Jesús Valentino: 26 October - 10 November, 2014
Emma Gilkison
The following is an edited version of the tribute given by Jesús’ mother Emma at his funeral.
My darling baby boy, the first time I saw your heart you were just eleven weeks and five days old. It twinkled like a star above your chest on the scan screen. I read that day about ectopia cordis, a condition affecting eight in one million babies, whose hearts grow outside of their chests. You were one of them.
We searched for a way that your life might be saved through surgery, prayed that might be possible. Sadly, the list of problems affecting your heart was too long for any surgeon to attempt to fix. By then you were almost five months old and making your presence felt with little drum beats inside me. Would we continue the pregnancy and bring you to full term even though you would die shortly afterwards? We - your Mum and Dad - had to look deep into our hearts. I realised the longer we had with you, the greater the opportunity we’d have to love and cherish your living presence. And so it was decided.
As you continued to grow, some very special people came into our lives to offer us wisdom. Father James told us the story of Saint Cristopher who saved the life of a baby by carrying him on his back across a dangerously flooded river. Only as he crossed the river, Saint Cristopher realised it was the baby who was saving his life by giving him the courage and determination to get to the other side. Once safely on land, the baby, who was really the Christ child, disappeared. I told Camilla, a practitioner of Nichiren Daishonin Buddhism, I wanted to do my best for my baby and give him all the love I could. Camilla replied that was exactly what my baby would want to do for me. In the Buddhist tradition he was my Bodhisattva or agent for enlightenment. This was another wonderful idea to contemplate while you were getting bigger by the day. I loved carrying you inside me and felt like all your kicks and turns and taps and tickles were like a secret conversation between us. I was so proud when every scan showed how active you were, and your measurements placed you at the top of the growth charts. I have a hunch you orchestrated things so that I felt in good health and happy in spirit throughout my pregnancy.
My darling, I thought I was head over heels in love with you even before you were born, but nothing could prepare me for the joy of seeing your face and gazing into your beautiful eyes. They looked like glowing black pearls, tiny planets from a far off universe. You were baptized straight after you were born, not long after dawn, and I remember flames in the room, although that could have been the drugs they gave me for pain relief.
I had not imagined anything beyond your birth, yet here you were, a bonny baby, doing the normal things that babies do. My darling how can I thank you enough for staying on earth long enough for us to become properly acquainted? We were told your heart was unlikely to beat for even one day. We had fifteen and a half days with you. So I got to know your sweet ways and your gentle, considerate nature. You showed your amateur parents what you needed through patient repetition of expressions and sounds. You were also very brave.
A week after you were born, we took to you to the Soka Gakkai Buddhist centre, then Sunday mass, and the next weekend we sat beside Suzanne Aubert’s grave while you drank from your bottle. There were many things said about your life by many people and perhaps there is truth in all the interpretations of your life, and yet the mystery of your soul remains. My darling baby JV, you have packed so much value into your life in and outside of the womb. Broadcaster John Campbell sent you a text:
‘JV you are remarkable. And the fact you don’t even know how remarkable you are makes you all the more remarkable – because this is a time when the least meritorious trumpet their own virtues as if they were real. To live beautifully, bravely, both inspiring love and surrounded by it too, and not to be made vain or pompous or self-satisfied by it, that makes you very special indeed. That makes you a gift. And every moment you stay is a moment more in which you remind us all that what matters most in life is how you make people feel. And you make people feel love. Which is the coolest thing there is, JV.’
My sweet baby Jesús Valentino, I miss you terribly and wish to have you awake in my arms again. But I promise I’ll do my best to keep my heart open and not get lost in the pain. I will keep loving you forever. I will always be your mother and you will always be my son. I look forward to seeing you again precious son.
Emma Gilkison is a communications advisor who lives in Hataitai, Wellington with her partner, Roy Costilla who is completing a PhD at Victoria University. Jesús Valentino was their first baby.
Abortion, feminism and disability
Robyn Hunt
As a human rights practitioner, and a former human rights commissioner I clearly understand the status of the unborn child in human rights law. My standpoint is that of human rights, and in particular disability rights, as codified in the CRPD (the United Nations Convention on the Rights of Persons with Disabilities). New Zealand played a major role in developing this human rights standard and ratified it in 2008.
There are disability issues around abortion that make it a very difficult and nuanced issue for disabled feminists. For many feminists this is a really clear cut issue. For us, not so much.
Abortion is not a simple issue of choice for disabled women, especially given that for many of us our choices are more constrained than those of non-disabled women. Many disabled women do not have control over their own bodies, never mind their reproduction and sexuality. For example, over generations thousands of disabled and other “undesirable” women all over the world have been sterilised without their consent and disabled women are still sometimes sterilised without their consent.
As a disabled, feminist, prospective mother I had to contemplate whether or not any children I might bear would share my impairment. I didn’t know. It was a leap in the dark. But I had decided that my life was very much worth living and so would theirs be. That is a critical part of the issue: Whose lives are worth living?
There are a number of threads to this issue for us, but they are rarely explored in an environment where we feel safe enough to honestly discuss our concerns about some of the implications. The ‘caring’, disability support, and health professions are well populated with women, yet it is paradoxical that disabled women’s voices struggle to be heard and attended to on this and other issues that are important to us.
Eleanor Lisney, Sisters of Frida (a disabled women’s cooperative), described this struggle: “In the discourse of feminism, disabled people are seldom included … Disabled people are often seen as a ‘burden’ on the feminist from before birth to the older parent often portrayed as with dementia. The decision of aborting a disabled child is seen to be totally understandable, disabled people need caring for – usually by low paid or unpaid carers where women sacrifice themselves as carers.”
Disability is often seen as a ‘fate worse than death’. It arouses a fear of what is unknown and not understood and carries social stigma as well as social and medical pressures.
Questioning whose lives are worth living led to the ‘hidden holocaust’of World War II where over 200,000 disabled people were exterminated; this holocaust began with a German father asking the Nazi regime to kill his infant son. This was the logical culmination of the eugenics movement. But eugenics did not disappear with the end of that regime; it is still alive and well and living in New Zealand in the form of pre-natal testing which leads to some babies not being born because of their ‘abnormalities’. Would we tolerate birth selection on the grounds of race or gender? I hope not.
The crunch point for me is contained in the phrase ‘bearing a child she doesn't want’. How is that ‘doesn't want’ constructed? Is it because she is afraid and faces negative social and medical pressure? Is it because support services are woefully inadequate in some cases, and parents of disabled children can be isolated and unsupported?
And is this because of society’s fear of disability, and the eugenicist move to eliminate certain impairment groups? Is the mother afraid of social and economic sanctions if she goes ahead with the pregnancy?
However, many impairments are not detectable before birth and even when a child is born “perfect,” they may not stay that way. What then? Medical and other science may not always be able to cure, and not everybody wants to be fixed, and while there are ways of ameliorating conditions that were unheard of even a generation ago, an accident or illness can result in lifelong impairment. Imperfection and impairment are part of who we are as humans.
Abortion should not be used as a tool for eugenics. Disability cannot be eliminated this way. Disability is part of the human condition. Just think about the message this gives to people already living with the impairment – it says you are of no value – your life is worthless and your birth should have been prevented. They might be living lives they see as definitely worth living, not a fate worse than death. I have witnessed this very direct pain in people I know.
Abortion on the grounds of disability devalues disabled lives.
Robyn Hunt, ONZM, is a former Human Rights Commissioner, Disability leader and activist, writer, and a founder of Not Dead Yet Aotearoa (New Zealand).
This piece is based on an address given by the author to the Abortion Law Reform Association of New Zealand.
Submission to ACART on Informed Consent and Assisted Reproductive Technology
Introductory Comments
Our approach to the moral/ethical issues associated with the use of assisted human reproductive technologies is based on a number of beliefs. Of those that are particularly relevant to this Consultation Document unconditional respect for human life at all stages of its development is the most important. Catholic teaching holds that without exception the living embryo has, from the moment of fertilisation, an absolute right to life. A unique human life is begun - it is already the human being it will always be and will only grow in size and complexity. On that basis all embryos are entitled to be treated with the same respect as persons.
Secondly, whatever people believe about the acceptability of IVF, a clear moral distinction exists between homologous IVF (where the gametes are sourced from both partners within the relationship) and heterologous IVF (where one or both gametes are sourced outside of the commissioning couple). This distinction rests on the fact that homologous IVF conserves the natural links between parenthood, family and genetic origins. Our sense of personal well-being is linked with a healthy self-identity, something that is intimately tied in with a lived knowledge of our biological ties. On this basis we believe that children have the right to grow up within the family networks that are generated by our biological ties. This right should only ever be compromised in situations where it is clearly in the interests of the child involved.
In previous ACART Discussion documents we have recognised and complimented ACART on the fact that there were real attempts to consider the ethical issues from a perspective that actively considers the rights and well-being of the child that is to be conceived. However, we are disappointed to note that, apart from Appendix 2, the term “potential offspring” arises only once in this document. While this might be understandable given the document’s specific focus on “informed consent”, in our view it highlights the serious short-comings of an “informed consent” approach for dealing with the ethical issues associated with the use of human assisted reproductive technologies. As we have previously stated: “An over emphasis on the sufficiency of individual informed consent … reflects a failure to acknowledge the wider impact of technological interventions.”
Issues:
- Access to information that must be disclosed to patients and donors prior to consent: We note that the Code of Health and Disability Consumers’ Rights upholds the right to be fully informed. We further believe that information provided to couples using heterologous IVF should summarise research on the importance of biological connections for the well-being of potential offspring.
- Form of consent: We agree with the arguments set out in the document supporting the need for consent to be in writing.
- Donor consent to use gametes or embryos for training purposes: We support the need to obtain consent from donors for the use of gametes or embryos for training purposes, as is consistent with Right 6 of the Code of Health and Disability Consumers’ Rights.
- Placing conditions on donor consent: We support donors’ rights to place conditions on their consent. We consider that gamete and embryo donations are different from blood or organ donations because they create on-going relationships. However, we agree that gamete or embryo donors should not have the right to limit the decisions of prospective parents after an embryo has been created, or after a donated embryo has been transferred to a uterus.
- Ongoing information for donors on the use of their gametes: We agree that gamete donors should be given the option of receiving ongoing information if the gamete is about to be used and on the outcome of the donation. Our status as relational beings demands respect for the genetic, gestational and social dimensions of human procreation. Providing on-going information to donors is consistent with the relational responsibilities that flow from human procreation and, in the situation where an embryo has been created from donated gametes, provides the best chance of maximising the possibilities of an on-going relationship between the potential offspring and their biological parent. While the law in New Zealand does not permit anonymous donation, it strikes us that information relating to a child’s biological origins still depends to a significant extent on the attitudes and willingness of the adults involved in the process.
- Withdrawal or variation of consent by donors: We agree that donors should be able to withdraw or vary consent to the use of their gametes up to the point of fertilisation.
- Consent of a partner, family or whānau to donation or use of donor gametes: We do not agree that the consent of partners should not be required. A spousal type relationship is based on a high level of trust and intimacy. In addition, it is of the essence of such relationships that they have a parental dimension. Direct involvement in parenting a child outside of such a relationship without disclosing it to one’s spouse/partner is arguably a violation of the trust, as well as the sense of exclusivity, that lies at the core of any permanent couple relationship – it has the potential to destabilise such a relationship, including commitments to any children that a donor might already have with her or his partner or might have in the future. We consider that although consent of family or whānau to the donation or use of a donor’s gametes should not be required, it is best, in the interests of transparency and relational integrity, that individuals be encouraged to consult their family or whānau (as happens generally with whāngai arrangements, for example). However, we do not think this should be mandatory.
- Couple disputes about the future use of embryos: We agree there should be a ‘cooling off’ period of twelve months where one party in a couple disputes the future use of embryos that have been created for them. We reiterate our belief that embryos have their own ‘intrinsic’ dignity which exists independently of the wishes and desires of any related adults and that giving time to resolve any dispute is consistent with this dignity. It is our hope that adults would have access to counselling in this situation and that counselling would include presenting a case in favour of life from the perspective of the embryo. We do not agree that if the couple cannot resolve the dispute in that time, the embryos should be disposed of. Allowing embryos to die if the dispute cannot not be resolved effectively gives power of veto to the non-consenting party, while ethically the rights of both parties should carry equal weight. We suggest that in these cases the existing 10 year storage limitation period set out in the HART Act should apply. Framing conflicts about the future of embryos in terms of whose interests should prevail – whether the male partner or the female partner – inevitably takes couples into a legal and therefore adversarial forum. We need to avoid an adversarial approach to conflicts over embryos because they are effectively based on (patriarchal) assumptions of ‘ownership’. A non-patriarchal and more child-centred approach is premised on the idea that parents have responsibilities towards their offspring, including embryos, rather than rights over them. A responsibility-based approach is more likely to bring about a satisfactory resolution without, even unwittingly, reinforcing the ‘ownership’ paradigm wherein the rights and dignity of embryos are too easily lost to view. We further suggest that all couples need to be counselled about the possibility of such a conflict occurring before they consent to any procedures that will result in the creation of embryos.
- Form of requirements for informed consent: We agree that the requirements for informed consent should be set out in regulations.
- Final comments: We are concerned about the language used, specifically the reference to embryos being “disposed of”. In general parlance we dispose of ‘things’ – usually things that have no value to us and that are seen as ‘rubbish’. The presence of this language in the Consultation Document highlights for us one of the dangers inherent in the use of assisted reproductive technologies; replacing what is a very human and personal act (the conjugal act) with one that is of a more technical nature (IVF), no matter the motivation behind such a decision, means that the risk of commodification lies but a small step away. While not a step that is logically necessary, it can be a step we take without realising it. This step is often revealed by the language we find ourselves slipping into, including terms such as ‘dispose’. The presence of this language in the Consultation Document is further evidence of a lack of awareness in practice of the rights of any “potential offspring”, as was highlighted in our introductory remarks.
Staff of The Nathaniel Centre
Bioethics in the News A brief introduction to two recent developments in bio-technology – gene or genome editing and Non-invasive Prenatal Testing.
Gene or Genome Editing
While gene editing technologies have been around for several years, a new technique has recently been developed that is cheaper and more efficient than earlier technologies. Known as CRISPR-Cas9, this technique enables faulty sections of DNA to be located, then ‘cut’ out and either replaced with a healthy copy or inactivated. Gene editing could in future be used to treat single gene inherited conditions, such as cystic fibrosis and sickle cell anaemia, and in the treatment of diseases such as HIV and cancer. It also has the potential to be used with crops, for example to develop disease resistance or to increase crop yields that use less water, and in livestock to improve certain advantageous traits.
Recently it was reported that scientists in China had edited the genomes of human embryos, and earlier this year researchers in the United Kingdom were given permission to modify human embryos in order to better understand the causes of miscarriages. However, there is some disquiet about the use of these techniques for humans. Apart from concerns regarding the unknown effects of germline modification on later generations, there is concern that gene editing will be used to ‘enhance’ humans. Scientists and bioethicists are debating whether or not there should be some moratorium on human gene modification until safety issues are resolved, and there has been a thorough examination of the broader social and ethical issues concerning human ‘enhancement’, such as ableism and disability, as well as economic and health inequalities.
In 2000 the New Zealand Catholic Bishops noted in their submission to the Royal Commission on Genetic Modification that human dignity must be ordered to the integral good of the human person as well as respecting the integrity of other species and of all creation. They specifically noted that they did “not see the technology of genetic modification to be in conflict with ethical values“ so long as “safety issues are resolved within acceptable limits of risk.” These limits include proper respect for the innate dignity of human life which excludes all forms of destructive research involving human embryos.
Non-invasive Prenatal Testing
While prenatal screening is currently available in New Zealand, the development overseas of a maternal blood test known as NIPT (non-invasive prenatal testing) that can more accurately detect some foetal chromosomal abnormalities has raised the issue of whether it should be publicly funded in New Zealand (it is currently available privately for payment). NIPT is able to analyse the small amount of cell-free DNA in maternal blood that comes from the placenta, and which mostly (98% of cases) matches the DNA of the foetus. This has meant that a blood sample taken from the mother can be analysed for the presence of certain chromosomal abnormalities, which include trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome).
The test is a screening test, not a diagnostic test, as it indicates only the probability of a trisomy pregnancy and a follow-up invasive test is still required to confirm results. It also has certain limitations: It was originally validated on a population of high-risk women so the sensitivity of the test on the low-risk population is unknown. For this reason it is usually offered only to women who are in the ‘high risk’ group. It is also known to be less accurate when maternal weight is high and its accuracy in multiple gestation pregnancies is unknown. The ease of use and safety of non-invasive testing is likely to lead to increased requests for testing and potentially the provision of free national screening. Because there is no ‘cure’ for these conditions, the reasons for informing mothers are to either enable them to begin to adjust to and make plans for living with a child with a disability, or for eugenic purposes, that is to enable them to seek a termination of the pregnancy.
The very availability and use of such screening carries an implicit message that raising a child with a disability is a burden both on the family and society, one that can be avoided. In France, the United Kingdom, Spain and Italy, between 90 and 95 percent of foetuses affected by Down syndrome, detected using current prenatal diagnostic techniques, are aborted. One of the consequences of the increasing use of pre-natal testing is that it introduces ‘eugenics’ by stealth, that is, without a proper debate taking place about the desirability or ethics of preventing the birth of babies with certain detectable conditions.
Reflections on Post Abortion Care
Dawn de Witt
Beginnings
Around 2000 I joined a small group of women to explore the merits of the Victims of Choice post abortion recovery programme from the United States. At the time, it struck me that I had very little knowledge of abortion issues despite my professional studies. In New Zealand, a termination of pregnancy is available through the public health system and is promoted as a safe medical option for those who do not wish to continue a pregnancy to term. The experience of the group was that there existed a real need for healing and reconciliation after abortion - and we wanted to make that possible.
The literature confounds
My interest in the issue prompted me to do a literature survey. This opened a Pandora's box for me. There were conflicting findings, heated debate, fierce criticism of unsound methodologies, vehement argument and counter argument. I was disappointed. The scholarly articles and debates seemed to be immersed in the politics and polarities surrounding abortion that were prevalent in American society, unable to transcend them. The title of the 1998 monograph of the American Psychological Association, The New Civil War: The Psychology, Culture, and Politics of Abortion1 appears to confirm that.
There was no consensus on the impact of abortion. In some reports, it was construed as just another stressful event. For others, it was a significant trauma associated with mental health issues and symptoms similar to Post Traumatic Stress Disorder (PTSD). The notion of Post Abortion Syndrome (PAS) was raised and rejected.
The American Psychological Association (APA) consistently asserted that the incidence of negative responses after abortion was low (19902, 19923). In 2006, a task force was assigned to evaluate the evidence.
The American Psychological Association Report on Abortion and Mental Health
In 2009, in their Report on Abortion and Mental Health4, the APA concluded that:
1. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however.
2. The evidence regarding the relative mental health risks associated with multiple abortions is more uncertain.
3. Some women experience sadness, grief and feelings of loss following an abortion, and some may experience "clinically significant disorders, including depression and anxiety." 5
4. No evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors." 6
The results related to the experience of a single abortion as opposed to multiple abortions. The Report noted factors that may be predictive of more negative psychological responses following first-trimester abortion among women in the United States:
• perceptions of stigma
• need for secrecy
• low or anticipated low social support for the abortion decision
• a prior history of mental health problems
• personality factors such as low self-esteem and the use of avoidance and denial coping strategies
• characteristics of the particular pregnancy, and the extent to which the woman wanted and felt committed to it.
Here was clear acknowledgement that some women were experiencing grief and mental health issues after an abortion. Yet, despite the report warning about the dangers of making globalising statements, the message disseminated was: Abortion Has No Impact On Women's Mental Health. This message persists today.
To better understand the impact of abortion, I undertook to listen to those who were seeking help after abortion.
Impressions from the field
The deepest of sorrows
The most poignant learning has been the depth of grief and sorrow I encountered. This is no ordinary grief. It is complex and complicated. There are multiple losses; complex personal and social narratives; intense emotions; and some level of responsibility in the death. The grief is disenfranchised. It is socially unrecognised, unacknowledged and unsanctioned. There are no socially accepted rituals for mourning. At its heart is a death of a baby.
In those seeking help, this sorrow seems universal. It has presented in men and women; in relationships that are secure or in more tenuous, uncommitted or even undesirable relationships; whether there had been full responsibility or coercion; where there is faith and where there is no faith; where there have been pre-existing mental health issues and where there has not; in cases of secure attachment histories and in those with histories of insecure attachments; whether the pregnancy was unwanted or wanted; and whether there was a sense of connection with the foetus or not.
Anger is a part of grieving. Coupled with bitterness and resentments, it can become intense. It may be directed towards God, oneself or others. At times, we see that anger directed at 'the State', the 'system', or society at large; this anger is about unrealistic societal expectations, mixed messages from society, insensitive processes and a lack of information about the risks.
Four areas of wounding have emerged from my own listening and reading: the wound to the child; the wound to self (primarily for being implicated in the termination, intentionally or by default); wounded relationships (with others involved in the abortion) and wounded spirituality. Healing entails reconciliation(s) in each of these areas.
The feminine face of coercion
The incidence of coercion is high, consistent with that reported by the Elliot Institute.7 The classic picture of threats, intimidation, ultimatums, stand-over tactics and/or violence is seldom reported. More prevalent is the subtle psychological pressure applied by others, usually female, to compel a woman to terminate a pregnancy against her will.
Younger women, not yet fully individuated, still dependent on their parents and lacking the confidence to challenge parental authority, tend to fall victim to the female face of coercion - a mother, sister, or grandmother may persuade, cajole or harass, the subtle use of a position of trust, power and influence in a close relationship. Youth, obedience to parents and respect for authority add to the pressure to comply.
The message 'I know what's best for you' masquerades as care and may go unnoticed by the professionals involved. Reports include not being listened to by medical personnel; not being given an opportunity to be seen alone; and being sidelined while the dominating figure conducts the conversation. Passivity is easily misconstrued as consent and the process quickly moves to completion. Powerlessness, isolation and a sense of abandonment ensue. Violated boundaries, betrayals of trust and the losses of abortion give rise to anger and rage which, if internalised, may trigger depression.
Family narratives
Family stories underpin decisions to terminate a pregnancy.
Fathers shape their daughters' perceptions and expectations of men. A daughter observes her father's care for her, for her mother and how he relates to his wife/partner in pregnancy. The absence of a father may prompt a daughter to exchange sex for love. In my experience father narratives have been less prominent than mother-daughter narratives.
A woman's relationship with her mother is seen as central and ambivalence in the mother-daughter relationship is significant. Themes and patterns of behaviour are noted over three generations of women as they respond to trauma, life events, societal and familial attitudes to women and sociocultural trends.
Narratives passed down inform womanhood and produce powerful, often subconscious, beliefs about motherhood, for example, 'Once you're a mother, your life is not your own'. Injunctions like 'be successful' and 'do something with your life' subtly undermine the value of motherhood. Mothers who have been disappointed or who have struggled with motherhood subtly communicate this to their daughters.
Presence of historical sexual abuse was not surprising and is well documented in the literature.8 What is surprising is the high incidence I've noticed in peer support groups with whom I have been involved – over 80% on one occasion.
Lack of information
It is surprising that reports of insufficient information are regularly heard. With some dismay, women say: 'Nobody told me'; 'I didn't know'; or 'I never expected this'.
The Code of Ethics for Psychologists 9 states that obtaining informed consent from those with whom they are working is "a fundamental expression of respect for the dignity of persons and peoples."
A psychologist needs to:
1. provide "as much information as a reasonable or prudent person, family, whānau, or community would want to know before making a decision or consenting to an activity" (para. 1.7.6)
2. take reasonable steps to ensure that the information is understood (1.7.7)
3. take all reasonable steps to ensure that consent is not given under conditions of coercion or undue pressure from them (1.7.4)
4. "have an increased responsibility to protect and promote the rights of those who were vulnerable because they have lesser power" (1.7.1)
5. give sufficient time for the recipients to respond to the information (1.7.7).
The omission of informed consent in the protocols around abortion may, in part, reflect the fact that the Contraception, Sterilisation, and Abortion Act 1977 was promulgated before there was any developed notion of informed consent.
The fact that other health care professionals operate under equivalent codes of ethics regarding information and consent is not borne out in the stories I have consistently heard from women.
Conclusion
Experience confirms that abortion is a significant life event that can cause considerable loss and grief. The circumstances of the decision and the factors that influence the decision are diverse and complex. Simplistic restatements of research findings, without elaboration, do women a disservice.
Full and accurate information about risks and effective screening for coercion by way of independent and neutral counselling, and enough time to consider her response to an unwanted pregnancy, is every woman's basic right. As psychologists and healthcare professionals, it is our responsibility to ensure that.
I am deeply grateful to those men and women who have shared their stories with me and I thank them for enabling me to grow in this field.
Dawn de Witt is a Counselling Psychologist with a background in general practice, relationship counselling and family therapy. She presently co-ordinates Project Rachel in the Catholic Diocese of Hamilton, New Zealand and is on the retreat team of Rachel's Vineyard Retreats.
Endnotes
1. http://www.apa.org/search.aspx?query=the new civil war retrieved on 2 February 2017
2. Adler, et al. 'Psychological responses after abortion'. Science 06 Apr 1990: Vol. 248, Issue 4951, pp. 41-44. http://science.sciencemag.org/content/248/4951/41 accessed on 21 March 2017
3. Adler, et al. 'Psychological factors in abortion: A review'. American Psychologist, Vol 47(10), Oct 1992, 1194-1204. http://dx.doi.org/10.1037/0003-066X.47.10.1194 accessed on 2 February 2017
4. http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf accessed on 2 February 2017
5. APA Press Release. http://www.apa.org/news/press/releases/2008/08/single-abortion.aspx accessed on 20 March 2017
6. Ibid.
7. http://www.theunchoice.com/articles/howcommoniscoercion.htm accessed on 20 March 2017
8. Boden, Joseph M; Fergusson, David M; & Horwood, L. John. 'Experience of sexual abuse in childhood and abortion in adolescence and early adulthood'. Child Abuse & Neglect, Volume 33, Issue 12, December 2009, pp. 870–876
9. Code of Ethics for Psychologists. Para 1.7 http://psychologistsboard.org.nz/cms_show_download.php?id=235 accessed on 6 March 2017.
Please do not make a hole in the dike
ORAL PRESENTATION to Health Select Committee Inquiry into Ending One’s Life in New Zealand
Petrus Simons
18 November 2016
Today it is forty-nine years ago since I arrived in New Zealand from the Netherlands. I was welcomed by a very friendly society. Migrants have a unique opportunity to compare the society they hail from with the one that has welcomed them. Often, this gives us a unique perspective on things.
Sadly, as I tried to keep up with events in my old country, I became aware of a trend towards euthanasia which culminated in 2001 in a bill to legalise it, after the courts had allowed doctors to practise it under conditions that were steadily made less strict. I note also that until the legalisation of euthanasia in 2002, Belgium had proportionately more people aged 100 years than the Netherlands had. This is likely to change as Belgium has adopted the same legislation and has become even more aggressive in applying euthanasia and assisted suicide.
In my younger years, in the early 1960s an older colleague had a child who was completely handicapped intellectually. No one in the family ever received one glimpse of recognition from her. Yet, they cared for her 24/7 with a love they had never believed they were capable of. When they were mourning her death after 13 years, they realised that that was precisely the precious gift they had received from that child.
Currently, parents in such a case would be under enormous pressure to get the child killed at birth as one believes this to be more efficient and useful, although one would use the word ‘compassion’. I maintain that the sick, the fragile and the vulnerable enable us to love, by caring for them, whether as doctors, nurses, friends or family.
The current law acts as a boundary which doctors and nurses know they should not cross. It enables them to provide loving appropriate care. It also allows them to stop applying highly technical medical procedures when they can only protract the dying process and when palliative care is called for instead. The boundary is like a dike which keeps the sea at bay and enables life to go on inside the polders.
The boundary, the dike, is necessary to ensure that medical efficiency remains focussed on preserving and caring for life, without a cold calculation of utility and disutility. Without the boundary, one goes down the road of killing efficiently as it might appear to provide the greatest utility to the vulnerable and to society. This would not be the friendly New Zealand I have come to know and love in my 49 years here.
No matter what sort of bill would be written to enable assisted suicide and/or euthanasia, it will make a hole in the dike. Inevitably, such a hole will get larger and larger till the dike ceases to exist.
Please do not make a hole in the dike.
By Dr Petrus Simons
Dr Petrus Simons is a retired economist with a PhD in philosophy.
Editorial - Why are abortion advocates afraid of informed choice?
The polarising issue of abortion has come to the fore again, triggered by the Abortion Supervisory Committee’s annual report to Parliament. Despite the ASC chairwoman saying that the committee had no opinion on major reform of the abortion laws – that it was solely a matter for parliament – many commentators who want further liberalisation have taken the opportunity to lambaste the current law, labelling it a legal obstacle course, archaic, hypocritical, a charade, cumbersome, and intrusive.
The simple solution, they say, is abortion on demand – no need to ask any questions. As articulated by David Seymour MP: “The right thing to do is reform abortion law to reflect what actually happens: women exercise choice for their own reasons.” He and others argue that the current law disempowers women. As one blogger wrote: “At the heart of it all is a distrust of women, innit? … a failure to understand that women are full moral adults.”
The debate that has ensued highlights an important point: the current abortion law is being consistently undermined by the way in which it is being implemented. This is what undoubtedly leads supporters as well as some opponents of abortion to label the present regime as hypocritical.
While the debate raises many interesting questions, the one critical question not often asked is whether removing the procedures that are part of the current law will in fact lead to better choices and better outcomes for women contemplating an abortion.
Our choices are limited by the constraints of our knowledge and context. These constraints generally take two forms: (i) a lack of proper information and (ii) the presence of coercion. Informed and free consent based on full, balanced and factual information, while allowing time to adequately consider that information, is the ‘sine qua non’ for making quality choices.
Research into the potentially negative health effects of abortion is characterised by claims and counter-claims. For example, research reported by the Health Research Council of New Zealand (by Professor David Fergusson of the University of Otago’s Christchurch Health and Development Study, 2008) suggests “women who undergo an abortion face a 30 per cent increase in the risk of developing common mental health problems such as depression and anxiety.” Conversely, other overseas studies have concluded that the rates of mental health problems for women with an unwanted pregnancy were the same whether they had an abortion or gave birth. Academically speaking, the question of potential harm to women remains a contested one.
The strongest evidence that there are real negative health effects following an abortion arises out of the day-to-day work done by clinical psychologists and counsellors. Their consistent experience is that they encounter many women whose mental well-being has been adversely affected on a number of levels by their experience of abortion.
Further reflection on “what actually happens” to women who have had abortions highlights the reality of coercion. Many women, after the event, report feeling that they had no other option at the time but to proceed, often because of pressure from parents, partner and/or peers. At times this pressure is also experienced as coming from staff at the Termination of Pregnancy Units. For other women, the pressure they feel is generated by employment or social factors. In the words of another commentator, in such situations, the decision for an abortion is best described as a tragic response to lack of choice.
Section 14 of the Contraception, Sterilisation and Abortion Act, which details the functions of the Abortion Supervisory Committee, states that they are “to take all reasonable and practicable steps to ensure that sufficient and adequate facilities are available throughout New Zealand for counselling women who may seek advice in relation to abortion.” When women repeatedly recount they were offered five to ten minutes with a social worker before the abortion ‘if you want it’, and when there is reliable evidence that abortions are signed off by some consultants over the phone with no face-to-face interview, it is hard to argue that this provision is being properly implemented.
In which case, it becomes impossible to argue that the current New Zealand practices surrounding abortions consistently promote informed and free choice.
There is surely no greater expression of “distrust of women” than society paternalistically deciding, whether through law reform or the inadequate implementation of its current laws, to censor the information provided to women contemplating an abortion. Equally, it is surely also a failure of care to neglect to put in place mechanisms that can help women contemplating an abortion to recognise and deal positively with any feelings of ambivalence as well as the actualities of coercion.
It is in the interest of free and informed consent and empowerment that all women are offered independent counselling that addresses the coercive realities surrounding many abortions and which makes them aware of all the risks as well as all the options they have. Honest reflection on what is actually happening only reinforces the fact that abortion on demand will not achieve this.
If as a society we truly want to respect choice, then why would we be afraid of promoting free and informed consent?
Cynthia Piper has over 20 years’ experience as a trained volunteer lay counsellor working with pregnant women and teens and their families, and with Project Rachel, a post-abortion healing and support service.
Dr John Kleinsman is director of The Nathaniel Centre.
Abortion and God’s Mercy and Grace
By Amanda Bradley
I have been an Anglican Priest for many years, also a contributor to Project Rachel in the form of counseling those who wish to come for reconciliation following a termination of pregnancy.
Over the years, I have spoken with, and listened to, many young women, and some men, for whom the experience of an abortion is new and raw. However, I have also met those for whom the experience is years old but has never gone away. One such meeting was with a woman of 93, in a Rest Home, who was very much afraid to die. I had been called by staff of the Home to speak to her because of her fear of dying.
She felt that God could never forgive her for a ‘sin’ she said she had committed more than 75 years previously. As an 18 year old student she had met a 20 year old man and they had fallen in love. She had become pregnant.
She did not know she was pregnant until after she experienced bouts of nausea and had fainted several times at her home where she lived with her father and stepmother. The doctor was called and the pregnancy was subsequently discovered.
The decision was then made that the doctor would carry out a termination at home and nobody would be any the wiser. This was carried out, she was forbidden to see the young man again and she was told, by the stepmother, that she would be going to hell for killing a child.
Some 4 years later this woman met her young man again, married him and they had many happy years together, as well as 5 lovely, successful children who, at the time I met her, were all middle aged.
Neither her husband nor her children knew about her abortion. Neither did this woman share her burden with anyone else. She lived all those years with the fear of a vengeful God waiting for her when she died. We talked at some length about the nature of God and of God’s forgiveness, mercy and grace. Eventually she agreed to tell her daughter in law, a school counselor, about her experience of so long ago. This she did, along with others in the family. Her family were all very supportive and sad that their mother had had to carry this burden alone for so long.
She died soon after, peacefully and unafraid.
Before she died she gave me permission to tell her story to anyone whom it might help.
I buried her, moved out of the family’s lives and changed parishes but I have often recalled this woman and given thanks that I can freely share her story to assist others.
During my next period of ministry, I attended a large church gathering of clergy and lay people where the subject of abortion, among other things, was raised. Some very judgmental opinions were voiced by a number of attendees and various punitive measures proposed by some. Eventually, I felt called to go to the microphone to tell the audience of my experience of Project Rachel. I reminded them of forgiveness, reconciliation, redemption and the mercy of God.
At lunch three women approached me. Two were tearful, admitting that they had each had an abortion when very young. The other shared sending her 16 year old daughter to Australia via SOS (Sisters Overseas) to terminate her pregnancy.
The four of us missed the next session as we talked together. All three expressed their gratitude that, after living for many years in silence, they had at last found an opportunity to tell someone about their regrets. I reminded them, as I gave them the prayerful absolution they craved, that God was waiting in the wings for them to turn to him in prayer and always had been. We then shared a time of prayer and while I felt gratitude that I had helped these women move on, yet I was saddened to see that all three had removed their name tags, not fully trusting me with who they were.
These were women who were very active in the church, in responsible positions, purporting to bring the love of God to others, yet they still could not fully trust God with their regrets or a priest working for Project Rachel with their identities. Work in the church-yes; prayers for others-yes; abortion details- yes; reveal their names- no.
It makes me think: ‘Just how many more women and men are out there living needlessly with such burdens?’
Rev Amanda Bradley is an Anglican priest who has worked as a nurse, taught at university, was a foster mother to seven children, and has worked with and counselled men and women post-abortion. Amanda and has been associated with Project Rachel for a number of years.