THE EDITOR, Sir:

I have been following the abortion debate since January of last year, and whatever decision is made by Parliament, the debate will continue ad infinitum. There were several recommendations made by the Abortion Policy Review Advisory Group (APRAG).

The main recommendations were:

a) Repeal the Offences Against the Person Act and substitute it with the Termination of Pregnancy Act, stating the conditions under which medical termination of pregnancy would be lawful.

b) Develop, train, register staff and maintain specified centres for the provision of therapeutic abortions.

c) Assess, register and monitor doctors' offices for the provision of abortion services.

Let us examine these recommendations.

1) The Offences Against the Person Act is too archaic and I agree that it should be repealed. I do not have any objections to it being called the Termination of Pregnancy Act, but I do not have a problem with the phrase that says, "stating the conditions under which medication termination would be lawful." The lawful conditions would be for incest, rape, the mentally challenged and life-threatening medical conditions. This addresses only a small minority of women, but the majority of women will seek and will continue to seek an abortion for socioeconomic reasons, whether it is legal or illegal. If you make it legal right across the board, it then becomes abortion on demand and will become another means of birth control. If you make it illegal, then abortion will continue to be performed in secret and the situation will remain as it currently exists.

2) Complications from doing an abortion are well known and do put a strain on the country's health budget. With the advent of the use of the drug Cytotec, I have seen a decline in serious complications related to abortions, as doctors are more reluctant to intervene with instrumentation, which carries a higher risk of these complications. The drug is not only administered and prescribed by doctors, but is also recommended by some pharmacists and health personnel.

Bottom of the list

3) Although abortion is cited as the eighth leading cause of maternal mortality in Jamaica, it is really at the bottom of the list. When you examine the absolute numbers, this varies from 0-3 deaths each year.

4) The specified centres to be developed may pose a problem in recruiting staff, as doctors and nurses do have rights to conscientious objection.

Whether we like it or not, abortion is here to stay. My recommendation is to amend the act substituting life imprisonment with a heavy fine. Those special or 'hard cases' should only be dealt with by an emergency unit in the Ministry of Health after careful medical and legal consultations. Making it legal or partially lawful does not get to the root of the problem, which is a breakdown in our social and moral values. More and more of our young men and women are engaging in sexual activity and this leads to many unwanted pregnancies. If only we could stop promoting sex through the printed and electronic media and through the lyrics of the dancehall culture. The moral values of our young people have been destroyed by a steady diet of pornography in our newspapers and on the cable network. We need to address this problem! After all, if you reduce the number of unwanted pregnancies, you will reduce the number of abortions.

I am, etc.,

CLIVE LAI (DR)

Gynaecologist

Concerned Christian Doctor

Mandeville