Healthy Skepticism Library item: 3818

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Publication type: news

Abbott T.
Tony Abbott: Best forum for RU486 decision
The Australian Newspaper 2006 Feb 6
http://www.theaustralian.news.com.au/common/story_page/0,5744,18048967%255E7583,00.html

Notes:

Ralph Faggotter’s Comments:

Tony Abbott, the Australian federal health minister, here presents his case for leaving the final decision over whether the abortion pill RU486 should be made available to Australian women.
Ultimately, in a rare ‘conscience vote’ in Federal Parliament, his arguments have not persuaded the bulk of parliamentarians, who passed a law this month to strip him of his power to continue to veto the possible TGA approval of this pill in Australia.

Full text: Tony Abbott: Best forum for RU486 decision The abortion pill is too risky to leave to medical officials, argues Health Minister Tony Abbott February 06, 2006

IN 1996, the federal parliament decided that decisions about abortion drugs were too important to be made by unelected, unaccountable officials. As Labor senator Belinda Neal said at the time: “These issues need to be addressed by the executive of the government and addressed with absolute and direct accountability.” As Greens senator Christabel Chamarette put it: “We deserve to have parliamentary scrutiny of decisions. We deserve to have a voice on issues and not simply leave them to boards of experts.”

Now, it seems, their parliamentary successors think politicians are unfit to make decisions on this topic. This week, the Senate will debate and vote on a private member’s bill to make abortion drug approvals the exclusive responsibility of the Therapeutic Goods Administration. If carried, there will be no parliamentary authority over these decisions and no democratically elected person will have to answer for them.

It’s lately been alleged that the parliament’s 1996 abortion drug decision was horse-trading for senator Brian Harradine’s vote on the Telstra sale at the time. This is an absurd proposition, as a moment’s reflection shows. The ALP, Greens and Democrats would have needed to be part of any such conspiracy because the Senate as well as the House of Representatives approved the changes on the voices and without a formal vote. In fact, the 1996 changes simply regularised the former Labor government’s sensible commitment not to introduce abortion drugs without a ministerial decision and the potential for parliamentary debate.

The parliament’s 1996 decision was about preserving women’s safety, not restricting existing rights to abortion. The parliament decided that it was not just the science of abortion drugs that mattered but the circumstances surrounding their use. Experts can explain facts but politicians then have to resolve the values that are to be placed on those facts to the satisfaction of a democratic electorate. The parliament decided that ministers rather than bureaucrats should have the final say on these drugs’ availability because politicians are accountable for their actions in a way that officials are not.

RU486 is used to bring about a miscarriage in women who are significantly advanced in their pregnancy. It’s not the morning-after pill, which prevents a fertilised egg from implanting, but a drug that causes the uterus to expel a developing fetus. Women can bleed for as long as two weeks after taking RU486. This is why abortion drugs are rightly in a class of their own.

First, their effect is not generally therapeutic at all but the end of an otherwise healthy pregnancy. Second, the resulting miscarriage, if untreated, runs the risk of severe complications. These can be handled in hospital or under close medical supervision. The problem is backyard miscarriages if unscrupulous doctors prescribe these drugs for desperate women.

What’s changed since 1996? The science surrounding RU486 has not changed, nor have the issues and problems surrounding its use. As far as proponents of the private member’s bill are concerned, all that’s really changed is the minister. For instance, senator Lyn Allison, one of the bill’s sponsors, has referred to “the problem of a Health Minister who, for his own personal religious reasons”, is allegedly “not prepared to consider all of the evidence, both medical and social”.

This is a classic case of shooting on suspicion. So far, no application to use RU486 has been finalised by the TGA for ministerial consideration. If an application did come to me, I would have to satisfy myself that competent doctors would administer the drug in safe circumstances to women who had fully considered the alternatives and understood the risks. I would want to be confident that the rules surrounding the use of the drug would not readily be flouted (as has reportedly been the case with the morning-after pill, dispensed to girls as young as 13 without any counselling, thanks to a bureaucratic rule change).

I would want to know how medical abortion would not be misrepresented as an easy option and what safeguards were in place against the development of an internet-based black market. These are prudential judgments which the TGA has no special competence to make about issues that have been studiously avoided in the RU486 debate thus far.

Why do the bill’s sponsors want to end the ministerial safeguard against important changes being made without public debate and without any enforcement of the dispensing regulations? Presumably, it’s because the current minister is “anti-abortion”.

For the record, I would not support withdrawing Medicare funding from abortion, let alone trying to re-criminalise it. With former US president Bill Clinton, I think there’s much to be said for ensuring that abortion is “safe, legal and rare”. The trouble, as most Australians seem to agree, is that up to 100,000 abortions a year is already far too many.

I can understand the bill’s sponsors wanting to affirm women’s existing abortion rights, but why do so by removing an important element of democratic accountability, especially when those rights are not under threat? What are Allison’s grounds for thinking that I am less capable than she is of distinguishing between what’s rightly rendered to God or Caesar? Ministers should be judged on their actions, not on other people’s prejudices. Any abuse of a ministerial discretion would be grounds for changing the minister, not for changing the law.