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[Therapeutic abortion during the 3d trimester for fetal malformation. The position of the French law].

Abortion in France is illegal except in certain cases specified in the 1975 and 1979 laws relating to abortions before the end of the 10th week of gestation and abortions for therapeutic reasons. Article 162-12 of the Public Health Code permits therapeutic abortions for 2 indications. Abortions are permitted for medical reasons if there is danger to the mothers health. The term danger refers to imminent danger but the term health is broad and imprecise probably reflecting the intention of the legislators. The text on abortion for eugenic reasons is very clear and specifies 3 conditions that must be met: strong probability seriousness and incurable nature of the disorder as of the moment of the diagnosis. Information provided by the mother should be detailed and ideally should be written and signed. Information concerning the fetus should be confirmed by available diagnostic means. Physicians who make antenatal diagnoses should be informed about their legal responsibility if they do not inform their patient of the diagnosis and if a malformed fetus is born although there was no hint of malformity. At present there is no absolute right to information. Recognition of the right of the patient to be informed is based not on the rights of the patient but on the conditions of medical responsibility. If there is prejudice the lack of information is considered a wrong. Neither is there a right to an exact diagnosis. The practitioner cannot be faulted for an erroneous diagnosis but he can be for not having utilized the most appropriate scientific methods. Any prejudice would result from the birth of a handicapped infant but no jurisprudence exists on this subject in France. The diagnosis of the malady is made by a physician or a team of physicians but the abortion must be authorized by 2 designated physicians who verify the legality of the proposed abortion and whose advise cannot be questioned in court. The decision to abort depends on the woman but the authorization depends on the physician. The persons protected in case of abortion or refusal to abort are the practitioner during the abortion and the woman as long as a physician is performing it. The father of the fetus has no protection and is excluded from the decision. The physician may refuse to perform the abortion but must refer the woman at an appropriate alternative establishment. The woman may also refuse the abortion. Methods of performing the abortion are at the discretion of the physician. If a child is born alive during the attempt at abortion any effort to make it die through active means or by withholding care is illegal and may be the object of legal action.