The real abortion scandal? That two doctors must testify a woman's sanity

Andrew Lansley is "shocked and appalled" at doctors pre-signing consent forms -- but the medical pro

The Care Quality Commission (CQC), ordered to perform spot-checks at abortion clinics, revealed yesterday that up to one fifth of clinics have been breaking the law by allegedly allowing doctors to pre-sign consent forms, presumably before they are assigned to a specific patient. Health Secretary Andrew Lansley is reportedly "shocked and appalled" by the findings.

I am shocked and appalled that in 2012 we still require two doctors to testify not to the physical fitness and consent of the woman in question but to the indomitable risk a continued pregnancy poses to her physical and mental health.

Assessed from that perspective, being pro-choice is actually nothing of the sort. Presuming you are bodily healthy, what you are actually consenting to is the notion that to be refused an abortion would make you just a baby away from barmy.

Thankfully, the medical profession is more pragmatic than the law; it's not too often you meet a glassy-eyed new mother lugging a child about, lamenting, "Oh, you know, there just wasn't enough chance of me having a breakdown so they wouldn't let me not have her." And doctors have had to be -- they are working with a piece of legislation that has only been updated once since 1967, an era where women couldn't get a mortgage without a male guarantor. Is it any wonder then that some doctors may think the double-signing about as anachronistic and inappropriate? And what about the thousands of women, myself included, that have ever had an abortion? It's time the law acknowledged that women can safely -- and sanely -- consent to abortion, with full awareness of the implications as they do so, and that one informed medical opinion is enough to guide that.

For a government that claims to want to give people more control over their own lives, the coalition has done a neat job of allowing the paternalist, Conservative backbenchers the steer of the abortion debate. The CQC investigation, the circumstances of which are politically suspect according to BPAS chief executive Ann Furedi, comes just a little too soon after Nadine Dorries' failed Bill proposing independent abortion counselling. It also conveniently distracts from the berating Lansley has faced over NHS reforms. Nothing like an abortion brouhaha to make people forget about the mismanagement of the health service -- except perhaps setting the already overstretched CQC to investigating procedural signatures rather than the abuse of old people or children isn't the slickest way of doing it.

The recent furore relating to illegal sex selective abortion has made the matter of women's "choice" even more inflammatory. But neither doing away with the need for the two-doctor signature rule nor changing the emphasis of the law to give women the right to opt out of motherhood rather than out of madness would automatically legitimise the right to sex selection. (Surely not revealing the sex of the foetus, except in circumstances where disability necessitated it, would circumvent that pretty easily?) Nor would it see the number of abortions rise exponentially. What anti-abortionists never seem to grasp is that, whatever the circumstances, nobody seeks a termination lightly. While not necessarily traumatic, it is a grave decision you do not forget making. And neither one, nor two, nor a thousand doctors' signatures can affect that -- unless the government makes it harder to seek abortion in the first place.

Nichi Hodgson is a 28-year-old freelance journalist specialising in sexual politics, law and culture.

Nichi Hodgson is a writer and broadcaster specialising in sexual politics, censorship, and  human rights. Her first book, Bound To You, published by Hodder & Stoughton, is out now. She tweets @NichiHodgson.

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It's time for police to admit their mistakes

Forces are not doing enough to protect the most vulnerable from harm.

Already this summer, four people have died after contact with the police. At least three of them were black men who died following police restraint. Last Saturday, 20-year-old Rashan Charles lost his life after being pinned to the floor of a convenience store, and restrained by an officer and another person in plain clothes.

These deaths aren’t included in the latest annual report from the Independent Police Complaints Commission (IPCC), which covers the year ending 31 March 2017. But the deaths of Rashan, Edir Frederico da Costa, Darren Cumberbatch, and a 16-year-old boy, who died in a crash during a police pursuit, recall those who have lost their lives during or following police contact in the months preceding them: Mzee Mohammed, Dalian Atkinson, Mohammed Yassar Yaqub.

Between 1 April 2016 and 31 March 2017, there were 32 road traffic fatalities involving police, an increase from the previous year and the highest since 2008-09. In the same period, there were 55 fatalities from "apparent suicides following police custody". Six people died from "police shootings", the highest since 2007/08. Fourteen people died "in or following police custody", and there were 124 "other deaths following police contact" independently investigated by the IPCC. 

"Deaths in or following police custody" is not as high compared to other categories, however deaths that happen while a person is being arrested or taken into detention are some of the most controversial. That there was no reduction in the number who died in or following police custody, compared to the previous year, suggest past mistakes are being repeated and systemic failures persist.

Over half of the 14 deaths were of people with schizophrenia, depression or self-harming or suicidal tendencies. Similarly, two thirds of the 124 who died following other police contact had mental health issues.

The most common reason for this other type of police contact was related to the safety or wellbeing of those who lost their lives. Twenty-six people died from the police responding to their health, injuries, intoxication, or a "general" incident, while 23 people died from the police responding to a concern about their self-harm, risk of suicide, or mental state. Of these 23 people, 35 per cent were black and minority ethnic (BME).

The individual stories show an even more disturbing picture than the raw numbers. Officers often encounter people with mental health conditions, yet treat them as criminals. In the case of Mzee Mohammed, he remained in handcuffs even when he finally received medical care. The police should be called as a last resort to deal with someone having a mental health crisis, but in many cases of deaths in custody, evidence shows they take it upon themselves to intervene.

In 2014, Staffordshire police handcuffed and detained Darren Lyons, who had a history of mental illness and alcohol dependency, instead of getting him medical help. An inquest heard he died after being left half-naked on a cell floor, covered in his own faeces. Similarly in 2012, Thomas Orchard was left lying unresponsive, after being put in restraints and having an emergency response belt wrapped around his face.

Although the police do not have the expertise of mental health workers, they are trained in using force proportionately, reasonably and when necessary. Members of the public experiencing a mental health episode have complex needs and it can be hard to understand the condition they are suffering from to provide appropriate assistance. This is a challenge for police officers, however using force can exacerbate a situation and even lead to death. In 2016, Dalian Atkinson, at the time suffering a mental health crisis, died after being Tasered and physically restrained by West Mercia officers.

The charity Inquest reports that the majority of its police-related cases in recent years “have involved the death of vulnerable individuals in some form of mental health crisis”. Its analysis in November 2016 of deaths in police custody since 1990 suggested that the “use of force/restraint is more likely to be a feature of the circumstances of BME deaths in police custody” and “the proportion of BME deaths in custody where mental health-related issues are a feature is nearly two times greater than it is in white deaths in custody”.  

Earlier this year, an inquest jury criticised the Metropolitan Police for excessive, unreasonable, unnecessary and disproportionate restraint on Olaseni Lewis, a 23-year-old black man, who died in 2010 at a psychiatric hospital.

Deborah Coles, director of Inquest, drew attention to the fact that the “evidence heard at this inquest begs the question of how racial stereotyping informed Seni’s brutal treatment”. Met officers, instead of attending to Seni’s welfare, left him once he was unresponsive after prolonged restraint, because they believed that he may have been "faking it". This disregard of a black life recalls the institutionally racist death of Roger Sylvester in 1999.

Seni’s case was pivotal in leading to the independent review into deaths in police custody, conducted by Dame Elish Angiolini QC. The publication has been postponed, on many occasions. The delay follows a common experience bereaved families constantly have with the police, the IPCC and the Crown Prosecution Service in their struggle for justice.

Despite deaths related to Tasers, spit hoods and firearms, the police have recently called for increases in such equipment and weapons. The Police Federation say they are necessary to protect the protectors. But the protectors are not protecting everyone.

The figures and individual stories show that some officers are threats to vulnerable people, in particular those with mental health issues and from ethnic minorities. Forces have failed to implement recommendations, while the CPS has failed to prosecute unprofessional and abusive police officers. "The officers involved in the restraint have not been able or willing to offer any word of condolence or regret in their evidence,” Seni’s parents responded after the inquest into their son’s death.

To prevent more needless lost lives, the police must first take responsibility and admit their mistakes.

Carson Cole Arthur is policy and communications co-ordinator at the campaign group StopWatch. He is writing in a personal capacity