Centre for Ethics in Medicine, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, BS8 2BN, United Kingdom.
Durham Law School, Durham University, United Kingdom.
Health Policy. 2021 Jan;125(1):17-21. doi: 10.1016/j.healthpol.2020.11.006. Epub 2020 Nov 16.
The COVID-19 pandemic has necessitated the rapid implementation of telemedical health services. In the United Kingdom, one service that has benefitted from this response is the provision of early medical abortion. England, Wales, and Scotland have all issued approval orders to this effect. These orders allow women to terminate pregnancies up to certain gestational limits, removing the need for them to contravene social distancing measures to access care. However, they are intended only as temporary measures for the duration of the pandemic response. In this paper, we chart these developments and further demonstrate the already acknowledged politicisation of abortion care. We focus on two key elements of the orders: (1) the addition of updated clinical guidance in the Scottish order that suggests an extended gestational limit, and (2) sunset clauses in the English and Welsh orders, as well as an indication of similar intentions in Scotland. In discussing these two issues, we suggest that the refusal of UK governments to introduce telemedical provision of early medical abortion previously has not been based on health concerns. Further, we question whether it would be appropriate for the approval orders to be lifted following the pandemic, suggesting that to do so would represent regressive and harmful policy.
新冠疫情大流行促使医疗服务迅速转向远程医疗。在英国，受益于这一应对措施的服务之一是提供早期医疗流产。英格兰、威尔士和苏格兰均为此发布了批准令。这些命令允许女性在一定的妊娠限制内终止妊娠，使她们无需违反社交距离措施来获得护理。然而，这些命令仅作为疫情应对期间的临时措施。本文记录了这些发展，并进一步展示了堕胎护理已经被承认的政治化。我们重点关注命令中的两个关键要素：(1)苏格兰命令中增加了更新的临床指导，建议延长妊娠限制；(2)英格兰和威尔士命令中的日落条款，以及苏格兰类似意图的暗示。在讨论这两个问题时，我们认为英国政府此前拒绝引入早期医疗流产的远程医疗服务并非基于健康考虑。此外，我们质疑在疫情结束后是否应该取消批准令，认为这样做将是倒退和有害的政策。
