Medical Treatment: Decisions and the Law

9. Abortion

The place of treatment

Save for the situation in which a termination is immediately necessary to save the life or to prevent grave permanent injury to the physical or mental health of the pregnant woman, by virtue of ss 1(3) and (4) of the Abortion Act 1967, terminations may only be performed in a hospital ‘or in a place approved for the purposes of this section by the Secretary of State.’ The Secretary of State has given approval to certain independent sector clinics to perform terminations subject to certain conditions.

By s 1(3A) of the Abortion Act 1967, the power to give such approval also includes power to approve a class of places in relation to treatment consisting primarily in the use of medicines. On 27 December 2018 the Secretary of State granted further approval in respect of the homes of pregnant woman undergoing treatment with mifepristone and misoprostol for early medical abortions, limited to the second stage of treatment, i.e., taking the second medication.

On 30 March 2020 the Secretary of State published a yet further approval of the ‘home of a pregnant woman’ as being a place authorised for the purpose of the Abortion Act 1967 where certain treatment for early medical abortion might be carried out, and approving the ‘home of a registered medical practitioner’ as a class of place for prescribing mifepristone and misoprostol for early medical abortions. Those approvals are time limited until either the temporary provisions of the Coronavirus Act 2020 expire or two years, whichever is the earlier. It was the former approval which was the subject of the unsuccessful challenge in R (Christian Concern) v Secretary of State for Health and Social Care. It remains to be seen whether this temporary approval in respect of certain early medical abortions in fact signals a movement to a more permanent extension of the places where some abortions may be performed by way of medication.

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