PhD ThesisThe topic of termination of pregnancy continues to attract extensive debate in both the
public arena and in the academy. Debates about termination of pregnancy for fetal anomaly
(TOPFA) in particular take place against this backdrop. Social science analyses of the views
of medical professional providers of TOPFA are underdeveloped, and social care
professionals (who care for those living with disability) are an under represented group in
research more generally. In this contentious area of public policy, the insights could make
an important contribution to the on-going policy debates.
Using a mixed methods approach, this thesis explores the views about the acceptability of
TOPFA from the perspective of two professional groups: medical professionals and social
care professionals. Four case studies were used to form a basis for the exploration, and
these were selected for intrinsic exploratory value. An epidemiological overview of TOPFA
acceptance rates from six areas of the UK was used to help inform the case study selection
process. Data collection from professionals by questionnaires and semi-structured
interviews followed. The questionnaire data suggest that the views between the
professional groups were not radically different. The thematic analysis of the interview data
generated two themes: theme one conceptualises the imagined child; theme two
conceptualises the predicted experiences of the imagined child. When comparing the
accounts given by the two professional groups, the data suggest that social care
professionals also look at the wider social context of a person with an impairment when
discussing their views regarding TOPFA. Medical professionals focus more on the
individual impairment when discussing their views on TOPFA.
Whether an anomaly can be ‘fixed’, what pain is associated with the particular anomaly,
whether a normal life experience will be had were all considered against what professionals
deemed a ‘morally acceptable’ outcome. Acceptable TOPFA was based on what was
morally acceptable to professionals both in their professional roles, and within a personal
capacity. These findings show professionals are able to negotiate acceptable TOPFA in at
least some instances while maintaining a sense of moral self. This research adds support to
existing arguments on the extent to which the personal views of medical professionals
influence their practices. It also offers insight into a previously under researched group,
social care professionals. The mixed methods and interdisciplinary approach has been
crucial in providing a productive framework within which to explore the concept of
acceptable TOPFA from the perspectives of professionals.MRC and ESR