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Abortion

Volume 986: debated on Friday 20 June 1980

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asked the Secretary of State for Social Services what is his policy on the participation by nurses or midwives in the termination of pregnancies by monitoring and controlling under the supervision of a registered medical practitioner the administration of abortifacient drugs.

Since the question relates to both England and Wales and Scotland, I have consulted my right hon. Friends the Secretaries of State for Scotland and Wales and it is our understanding, based on the advice of my right hon. and learned Friends the Law Officers of the Crown, that nurses and midwives may participate in the termination of pregnancies where that participation includes the monitoring and control, under proper supervision by a registered medical practitioner, of the administration of abortifacient drugs.We understand that this view is taken after careful consideration of the whole of the Abortion Act 1967, section 1 of which provides in certain circumstances a defence in respect of an offence under the law relating to abortion. I can best summarise that advice as follows.The defence is provided to "a person" and clearly this is intended to cover more than just the registered medical practitioner. It would certainly require to cover the patient whose pregnancy is terminated, and I am advised that it would cover a nurse or midwife or other person participating in the treatment. This is obviously envisaged in section 4 of the Act which says that

"no person shall be under any duty … to participate in any treatment authorised by this Act".

There is a clear distinction between the participation in treatment (which is the termination of pregnancy) and the actual termination by a specified person i.e. a registered medical practitioner, and Parliament envisaged that there would be persons other than the registered medical practitioner who would be involved in the process of termination of pregnancy. In other words, a termination does not cease to be by a registered medical practitioner because another person participates in it.

At the time when the Bill which became the 1967 Act was proceeding through its Parliamentary stages, the methods generally adopted for termination of pregnancy were surgical procedures that took place in the operating theatre where the role of the nurse is as one of the theatre team. In these circumstances it would have been inconsistent with the usual operating theatre procedures to terminate a pregnancy without the active participation of a nurse.

In the procedure in question, the doctor is no less the principal participant in that the treatment for the termination is initiated by him and throughout the treatment he remains responsible for its overall conduct and control. The role of the nurse or midwife is of the sort in which nurses frequently engage under a doctor's direction in other spheres of clinical work.

We are advised that to interpret the words

"terminated by a registered medical practitioner "

in a way which would preclude the participation of nurses or midwives or other members of the clinical team in the manner described would be to produce an unreasonable result which would be at variance with the intention of Parliament in passing the 1967 Act.