Soldiers, doctors and the 8th

During the Second World War the American army made an interesting discovery. Only 15% to 20% of riflemen would actually fire at the enemy. Lieutenant Colonel Dave Grossman, one of the pioneers in studying this area of human behaviour, speaks of how there is ‘within most men an intense resistance to killing their fellow men.’ Subsequent research has shown that these rates were comparable in the Napoleonic and American Civil wars.

Military trainers have found ways of overcoming this resistance and in the Vietnam war over 90% of soldiers were able to shoot to kill. Military training was re-designed to develop what is called a denial defence mechanism. Even language was reshaped; instead of shooting, the soldier ‘engaged the target.’ Such desensitisation has always played an important part of warfare. In Vietnam, Americans and Vietcong alike needed no training to refer to each other as ‘gooks’ and ‘big hairy monkeys,’ but never before had desensitisation been turned into a science.

Abortion, like warfare, is killing sanctioned by law. Whatever one’s views of the morality of either activity, those who do so have to overcome that fundamental human resistance to killing others. The coarse language of soldiers is not an option for the medical profession but ‘termination of pregnancy’ and ‘fetus’ eliminate the need to refer to any life other than that of the woman whose pregnancy is to be terminated. It has something of the same depersonalising quality as ‘engaging the target.’

For soldiers, public approval and justification for what they have done is vital. It is easy to dismiss military parades, monuments, medals as triumphalistic gloating, but there is little doubt that the absence of these rituals for returning Vietnam veterans had a devastating effect on an entire generation. The medical profession terminates between 40 and 50 million pregnancies every year but it does not look for medals, or monuments or parades. On the other hand it does enjoy very high public esteem. It has commanded such esteem since ancient times and this, more recently, has been augmented by the impact of scientific research on medical practice.

We expect doctors to develop and adapt their skills and to practise their profession to the highest standard. They take pride in this and rightly so. It is twenty years since Dr. John Parsons, founder and former director of King’s College Hospital’s assisted conception unit spoke of how what others might see as ‘messy and ugly,’ can be for him as a surgeon ‘quite beautiful.’ He contrasted this experience with termination procedures in which ‘you are exposed to a rather gross destructive process.’ He added candidly: ‘Earlier terminations are so much easier to manage, because you can actually do them in an aesthetic way. If you are doing a suction termination you virtually do not see anything, so it is nice and tidy. If you do later terminations you may see things which are not very pleasant. That is why we are not keen on people observing abortions.’

He was speaking at a discussion convened in the Contemporary Arts Institute in London by Pro-Choice Forum and titled ‘Don’t mention the ‘A’-Word: Why can’t the truth be told about abortion?’ Another speaker at this event, Ann Furedi, Director of Birth Control Trust, was even more candid: ‘The majority of women who seek abortion in this country, and I imagine in the States as well, are not really the victims that they are made out to be. They are women who could incorporate a child into their lives if they absolutely had to. They would not have a nervous breakdown, they would not fall to pieces, they would not be entirely impoverished. These women are not seeking to end the pregnancy because they are incapable of coping, but because they do not want to have to cope.’ In her view abortion should be ‘a matter of choice rather than necessity.’

Those who argue for the repeal of the eighth amendment offer genuine tales of hardship but they cannot deny that a repeal of the eighth will open up the scenario which Ann Furedi describes. The twelve week time limit is a period in which there will be no restriction of any kind and, once the amendment is removed, the twelve week limit can be extended by the Oireachtas. When the time comes for an extension of the limit – and it will come – the main protagonists will be our elected politicians and a medical profession which commands unrivalled popular esteem. In such a scenario there can be no doubt as to whose – pro-choice – views will prevail.

Medicine is a globalised profession in which abortion is now an established part of professional practice. But is it really possible for doctors to take a professional pride in what Ann Furedi has described as ‘the destruction of a biological life?’ How many would disagree with John Parsons’ view of the ‘termination’ process? We know that soldiers do what they are trained to do, when they kill. Thanks to Lt. Col. Grossman there is a growing body of research into the effect on soldiers of the experience of killing. Doctors also end life but there is no equivalent body of research into the effect of this activity on doctors as individuals or as a profession.

In this debate the medical profession is exercising powerful leadership on the pro-choice side. A question needs to be asked: is this leadership rooted in a healthy professional pride, espousing the highest standards of medicine, or is it rooted in a more ambivalent sense of shame – and defensiveness – around the act of killing? No one can pretend to have an authoritative answer to this question but there are means of arriving at it in a scientific manner. They have not been availed of and meanwhile the people of this country are asked to place a critical matter of life and death in the hands of a profession which is in a morally ambivalent position. If this amendment is carried there will be no turning back. So if you are in doubt, vote ‘no.’ Better to wait and see and learn.