So you’re in your medical school interview and things are going okay so far. Then comes the following question: Do you agree with abortion procedures? 

Suddenly a million and one thoughts are flying around your head: What do they want me to say? Should I give my honest opinion? Oh God, I can’t remember what the laws are regarding abortion procedures… Isn’t there a set number of weeks it’s allowed up to for the pregnant woman? Something about two doctors… 

STOP! 

Let’s break this question down into manageable chunks. Remember this is an ethical question at its heart so we can structure it like a story with a beginning, a middle and an end. If you can’t quite remember how to structure these answers then refer back to our blog ‘How to answer medical school ethical questions'.

THE LAW REGARDING ABORTION PROCEDURES

Let’s set the scene by defining our terms and identifying our key issues. First off what is an abortion? Well, it’s the termination of a pregnancy so that it doesn’t result in the birth of a child. 

In the UK, the Abortion Act of 1967 allows doctors to perform abortions lawfully as long as certain conditions are met. These conditions allow for termination of a pregnancy up until 24 weeks if two doctors agree that ‘the continuance of the pregnancy would involve risk, greater than if the pregnancy was terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family’. 

The act also allows for terminations with no time limit in cases where there is a risk to the pregnant woman’s mental or physical health, or when the unborn child has been found to have abnormalities that would cause suffering on birth.

PRO-LIFE VS PRO-CHOICE

This is where you can show off your knowledge about the ethical principles! Let’s go through them in turn.

AUTONOMY:

• Pro choice: The pregnant woman should be able to choose what happens to her own body including whether she does or does not want to carry a child.
  
• Pro life: You may think that abortion goes against the autonomy of the foetus, however, in current UK law the foetus is not recognised as a person and therefore the unborn child cannot have autonomy.

BENEFICENCE:

• Pro choice: Pregnancy comes with a risk of serious health issues including death, therefore ending the pregnancy lowers the risk to the woman.
• Pro life: Not performing the abortion clearly benefits the foetus. 

NON-MALEFICENCE:

• Pro choice: Continuing an unwanted pregnancy could cause the mother serious mental health problems. If a pregnant woman is denied abortion they may seek out ‘backstreet’, illegal and unsafe abortions and medical care which put their health/life at serious risk compared to legal abortion clinics.
• Pro life: Abortion causes definitive harm to the foetus and could be argued as ending a human life. There is also the debate about if a foetus can feel pain. Abortion itself can cause medical problems for the woman such as bleeding, infection and rarely death. 

JUSTICE

• Pro choice: If the woman continues the pregnancy but isn’t able to care for the child after it’s birth then the state will take on the cost of care for the child. In a time of limited resources, it could be argued (even if it feels somewhat crude) that it would be more cost effective to perform the abortion. Abortion also allows for women to have gender equality.
• Pro life: Abortions cost more than general pregnancy preventive measures such as the contraceptive pill or condoms. The easy availability of an abortion could encourage people to be less careful with their contraception and therefore take more money from the limited pool of finances. 

These are just a few of many possible arguments that could be made to argue for and against abortion, but these should be enough to get you started. And don’t forget to also consider the 3 C’s: Consent, Capacity, and Confidentiality.

ASKING FOR MORE INFORMATION OR HELP

At this point, you can also ask for additional information. In this instance, the question asks for your opinion so you don’t really need any more information but if the question asked you about a specific case then you may want to clarify certain points.This could include: How many weeks pregnant is the patient discussed? What are the circumstances of the pregnancy, for example, was it a planned parenthood or are there medical issues with the unborn child? What support does the pregnant woman have available to her? 

You can also say if you would ask for help at this point and if so who from. Again, this would depend on how the question was asked but for very difficult ethical cases you can always consider talking to a senior colleague or your defense union.

CONCLUDE AND STATE YOUR ANSWER

So now you’ve discussed all the different arguments for and against abortion it’s time to nail your colours to the mast and pick a side. But is there a right answer to this question? In most ethical questions there isn’t a right or wrong answer as long as you backup what you say with your ethical points. 

The one caveat to this is that you act in the best interests of your patient. In this instance, if you ethically object to abortion and the termination of human life then that’s okay but you should recognise that it would be wrong to impose these views on your patient and therefore enable them to see a different doctor about the issue.

I hope this has given you some ideas about how you would go about answering questions about abortion in your medical school interview. It would now be good practice for you to try putting all these points together to form your own answer to this question.