Abortion Law and Professional Boundaries

Abstract

The medical profession’s formative role in the development of abortion law has been acknowledged. A number of the studies to have considered the development of law in the nineteenth century have traced how the emerging profession’s campaigns against abortion advanced its social and economic goals. Analysis of abortion law as a focus for medicine’s professionalisation has not, however, extended into the twentieth century. Consideration of this period generally characterises medicine’s influence as a product of its professional power. Rather than evidence of a static professional status, this article argues that consideration of the first half of the twentieth century reveals how abortion remained the terrain on which the profession actively pursued its occupational ambitions. Further, it highlights how medical responses to abortion changed as the imperatives of professionalisation changed. Employing work that has highlighted the importance of boundaries for enduring social entities, this article recognises abortion as a boundary issue for the profession; that is, a key site where professional jurisdiction is asserted. A dynamic model of the processes of professionalisation, and an identification of the role of abortion in medicine’s professionalisation project, is essential in order to understand the contemporary social and legal reality of abortion.

The 1967 Abortion Act fifty years on: Abortion, medical authority and the law revisited

“…The starting point for this article was the 50 th anniversary of a key piece of legislation -the 1967 Abortion Act -which scholarly work has often presented as a reflection of the interests and dominant social position of the medical profession (Keown, 1998;Thomson, 2013). Sally Macintyre's seminal study conducted at the time of the Act's introduction drew attention to difficulties and tensions regarding the operation of medical authority, considering specifically how 'concepts of health' reflected in the terms of the Act might affect medical 'decision making' and 'professional relationships with society'.…”

“…The central insight to emerge from our research overall concerns the shifting meaning of medical authority and medical professionalism. The legal scholar Michael Thomson (2013), building on Keown's (1998) work on abortion, doctors and the law, encourages us to think of medical professionalism as a process, and consider the importance of boundaries. Abortion can be thought of as a 'boundary issue', he argues, and thinking of abortion this way, 'draws attention to specific sites where professional groups return to defend, assert or extend their interests ' (2013, p.194).…”

Conscientious objection, harm reduction and abortion care

“…Some believe that healthcare professionals should not be able to refuse healthcare on grounds of conscience (Savulescau, 2006;Gallagher et al, 2013: 6;Kelleher, 2010;Fiala and Arthur, 2014) and that CO operates simply as an obstacle to women's access to healthcare (Thomson, 2013). Their argument is that the duty to provide public healthcare requires that providers put their personal views and opinions to one side.…”

Conceptualising Conscientious Objection as Resistance

“…As a community of actors with an ostensible shared purpose and claims to expert knowledge, medical practitioners as a group are able to influence both public perceptions of medical treatment, as well as specific laws concerning medical practice. Again, using the example of the nineteenth century, doctors as an epistemic community were instrumental in the restriction of access to abortion in the UK and the increase in criminal sanctions for performing the procedure 49 . In turn, doctors were consulted and actively involved in the reframing of abortion in the twentieth century as an issue about the healing of women, and the permissibility of abortion for therapeutic reasons 50 .…”