Abortion: why we must think again

Women now have complete freedom to choose whether to continue a pregnancy. But society should not tolerate the consequences

Partial birth abortion involves withdrawing the foetus until only the head remains inside, then piercing the skull and sucking the brains out until the head collapses. It is routinely used in America, but it is not known how often it happens in this country. A recent Parliamentary question from David Alton failed to elicit a figure from the Department of Health. Meanwhile, more than 50 MPs have signed an Early Day Motion, promoted by the Tory Elizabeth Peacock, attacking the practice.

Of course, the more familiar suction method of abortion - in which the foetus emerges in pieces which have to be counted to ensure nothing has been left behind - might be said to be just as horrific as partial birth. Either way a human body is butchered by the doctors.

So maybe Mrs Peacock's motion is irrelevant to the abortion debate. The details of abortion are always going to be nasty and they only add an emotional layer to an ethical argument already clouded, especially in the US, by irrational and occasionally lethal outbursts. Pro-lifers in this country are not so fierce and, as a result, most people probably think the abortion debate is an issue of the past.

This is a big mistake. The real abortion debate has yet to begin. It is now almost 30 years since abortion was legalised and things have gone badly wrong.

There are now 184,000 terminations annually in this country and 98 per cent of them are done for social reasons. Abortion is in effect available on demand - something that was specifically not intended by Parliament - and even the clause that allowed a social justification was added only as an afterthought during the bill's progress. Furthermore, subsequent legislation, although reducing the legal limit on foetal age from 28 to 24 weeks, also made later abortions legal in cases of handicap. But, since handicap was not defined, almost any disorder, however mild, can now be used as a justification.

So it is evident that, because of the way legislation has been framed, a huge gap has opened up between the pro-choice rhetoric of the Sixties and the actual practice of abortion. Abortion is available on demand when it was never intended to be and the hard cases - rape, incest and disability - which were used to convince people of the justice of the cause now only account for 2 per cent of terminations.

Maybe, even in the light of these facts, Parliament does not want to return to these difficult matters. But, sadly for quietist MPs, developments are likely to make things worse.

First there is the matter of foetal suffering. Today a pro-life group of MPs, which includes Mrs Peacock, is to issue a report based on medical evidence - notably from Professor Nicholas Fisk at Queen Charlotte's Hospital in London - that strongly suggests that the foetus feels the pain of abortion. This raises a serious moral challenge to pro-choicers. It means, if true, that the foetus is not a mere piece of the mother, but a sentient being. The element of innocent pain enters the abortion calculus.

Secondly, we are at the start of an era in which there will be more reasons than ever to abort. The expanding science of genetics is transforming our ability to diagnose pre-natally. Assuming, as is likely, cheap and safe methods of isolating foetal cells are found, then, by reading the DNA, we shall soon be able to provide a bewildering array of forecasts about our child's future.

We can already know, for example, if the foetus carries any of the 4,000 rare but often disastrous single-gene disorders, such as cystic fibrosis, muscular dystrophy or Huntingdon's chorea. The next stage - on which billions of pounds of research funds are being spent - is to identify the genes involved in the more common polygenic disorders. These may include heart disease, cancer, schizophrenia and manic depression. And they may also include conditions we might not regard as disorders at all - a predisposition to homosexuality, shortness or even a tendency to criminal behaviour.

Huge problems arise with these kind of diagnoses. They will often, for example, be presented in statistical terms - your child has an X per cent chance of being schizophrenic or having a heart attack by the age of 40. Do you abort and try for something better? They will also create a new category of illness, in which people who are perfectly healthy at the moment might be considered to be diseased because of their genetic make- up. But the most serious problem is that the only treatment doctors can offer for most genetic disorders is abortion.

Pre-natal testing is all about abortion. Geneticists may argue that knowing you are predisposed to heart disease gives you vital information which will encourage you to modify your lifestyle. But such testing can be done after birth. Testing before birth is just a way of leaving the abortion option open.

This will continue to be the case for the foreseeable future. In spite of the deluge of stories about scientists finding the genes for disease or behavioural abnormalities - happiness was the latest - the reality is that there is, as yet, no sure route from the gene to treatment. Nobody can yet be said with certainty to have been cured by gene therapy and devising new drugs on the basis of genetic insights is a slow process that will not necessarily be successful. Furthermore, there is intense controversy over whether genes are the whole story. The idea of genes "for" something may yet prove far too simple an approach to have any medical relevance.

The one certainty is that pre-natal testing and genetic information will increase rapidly in the next decade and the one sure treatment - abortion - will ever more frequently be applied. The handicap clause on our legislation may be invoked not just to cover muscular dystrophy but also predisposition to heart disease or even potential for criminality. By then it should be absolutely clear that our legal framework is largely meaningless.

Of course, hard pro-choicers will still say parental freedom must be protected - an unwanted child is a worse crime than abortion and reproductive decisions are too intimate for the state to get involved. But more lucid thinkers will see that society has an interest in its future and cannot simply stand by while an avalanche of technology, much based on highly speculative science, promotes fundamental changes in our social structures. Mrs Peacock is right to try and stimulate the "yuk" response in her fellow MPs. Abortion is the issue of the future, not the past.