potentially survive outside the womb, typically around 24 weeks of gestation. Advances in neonatal care have occasionally seen survival rates improve for pre-term births as early as 22 weeks.

Current UK Laws on Abortion

In the UK, abortion is regulated under the Abortion Act 1967, as amended by the Human Fertilisation and Embryology Act 1990. It is legal under certain conditions:

• Up to 24 weeks: If continuing the pregnancy would involve greater risk to the physical or mental health of the woman or her existing children than terminating it. For example, a pregnant person with severe hypertension may qualify for abortion under this criterion.

• Beyond 24 weeks: Allowed only if there is a risk to the woman’s life, evidence of severe foetal abnormalities, or risk of grave permanent injury to the woman. An example includes a diagnosis of anencephaly, a condition where the foetus has no chance of survival.

Example Legal Cases

1. R v Bourne (1938): This case laid the foundation for legal abortion in cases where the pregnancy endangers the mother’s physical or mental health. Dr. Bourne was acquitted after performing an abortion on a 14-year-old rape survivor.

2. Smeaton v Secretary of State for Health (2002): This case addressed the use of abortifacient drugs like the morning-after pill and reinforced the importance of aligning practices with the provisions of the Abortion Act.

3. Paton v British Pregnancy Advisory Service (1978): This case ruled that a father has no legal right to prevent an abortion, emphasising the primacy of the woman’s autonomy.

Reasons for Being Pro-Choice or Pro-Life

Pro-Choice Arguments 🌿

1. Bodily Autonomy: Women have the right to make decisions about their own bodies. For example, a woman with a high-risk pregnancy may choose to prioritise her own health.

2. Health Risks: Pregnancy can pose significant physical and mental health risks. For instance, severe complications like eclampsia can endanger the mother’s life.

3. Socioeconomic Factors: Women may be unable to support a child due to financial or personal circumstances. For example, a single mother with limited resources may feel incapable of providing for another child.

4. Cases of Rape or Incest: Continuing the pregnancy may cause significant trauma. For instance, survivors of sexual violence may find carrying the resulting pregnancy to term psychologically devastating.

5. Foetal Abnormalities: Some pregnancies involve conditions incompatible with life outside the womb, such as Trisomy 13 or anencephaly.

Pro-Life Arguments

1. Sanctity of Life: Life begins at conception, and every foetus has a right to life. Proponents often cite ethical principles and moral absolutes.

2. Alternatives to Abortion: Adoption is an option that allows the child to live. For example, there are cases where birth mothers later connect positively with the children they placed for adoption.

3. Potential for Abuse: Concerns about abortion being used as a method of contraception. Some argue for stricter oversight to prevent this.

4. Impact on Mental Health: Some studies suggest that abortion can have adverse psychological effects, such as post-abortion syndrome, though this is debated in the medical community.

Ethical Aspects of Abortion

Key Ethical Principles

1. Autonomy: Respecting a woman’s right to choose. For example, a doctor might prioritise the patient’s informed consent above other considerations.

2. Beneficence: Acting in the best interests of the woman’s health and well-being. An example is providing safe access to abortion to prevent unsafe, illegal procedures.

3. Non-Maleficence: Avoiding harm to both the woman and the foetus. A doctor might weigh the risk of continuing a high-risk pregnancy against terminating it.

4. Justice: Ensuring fair access to abortion services. For instance, advocating for equitable services across socioeconomic groups aligns with this principle.

Ethical Dilemmas

1. Foetal Rights vs. Maternal Rights: At what point does the foetus gain rights, and how do they balance against the mother’s? For example, some argue viability (around 24 weeks) should be the threshold for granting foetal rights.

2. Late-Term Abortions: The moral implications of terminating a viable pregnancy, such as in cases where late-diagnosed abnormalities or maternal health risks arise.

3. Selective Abortions: Issues related to terminating pregnancies based on gender, disability, or other criteria, such as cases of sex-selective abortion in some cultural contexts.

Religious Views on Abortion

Christianity

• Roman Catholic Church: Strongly opposes abortion, viewing life as beginning at conception. For instance, Catholic healthcare providers may refuse to perform abortions due to conscientious objections.

• Protestant Denominations: Views vary; some, like the Church of England, support abortion in cases of rape, incest, or health risks. For example, the Methodist Church emphasises compassion for women facing difficult decisions.

Islam

• Generally prohibits abortion but allows it if the mother’s life is at risk or in cases of severe foetal abnormalities. For instance, some scholars permit abortion before ensoulment (120 days) for significant reasons.

• The concept of ensoulment plays a key role in influencing rulings on when abortion is permissible.

Judaism

• Permits abortion when the mother’s life or health is at risk, as preserving life (pikuach nefesh) takes precedence. For example, if a pregnancy endangers the mother’s mental or physical health, abortion is typically supported.

• Views on abortion for other reasons can vary among Orthodox, Conservative, and Reform Jewish communities.

Preparing for Medical School Interviews

How to Structure Your Answers

1. Define the Issue: Start with key definitions and context, such as the laws and ethical principles involved.

2. Acknowledge Different Perspectives: Show empathy and understanding for both sides by discussing pro-choice and pro-life views.

3. Use Ethical Frameworks: Reference autonomy, beneficence, non-maleficence, and justice to structure your argument.

4. Incorporate Evidence: Refer to legal cases, studies, and relevant laws, such as citing the Abortion Act 1967.

5. Stay Neutral and Balanced: Avoid showing bias; demonstrate critical thinking and respect for diverse opinions.

Example Question

"What are the ethical considerations surrounding abortion?"

Answer: "Abortion raises ethical questions about autonomy, beneficence, non-maleficence, and justice. While some argue for a woman’s right to choose based on bodily autonomy, others highlight the sanctity of life and foetal rights. Legal frameworks in the UK allow abortion under specific conditions, balancing these ethical concerns. Religious perspectives also play a role, with differing views across Christianity, Islam, and Judaism. A balanced approach considers the unique circumstances of each case while respecting ethical principles and societal values."

Conclusion

Abortion is a multifaceted issue requiring medical professionals to navigate legal, ethical, and cultural complexities with compassion and professionalism. Understanding this topic deeply will not only prepare you for interviews but also for future practice in medicine. 🌟