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Medical Law

Sem 1 - Abortion and Human Embryology

What is the legal limit on research on a human embryo? Up to the 14 days (after fertilisation)
Is every doctor obliged to perform an abortion? No; The Abortion Act has a conscientious objection clause, which permits Doctors to refuse to participate in terminations
What must every Doctor do, regarding termination? 1) Must provide treatment in an emergency, when the woman's life is at risk 2) Provide information to people who wish to have an abortion, butcmay refer the patient to another doctor with an explanation that it is their right to see another Doctor
When was The Abortion Act passed? 1967
What are the clinical criteria for termination? Two registered medical practitioners are of the opinion that the legal criteria is met and also termination must be carried out by a registered medical practitioner
Which act addresses treatment involving the use of donated genetic material and research on human embryo? Human Fertilisation and Embryology Act (1990, amended 2008)
When is IVF and embryo selection allowed? When there are medical reasons - can also be a "saviour child" i.e. if they already have a handicapped child
Does the foetus have legal rights? There is no legal personality before birth (but the law does recognise that the foetus has a certain interest short of rights, and these are sometimes protected)
Does the father have any legal rights concerning abortion? No
What is criteria A of The Abortion Act? a)Not exceed the 24th week, and the continuance of pregnancy would involve greater risk (than if the pregnancy were terminated) of injury to the physical or mental health of the women, or her existing children
What is criteria B of The Abortion Act? The termination is necessary to prevent grave permanent injury to they physical or mental health of the pregnant woman
What is criteria C of The Abortion Act? The continuance of pregnancy would involve risk to the life of the woman
What is criteria D of The Abortion Act? There is a substantial risk that, if the child were born, it would suffer from such mental or physical abnormalities as to be seriously handicapped
Which hormone does Mifepristone block the action of? Progesterone
When progesterone is blocked, what does this result in? 1)Changes in the uterine lining and detachment of the pregnancy 2) Stretching and opening of the cervix 3) Increased uterine sensitivity to prostaglandin
Outline the process of a surgical two-stage abortion? Requires an overnight stay in hospital 1) Stops foetal heartbeat and softens the cervix 2) Carried out the next day; foetus and surrounding tissue are removed (Under general anaesthetic)
Outline the process of a medically induced abortion? Similar to a late natural miscarriage. Prostaglandin is injected into the womb, causing strong contractions lasting 6-12 hours. Woman will stay awake and my be given pain relief
What are the two types of a late abortion? Surgical two-stage abortion and medically induced abortion
What happens during surgical dilation and evacuation? Under general anaesthetic, cervix is stretched and dilated. Forceps and suction tube are used to remove the foetus. 10-20 mins to complete. If there aren't any complications, can leave on the same day. May experience vaginal bleeding for u to 14 days.
Outline the process of a late medical abortion Mifepristone and prostaglandin can also be used later on in pregnancy. A second does of prostaglandin may be required. Usually return home the same day, overnight may be required. <1/20 cases placenta and afterbirth may not pass, requiring operation
Outline the process of vacuum termination or suction termination Takes 5-10 mins under local/general anaesthetic. Tablet may be placed inside the vagina a few hours before the abortion to soften the cervix. A suction tube connected to a pump is inserted into the womb to remove the foetus and surrounding tissue.
Outline the mechanism of mifepristone Binds to the progesterone receptor and acts as a competitive inhibitor. 18 hours later, trophoblast seperates from the decidua, maternal blood beta-hCG falls, prostaglandins are released locally. Causes uterine bleeding and rhythmic uterine contractions
What are the different methods of termination? Early medical abortion (up to 9 weeks) Vacuum aspiration/suction termination (7-15 weeks) Late medical abortion (9-20 weeks) Surgical dilation and evacuation (from 15 weeks) Late abortion (20-24 weeks) Saline solution (ILLEGAL in UK)
Which method of abortion is illegal in the UK? Use of saline solution
Outline the process of early medical abortion Take mifepristone and prostaglandin 48 hours apart. First pill causes mild cramps and a little bleeding, second causes womb breakdown which is lost, with the embryo, through the vagina.
What effect does mifepristone have? Blocks progesterone receptors so lining of the uterus breaks down
What effect do prostaglandins have? Causes the womb to contract which causes cramping and bleeding
Created by: SandersE