Evidence showing ‘no mental health benefit to abortion’ cannot be ignored

Column: Those who believe abortion should be available in Ireland are ignoring scientific evidence in favour of faith-based dogma

It does not matter if you set up panels with six doctors, or 600: there is no mental health benefit to abortion. Photograph: Alan Betson/The Irish Times

It does not matter if you set up panels with six doctors, or 600: there is no mental health benefit to abortion. Photograph: Alan Betson/The Irish Times

Thu, Aug 1, 2013, 12:36

Christians and other believers are often derided for believing in a God or gods on faith alone.

However, thoughtful believers say they make a leap of faith based on a reasonable, though not definitive, level of proof. They don’t endorse blind faith or dogma that flies in the face of evidence, a stance they consider to be fideism, not faith. Those who operate on faith alone are what most of us call fundamentalists.

Scientists and rationalists pride themselves on avoiding faith-based dogma by strenuously adhering only to empirical evidence.

Yet we have the extraordinary situation where people who believe that abortion should be available in Ireland are ignoring the best available scientific evidence, in favour of a faith-based dogma that abortion is somehow good for women when they are in crisis.

Doctors have a professional duty to practise evidence-based medicine. You cannot invent a new treatment and test it on unsuspecting women because you have a hunch that it might be good for them, particularly when research shows there is no benefit at all, and some risk of harm.

Shift goalposts
In recent times, we have seen prominent psychiatrists shift the goalposts. Confronted with scientific evidence that abortion has no mental health benefits, they have decided that there is a category of women who are not mentally ill, but who are suicidal because they are pregnant. Removing the pregnancy will remove the desire to die by suicide, they declare. Among the analogies they have used are people who are suicidal because they are in mortgage arrears and who will no longer be suicidal if they find out that they can keep their home. Or a farmer, suicidal because he is about to lose his herd, who will have renewed mental health if he finds that his herd is not diseased after all.

Heartwarming scenarios, but none involves taking life. In fact, none of them has any downside at all. And I presume no psychiatrist would say to the patient in arrears or whose herd is to be put down that there is no hope, and they should just proceed with their plans? I don’t want to be flippant about pressing problems people have, but many people in arrears feel like shooting the bank manager.

To date, no psychiatrist has endorsed that “solution”, to my knowledge, but when the solution is to eliminate the child before birth, it is somehow acceptable and humane? You could only contemplate that terminal “solution” if you reject the unborn child’s right to life, and if you refuse to accept that doing something as irrevocable as taking her child’s life could also have a severe impact on a woman’s mental health. But people acting on faith do not need to provide evidence that abortion helps. They just know.

The evidence these doctors are choosing to ignore is found in the peer-reviewed study by David Fergusson and others in the Australian and New Zealand Journal of Psychiatry this month. Fergusson is pro-choice and believes abortion should be available on social or economic grounds. However, he and others decided to examine the research in order to ascertain whether there were any mental health benefits to abortion. The findings are stark: “at the present time there is no credible scientific evidence demonstrating that abortion has mental health benefits”.

The authors say this creates “an urgent need to revisit both clinical practice and the law in those jurisdictions in which mental health grounds are the principal criteria for recommending and authorising abortion”. They recognise that this new evidence is likely to “resurrect politically uncomfortable and socially divisive debates”. “However, it is our view that the growing evidence suggesting that abortion does not have therapeutic benefits cannot be ignored indefinitely, and it is unacceptable for clinicians to authorise large numbers of abortions on grounds for which there is, currently, no scientific evidence.”

Suicidal ideation
We in Ireland, who have avoided the trap of legislating on grounds such as suicidal ideation, are about to do so just as conclusive evidence emerges that there is no mental health justification for abortion. In fact, there are small to moderate increases in issues such as depression, anxiety and suicidal ideation after abortion.

It does not matter if you set up panels with six doctors, or 600: there is no mental health benefit to abortion, and suicidal intent should never be a ground for permitting abortion. Will politicians be able to let go of the “there is no alternative” (Tina) and psychiatrists in favour of abortion be able to let go of their blind faith that this will benefit women and join their 113 colleagues who accept the evidence that it won’t? For the sake of the mental health of women, and the survival of unborn children, let us fervently hope they can.