Think twice before making home abortions the new normal - Dr Calum MacKellar
Since 2017, partial home abortions have been possible in Scotland for medical terminations. These usually take place in the first ten weeks of gestation, whereby a woman is given two sets of pills. The first (mifepristone) is generally taken in a clinic and obstructs a hormone which is necessary for the uterus to support the implanted embryo/foetus. The second pill (misoprostol) is taken at home (if the woman so wishes) two days later and causes the lining of the womb to break down, resulting in the uterus contracting and expelling the dead embryo/foetus.
However, since the end of March 2020 and in the light of the risks of Covid-19 infection, a woman seeking a medical abortion can now take both sets of pills at home if this is considered appropriate. And because of this precedent, the Scottish Government is consulting until 5 January 2021 whether this arrangement should be made permanent even after the threat of Covid-19 recedes.
One significant challenge, amongst others, with these partial or complete home abortions, however, is the destiny of the remains of the embryo/foetus. Indeed, when the termination occurs in a clinic, these remains are usually placed in an individual box with appropriate respect. The woman then signs a consent form giving permission for them to be sent to a mortuary to be forwarded to a local crematorium, though the ashes are not generally available to the woman. Alternatively, if she wishes to make her own arrangements for the disposal of the embryo/foetus, the woman can approach a healthcare professional at the clinic.
With home abortions, however, appropriate and sensitive respect for the disposal of the remains of the embryo/foetus does not generally take place since these are usually flushed down the toilet or discarded as waste in another manner. An outcome which may cause considerable distress to some vulnerable women having an abortion as well as the persons supporting them at home. This may happen because of their possible grief, especially when they see the dead embryo/foetus, which is up to 3-6cm in size at about ten weeks of gestation and which ends up in the sewage. It may also create very significant trauma to other professionals, such as sewage and plumbing professionals, if they ever encounter these dead human embryos/foetuses in the course of their work.
In addition, Scottish law has never considered the remains of an embryo/foetus, or those of a deceased person who was born, as worthless waste because of the respect ascribed to past lives. A respect which would be completely undermined if the remains of the dead were considered as being just waste or even rubbish.
Moreover, in Scotland, deciding the value and worth of an embryo/foetus, or a person who has been born, has never been the responsibility of a single or a few individuals. Instead, it has always been the remit of society as a whole. This happens to protect it from degenerating into barbarity or into a moral wilderness. Scottish society cannot, therefore, continue to let the remains of embryos/foetuses simply be discarded as worthless waste.
Dr Calum MacKellar, Director of Research of the Scottish Council on Human Bioethics
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