By Michael Pakaluk
ARLINGTON, Virginia, 19 NOV. 2009 (ZENIT)
Imagine that in a
certain country there was a pain-killing drug that patients
really wanted to take because it improved their mood.
The legislature of this country had passed a law, however,
saying that, in view of this drug's power, physicians could
prescribe it only if a dose of the drug would stave off some
serious threat to a patient's health. In fact, for someone to
get this drug at all, two physicians had to sign a certificate
averring that, if the patient did not receive it, then his
health would be seriously at risk.
Now imagine that since the time the drug was discovered, and
the law passed, various studies had been carried out suggesting
that the drug was actually harmful to someone's health. There
was evidence that even one dose seemed to increase substantially
a person's risk of developing various kinds of serious health
Nonetheless, the doctors in this country still continued to
prescribe the drug to their patients, certifying that it was
necessary for health reasons, while pocketing handsome
consulting fees in the process.
Sounds pretty corrupt, don't you think? A situation ripe for a
class-action lawsuit, you might suppose.
Maybe it would even seem unbelievable that professionals, who
profess a code of ethics, could act in this way: Certify
something as healthy, when they had good reason to think that it
was actually bad for their patient's health.
Yet a recent study suggests that this is exactly how doctors
in some countries behave regarding abortion.
The study, "Reactions to Abortion and Subsequent Mental Health"
(British Journal of Psychiatry, November 2009), by David
Fergusson and colleagues, analyzes data collected as part of the
Christchurch Health and Development Study (Christchurch, New
Zealand), which has tracked and measured on a regular basis
1,265 persons from birth through age 30.
Fergusson found that women in this cohort who have had a
single abortion and report feeling conflicted about it (i.e.
most of these women) are roughly 80% more likely to develop a
diagnosable mental illness than women who in similar
circumstances carry their pregnancy to term.
In fact, extrapolating from the data, the authors suggest
that at least 5% of the mental illness of women under 30 is
ascribable to abortion.
To put this finding in perspective, consider that patients who
smoke likewise have roughly an 80% increased risk of a heart
attack. That is, abortion seems to be as bad for a woman's
mental health as smoking is for her heart.
Fergusson's study does not stand on its own; rather, it
confirms earlier findings based on the Christchurch research, as
well as other studies. Reviewing the total body of evidence,
Fergusson comments that, although there is good evidence that
abortion increases the risk of mental illness, "there is no
evidence […] that would suggest that unwanted pregnancies that
come to term were associated with increased risks of mental
And yet in New Zealand
as well as England and Wales
abortion is typically justified on mental health grounds.
In New Zealand, for example, two doctors must certify that, in
the language of the statute, "continuance of the pregnancy would
result in serious danger to mental health." Over 98% of
abortions are approved on these grounds.
According to the country's Abortion Supervisory Committee,
for certifying these abortions, doctors in New Zealand received
over $5 million in consulting fees last year alone.
What is going on here? It is tempting to say that in this
practice one sees at work a principle that can be observed in
other kinds of fraud and corruption
namely, one corrupt practice tends to engender increasingly
Abortion itself is, strictly, a corruption of the art of
medicine, since it represents the use of medical skill for no
genuine medical end (In this respect it is on a par with a
doctor administering a lethal injection to a prisoner.)
As a direct attack on the life of an immature human being, it
has no genuine medical justification, only a utilitarian
rationale. Thus it admits of continued practice for utilitarian
as in New Zealand
even when medical reasons are not merely absent for it, but
Doctors in England show signs of being uncomfortable with the
current practice. Back in 1993 the Royal College of
Psychiatrists stated that "the risks to psychological health
from the termination of pregnancy in the first trimester are
much less than the risks associated with proceeding with a
pregnancy which is clearly harming the mother's mental health."
However, last year that position was rejected and replaced by
a new statement which read: "The specific issue of whether or
not induced abortion has harmful effects on women's mental
health remains to be fully resolved. The current research
evidence base is inconclusive
some studies indicate no evidence of harm, whilst other studies
identify a range of mental disorders following abortion."
The change looks like movement from recommending abortions
for mental health reasons, to a position of neutrality; yet it
isn't that, because note how the Royal College now frames the
question: What is at issue, they say, is whether abortion, as
suspected, leads to mental disorder.
Whether, in contrast, abortion is actually beneficial to a
woman's mental health is not an open question for them: The
evidence is conclusive that it is not.
Fergusson's findings, and the other evidence, have ramifications
beyond those jurisdictions in which abortion is typically
justified on mental health grounds
since any woman contemplating abortion should at least be given
the information that allows her to make a genuinely informed
Indeed, the mental health consequences of abortion are
potentially far worse than Fergusson's study would indicate, for
First, Fergusson so far has studied women only up to the age of
30. Yet there is much anecdotal evidence to suggest that a
woman's distress over abortion can actually be triggered by
events later in life, such as pregnancy and birth, or the death
of family members.
Second, Fergusson followed a practice set down by earlier
studies and looked at only a limited class of mental illnesses
from the standard diagnostic manual (DSM-IV): "major depression;
anxiety disorders (including generalized anxiety, panic
disorder, agoraphobia, social phobia and specific phobia);
alcohol dependence; and illicit drug dependence."
But seasoned clinicians have pointed out that for women
procuring abortion one might expect additionally to see
"adjustment disorders" and Post Traumatic Stress Syndrome (PTSD),
not to mention sub-clinical pain and distress, which would be
very real for affected women yet not necessarily captured in a
So, true informed consent would require women telling a woman
who is contemplating an abortion something like: "Studies have
suggested that a single abortion increases by as much as 80%
your risk of developing certain serious mental illnesses before
you reach age 30, and it potentially implies a much higher risk
of mental illness in general over a lifespan." Needless to say,
women are not told anything like this.
An incidental fact about Fergusson's study tends to confirm
the suspicion that the research has revealed only the tip of the
iceberg. Fergusson determined whether a woman had procured an
abortion by accepting that woman's own reports. Women were asked
at roughly three-year intervals whether, in that interval, they
had become pregnant, and, if so, what happened with the
whether it ended in miscarriage, birth, or abortion. They were
also asked the same question retrospectively, about their
lifespan as a whole, at 30 years of age.
Note that the replies were given privately and also
anonymously, in the sense that the data were collected in such a
way that answers could not be mapped to any particular
Yet, curiously, Fergusson found that 32% of the women in his
cohort declined to report an abortion
that is, either they did not report, in some interval, an
abortion that they later reported retrospectively (at age 30),
or they did not report retrospectively (at age 30) an abortion
that they had reported in an earlier interval.
Moreover, the women in the study as a whole under-reported
the abortions that they had. Through comparisons with data for
the general population, it became apparent that women in the
study reported (whether prospectively or retrospectively) only
85% of the abortions that they actually procured.
To translate this point into plain language: In an anonymous
study, in which answers are given privately and can cause no
embarrassment or public humiliation, nearly half of the women
who are asked declined to say that they had an abortion
even though they were asked directly about their pregnancies and
the outcomes, and whether one has had an abortion is not
something that can be forgotten or easily overlooked.
Another fact about Fergusson's study appears strange when
compared with this curious fact of under-reporting. He also
asked women at the 30-year point to give their judgment on the
rightness of their choice to have an abortion. Was it
"definitely the right decision," "definitely the wrong
decision," or was the woman unsure? Fergusson found that 90% of
women replied that their abortion was "definitely the right
These two curious facts
massive under-reporting (which is a form of denial), together
with an apparent dogmatism in affirming the rightness of one's
choice of an abortion
would seem to indicate severe interior conflict on the part of
Such conflict, even if it does not lead eventually to
outright, clinically diagnosable mental illness, would seem at
very least incompatible with mental peace and ordinary
With fear and trembling one is reminded of Blessed Mother
Teresa's statement that in an abortion two things die: the
unborn child, and the mother's conscience.
As for the medical integrity of the physician who recommends
or performs the surgery
that has presumably been dead for a long time.
* * *
Michael Pakaluk is a professor of philosophy and the director
of Integrative Research at the Institute for the Psychological
Sciences in Arlington, Virginia.