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Comment on ‘The policing of abortion services in England’
  1. Matthew Phillips, LLM, MRCP
  1. Specialist Registrar in Genitourinary Medicine, Manchester Centre for Sexual Health, Manchester, UK; phillima{at}

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I was deeply saddened to read the opinions of Dr Rowlands in his article entitled ‘The policing of abortion services in England’ in the April 2013 issue of the Journal.1 Although the argument is clear that the requirement for two signatures on the HSA1 form is burdensome, and is not seen as necessary by everyone, the article seems to miss a key point. An overriding ethical duty for any clinician is truth telling, with the quality of probity reflecting this. By pre-signing blank forms for abortion, the clinician is failing on both of these accounts. To sign that one is satisfied that a procedure can take place in the absence of knowledge of the patient is a clear departure from truth telling, and raises important questions about probity. The pre-signature demonstrates a willingness of the clinician to claim falsely that they have assessed a patient, either in person or via professional consultation. Perhaps the seriousness of a false claim has been underestimated in Dr Rowlands’ considerations in terms of its reflection on us as practitioners. The need for simplification of the abortion process is stated eloquently, but still must not be used as a justification for departure from professional standards of behaviour.


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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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