The Editor, Sir:

It would seem that in debating the abortion issue people with opposing views use the extremes of the opposite side to attempt to bolster their argument. Abortion on demand is an extreme position which I believe the majority of Jamaicans would find morally reprehensible and which the advisory committee on abortion never suggested. The diametrically opposite view, that is, to disallow abortion no matter what the circumstances is an equally extreme view, untenable to thinking Jamaicans.

In arriving at a national consensus on this issue, two principles should guide us: 1) That we are out of many, one people, and therefore the various stakeholders should be given an opportunity to fully ventilate their points of views in a broad and consultative approach, and 2) That we are and continue to be primarily a Christian nation in which Christian precepts cannot be ignored and should continue to inform our decision making (read our national anthem and pledge).

On this background, I wish to make the following suggestions along with reasons for them.

Lawful abortion could be permitted under the following circumstances:

(1) Where if a pregnancy were to continue, the life or health (and not the mental health) of the mother would be seriously threatened in the expert opinion of at least two independent medical practitioners. In exceptional circumstances, if the mental health of the woman was so disturbed that she became suicidal then abortion could be considered.

(2) In established cases of rape, carnal abuse and incest. In the first, natural justice dictates that a woman be allowed to reassert her autonomy over her body and decide whether or not she wants to birth a child she had no choice in conceiving when her autonomy was brutally taken away. In the second, a minor should not be allowed to bear the ravages of pregnancy, which is a parasitic state, and be doubly victimised. In the third case, overwhelming medical evidence points to the debilitating effect of consanguinity on the genetic and immune robustness of offspring which would threaten the very health of society. Those Christians who object to this may be reminded of Ecclesiastes 3: 1-3, which clearly states that there is "a time to kill".

When parents should have the last say

(3) Where pregnancy would result in the delivery of an individual requiring lifelong intensive support and caregiving. The State has no ethical grounds in disallowing abortion in this instance if it can't itself guarantee the lifelong, humane, specialised, expensive and institutional care such an individual may require. The parents are the only ones who should make that decision.

(4) In selected cases of juvenile pregnancy, where in the expert opinion of a panel adjudicating the merits of abortion it felt, inter alia, that the biologically underdeveloped female may be permanently harmed by a continuation of the pregnancy.

Moral behaviour and decency cannot be enforced by law but once society determines the parameters under which abortions can legally take place, anyone performing abortions outside of these should be criminally charged and imprisoned once found guilty. In the case of medical practitioners, their licence to practice medicine should be permanently revoked.

I am, etc.,

WILLIAM D AIKEN (Dr)

Lecturer in Surgery

Department of Surgery, UWI, Mona