How to answer questions on abortion in your medical school interview?

How to answer questions on abortion in your medical school interview?

By Dr Hannah Pierce • January 18, 2018

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?

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… Isn’t there a set number of weeks it’s allowed up to? 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 ethical scenarios'.

medical-school-ethics-scenarios


1. In the beginning…

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 risk to the pregnant woman’s mental or physical health, or when the child has been found to have abnormalities that would cause suffering on birth.

Okay so that’s the knowledge bit covered, what are our key issues here? I bet you’ve already heard about the pro-life versus pro-choice argument, well put that into medical ethics terminology and you have your key conflicting arguments.

But which ethical pillars are we specifically talking about here? Again if you’re feeling a little rusty on your ethical pillars then go back and check out our ‘Understand medical ethics’ blog. The main issue in this question is the autonomy of the mother versus non-maleficence to the foetus.

 2. Stuck in the middle?

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

 

Pro-abortion

Anti-abortion

Autonomy

The mother should be able to choose what happens to her own body including whether she does or does not want to carry a child.

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 cannot have autonomy.

Beneficence

Pregnancy comes with a risk of serious health issues including death, therefore ending the pregnancy lowers the risk to the woman.

Not performing the abortion clearly benefits the foetus.

Non-maleficence

Continuing an unwanted pregnancy could cause the mother serious mental health problems. If woman are denied abortion they may seek out ‘backstreet’, illegal and unsafe abortions which puts their health/life at serious risk.

Abortion causes definitive harm to the foetus.

 

Abortion itself can cause medical problems for the woman such as bleeding, infection and rarely death.

Justice

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 allows for woman to have gender equality.

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.

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? What support does she 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 defence union. 

3. And to finish off!

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 back up 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 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 a question on 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. If you would like to see a model answer for this question, then check out our online video series on medical ethics which includes a section on this very topic!


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