Today on Morning Ireland Cathal MacCoille interviewed Dr David Fergusson about a paper he has written regarding the mental health effects of abortion.

In the course of that interview, and a subsequent interview with Professor Patricia Casey, MacCoille badly misinterpreted The Iona Institute’s take on the Fergusson paper and led listeners to believe that Dr Fergusson was unhappy with how we quoted his research.

This is absolutely false as a reading of the interview with Fergusson shows. Twice MacCoille put quotes from our website to Fergusson and twice Fergusson said he had no issue with how we presented his research.

Here is the exchange between the two men:

Cathal MacCoille: Some of the references to your work by the Iona Institute. April 17th 2013: “Abortion does not improve mental health of women, says new study”, “Abortion has no mental health benefits, poses more risk for ‘unwanted pregnancies’: study”.

David Fergusson: We have just completed a review of the evidence and our review was that there was no evidence that abortion mitigated any mental health risks of unwanted pregnancy and that was based upon a review of the very limited research and I think the first point to make is that the research is not particularly good and any conclusion drawn should be made very cautiously. But that was our major conclusion. We could not find any evidence of benefits.

C MacC: Quote from Iona website: Researchers found that “found that abortion had no therapeutic value in reducing the mental health risks”. “Instead, the evidence suggests that abortion may be associated with an increased risk of some mental health problems.”

DF: That statement is true. We found that when we compared women who had an abortion with equivalent groups of women who had unwanted pregnancies or intended pregnancies the women having abortions had slightly higher rates of mental health problems.

(For a full transcript of the interview, and the subsequent interview with Patricia Casey, see below).

So in no way did Fergusson contradict anything we said or express any unhappiness.

But when MacCoille interviewed Patricia Casey later in the show he began with this highly misleading intro:

C MacC: Earlier in the programme, we heard from Professor David Fergusson, a psychologist at the University of Otago in Christchurch who was unhappy with the way he believes his views and particularly the results of his researches are being used by those opposed to abortion legislation in Ireland. We specifically put to him a number of remarks made to him, rather about him, by the Iona Institute, which of course opposes legislation and he made clear his unhappiness with the way in which his views had been interpreted [our italics] and he specifically said that he has not carried out any research at all into women who say they are suicidal and who are looking for an abortion.

‘Made clear his unhappiness’? Fergusson did no such thing. Read the exchange between Fergusson and MacCoille again. Fergusson agreed with our presentation of his findings. So why did MacCoille suggest otherwise and lead his listeners to believe otherwise?

The answer seems to be that MacCoille has got it into his head that we and other pro-life bodies have claimed that the Fergusson study says something about suicide in pregnant women. But we have never said any such thing and therefore MacCoille is on a complete wild goose chase, and from one end of Morning Ireland to the other he never stopped chasing that goose.

If you read the exchange between Casey and MacCoille below you will see that MacCoille persists in his belief that Fergusson is unhappy with how we presented his research. To repeat, that is not true. Why MacCoille actually listening properly to his own interview? It would appear not.

To sum up, Cathal MacCoille has led his listeners to believe that David Fergusson is unhappy with how The Iona Institute has presented his findings, which is completely untrue. Therefore Morning Ireland owes it to us and its listeners to make clear that we have not misused Fergusson’s study in any way and that Fergusson himself has accused us of no such thing.

Transcript of interview between Cathal MacCoille and Dr David Fergusson

Cathal McCoille: Have you carried out study on women who seek abortion because they are suicidal?

Dr David Fergusson: No I have not been involved in any such research and I am not aware of any such research explicitly. There may be some but I am not aware of it.

C McC: Some of the references to your work by the Iona Institute. April 17th 2013: “Abortion does not improve mental health of women, says new study”, “Abortion has no mental health benefits, poses more risk for ‘unwanted pregnancies’: study”.

DF: We have just completed a review of the evidence and our review was that there was no evidence that abortion mitigated any mental health risks of unwanted pregnancy and that was based upon a review of the very limited research and I think the first point to make is that the research is not particularly good and any conclusion drawn should be made very cautiously. But that was our major conclusion. We could not find any evidence of benefits.

C McC: Quote from Iona website: Researchers found that “found that abortion had no therapeutic value in reducing the mental health risks”. “Instead, the evidence suggests that abortion may be associated with an increased risk of some mental health problems.”

DF: That statement is true. We found that when we compared women who had an abortion with equivalent groups of women who had unwanted pregnancies or intended pregnancies the women having abortions had slightly higher rates of mental health problems.

C McC: So to summarise, is it fair to say that your research shows that abortion is not a treatment for a woman who is feeling suicidal?

DF: No it does not show that to be so because we haven’t compared women who coming, seeking abortion, their risk of suicide subsequently. It does distinctly raise the possibility that the claim may not be sound, but it doesn’t in effect, it doesn’t test that claim directly. But until the claim is tested directly I think it would be misleading for anyone to state emphatically that abortion does or does not help suicidal women. So I’m really taking a position of sitting on the fence here, saying if the research hasn’t been done, we really need to adopt a neutral position on this argument, until better information is available.

C McC: But abortion may be associated with an increase in some mental health problems?

DF: Yes, subsequent to abortion, yes that is possible. I think that…

C McC: Sorry go on..

DF: I think the issue here is, when someone comes presenting directly with suicidal, intense suicdal thoughts, which do threaten their lives, it would be wrong to generalise back from that research to the situation I’m describing.

C McC: Does your research or any research show that if you’re thinking of commiting suicide and you have an abortion that that’s likely or may increase your suicide risk?

DF: There’s no evidence that I know of about that although we do see amongst women who have abortions an increased rate of suicidal thoughts when compared with women who come to term or who give birth to unwanted pregnancies and those rates tend to be higher amongst women who find the thing distressing and guilt provoking. So this is a quite complicated situation where you can, in a sense, after the pregnancy you may see these differences but whether it applies explicitly to women who are suicidal at the time that they present is another matter entirely.

C McC: And that’s research not done?

DF: That’s research not done. So it would be very difficult for anyone to argue emphatically either way.

C McC: Can I quote to you one other statement made directly by Ms Caroline Simons of the Pro Life Campaign speaking to an Oireachtas committee, a parliamentary committee in Dublin when she said and I quote: “The testimony that we have heard over the past two days has completely demolished any argument that suicidality can be addressed by abortion, even during crisis pregnancy.” And she went on: “Professor David Fergusson, in the British Journal of Psychiatry states: ‘There is no evidence…that suggests that abortion reduces the mental health risks of unwanted or mistimed pregnancy.” Is that a fair representation of your views?

DF: No it’s not quite a fair representation. There is no evidence, but there’s no evidence either that the situation which we’re talking about, dealing with women with intense suicidal reactions to a pregnancy, is covered by that conclusion. I mean this is a debate in subtle shades of grey, which gets rendered in the public as a black and white argument. There’s so much not known about this, largely because the research has not been done. That research which has been done hasn’t been done particularly well and following that it has been reconstructed in the battle between the pro life and pro choice groups into black and white debates where it’s much more subtle. I mean, the best position I would say is, I don’t know whether this is true or not, I’ve a suspicion it may not be true, but I would not be dogmatic about it.

C McC: And in general as an outsider, would you have any advice to our legislators on abortion?
 
DF: I think either way it’s going to be a precarious debate. From my personal point of view, if I were to give advice to parliamentarians about the issue of abortion I would say there’s a real need to consider the real reasons why women seek abortions and these aren’t to prevent suicide. They’re to do with real issues of families about poverty, about relationships. I’ll declare my position, I’m a pro-choice atheist, and I’m of the view that the State should not be legislating on what is a divided moral issue and if I were to give advice, and I realise in Ireland this is not particularly going to be well received I would say that the morality of this debate needs to be decided by the woman and the physician involved rather than by the State.

Transcript of interview between Cathal MacCoille and Patricia Casey   

Cathal Mc Coille: Earlier in the programme, we heard from Professor David Fergusson, a psychologist at the University of Otago in Christchurch who was unhappy with the way he believes his views and particularly the results of his researches are being used by those opposed to abortion legislation in Ireland. We specifically put to him a number of remarks made to him, rather about him, by the Iona Institute, which of course opposes legislation and he made clear his unhappiness with the way in which his views had been interpreted and he specifically said that he has not carried out any research at all into women who say they are suicidal and who are looking for an abortion.

We’re joined by Professor Patricia Casey of the Iona Institute, clinical psychologist, thank you very much.

Patricia Casey: Psychiatrist, Cathal, sorry, consultant psychiatrist in UCD and the Mater.

C McC: Consultant psychiatrist in UCD and the Mater. Now, the Professor is saying that things are being said and interpretations are being placed on his work which are not accurate. Do you accept that?

PC: Well no, he didn’t say that at all. In fact, what he is saying is what I have been saying as a psychiatrist since this debate began. There is absolutely no evidence that abortion is a treatment for women who are suicidal. The evidence just isn’t there because it hasn’t been investigated. And in fact I emailed Professor Fergusson over the weekend when this story hit the, when this story came to public attention in the Sunday Business Post and here’s what he said: “In response to your comments, I think that it is drawing a long bow to claim that abortion may be an effective response to suicidal thoughts in pregnancy. As far as I know, there is no evidence to support this view, and claims of indirect evidence seem far-fetched.” That’s what he said to you. Then, in relation to the possible effects of abortion on mental health, and again, you quote two clips from the Iona and he, he said….

C McC: Yeah, specifically one was a statement made on the website on the 15th April “Abortion has no mental health benefits,”, he said clearly there’s no research about that…

PC: No sorry he has done research about that and he said that his latest research found there was no mental health benefit, it was published on the 4th of April…

C McC:…and that statement went on, the Iona statement went on “poses more risk for ‘unwanted pregnancies’”

PC: Yes, he, because he has found some evidence of mental ill health. What he says here, and again, he says to me in the email “I think that the facts of the matter are relatively simple. There is currently no evidence to suggest that abortion reduces mental health risks. There is suggestive but contested evidence that abortion may be associated with modest increases in mental health problems when compared with the outcome of women coming to term with unintended pregnancies. These considerations suggest that the use of mental health grounds for abortion is highly questionable and that broader criteria that reflect why women seek abortion are required.” So there is absolutely no disagreement whatsoever.

C McC: So when he says, as he did, that it would be misleading for anyone to state emphatically that abortion does not help women, do you accept that.

PC: No, he says there is suggestive evidence and that’s what I’ve always…

C McC: He said specifically it would be misleading for anyone to state emphatically that abortion does not help women, which I understand you and others who would take a similar view have said repeatedly, that abortion does not help women. He’s saying it’s misleading for anyone to state that emphatically.

PC: Well look, he has said that there is no evidence that abortion helps women’s mental health. He has said it in the most recent systematic review that he published and indeed I sent a copy of a letter from Peadar O’Grady of Doctors for Choice to him and he said it presents a more or less standard pro-choice reaction by seeking to denigrate the findings of his study while arguing for the validity of other reviews.

C McC: He is a man who has never studied women who are seeking abortions because they are suicidal…

PC: That’s right…

C McC: What’s the point of quoting him at all, except to say there’s no research?

PC: No, no, no, you’re getting things confused, there are several aspects here. The first is, women who are suicidal. He has said there is no evidence about them…

C McC: He said he has carried out no research on this area…

PC: Exactly. You cannot say that something is beneficial if there is no evidence for it.

C McC: Isn’t the opposite side of the coin to say that you cannot state the opposite, because there isn’t evidence or research to show that it is?  

PC: Well the Government is proceeding as if there was evidence that it was beneficial and there is no evidence. The second point is that he makes in his study is that when you study women who have had abortions for unwanted pregnancies and compare them with women who give birth there is no evidence of benefit.

C McC: When he says that it would be misleading for anyone to state emphatically, and I’m quoting directly what he said, it would be misleading to state emphatically that abortion does not help women, do you accept what he says?

(This is not a direct quote. Cross reference with the Fergusson transcript. Here’s what Fergusson said when warned against being emphatic: “C McC: Does your research or any research show that if you’re thinking of commiting suicide and you have an abortion that that’s likely or may increase your suicide risk?

DF: There’s no evidence that I know of about that although we do see amongst women who have abortions an increased rate of suicidal thoughts when compared with women who come to term or who give birth to unwanted pregnancies and those rates tend to be higher amongst women who find the thing distressing and guilt provoking. So this is a quite complicated situation where you can, in a sense, after the pregnancy you may see these differences but whether it applies explicitly to women who are suicidal at the time that they present is another matter entirely.

C McC: And that’s research not done?

DF: That’s research not done. So it would be very difficult for anyone to argue emphatically either way.”)

PC: If he’s saying that, in relation to suicidal women, the answer is yes, but only because there is no evidence, no studies have been done. That is the problem and that’s what we have said all along. There is no evidence to back up what the Government is doing, even though the Government is proceeding as if there was evidence, there isn’t any evidence.

C McC: Professor Patricia Casey, thank you very much for talking to us.