British Section of the World Federation of Doctors Who Respect Human Life

Sir, The deregistration of Margaret Haywood by the Nursing and Midwifery Council (report, April 17) is a dismal example of adherence to rules taking precedence over a broader concern for professional standards. It is abundantly clear that Ms Haywood’s motivation was solely to correct failures at the Royal Sussex Hospital. Ms Haywood was evidently aware of the risks attached to breaking the rules of patient confidentiality, yet it is clear she saw it as a higher professional duty to patient wellbeing that the disgraceful abuse of elderly and dying patients should be exposed.

Patient confidentiality is a serious matter, but to remove Ms Haywood from the NMC Register for what amounts to a technical breach of the rules is, in the context of this case, a denial of reason and justice.

Peter Lindon

Lewes, E Sussex

Sir, Margaret Haywood is an experienced nurse of long standing. The kind of nurse that the NHS desperately needs. She should not have been struck off for exposing the failures of the Royal Sussex.

The feeling seems to be that the public should just accept the falling standards of the NHS, with draconian measures to keep mum about failure.

Jenny Mccoy

Coulsdon, Surrey

Life and Death Matters: Disability Rights and Incapacity Date: Postponed, new date to be arranged.

Barristers and solicitors are entitled to claim 6 CPD points for attendance.

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From The Daily Mail

By Chris Brooke

A girl of 15 died five days after an abortion because of a blunder at her clinic, an inquest heard yesterday.

Alesha Thomas was supposed to have been given antibiotics to combat infection after the procedure.

But she never received the medication and was struck down by a heart attack caused by a bacterial toxin.

The sexual health organisation Marie Stopes International, which ran the clinic, was strongly criticised by the coroner for procedural failings. He warned it could face legal action.

Due to inefficient practices at the clinic it was not uncommon for patients to leave without being given their prescribed medication, the inquest heard.

Alesha was a 'healthy and fit adolescent' who confided in her mother Rose Bent that she was pregnant in June 2007, Huddersfield Coroner's Court heard.

After discussing her options, they chose an abortion at the Marie Stopes International clinic in Leeds.

Two weeks later, when Alesha was just over 15 weeks into the pregnancy, the 25-minute procedure was performed successfully by gynaecologist Dr Peter Paku.

From The Times

Ruth Gledhill, Religion Correspondent

Condoms are to be advertised round-the-clock on television under proposals published today.

In an attempt to cut the teenage pregnancy rate, which is the highest in Europe, the Committee of Advertising Practice and Broadcast Committee of Advertising Practice wants to relax the current rules. The authority also proposes to allow pro-abortion services to advertise on television for the first time in a move condemned immediately by anti-abortion groups.

The 9pm watershed on condom advertisements is to be abolished, although they will not be broadcast around programmes aimed at children under 10.

The change is outlined in a consultation by the authority beginning today on new advertising codes for broadcast and other media. Pregnancy advice services will be able to advertise on television but must make it clear whether or not their service includes abortion referrals.

The use of condoms was condemned last week by the Pope as a health measure that “aggravates” rather than protects against the problem of HIV/Aids infection.

Anti-abortion and Catholic groups believe that condoms encourage promiscuity and so have the opposite effect of what is intended, increasing rates of unwanted pregnancies and risking an increase of sexually transmitted diseases.

At present, condoms cannot be advertised on Channel 4 before 7pm and on other channels before 9pm, in order to protect younger viewers from “inappropriate” content. Britain’s growing teenage pregnancy rate, however, has prompted the proposal for change.

Baroness Gould of Potternewton, the chairman of the Government’s Independent Advisory Group on Sexual Health and HIV, wrote to the Broadcast Committee of Advertising Practice in 2007 to request a review of the scheduling restrictions on condom advertising, noting that Britain had the highest teenage pregnancy rate in Europe and spiralling rates of sexually transmitted infections. Her group’s annual report had showed that young people believed television was one of the most effective ways of encouraging those of the same age group to use condoms.

Advertising chiefs have also examined figures in the House of Commons Library which show that, from 2002 to 2006, more than 11,000 under-16s had gonorrhoea, chlamydia, syphilis, herpes or genital warts diagnosed.

“The presence of condom advertisements on television continues to be a subject of complaint to the Advertising Standards Authority, but numbers are very low,” the consultation document reports.

The document advises that public sensitivities must be balanced against “a public health problem that is clearly urgent”.

In her letter to the committee, Lady Gould argued that relaxing restrictions on sanitary protection had helped to increase familiarity with those products and that advertising now associated them with “healthy and active lifestyles.”

Michaela Aston, of the pregnancy crisis service Life, said: “This is awful. Pro-life charities have no money and pro-abortion charities have a lot. We will never be able to afford to advertise on television. The only thing we will see is abortion agencies targeting the young. Going alongside condom advertising throughout the day, it is just going to encourage young people to have sex.

“The message is that if they use condoms it will reduce teenage pregnancy, even though the last decade has shown that the opposite is true. The next thing we will see is free condoms in breakfast cereals.”

John Smeaton, of the Society for the Protection of Unborn Children, said: “This is rather predictable on abortion, and condom advertisements throughout the day won’t help either. There is plenty of evidence to show that the more you promote easy access to birth control among young people, the higher the preg- nancy rate, the higher the abortion rate. This is not the solution to the problem.”

Andrew Brown, the chairman of the Broadcast Committee of Advertising Practice, said: “The UK advertising codes are widely recognised for setting a high bar for social responsibility. Our priority is to ensure that the rules remain relevant for the future so that consumers can continue to enjoy and trust the ads they see. Throughout this process, we sought the views of industry and policy makers and now we want to hear from all other interested parties, including the people that matter the most in advertising, the general public.”

From The Sunday Times

Given no other way to end their lives, patients are choosing an Euthanasia agonising death with the help of GPs

Sadness at the prolonged illness of young Hannah Jones is only exceeded by sadness at the heavy-handed paternalism that decided Hereford Hospital consultants to try to remove her from her family and home and force her to have a heart transplant against her considered will. Her reasons are her own but perhaps include some realisation that living hearts can only come from living bodies, as well as her generosity in thinking of others who are waiting for such an operation.

As we admire her courage, we can pray that she will continue to enjoy life at home for much longer than is at present anticipated.

Dr David J Hill.

From C-fam.org

By Austin Rose

(C-FAM – WASHINGTON, DC) The pro-abortion law group the Center for Reproductive Rights (CRR) has already called for President-elect Barrack Obama to renew America’s commitment to “reproductive rights” which, according to CRR, prominently includes a right to abortion. It is likely the new president will work almost immediately to correct what his ideological allies like CRR view as multiple mistakes of the Bush administration with regard to international social policy.

By Wesley J. Smith

THURSDAY, NOVEMBER 06, 2008

One of the most important services that medical professionals can offer to the people they serve, I think, is to declare their offices and facilities to be "assisted suicide free zones." Indeed, I hope that medical organizations create plaques and certificates to that doctors and health care facilities can mount on office walls.

Some hospitals are already on this bandwagon, declaring that assisted suicides will not be permitted on premises: From the story:

While Washington voters made it legal for doctors to help terminally ill residents end their lives, opponents of the assisted suicide measure indicated Wednesday they will continue to resist the practice...Eastern Washington's largest hospital system, Providence Health and Services, will forbid physicians from helping patients die at its hospitals, nursing homes and assisted care centers. "Providence will not support physician-assisted suicide within its ministries," the owner of Sacred Heart Medical Center and Holy Family Hospital said in a prepared statement. "This position is grounded in our basic values of respect for the sacredness of life, compassionate care of dying and vulnerable persons, and respect for the integrity of medical, nursing and allied health professions. We do not believe health care providers should ever be put in a position of aiding a patient in taking his or her own life."

This is important. Medical professionals must resist turning killing (which means to end life) into a medical treatment. None can be forced (yet) to participate. Such modeling may save lives of people who, thanks to the continued professionals of non participating medical professionals, will never ask for assisted suicide. And it will give courage to others to resist the culture of death that this way comes.

Of course, eventually the ideologues will try and force people to participate or be complicit in the killing, as I have written here at SHS. In the end, the culture of death brooks no dissent. But dissent we must, and resist we will.

Daniel James's death is a tragic end to his very sad story.

Suicide attempted in the months following an accident resulting in paralysis in a young man is far from unusual. The awful truth about his future can only be faced if there is adequate support from family and friends around the clock. Psychiatric help is essential with an on going commitment.

Suicide is not a punishable offence in law. Assisted suicide is different, it involves another person often a relative who is emotionally involved and may be blackmailed into believing that they are being compassionate and caring. The unfortunate victim has no chance of allowing second thoughts to change his mind.

Allowing assisted suicide is a pernicious ideology.

Mary Knowles

Daily Telegraph

Sir – As a Catholic, a Jew, and a humanist, with shared values in the area of medicine and ethics, we strongly support medical research using human tissue.

We encourage people, if they have the opportunity, to donate blood or tissue samples to “tissue banks”.

However, in 2008 it is an outmoded concept to expect people to allow blood or tissue to be used without consent.

Britain has led the way in promoting effective procedures to ensure this, via the Human Tissue Authority.

We believe that we should continue to show such leadership: so, if the research is itself controversial, then we expect that the right to “conscientious objection” – for both donor and doctor – should be respected.

We regret that this week the Commons did not amend the Human Fertilisation and Embryology Bill to incorporate a robust consent clause.

If this is not corrected, then we believe that prospective donors will be discouraged from donating to tissue banks.

We have differing perspectives on human-animal hybridisation, but share the concern: how can people trust in science if their tissue can be used in this way without their consent?

“Presumed consent” is no consent at all.

Professor David Albert Jones, St Mary’s University College, Twickenham

Professor David Katz, University College London Medical School; Dr David King Director, Human Genetics Alert

Sunday Telegraph

By Laura Donnelly, Health Correspondent

On Wednesday MPs will vote on a bill which would allow the creation of human/animal hybrid embryos to be used for stem cell research, change the conditions for granting IVF, and possibly liberalise the abortion laws.

The passage through Parliament of the Human Fertilisation and Embryology Bill has been dogged by controversy. Failed attempts to outlaw late abortion have dominated the debate, while scientists, medical ethics experts and religious leaders have clashed over the hybrid embryo issue.

Defenders of the bill have repeatedly stressed the importance of gaining consent from anyone whose tissue is taken for the creation of human/animal hybrid embryos.

It can now be revealed that a Government amendment, agreed after the main parliamentary debates, would allow tissue to be used from people who lack the "mental capacity" to give consent, children whose parents give permission, and anyone who has previously donated samples to hospitals for medical research but can no longer be traced.

Medical ethics experts and religious leaders are furious that the provisions, which they say ride roughshod over basic human rights, have already been agreed by an all-party committee of 17 MPs charged with scrutinising the bill, without any public debate or discussion in the main chambers of Parliament.

Prof David Jones, director of the Centre for Bioethics and Emerging Technologies at St Mary's University College, London, said: "In May we had a public debate about whether or not it is a good thing to create hybrid embryos.

"Now it transpires that just weeks later, with no public debate at all, the Government inserted these amendments which cross a fundamental line in medical ethics by presuming consent in many cases. I think it is totally objectionable, and I really worry that this will create a backlash against medical research."

He said he feared that someone who had strong ethical concerns about the creation of embryos could have their original wishes overruled, if they developed a disease such as Alzheimers and decisions about consent were taken by someone who did not know them.

Prof John Haldane, director of the Centre for Philosophy and Public Affairs at the University of St Andrews, described the draft legislation as a "mess" which would sweep away 25 years of progress in medical ethics.

"The most intimate thing over which you have control is your body and its fate; and this is total violation of that basic right," he said.

Under the amendment, if a person was deemed unable to give consent their carer would make a decision on their behalf. If the person did not have a carer, researchers would nominate a person to make the judgement. If scientists wanted to use human tissues already donated for research, perhaps during a medical procedure, but were unable to trace the donors because the research had been anonymised or the person had moved house, the samples could also be used.

Labour MP Dr Ian Gibson, one of the members of the committee which passed the amendments proposed by public health minister Dawn Primarolo, said he feared that major changes were being made with little consideration by Parliament and almost no public debate.

"I am really worried that this whole debate has become hijacked by the issue of abortion, and that really significant issues like this have not had a good airing, and are unlikely to do so this week when the bill gets to its final stage, despite the fact this is a once-in-a-lifetime chance to make some fundamental decisions," he said.

Dr Gibson said he personally opposed any use of tissue without consent. "There has to be consent, there can be no substitution for it. If you are not sure it is what the person would have wanted, that is just not good enough," he said.

Jim McManus, from the Catholic Bishops Conference of England and Wales, described the changes to the bill as a "macabre" prospect. He said: "This is a reckless step backwards, and it rides roughshod over a basic human right."

Scientists say combining animal embryos with human cells would allow an expansion in research, which is currently limited by numbers of donations of human embryos.

Catherine Elliot, from the Medical Research Council, said such research could provide a "powerful tool" to examine the development and treatment of different diseases. She said research would "rarely" be carried out without consent, because under the amendment, ethics committees must be satisfied the same research could not have been carried out using tissue from patients who had granted permission.

Charities representing people with degenerative diseases and learning disabilities last night said they knew little about the changes to the bill, which have received almost no publicity.

Mencap and The Motor Neurone Disease Association said they would now be studying the amendment, while the Alzheimer's Society expressed some reservations, but said it was optimistic that ethics committees would take cautious decisions about the use of tissue if consent had not been obtained.

A counter-amendment, deleting the changes to consent, has been listed for the bill's final debate on Wednesday, but campaigners fear it is unlikely to be discussed, as it is one of dozens vying to be chosen for the bill's final debate before MPs vote.

The Department of Health said the amendment came in response to concerns raised in the House of Lords about the use of cells from children who were not able to give consent, and adults who lacked mental capacity to consent to research into serious illnesses from which they suffered.

A spokesman said ministers were satisfied that a case had been made which justified limited exceptions from the European Convention on Human Rights.

Although MPs have been given a free vote on some aspects of the bill, including the clauses governing the creation of hybrid embryos, Labour MPs will be under a three-line whip to support the changes on consent, which are dealt with in a separate part of the legislation.

By: Wesley J. Smith

The Swiss have overtaken the Dutch as the prime harbingers of things to come in the Culture of Death. As it grants individual intrinsic dignity to plants, its Supreme Court declared a constitutional right to assisted suicide for the mentally ill. Now, a debate is opening, the end point of which is to force all nursing homes and hospitals to permit assisted suicides to take place on premises. From the story:

In 2007 Exit carried out 245 assisted suicides by Swiss or foreign nationals living in Switzerland. Exit assists only Swiss residents and usually goes to them in their own homes.

But Lausanne and Geneva university hospitals and several nursing homes also allow assisted suicide on their premises. Out of the 66 assisted suicides in French-speaking Switzerland last year, five took place in old people's homes.

Jérôme Sobel, president of Exit for French-speaking Switzerland, told Swissinfo that the five cases "took place normally", but said some homes do not allow the practice at all or put up obstacles. The purpose of the initiative is to put pressure on them to ensure that terminally ill patients' full rights are respected. "We have encountered major difficulties on several occasions," he explained. "When we go to a nursing home to help someone there shouldn't be a stand-off each time with the directors."

Exit's initiative asks for nursing homes receiving state subsidies to allow elderly residents to receive assistance to suicide if they request it, in accordance with article 115 of the Swiss Penal Code and article 34 of Vaud's cantonal Penal Code. "When a nursing home stops us, they are contravening the law," said Sobel. Exit has until February 3, 2009 to collect 12,000 signatures in canton Vaud to force a local vote on the issue.

That would make dissenting facilities complicit in suicide, of course, which is the point.

The Swiss proposal is not an isolated incident. As I wrote here at SHS and elsewhere, the last assisted suicide legislation in California, that did not pass, would also have required all health care facilities but acute care hospitals to permit assisted suicide on premises, with no exemption for religious or moral objection allowed, meaning that Catholic nursing homes (as but one example) would have been forced to permit their patients to be helped in suicide.

As the Culture of Death gains strength, expect more of this kind of coercion, an approach already occurring in other issues, both to ensure that all are complicit and to stifle the silent message of dissent that non cooperation with the agenda sends. The Culture of Death demands that obeisance from all.

By: Wesley J. Smith

The Swiss have overtaken the Dutch as the prime harbingers of things to come in the Culture of Death. As it grants individual intrinsic dignity to plants, its Supreme Court declared a constitutional right to assisted suicide for the mentally ill. Now, a debate is opening, the end point of which is to force all nursing homes and hospitals to permit assisted suicides to take place on premises. From the story:

In 2007 Exit carried out 245 assisted suicides by Swiss or foreign nationals living in Switzerland. Exit assists only Swiss residents and usually goes to them in their own homes.

But Lausanne and Geneva university hospitals and several nursing homes also allow assisted suicide on their premises. Out of the 66 assisted suicides in French-speaking Switzerland last year, five took place in old people's homes.

Jérôme Sobel, president of Exit for French-speaking Switzerland, told Swissinfo that the five cases "took place normally", but said some homes do not allow the practice at all or put up obstacles. The purpose of the initiative is to put pressure on them to ensure that terminally ill patients' full rights are respected. "We have encountered major difficulties on several occasions," he explained. "When we go to a nursing home to help someone there shouldn't be a stand-off each time with the directors."

Exit's initiative asks for nursing homes receiving state subsidies to allow elderly residents to receive assistance to suicide if they request it, in accordance with article 115 of the Swiss Penal Code and article 34 of Vaud's cantonal Penal Code. "When a nursing home stops us, they are contravening the law," said Sobel. Exit has until February 3, 2009 to collect 12,000 signatures in canton Vaud to force a local vote on the issue.

That would make dissenting facilities complicit in suicide, of course, which is the point.

The Swiss proposal is not an isolated incident. As I wrote here at SHS and elsewhere, the last assisted suicide legislation in California, that did not pass, would also have required all health care facilities but acute care hospitals to permit assisted suicide on premises, with no exemption for religious or moral objection allowed, meaning that Catholic nursing homes (as but one example) would have been forced to permit their patients to be helped in suicide.

As the Culture of Death gains strength, expect more of this kind of coercion, an approach already occurring in other issues, both to ensure that all are complicit and to stifle the silent message of dissent that non cooperation with the agenda sends. The Culture of Death demands that obeisance from all.

Daily Telegraph

By Roger Highfield, Science Editor

A safer way to turn one kind of cell into another has been developed that could make it much easier to develop revolutionary new treatments based on stem cells.

By Wesley J. Smith

Barach Obama has been accused of opposing the Infant Born Alive Protection Act, which requires hospitals and doctors to treat the survivors of attempted abortion. He denies this despite having refused repeatedly to vote for the Illinois versions.

This 2001 transcript, pp.86-87, is telling. Expressing a hyper-legalism to avoid grappling with the issue, Obama argued against the legislation, stating:

The second reason that it would probably be found unconstitutional is that this essentially says that a doctor is required to provide treatment for a previable child or fetus, however way you want to describe it. Viability is the line that has been drawn by the Supreme Court to determine whether or not an abortion can or cannot take place. And if we place the burden on the doctor, that says you have to keep alive even a previable child as long as possible and give them as much medical attention--as is necessary to try to keep the child alive, then we're probably crossing the line in terms of unconstitutionality.

"A previable child or fetus, however way you want to describe it"? Once the child is delivered, he or she is an infant, not a fetus. And the requirement that a living baby be treated once delivered, has nothing to do with abortion or the woman's right to the same. So, it seems to me that the only way to read Obama's statement is that he doesn't believe that abortion survivors should have to be treated as fully human beings.

And how's this for leadership? After making his statement, after asserting that the bill is unconstitutional, Obama said:

I think that we will probably end up in court once again, as we often do on this issue. And as a consequence, I'll be voting Present.

The courage to lead!

By: Wesley J. Smith

This YouTube video demonstrates the garbage thrown by animal rights activists and those who make a quasi-religion out of the environment.

Governor Sarah Palin does indeed, support aerial hunting of wolves. But not for fun (and she has never done it). The point is predator control, as an article in Slate (http://www.slate.com/id/2199140) points out that aerial hunting is against federal law and is only permitted to control predators. Moreover, in Alaska permits are given only "in select areas" where moose and caribou populations are threatened. The article says this leaves more meat for human hunters. I don't doubt that, and I see nothing wrong with it. Subsistence hunting is a mainstay for some Alaskans' diets. But it would also seem that the hunts, which have controlled numbers of permitted kills, are also conducted as a matter of proper ecosystem management.

By: Wesley J. Smith

According to a UK study, the concerted drive to prenatally detect Down syndrome or other anomalies through genetic testing aimed at eugenic abortion is also causing the deaths of babies who have no disabling condition through miscarriage. From the story:

Two healthy babies are miscarried for every three Down's Syndrome babies that are detected and prevented from being born, research has suggested...

DSEI chief executive Frank Buckley and Professor Sue Buckley, who conducted their research using a database at London's Bart's Hospital, also point out that 95 per cent of women deemed to be high risk by the blood test will not be carrying a baby with the disorder, yet most go on to have the tests.

"The screening for Down's syndrome has consequences for every pregnant woman," they said. "You cannot look at it as just a search-and-destroy mission focused on babies with Down's alone."

Although they admit that their ratio is only an estimate, they are backed by a number of independent experts who fear inexperienced practitioners may also be to blame. Professor Kypros Nicolaides, head of the Harris Birthright Centre at King's College Hospital in south London, said the loss of healthy babies was "completely unacceptable"

"Search and destroy," yup that's a good description of an ugly process, with the unaffected babies apparently the collateral damage.

Here's an idea: How about not trying to destroy these babies in the first place and then the others will be safe, too.

By Rita L. Marker

Oregon seems to have found a surefire way to lower health care costs: Tell the patient you'll pay for drugs that will end her life, but not those that would extend her life.  Here's how it works:

• The oral requests, which must be separated by fifteen days, do not need to be witnessed. In fact, they don't even have to be made in person. They could be made by phone - even left on the physician's answering device. The written request must be witnessed, but it could be mailed or faxed to the doctor.

• The law states that the physician is to "recommend that the patient notify next of kin," but family notification is not required. It is entirely possible that the first time family members find out that a loved one was contemplating suicide could be after the death has occurred.

• Doctors can facilitate the suicides of mentally-ill or depressed patients without any prior counseling being provided. A psychiatric evaluation is required only if the physician believes that the mental illness or depression is causing impaired judgment. According to Oregon's latest official report, not one patient who died after taking the lethal drugs was referred for counseling prior to being given the prescription.

When all is said and done, it is not the intent of assisted-suicide supporters that matters.   Instead, it is the law's deadly content and the inevitable price that we would all pay for health care cost containment - Oregon style.

From the Daily Telegraph,

18 July 2008

A nurse has been cautioned but allowed to continue practising after she gave a chemical abortion to the wrong woman.

Ann Downer, 44, gave the drugs to a woman who had only gone into the clinic for an initial consultation following a mix-up over patient names.

She had not decided to have a termination when Downer gave her a dose of Misoprostol at the Calthorpe Clinic in Edgbaston, Birmingham.

Downer failed to check the patient's personal details to verify her identity before she administered the drug.

An NMC spokesman said the committee was told that the clinic's usual practice was to only call out first names of patients to protect their confidentiality while in the waiting room.

Once the patient was in a private room, other details, like their full name, date of birth and address, were checked to make sure they were the person the nurse was expecting.

The patient was only due to have an initial consultation, which would have involved a consultation with a doctor, blood tests and a scan.

The second stage - in which Misoprostol was administered - would only follow if the patient and doctor gave consent.

When staff realised what had happened the distraught woman, referred to as Patient A in the hearing, was called back to the clinic "in pain".

Doctors subsequently advised her to undergo a surgical abortion.

Downer should have given the drugs to a second patient, Patient B, who was in the later stages of a termination.

Patient A attended the clinic on October 13, 2006.

Patient B, who had the same first name, was due to have the drugs for the second stage of her medical abortion - only undertaken on women who have been pregnant for less than nine weeks.

Patients at the first stage are given a tablet of Mifepristone to swallow, which stops the growth of the foetus.

At the second stage, women are given Misoprostol to complete the abortion.

Nailah Mears, for the NMC, told the panel Downer was in charge of treating patients at the second stage when the mix-up was made.

She said: "During the course of the morning, it was discovered Miss Downer had mistakenly administered the second visit treatment to Patient A instead of Patient B.

"The registrant failed to carry out proper identity checks, and as such did not realise the treatment was being given to the wrong patient."

Miss Mears also told the panel that Patient A was over the nine week gestation period limit for giving such early abortion tablets.

She said: "Once the mistake came to light, Patient A was asked to return to the clinic and was later transferred to Birmingham Women's Hospital.

"She was given an ultrasound, and that ultrasound showed that Patient A was over the nine week gestation period.

"That is very significant in determining whether the early medical abortion was appropriate. It was not appropriate in this case."

Nurse manager Evlyn Mike told the hearing: "They telephoned Patient A and asked her to return to the clinic. She did return. Apparently she was in pain, and obviously very upset."

Downer, from Browns Green, Birmingham, was not present at the hearing.

She had admitted giving the abortion drug to the wrong patient but had denied failing to obtain Patient A's consent to give her the drug.

Downer will have a caution on her record for the next three years.

The Conduct and Competence Committee, which met in London, said she can continue to practise but will have to declare the caution if she applies for a different job.