158. We consider the health risks of abortion to
be relevant to the abortion issue mainly as they relate to obtaining
informed consent, especially as this would be the basis for proceeding
with many abortions if the requirement for two doctors' signatures
is lifted. It is important that the guidelines for nurses and
physicians gaining consent are accurate and up to date so that
the risks are accurately communicated to the patient. The RCOG
has said that it will "maintain a watching brief on the need
to review recommendations in the light of new research evidence".
We note that the last review took place in 2004, and the one before
that in 2000. Both of these were funded by the Department of Health.
159. Abortion and possible related health risks is
a matter of public health. The Department of Health should take
responsibility for a rigorous assessment of the evidence and/or
request updated consensus statements from the appropriate professional
bodies on the level of risk or absence of risk for the conditions
160. We therefore recommend to the Government
and the National Institute for Health and Clinical Excellence
(NICE) that the clinical guidelines on abortion provision, including
health risks associated with abortion, should ultimately be taken
over by NICE.
161. We further recommend that the Government
fund the RCOG or NICE to review the RCOG guidelines.
162. We believe that most, if not all, providers
of abortion services currently make available the content of the
latest guidelines prior to obtaining consent.
163. While we recognise that obtaining informed
consent is a process that is not always best carried out through
leaflets and checklists alone, we recommend that abortion providers
are required to ensure this information is given to patients as
part of the process of informed consent.
164. To ensure that no patients are misled, we
further recommend that the Government consider ways of ensuring
that all those claiming to offer pregnancy counselling services
make the guidelines available or indicate clearly in their advertising
that they do not support referral for abortion.
165. We recommend that Members of Parliament,
when considering the issue of health risks in the context of clinical
guidance and informed consent, consider also our report and conclusions.
166. This has been a difficult inquiry to conduct
in the light of the extremely controversial and sensitive subject
matter. Parliament will ultimately take the decision on the reform
of abortion law. We have tried to examine the scientific issues
as objectively as possible and we offer our conclusions to the
House to aid the debate.