Colin Steer | Abortion debate rewind
Below is an edited version of an article published February 17, 2008, which attempted to put in context proposals to amend Jamaica's abortion laws and the opposition to such a move. Ten years later, we have circled back to where we were in 2008 and even earlier in 1975.
The resurgent controversy over abortion is anchored in three broad sets of concerns: the morality and ethics of terminating pregnancies (at any stage), public-health issues and considerations of the rights that a woman should have over what happens in her body.
Various spokespersons from Christian groups have articulated a strong moral conviction against the legalising of what they term 'abortion-on-demand', reflecting the widely held view of many Jamaicans. This descriptor does not, however, accurately represent the recommendations of the Abortion Policy Review Advisory Group as outlined in the report submitted to the Ministry of Health, and subsequently to Parliament.
A bit of background provides the context in which this issue resurfaced. In January 1975, then Minister of Health Dr Kenneth McNeill tabled a ministry paper outlining the government of the day's policy position on abortion and the context in which it was felt that the law relating to the termination of pregnancies needed to be clarified and amended.
Under Jamaican statute (then and now), it is a criminal offence for anyone to procure an unlawful abortion. Sections 65 and 66 of the Offences Against the Person Act lay down a maximum penalty of life imprisonment for the offence. The statute also provides a maximum penalty of three years' imprisonment for anyone who assists in the procuring of an unlawful abortion.
McNeill noted that the common-law position (that is, one which derives its authority from 'universal consent' based on precedent instead of statute) was that it was lawful for a registered medical practitioner, acting in good faith, to take steps to terminate the pregnancy of any woman if the doctor believed that the continuation of the pregnancy was likely to constitute a threat to her life or have an adverse effect on her mental and physical health.
The Government at the time said that after careful consideration, it would take steps to amend the relevant sections of the Offences Against the Person Act to make it clear when an abortion would be lawful in Jamaica. The intention was to have the common-law position clearly spelt out in new legislation. It also proposed that steps be taken to make rape, carnal abuse and incest lawful grounds for abortion. Strong opposition, however, resulted in no legislative change flowing from that ministry paper.
In subsequent years, medical personnel in public-health facilities continued to report a high incidence of botched abortions and complications, prompting a renewal of the call to re-examine the entire legal framework within which doctors are expected to operate. Also, medical personnel from the Victoria Jubilee (VJH) and Cornwall Regional hospitals have tabulated data of women - many of them teenagers - turning up at the facilities with complications arising from "incomplete abortions" each year. According to the advisory group, as many as 641 patients were admitted to the VJH, which deals with abortions and their complications, between March 1 and August 31, 2005.
Against the background of these concerns, the Abortion Policy Review Advisory Group was established by a former health minister, John Junor, and had its first meeting in September 2005. The group was also set up against the background of the Ministry of Health's stated objective of reducing maternal deaths in Jamaica by 75 per cent by the year 2015. This would be in keeping with the Millennium Development Goal for improving maternal health.
Among the objectives the advisory group cited were:
1. To articulate a policy for the provision of safe reproductive health services in Jamaica with special emphasis on safe abortions;
2. To draft recommended amendments to the existing Offences Against the Person Act in support of termination of pregnancy for medical and humanitarian reasons, e.g., statutory rape.
A cover letter accompanying the draft report dated February 10, 2007, addressed to then Minister of Health Horace Dalley, and chairperson of the advisory group, Dr Wynante Patterson (now deceased), referred to the Government's commitment to public consultation and of her group's taking steps to help in that process. Among the group's recommendations were the repeal of the relevant sections of the Offences Against the Person Act to be replaced with a Termination of Pregnancy Act stating conditions under which medical termination of pregnancy would be lawful.
They also said that the Government should develop, maintain and staff specified centres in each health region for the provision of therapeutic abortions. Pregnancies over 12 weeks' gestation should be performed only by authorised medical practitioners and in registered facilities; pregnancies over 22 weeks' gestation were not recommended, except under exceptional circumstances agreed by the woman and two authorised medical practitioners.
In her letter, Patterson noted that not all members of the advisory group had signed off on the draft report. Among those who did not sign were Methodist minister, the Rev Phillip Robinson, who was president of the Jamaica Council of Churches at the time, and Sheila Jones, representing the Nursing Council of Jamaica. The Nursing Council representative reiterated its position of supporting abortion only in instances of a threat to the life of the mother, incest and rape. This was attached to the advisory group's report.
Rev Robinson said he had not been able to have sufficient consultation with the wider church community - apart from a meeting called at short notice and attended only by representatives of the Roman Catholics and Ethiopian Orthodox Church, and so did not consider it appropriate to sign the document at the time.
He also noted that medical personnel were largely guided in the deliberations by the reports they were getting from within their profession about the number of botched abortions. "But they did give consideration to wider ethical perspectives and concerns," Rev Robinson said. He added that he was not of the opinion that the advisory group was recommending abortion-on-demand.
Beryl Weir, a member the advisory group and director of the Women's Centre Foundation of Jamaica, also said there had been vigorous discussion among members of the group taking into account the law as it existed in Jamaica and elsewhere, considerations of ethics, and conscience, as well as social realities that obtained in Jamaica.
She stressed that the matter of counselling was highly recommended for persons who might be seeking an abortion, given the experience of professionals working with women who may have been traumatised by the circumstances of their getting pregnant.
"It is inaccurate to suggest that we were recommending abortion-on-demand," she said. "In fact, in my experience at the Women's Centre, often after the girls are counselled, they indicate that they do not want to have an abortion. And the counselling aspect is strongly advocated in the draft report. The next step is to get them into a programme that will allow them to have their babies while continuing their education. However, it is also a fact that many women are very clear that they do not want to carry the pregnancy to full term and will have an abortion by whatever means."
She said the challenge for the public-health system was that in the absence of proper facilities, women resort to various risky back-door methods that often later end up as serious public-health issues.
However, for many Christians, neither rape (including statutory abuse of a minor) nor incest is good enough reason for the termination of a pregnancy. The argument goes that just because a man has committed a crime against a woman, that is no good reason for her to commit one herself by taking a life. Activists for women's rights have rejected this position, saying that essentially, the woman is being forced to be a container for a foetus, even in cases where she herself was an unwilling victim.