A Korean gynaecologist explains why he abandoned a lucrative procedure and is campaigning to reduce abortions.
South Korea has one of the highest rates of abortion in the world, even though abortion is technically illegal there except in a few rare circumstances. According to official government figures, there are 340,000 abortions each year, although one parliamentarian has estimated that there may be as many as 1.5 million. At the same time, Korea's birth rate is the second-lowest in the world – 1.19 births per woman -- and some Koreans fear that their very survival as a nation is in doubt.
That is the background for a courageous decision by a 50-year-old Seoul obstetrician and gynaecologist, Dr Sang-duk Shim, to stop doing abortions and to lobby the government for a dramatic reduction. He has even received death threats for his stand. MercatorNet conducted this email interview with him:
Could you explain the goal of your activist group of doctors? What is its name? How many members do you have?
Dr Shim: This movement is the Korean Gynecological Physicians' Association, or "Gynob", and is an organization consisting of obstetricians and gynaecologists. Currently we have about 680 listed members. Of course, Gynob is not an organization designed only to resolve the problem of abortion, but is intended to improve the distorted medical enviroment in which OB/GYNs work. It does not mean that all of the members of Gynob actively participate in Gynob activities. Our movement is led by a group of about 30 activists.
The goal of our movement is a Korea without abortions. To be more specific, our immediate goal is to reduce the number of abortions to 100,000 cases within ten years -- one-third of what it is today -- and to eliminate all forms of abortion except when necessary to save the life of an expectant mother.
How long did you do abortions? How many did you do?
Dr Shim: It has been about 20 years since I obtained my qualification as an obstetrician. I have been involved in abortion for almost 20 years until I discontinued it in October, as part of my commitment to the anti-abortion movement. I do not have any written record of the abortions I did. However, I had about 20 cases a month, which means a total of 4,000 cases over the period of 20 years.
Why did you stop? Has it been a big sacrifice for you?
Dr Shim: Practicing abortion violates fundamental ethical values for medical doctors and I have suffered pangs of conscience for a long while. Over time, I have noticed that society as a whole and the medical services sector in particular did not try hard to reduce the number of abortions. Rather abortion was encouraged and the basic issues have been left untreated. Simply because of financial pressures on obstetricians, it became clear that abortion has been encouraged and generally accepted.
We feel that this problem cannot be left as is, and it must be rectified by the self-purification of medical doctors. Based on these convictions, we decided to launch this movement. However, the doctors who join the movement suffer from financial pressures and, at the same time, experience serious mental pains because they are treated as traitors by the medical doctors who do not support this movement.
In addition, anti-abortion doctors also suffer abuse from feminist activists who criticize us. They allege that we ignore their right to self-determination and their right to pursue happiness.
How has the public responded?
Dr Shim: Abortion has become a national issue. The government, as well as society in general, has begun to seek better ways to resolve this problem. However, because it has become so established and because there are so many different viewpoints in society, no one is taking drastic measures such as filing complaints with the police.
However, national recognition of the right-to-life issue has changed dramatically compared to several decades ago. Our movement has attracted the support of more than half of the population and we are expecting favorable results soon or later.
How have your doctor colleagues reacted?
Dr Shim: It is true that most OB/GYN doctors do not participate in this movement. Non-members even complain about us for two reasons. One is possible loss of income that abortions have provided for them in the past. Strictly speaking, abortion is illegal and so physicians used to charge handsomely for it. If they give up abortion, they are fearful of the sacrifice that they would have to endure. They are also afraid of tarnishing their image and being regarded as doctors who engage in unethical operations.
Your new philosophy is "Abortions, which abandon the valuable life of a fetus, create misery for the nation and society as well as pregnant women, families and OB/GYN doctors." But why is abortion a misery for the nation? Why for OB/GYN doctors?
Dr Shim: The practice of abortion undermines the government's effort to improve facilities for deliveries and thus discourages the efforts of healthcare personnel to improve the environment for expecting mothers. As well, systemic support for unmarried or disabled mothers is disregarded. Accordingly, the human rights of pregnant mothers are infringed. This negative atmosphere is an important factor in Korea's low fertility rate and thus it endangers the existence of the nation itself in the long run.
In addition, if there is little respect for life, social ethics will be endangered, and therefore, society will be weakened.
From the point of view of an OB/GYN, abortion makes life difficult, too. Because most abortions are technically illegal, doctors charge a premium for their services but hospitals receive a very low medical service charge which covers less than half the cost. Many clinics are suffering serious financial problems as a result. If the number of abortions decreased, the service rates could be normalised and the clinics would benefit. Furthermore, the present climate of illegality forces medical doctors to keep quiet on issues even when they have good reason to complain.
Do you think that there is any hope of changing Korean attitudes towards abortion?
Dr Shim: I want to emphasize that people's attitudes toward abortion have already changed significantly. Traditionally Koreans used to treat an infant in pregnancy as an independent being. We considered a fetus to be an individual and when it was born we used to say that it was one year old. With attitudes like these, the population growth rate was around 3.1 percent in 1972.
However, the primary concern of the Korean government at that time was to increase per capita income, which was then only about US$254. Liberalization of abortion was used as a means of achieving a higher rate of growth within a given number of years.
On March 21, 1973 the Mother-Child Health Act was promulgated. Article 14 of the Act established exceptions to Article 269 of the Criminal Code and exempted abortion from criminal sanctions. Until that time the criminal code had punished abortion with a one or two year jail term. The Mother-Child Health Act freed abortions from criminal sanctions. This was the key step in public acceptance of widespread abortion.
As a result, right now the annual growth rate of the population in Korea is 0.4% and it is anticipated that it will drop to 0% by 2014. This implies that Korea will face another stumbling-block on the path to continued economic growth. It is time to change the law and to reactivate Article 269 of the Criminal Code to make abortion a criminal act once again.
I believe that that there is a growing consensus in Korea that human life must be respected. It is our hope that all the efforts made by the activists of the pro-life movement will succeed and that life will return to our nation and to all of our families.
Do you ever regret having stopped doing abortions?
Dr Shim: Although I do not have any religious convictions, I feel that we must restore our own personal legal and ethical validity before we take a stand and ask the government and the society to improve. It seems to us that restoring the integrity of just one medical doctor will be the first step toward the correction of a distorted medical environment.
Frankly speaking, the operation of my hospital has become very difficult since we started our anti-abortion campaign. I have been considering whether I will have to close my office or not. As I already said, income from abortions compensates for the low rates we charge for medical services, which are predetermined by the government.
However, even if these rates are much lower than is reasonable, I have decided to continue because it may compensate for my past wrong-doing. I am very proud of what I am doing right now.
Medical doctors exist for the benefit of our patients. It is not the other way around. This is a fact we cannot deny. While we may be sacrificing money and prestige at this present moment, things will get better in the future for our country. Our actions will certainly contribute to the improvement of medical environments as well as the promotion of women's health in the days to come.
This interview was conducted by Michael Cook, editor of MercatorNet and translated by Chan-Jin Kim.