Being informed and the Right to Know

However different American healthcare is from British healthcare, it wouldn’t be unreasonable to assume that the principles of consent are similar. One such principle is that valid consent needs to be informed; one must be aware of the implications of a decision to have a procedure, the benefits, risks and so on. When it comes to abortion, it seems people cannot agree on what it means to be informed. Some Americans feel that to be sufficiently informed about a decision to terminate one’s pregnancy a woman must undergo transvaginal ultrasound. They refer to this together with the provision of other information as “the right to know”.

Why would a transvaginal ultrasound be performed in the context of abortion? In Britain, it wouldn’t. Over here, transvaginal ultrasound is used to examine the womb, ovaries and other organs for any abnormalities: it is a diagnostic tool. Other than letting a woman know she has a baby, which one suspects she already knows, the purpose of the transvaginal ultrasound in a healthy pregnancy was initially unfathomable to me.

...disregard the controversies surrounding abortion itself and focus on what it means to be informed

The argument given by campaigners for the “right to know” is “to ensure that women considering an abortion would be guaranteed access to independent information and advice from someone who had no vested financial interest in the outcome of their decision.” At first glance this appears innocent and even moral and maybe it is, but some say their motive is to discourage abortions.

Although it could have helped illustrate the issues, I will refrain from comparing abortion to any other operation as such a decision is vastly more complex. A better way to look at the compulsory inclusion of transvaginal ultrasound may be to disregard the controversies surrounding abortion itself and focus on what it means to be informed about a decision. The objective of providing information to make a decision is neither to condemn nor promote a choice. In fact, it is unethical to impose an option on a person; that person has the right to make autonomous decisions regardless of how unwise that decision appears to others. Absurdly it has been said that the idea is to put a woman off having an abortion by forcing her to look at the image of her foetus. Maybe they haven’t checked but even if one could justify why a woman should be persuaded not to have an abortion, this experience is highly unlikely to change her mind!

Before anyone goes as far as to say that denying a woman a transvaginal ultrasound is depriving her of vital information that she needs to give informed consent, perhaps they should ask themselves two questions. Firstly does it override a person’s autonomy to include dissuasion in the process of informing consent? And secondly is it acceptable for an invasive procedure such as transvaginal ultrasound, which is of no visible benefit to any party, to be a hoop through which a pregnant woman must jump before she can have an abortion?