[Psychiatric and ethical aspects of the termination of pregnancy]

The progress in the diagnostic and the therapeutic possibilities of medicine, the amendment of articles 218 foll. StGB (= Penal Code), and a fundamental change in the attitude towards sexuality and abortion, on the background of the demand for free self-determination of the woman, have fundamentally changed the fields of medical activities and tasks, especially those of psychiatry, in ascertaining the indication for the legal termination of pregnancy and in giving advice in cases of pregnancy conflicts. By far the most terminations of pregnancy today are carried out on the basis of a social or a social predicament indication, for whose assessment the psychiatrist, as a rule, ist not competent. This functions should be stronger orientated towards giving advice and providing therapy in cases of pregnancy conflicts. Particular attention has to be payed to special aspects of contraception and negative psychic after-effects of an abortion. Psychiatric indications should only be accepted, in cases in which they can be substantiated clearly. All advisory and therapeutic measures have to serve the aim of furthering the freedom and autonomy of decision of the pregnant woman, of facilitating the solution of intrapsychic and ethical conflicts, thus making genuine responsibility realizable.