Marie Stopes clinic suspends services

Smondie · 21-08-2016 06:39PM

Grayson wrote: »

That is a moral and ethical minefield. There's so many factors to consider. Let's take a simple case. I think the youngest ever girl to give birth was something like 9 years old. There have been many other pregnancies reported about that age (9, 10, 11) but nearly every one has resulted in the death of the child. And I think most of those pregnancies were as a result of rape or incest. In that case it could be seen to be a life saving treatment since the girl is in actual danger from the pregnancy.

Now I said that's a simple case. It's not really but it's a hell of a lot more simple that a 15-16 year old, who with proper medical care, doesn't face the same medical risks. It is still riskier than it is for an adult, but not as risky. Also a 15-16 year old is more capable of making a decision. In that case I'm honestly not sure. Like I said it's an ethical nightmare. I'm not sure what the law is regarding other procedures. Can a parent make a 15 year old get a transplant or any other surgical treatment against their will?

What are your thoughts?

I agree it's a legal and ethical mine field.

Here's what citzensinformation say regarding parents making medical decisions for thier children in ireland:

The rights of parents to make decisions on behalf of their children are the same whether or not those children have disabilities. This means that, in general, parents have no right to make decisions on behalf of their children once they reach 18. Children under 18 have the right to make specific decisions, for example, they may validly give consent to medical treatment from the age of 16 and they may legally engage in sexual activities from age 17.

In practice, parents of children with intellectual disabilities frequently make decisions on behalf of their adult children but they do not have the legal right to do so.

http://www.citizensinformation.ie/en/health/health_services/children_s_health/caring_for_a_child_with_a_disability.html

From the age of 16 people can make medical decisions for themselves. An independent social worker appointed to each case is a good idea. In practice though thier parents may have a lot of influence over thier decision as at this age they are usually providing housing etc for the teenager and may exert a lot of pressure for the teenager to conform to thier wishes.

Under 16's are not able to make medical decisions.We could perhaps lower the age of consent to make medical decisions but i'm not sure that's a great idea either.

Smondie · 21-08-2016 06:41PM

eviltwin wrote: »

I'm confused as to what situations you mean. A social worker has to be involved here if an underage girl is pregnant. Or a vulnerable one, I had one when expecting my first child. Pre and post counselling is sketchy at best and its not compulsory. I wouldn't feel comfortable with a teenager having an abortion without impartial advice. A counsellor will also probably be better than a gp or other professional at getting information.

From my understanding counselling is not compulsory in the UK model. I could be wrong.

astrofool · 21-08-2016 07:42PM

Smondie wrote: »

I am shocked and appalled that clinics providing medical services to women seeking abortions have been found to have such serious failings, services have been suspended with immediate effect, from providing abortions to the following groups of women:

-Suspended termination of pregnancy provision for under-18s and vulnerable groups of women.
-Suspended terminations under general anaesthetic or conscious sedation (over 12 weeks pregnant)
-Suspended all surgical terminations at their Norwich centre.

The Care Quality Commission has raised a number of concerns over patient safety.
The issues raised were poor governance arrangements, leading to what it called "specific immediate concerns" about consent and safeguarding.

It was not satisfied about training and competence for terminations which take place under general anaesthetic or conscious sedation

Each year 70,000 terminations are carried out at Marie stopes clinics with an estimated 10, 000 Irish women being treated. Inspections of clinics only started in March of this year. I don't think it's acceptable to have medical treatment in what appears to be a sub standard environment.

The UK Government has informed Marie Stopes International that Ministers will not give approval for further clinics in accordance with their statutory role to offer termination services until the CQC are satisfied that their concerns have been fully addressed.

Women are being accomadated in other clinics and they are trying to minimise the effect of the suspension of services, although some women, especially those closer to the time limit maybe effected. There is a helpline to call from ireland in the nhs link below.

http://www.bbc.com/news/health-37135380

https://www.england.nhs.uk/2016/08/marie-stopes-int-clinics/

https://www.theguardian.com/world/2016/aug/19/marie-stopes-suspends-some-abortion-services-over-safety-issues
http://www.thejournal.ie/marie-stopes-abortion-services-suspended-2938689-Aug2016/

It's not the first time practices at marie stopes has come under controversy.

Women have died after leaving the clinic
http://www.irishtimes.com/news/ireland/irish-news/medics-face-trial-after-irish-woman-dies-after-abortion-1.2255918

A doctor struck off after botching an abortion
http://m.independent.ie/world-news/europe/doctor-struck-off-as-abortion-nearly-kills-irish-woman-26798027.html

Marie stopes advocates that no doctors needs to see a patient before a termination, even thought the government recommends two.

http://www.telegraph.co.uk/news/health/news/10575108/Abortion-on-demand-gets-Government-green-light.html

I find it interesting that there is not more discussion from rights organisations about this. Many women who have received sub standard care find it difficult to raise a complaint in case they are labelled "anti abortion". Often valid complaints are ignored.

I think Irish services should stop recommending this clinic to women seeking a termination with immediate effect.

Do you think that Irish services should stop recommending this clinic to women seeking terminations?

I hesitate to say, if we performed the same level of audits on general hospitals that are dealing with much weaker and vulnerable patients, then the majority of them would be closed. Abortion clinics get a lot more scrutiny because of what they do, but it also pushes the standards they operate at far higher than any other medical services.

Smondie · 21-08-2016 08:18PM

astrofool wrote: »

I hesitate to say, if we performed the same level of audits on general hospitals that are dealing with much weaker and vulnerable patients, then the majority of them would be closed. Abortion clinics get a lot more scrutiny because of what they do, but it also pushes the standards they operate at far higher than any other medical services.

Inspections for abortion clinics in the UK only started in march 2012. The need to introduce inspections was because the requirement for 2 doctors to sign off before an abortion is performed was being flouted. Pre signed forms were being made available by doctors who never actually saw the patient. This is against the legislation. Marie Stopes advocates for no doctor to be present as the feel it is unnecessary.

http://www.abortionreview.org/index.php/site/article/1152/

astrofool · 21-08-2016 08:44PM

Smondie wrote: »

Inspections for abortion clinics in the UK only started in march 2012. The need to introduce inspections was because the requirement for 2 doctors to sign off before an abortion is performed was being flouted. Pre signed forms were being made available by doctors who never actually saw the patient. This is against the legislation. Marie Stopes advocates for no doctor to be present as the feel it is unnecessary.

http://www.abortionreview.org/index.php/site/article/1152/

Yes, John Oliver has a wonderful segment on these practices, they are not for patient safety, but as ways to delay and frustrate the process of getting an abortion, Texas recently had this practice overturned by the supreme court:
http://www.cnn.com/2016/06/27/politics/supreme-court-abortion-texas/
(and, by God and Jesus, even the link you provided identifies these inspections as being politically rather than medically motivated, how do you live with yourself?)

And I presume you mean no doctor present when the patient takes a tablet, as different from when a doctor performs a surgical abortion? In which case do you want all tablet taking to be performed in front of a doctor?

Please, when giving an answer, put it in the correct context, as all the glib replies are in responses to completely different scenarios, making your argument weaker and weaker, except to those who are unable to do any fact researching for themselves (but then I guess this group is your number one target for disinformation?)

What you point out above has no bearing on the fact that abortion clinics are held to a far higher standard and therefore likely to be much much safer for a patient than visiting any general hospital.

Smondie · 21-08-2016 09:19PM

astrofool wrote: »

Yes, John Oliver has a wonderful segment on these practices, they are not for patient safety, but as ways to delay and frustrate the process of getting an abortion, Texas recently had this practice overturned by the supreme court:
http://www.cnn.com/2016/06/27/politics/supreme-court-abortion-texas/
(and, by God and Jesus, even the link you provided identifies these inspections as being politically rather than medically motivated, how do you live with yourself?)

And I presume you mean no doctor present when the patient takes a tablet, as different from when a doctor performs a surgical abortion? In which case do you want all tablet taking to be performed in front of a doctor?

Please, when giving an answer, put it in the correct context, as all the glib replies are in responses to completely different scenarios, making your argument weaker and weaker, except to those who are unable to do any fact researching for themselves (but then I guess this group is your number one target for disinformation?)

What you point out above has no bearing on the fact that abortion clinics are held to a far higher standard and therefore likely to be much much safer for a patient than visiting any general hospital.

If they are not for patient safety why did Marie stopes agree with the cqc over the failings?

Yes I know the link I provided says the inspects began because of political motivation. You seemed to have ignored my previous links in the op, so I thought i'd try a different source.

Why shouldn't politicians act and push for inspections when leglislation is being ignore and records are being falsified? Do you expect them to ignore law breakers?

No need to presume anything about tablet taking, it's all there in the link I provided in the op. Here it is again.
http://www.telegraph.co.uk/news/health/news/10575108/Abortion-on-demand-gets-Government-green-light.html

What are the standards they are held to, can you link? I'd be interested in seeing the comparison.They were falisfying documents, doctors never having seen the patients authorising abortions, saying the had seen the patient.

Can you enligten me as to what you feel is the disinformation i am spreading?

I sleep fine, thanks for asking

astrofool · 21-08-2016 09:49PM

Smondie wrote: »

If they are not for patient safety why did Marie stopes agree with the cqc over the failings?

Yes I know the link I provided says the inspects began because of political motivation. You seemed to have ignored my previous links in the op, so I thought i'd try a different source.

Why shouldn't politicians act and push for inspections when leglislation is being ignore and records are being falsified? Do you expect them to ignore law breakers?

No need to presume anything about tablet taking, it's all there in the link I provided in the op. Here it is again.
http://www.telegraph.co.uk/news/health/news/10575108/Abortion-on-demand-gets-Government-green-light.html

What are the standards they are held to, can you link? I'd be interested in seeing the comparison.They were falisfying documents, doctors never having seen the patients authorising abortions, saying the had seen the patient.

Can you enligten me as to what you feel is the disinformation i am spreading?

I sleep fine, thanks for asking

Did you even read the article you quoted? It basically agrees with all I say above apart from this part from some idiot in the "Christian" Medical Fellowship, which seems to be the part you want to brow beat into everybody else.

Opponents say the guidelines will turn uncertainty over the law into a green light for abortion without doctors. “We are seeing a significant change in the practice of abortion,” said Dr Peter Saunders, of the Christian Medical Fellowship.
“This further trivialises the procedure and erodes the protections intended by Parliament for both the unborn child and the woman.”

Ultimately, they have found, from a legal point of view, that a doctor does not need to intervene when a patient is getting an abortion via non surgical means, such as taking a tablet, and that a nurse will be able to do this instead. The doctors hitherto had been pre-filling the forms on the basis that they were not legally needed anyway, and part of a bureaucratic system solely designed to delay and frustrate the abortion process, which is, itself, a time critical process.

You are right in that it starts normalises the process of an abortion to the degree that women no longer feel isolated from society for taking a personal decision. That is a good thing, I do not like making people feel isolated from society due to my own personal beliefs. If you want to impose your beliefs on others, then make it clear you are trying to do so, rather than hiding behind numerous articles and making ridiculous inferences from them.

Smondie · 21-08-2016 10:20PM

astrofool wrote: »

Did you even read the article you quoted? It basically agrees with all I say above apart from this part from some idiot in the "Christian" Medical Fellowship, which seems to be the part you want to brow beat into everybody else.

Ultimately, they have found, from a legal point of view, that a doctor does not need to intervene when a patient is getting an abortion via non surgical means, such as taking a tablet, and that a nurse will be able to do this instead. The doctors hitherto had been pre-filling the forms on the basis that they were not legally needed anyway, and part of a bureaucratic system solely designed to delay and frustrate the abortion process, which is, itself, a time critical process.

You are right in that it starts normalises the process of an abortion to the degree that women no longer feel isolated from society for taking a personal decision. That is a good thing, I do not like making people feel isolated from society due to my own personal beliefs. If you want to impose your beliefs on others, then make it clear you are trying to do so, rather than hiding behind numerous articles and making ridiculous inferences from them.

Your quote about how I want to brow beat the Christian fellowship in to people highlights how narrow minded you are on this issue. I have provided loads of other links. And you ignore other mp's that have commented in the article.

It is best practice to be seen by doctors and the nhs still go by this procedure in thier clinics. http://www.nhs.uk/conditions/Abortion/Pages/Introduction.aspx
The department of health didn't include it in the guidelines because it is not explicitly stated in the act and would require a change in leglislation to do so. Private clinics do not have to as it is not explictly stated.

The guidelines are not just about nurses giving tablets:
It gives the example of nurses administering the necessary drugs in medical abortions but does not rule out the possibility of them carrying out surgical procedures....

But abortion providers said the guidelines did not go far enough. Tracey McNeill, the director of Marie Stopes International, said: “It is entirely unnecessary for women to see a doctor.

“Nurses are often much better at dealing with the emotional and psychological needs of women.”

What are you on about imposing my beliefs on others? You do know this is a discussion board and not compulsary reading? Can you not make your point without the aggressive tone?

Mary63 · 21-08-2016 10:39PM

There were also questions raised about the standard of training of the people performing the abortions.

It stinks to high heaven to me and Marie Stopes international saw no problems until the Care Commission arrived to do the unannounced inspections.Allof a sudden then marie Stopes agreed there was an issue and took action immediately.

Is it difficult I wonder to get adequately trained people to perform abortions at twenty four weeks,is this why it was noted that the staff carrying out the procedures were poorly trained.Women intending to have abortions should be made aware that they are putting their lives in grave danger,the Care commission should issue a full comprehensive report outlining what they found.People who do perform these late abortions say they don't like doing it because the foetuses are too big,they mean the foetuses are too baby like.

Smondie · 21-08-2016 10:58PM

Mary63 wrote: »

There were also questions raised about the standard of training of the people performing the abortions.

It stinks to high heaven to me and Marie Stopes international saw no problems until the Care Commission arrived to do the unannounced inspections.Allof a sudden then marie Stopes agreed there was an issue and took action immediately.

Is it difficult I wonder to get adequately trained people to perform abortions at twenty four weeks,is this why it was noted that the staff carrying out the procedures were poorly trained.Women intending to have abortions should be made aware that they are putting their lives in grave danger,the Care commission should issue a full comprehensive report outlining what they found.People who do perform these late abortions say they don't like doing it because the foetuses are too big,they mean the foetuses are too baby like.

It totally is worrying, especially when cases like this have happened.

http://m.independent.ie/world-news/europe/doctor-struck-off-as-abortion-nearly-kills-irish-woman-26798027.html
A GYNAECOLOGIST who botched the termination of an Irishwoman’s pregnancy and left her fighting for her life, has been struck off in Britain.

This is only one of many women who have had botched operations at these clinics (5 more by that same doctor). The standard of care is questionable at the very least.

It's only in 2012 marie stopes stopped carrying out late term abortions in Australia.

Marie Stopes Australian chief executive Maria Deveson Crabbe said the decision to discontinue late-term abortions was unconnected with any investigations into the clinic and was made purely for operational reasons. Ms Crabbe said Marie Stopes remained supportive of women's access to late-term abortion.

http://www.theage.com.au/victoria/clinic-will-cease-lateterm-abortion-20120125-1qhqh.html

Do you remenber the scandal in 2005 where a whistleblower alleged they were paying cash bonuses to staff to encourage them to reach a daily target number of abortions performed?

This international clinic has serious issues and that's even before the consent issues highlighted are discussed.

lazygal · 21-08-2016 11:01PM

Pretty sure both of you oppose abortion regardless of how safe it is so I don't know what point you're trying to make.

rainbow kirby · 21-08-2016 11:04PM

I'd rather see a proper regulatory framework in place that identifies issues when they happens than a constitutional ban, just saying...

lazygal · 21-08-2016 11:06PM

rainbow kirby wrote: »

I'd rather see a proper regulatory framework in place that identifies issues when they happens than a constitutional ban, just saying...

I'm sure many Irish maternity services would be closed if stringent regulations had to be followed.

meeeeh · 21-08-2016 11:09PM

This subject is discussed very much through Irish perspective. It's worth to remember that abortion is a lot less traumatic for women in countries where they are not constantly told how guilty and hurt they should feel.

I don't like to see cowboy practices but I seriously doubt there was much damage done with not seeing two doctors.

This thread was started as tiny veiled attempt of scaremongering about abortions. I know a few women who had them and they are not carrying some deep scars that will never heal. And frankly it doesn't seem to be an issue that would need much counseling or discussing where I come from. And I think it's because there is not much right wing nut job hostility towards women who have them.

Smondie · 21-08-2016 11:14PM

rainbow kirby wrote: »

I'd rather see a proper regulatory framework in place that identifies issues when they happens than a constitutional ban, just saying...

Even with a proper regularly framework in place issues can slip under the radar as can been seen with this private clinic.

Abortion is not banned in ireland. It can be performed under certain circumstances. Abortion on demand is banned.

Stheno · 21-08-2016 11:17PM

Smondie wrote: »

Even with a proper regularly framework in place issues can slip under the radar as can been seen with this private clinic.

Abortion is not banned in ireland. It can be performed under certain circumstances. Abortion on demand is banned.

Do you know how many abortions were performed here last year?

Smondie · 21-08-2016 11:17PM

Stheno wrote: »

Do you know how many abortions were performed here last year?

No, do you have the figures there?

Stheno · 21-08-2016 11:19PM

Smondie wrote: »

No, do you have the figures there?

Yes, there were 26 carried out yet over three and a half thousand women travel yearly to have abortions.

http://www.thejournal.ie/abortions-ireland-26-2188298-Jun2015/

Smondie · 21-08-2016 11:21PM

Stheno wrote: »

Yes, there were 26 carried out yet over three and a half thousand women travel yearly to have abortions.

http://www.thejournal.ie/abortions-ireland-26-2188298-Jun2015/

So 26 for valid medical reasons

See it's not banned!

Stheno · 21-08-2016 11:23PM

Smondie wrote: »

So 26 for valid medical reasons

See it's not banned!

Right and tell me that you'd be ok having to go through multiple psychiatrists etc to have an abortion.

What of the three and a half thousand women who travelled?

You come across as extremely misogynistic.

Smondie · 21-08-2016 11:26PM

Stheno wrote: »

Right and tell me that you'd be ok having to go through multiple psychiatrists etc to have an abortion.

What of the three and a half thousand women who travelled?

You come across as extremely misogynistic.

Yes I would. It's a major decision which should not be taken lightly.

The 3500? Some travelled to a clinic that has now been flagged as having serious safety concerns and breeches of protocol.

eviltwin · 21-08-2016 11:28PM

Smondie wrote: »

Yes I would. It's a major decision which should not be taken lightly.

The 3500? Some travelled to a clinic that has now been flagged as having serious safety concerns and breeches of protocol.

Many women manage to make the decision to have an abortion without the need to talk to anyone and turn out just fine.

Smondie · 21-08-2016 11:30PM

eviltwin wrote: »

Many women manage to make the decision to have an abortion without the need to talk to anyone and turn out just fine.

Grand so, good for them! wasn't you earlier that was saying about the need for counselling pre and post abortion? Why do they need it if they're fine?

eviltwin · 21-08-2016 11:32PM

Smondie wrote: »

Grand so, good for them! wasn't you earlier that was saying about the need for counselling pre and post abortion? Why do they need it if they're fine?

I mentioned counselling in relation to underage girls mostly because it might give them an opportunity to discuss their own desires away from the caregivers. I wasn't talking about mature adults.

Counselling is a world away from having to see three psychiatric professionals. Apple's and oranges.

Smondie · 21-08-2016 11:38PM

eviltwin wrote: »

I mentioned counselling in relation to underage girls mostly because it might give them an opportunity to discuss their own desires away from the caregivers. I wasn't talking about mature adults.

Counselling is a world away from having to see three psychiatric professionals. Apple's and oranges.

I disagree that mature adults don't need counselling for abortions.

eviltwin · 21-08-2016 11:42PM

Smondie wrote: »

I disagree that mature adults don't need counselling for abortions.

It's there for those who want it. I don't believe forcing counselling on unwilling participants is a good use of resources. Most women are able to manage without it.

Smondie · 21-08-2016 11:45PM

eviltwin wrote: »

It's there for those who want it. I don't believe forcing counselling on unwilling participants is a good use of resources. Most women are able to manage without it.

But that was one of your reasons why abortion on demand should be in Ireland.

I think both mature adults and immature adults should talk it through with someone first. Especially immature adults because they mightn't have the maturity to realise the consequences of thier decision.

I'm guessing more immature than mature adults seek abortion on demand. Mature adults are more likely to work contraception better and take care of thier sexual health.

eviltwin · 21-08-2016 11:49PM

Smondie wrote: »

But that was one of your reasons why abortion on demand should be in Ireland.

I think both mature adults and immature adults should talk it through with someone first. Especially immature adults because they mightn't have the maturity to realise the consequences of thier decision.

I mentioned counselling in relation to underage girls. Don't go twisting things.

I agree anyone vulnerable or who has doubts should seek out support. It's a big decision. But it shouldn't be compulsory. I didn't get any, I didn't need it and I would hate to take up a valuable appointment that someone who does need it could use.

Tasden · 22-08-2016 12:00AM

eviltwin wrote: »

I mentioned counselling in relation to underage girls. Don't go twisting things.

I agree anyone vulnerable or who has doubts should seek out support. It's a big decision. But it shouldn't be compulsory. I didn't get any, I didn't need it and I would hate to take up a valuable appointment that someone who does need it could use.

I availed of "crisis pregnancy" counselling as a teenager. It was basically a woman trying to convince me that if I go ahead with the pregnancy I will not be able to continue with my education as planned. I had made my mind up and I dread to think about any vulnerable girls/women going to her having made their mind up only to be swayed into a decision that she felt was best for them instead. I'm unsure if it should be compulsory in relation to those wanting a termination but it would need to be regulated in some way if it was.

RDM_83 again · 22-08-2016 12:04AM

eviltwin wrote: »

I mentioned counselling in relation to underage girls. Don't go twisting things.

I agree anyone vulnerable or who has doubts should seek out support. It's a big decision. But it shouldn't be compulsory. I didn't get any, I didn't need it and I would hate to take up a valuable appointment that someone who does need it could use.

A short waiting period and mandatory counseling seems to work pretty well in Germany though.

Also if abortion is in general not traumatic etc wouldn't that mean that going to England isn't that big a deal

Marie Stopes clinic suspends services

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