Some Real Issues Surrounding Abortion,
or the Current Practice of Abortion is Unscientific

Philip G. Ney, MD

Copyright 1993, The Journal of Clinical Ethics. May not be copied without the express written permission of JCE jce@clinicalethics.com.

The four conclusions drawn from “Prolonged Grieving after Abortion.” By Douglas Brown, Thomas E. Elkins and David B. Arson, appear to be justified on the basis of clinical observations rather than research. The authors could have made greater used of their clinical observations to elaborate on the deductions since they used no statistical tests of significance. Their observation that guilt is more frequent among women who felt coerced to have an abortion and among those who terminated pregnancies after Roe v. Wade may have a variety of explanations not considered – family size, socioeconomic condition, greater public awareness or support for abortion, and so forth. It seems that the greater the ease of obtaining abortion, the more the coercion.

There is considerable clinical evidence of a wide variety of untoward reactions to abortions. Clinicians must at least inquire about them. I teach residents and medical students to ask patients about all pregnancies, not just about births. More often than not, there is a pause and a flood of tears as women talk about miscarriages, stillbirths, and abortions that have not been properly mourned. Unfortunately, because there is such social prohibition to discussing an abortion, and there are so few physicians who are interested, a large number of women are repressing memories and feelings about their pregnancy termination. The authors suggest that religion either makes a woman more guilty or provides support. Maybe the real issue is whether guilt is a reasonable response to the abortion and needs to be dealt with as such.

This article is much less about post abortion grieving than it is about the objectivity of science and the ethics of publishing. The authors must have muscle spasm from leaning over backwards and very sore mouths from biting their tongues. To say, “We are not taking issue with the generalization, ‘legal abortion of an unwanted pregnancy in the first trimester does not pose a psychological hazard from women’ “ is both false and lame. They are taking issue and should be direct and honest about it.

Truth has never been well accepted in any age. The problem is for scientists and editors to admit bias. Unfortunately, they are aware that if they do, they may not expect to be taken seriously. Everyone pretends to be unbiased or to have controlled for it in research sufficiently well to justify a reasonable physician’s consideration. But so much is a sham. For the authors to state that they could not provide a study of the gold standard – “a randomized, double-blind longitudinal study” – is almost a joke, because: (a) pregnancy is not a disease, (b) one cannot randomize the “treatment” of women by abortion, (c) it is virtually impossible to do any double-blind study.¹

These authors and others who gently attempt to expose the fallacious idea that abortion is therapeutic are like bystanders of the Emperor’s parade. Whispers one to his colleague, “He, look, he doesn’t have any clothes.” The other responds, “Not so loud, we don’t want anyone to think we are different.” Are they being swayed by the hope of being published, or are they afraid of criticism? Would it not be better to shout aloud, “He look everybody, the Emperor is naked.” Even if there is a good possibility of being executed?

When I² or others³ have written something to that effect, there seems to be a general response of “Shut up,” or “Well, so he is; glory be, his is quite naked. But for the utility of the academic games we must play, we will go on pretending he is well robed.” I have played the academic and publishing games with reasonable success. Yet, if I submit an article on a controversial subject with a politically incorrect conclusion, it goes nowhere – no matter how good the science. I thank God for two courageous editors who stuck their necks out for awkward articles I wrote.⁴ They both took their lumps from nasty letters to and about editors for more than one year after publishing these pieces.

We should remember that in the science of medicine, the onus of proof lies with those who perform or support any medical or surgical procedure to show beyond reasonable doubt that the procedure is both safe and therapeutic. There are no proven psychiatric indications for abortion. The best evidence shows abortion is contraindicated in major psychiatric illness. There is no good evidence that abortion is therapeutic for any medical conditions with possible rare exceptions. In fact, there are no proven medical, psychological, or social benefits. Yet, physicians continue to perform abortions in hospitals, paid by scarce medical dollars. If abortion was a drug or any other surgical procedure about which so many doubts have been raised regarding its safety and therapeutic effectiveness, it would have been taken off the market long ago.

The most elementary of studies to show the benefit and safety of abortion have not been attempted, mainly because those who advocate or perform “therapeutic abortions” are so secure in their knowledge that they are politically correct that they do not have to bother. There have been few long-term, follow-up studies, particularly when the indication for the abortion has been noted, and no prospective studies using contrast groups. Obviously, one cannot randomize the treatment in humans, but it could be done with rats. A study of 500 pregnant rats aborting the randomly selected subjects at various stages of their pregnancy could provide a great deal of information about medical and psychological sequelae. I have advocated such a study for many years, particularly because it would give me a chance to study the possible effects on the subsequent parenting of the young. Lest anyone who opposes the present day, unscientific, non-medical use of abortion (an antiabortionist) objects, I hasten to point out that no group that represents them has provided any serious funding for research into the effects of abortion.

So what shall we say of this macabre dance called “therapeutic abortion”? The adolescents I treat tend to be direct and would say, “Abortion is stupid and it stinks.” Put more politely, “Abortion is unscientific medicine and it promotes a bias in what gets published.”

Have we forgotten that no one can benefit at the expense of a neighbor? In any civilization, what is good for man must also be good for woman, if for white then also for black. Otherwise no one really benefits. If this is true, then what is good for the unborn child will be good for the mother. The best evidence indicates that what is destructive to the preborn infant – abortion – is harmful to the mother too.

¹ P.G. Ney, C. Collins, and C Spenser, “Double Blind: Double Talk or Are There Ways to Do Better Research,” Medical Hypothesis 21 (1986): 119-26

² P.G. Ney and A. R. Wickett, “Mental Health and Abortion: Review and Analysis,” Psychiatric Journal of the University of Ottawa 14 (1989): 507-16

³ K. Doane and B.G. Quigley, “Psychiatric Aspects of Therapeutic Abortion,” Canadian Medical Association Journal 125 (1981): 427-32

⁴ P.G. Ney, “Relationship between Child Abuse and Abortion,” Canadian Journal of Psychiatry 24 (1979): 610-19; P.G. Ney, “ Effects of Sexual Congress,” New Zealand Medical Journal 98 (1985): 449