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Published in British Journal of General Practice 2007

Dear Editor,

The fascinating paper by Bryant et al on patient choice highlights the impact of health care policies on human behaviour.(1)

One area that particularly interests me is the concept of choice in relation to abortion and how it may affect decision making.

If "framing a decision as a choice can enhance the perceived value of a particular option"  (1) perhaps the default state for a society in dealing with crisis pregnancy shifts towards abortion and more women may opt for it.

I am at the anti-abortion end of the spectrum of opinion on this issue and realise that most GPs pitch camp elsewhere. But it strikes me that most people agree it would be better for those women (an unknown percentage) who have a termination only to regret it, to somehow be enabled to make a different choice if it is right for them.

Research into this area of decision making will undoubtedly be challenging, but it may help some of those women for whom pro-choice is no choice at all.

Yours faithfully

Dr. James Gerrard

  1. Bryant LD, Brown N, Bekker HL, House A. The lure of ‘patient choice’ Br J Gen Pract 2007;57(543):822-826





Letter Published in British Medical Journal 24th February 2007.


As a longstanding anti-choicer, I commend Gornall on a balanced and informative article on abortion (1). There are a lot of eloquent words on both sides but it got me wondering if the abortion debate isn’t all a bit pointless. There is a fundamental disagreement between pro-choicers and pro-lifers. And that is the question of whether children can be treated differently depending on whether it’s before or after they’re born. The "right" answer to this seems to depend on what part of the world you’re in. Even within the mainly pro-choice United Kingdom, one nation (Northern Ireland) remains essentially pro-life. The point is that this argument will continue for the foreseeable future without a winner.

Now, here’s an idea. What if we changed the focus to our main area of agreement: that women and children should be able to lead happy and fulfilling lives?

What if pro-lifers and pro-choicers worked together for a better deal for pregnant women and the parents of young children? Does anyone really want any woman to have an abortion because she can’t afford to have a baby or because her job prospects will be wrecked? As a society, are we really doing enough to give women a real choice? How come a 36 year old medical consultant is able to have children with relatively little detrimental impact on finances or career compared to a 25 year old junior doctor or a 36 year old cleaner? What if maternity pay and leave was funded by the government rather than individual companies so that the cost is evenly distributed? What if….?

The general consensus in Britain is that abortion is a necessary evil. Pro-lifers have spent a lot of time unsuccessfully trying to persuade the public that abortion is too evil to be necessary. It might be time to accept the prevailing view and instead work towards a society where it’s unnecessary to be so evil. And perhaps pro-choicers can join us? Then maybe we can all be truly pro-choice.

Yours sincerely

Niall Cox Consultant Geriatrician, Leeds, West Yorkshire LS8 2BS

  1. Gornall J. Where do we draw the line? BMJ 2007; 334: 285 – 289