Opposition to the legalization of abortion

Opposition to the legalization of abortion is centered around the pro-life, or anti-abortion, movement, a social and political movement opposing elective abortion on moral grounds and supporting its legal prohibition or restriction. The modern pro-life movement began as a countermovement in response to the decriminalization and legalization of elective abortion in various states, and it grew following the U.S. Supreme Court's 1973 decision in Roe v. Wade, which struck down most state laws restricting abortion.[1][2] In the United States this movement is frequently, but not exclusively, allied with the Republican Party,[3][4] and seeks to restrict abortion with legislation such as the Human Life Amendment.[5] Advocates generally maintain that the human fetus (and in most cases the human embryo) is a person and therefore has a right to life.

On the other side of the abortion debate is the pro-choice movement. Subscribing to different moral grounds than the pro-life movement, pro-choicers hold the view that a woman should have the right to terminate her pregnancy; they also advocate legal abortion as an important facet of women's reproductive rights.

The "pro-life" concept is sometimes broadened to include positions on other issues, such as opposition to euthanasia and embryonic stem-cell research.[6][7]

Contents

History

In the late 1960s, a number of organisations formed opposed to abortion. In the United States, the National Right to Life Committee was formed in 1968, while in Australia, the National Right to Life formed in 1970.[8]

The term "pro-life" was coined by U.S. leaders of the right-to-life (anti-abortion) movement following the January 1973 U.S. Supreme Court case Roe v. Wade,[5] which held that a mother may abort her pregnancy in the first trimester, and may also abort "subsequent to viability ... for the preservation of the life or health of the mother."[9] The term "pro-life" was adopted instead of "anti-abortion" to highlight the belief that they consider abortion the taking of a human life, rather than an issue concerning the restriction of women's reproductive rights.[5] The first organized action was initiated by U.S. Catholic bishops who recommended in 1973 that the U.S. Constitution should be amended to ban abortion.[5]

Roe v. Wade led to the growth of a largely religious-based anti-abortion movement even as Americans became, in the 1970s and 80s, increasingly pro-choice. The first major pro-life success came in 1976 with the passing of the Hyde Amendment prohibiting the use of certain federal funds for abortions.[10] In Harris v. McRae, pro-life advocates won a 1980 challenge to the Hyde Amendment. That same year, the pro-life movement gained control of the Republican Party's platform committee, adding pro-life planks to the Republican position, and calling for a Human Life Amendment to the U.S. Constitution, banning abortion.[5] Two pro-life U.S. Presidents – Ronald Reagan and George H. W. Bush – were elected, although according to M. McKeegan, the majority of Reagan voters were pro-choice.[11]

Some in the media have noted a revitalization of the pro-life movement in the 21st century. In 2011, Fred Barnes of The Weekly Standard wrote:

That the pro-life movement is bigger is a given. It’s also younger, increasingly entrepreneurial, more strategic in its thinking, better organized, tougher in dealing with allies and enemies alike, almost wildly ambitious, and more relentless than ever. Pro-lifers have captured the high moral ground, chiefly thanks to advances in the quality of sonograms. Once fuzzy, sonograms now provide a high-resolution picture of the unborn child in the womb. Fetuses have become babies.[12]

Barnes also discussed the rise in opposition to abortion among the younger generations, especially the millennials, the prevalence of crisis pregnancy centers, and the rejuvenation of old pro-life groups, such as Students for Life, and the rise of new ones, such as 40 Days for Life and Live Action.[12] Lisa Miller of The Washington Post wrote about the younger, more feminine face of the pro-life movement with the rise of leaders such as Lila Rose of Live Action, Marjorie Dannenfelser of the Susan B. Anthony List, Charmaine Yoest of Americans United for Life, Penny Nance of Concerned Women for America, and Kristan Hawkins of Students for Life, all "youngish Christian working mothers with children at home" who offer a pro-life perspective on the women's rights aspect of the abortion issue instead of focusing exclusively on the fetus.[13]

The pro-life movement has been highly successful in recent years in advancing new laws against abortion within the states. The Guttmacher Institute said eighty laws restricting abortion were passed in the first six months of 2011, "more than double the previous record of 34 abortion restrictions enacted in 2005—and more than triple the 23 enacted in 2010".[14]

Roman Catholics

Before the Roe v. Wade decision, the right-to-life movement in the U.S. consisted of lawyers, politicians, and doctors, almost all of whom were Catholic. The only coordinated opposition to abortion during the early 1970s came from the United States Conference of Catholic Bishops and the Family Life Bureau, also a Catholic organization. Mobilization of a wide-scale pro-life movement among Catholics began quickly after the Roe v. Wade decision with the creation of the National Right to Life Committee (NRLC). The NRLC also organized non-Catholics, eventually becoming the largest pro-life organization in the United States. Connie Paige has been quoted as having said that, "[t]he Roman Catholic Church created the right-to-life movement. Without the church, the movement would not exist as such today."[15]

Evangelicals

Randall Herbert Balmer, Ph.D., argues in his book, Thy Kingdom Come, that despite the popular belief that pro-life sentiments galvanized the fundamentalist evangelical movement, what actually galvanized the movement was evangelical opposition to the American Internal Revenue Service (IRS). The IRS stripped evangelical universities, like Bob Jones University, from their tax-exempt status for remaining racially segregated.[16][17][18]

Before 1980, the Southern Baptist Convention officially advocated for loosening of abortion restrictions.[19] During the 1971 and 1974 Southern Baptist Conventions, Southern Baptists were called upon "to work for legislation that will allow the possibility of abortion under such conditions as rape, incest, clear evidence of severe fetal deformity, and carefully ascertained evidence of the likelihood of damage to the emotional, mental, and physical health of the mother."[19] W. Barry Garrett wrote in the Baptist Press, "Religious liberty, human equality and justice are advanced by the [Roe v. Wade] Supreme Court Decision."[19]

By 1980, conservative Protestant leaders became vocal in their opposition to legalized abortion,[16] and by the early 1990s Pat Robertson's Christian Coalition of America became a significant pro-life organization.[11] In 2005, Richard Land, president of the Southern Baptist Convention’s Ethics and Religious Liberty Commission, said that making abortion illegal is more important than any other issue.[20]

Overview

Pro-life individuals generally believe that human life should be valued either from fertilization or implantation until natural death. The contemporary pro-life movement is typically, but not exclusively, influenced by Conservative Christian beliefs, especially in the United States, and has influenced certain strains of bioethical utilitarianism.[21] From that viewpoint, any action which destroys an embryo or fetus kills a person. Any deliberate destruction of human life is considered ethically or morally wrong and is not considered to be mitigated by any benefits to others, as such benefits are coming at the expense of the life of what they believe to be a person. In some cases, this belief extends to opposing abortion of fetuses that would almost certainly expire within a short time after birth, such as anencephalic fetuses.

Some pro-life advocates oppose certain forms of birth control, particularly hormonal contraception such as emergency contraception (ECPs), and copper IUDs which prevent the implantation of an embryo. Because they believe that the term "pregnancy" should be defined so as to begin at fertilization, they refer to these contraceptives as abortifacients.[22] The Catholic Church endorses this view,[23] but the possibility that hormonal contraception has post-fertilization effects is disputed within the scientific community, including some pro-life physicians.[24]

Attachment to a pro-life position is often but not exclusively connected to religious beliefs about the sanctity of life (see also culture of life). Exclusively secular-humanist positions against abortion tend to be a minority viewpoint among pro-life advocates.[25][26] Many holding the pro-life position also tend toward a complementarian view of gender roles, though there is also a self-described feminist element inside the movement.[27]

Moreover, conservative publications, such as American Thinker, cite studies such as a comprehensive review of literature published in the British Journal of Psychiatry which suggests that, among women, "there is a significant increase in mental health problems after abortion."[28][29] However, the Royal College of Obstetricians and Gynaecologists responded to the review with a position statement in which they said that three previously published systematic reviews and the RCOG guideline development group (who reviewed all available literature up to February 2011) have concluded that women who have an abortion are not at increased risk of mental health problems when compared with women who continue an unintended pregnancy. Furthermore, they questioned the fact that while the paper’s findings pointed to increased substance misuse and suicidal behaviors among the groups of women, the research did not fully examine if these women had pre-existing mental health complications such as dependency issues and mood disorders before the abortion.[30]

Religion and pro-life movements

The variety in opinion on the issue of abortion is reflected in the diverse views of religious groups. For example, the Roman Catholic Church condemns every procured abortion as morally evil,[31] while traditional Jewish teachings allow abortion as a means of safeguarding the life and well-being of the pregnant woman.[32]

Christianity

Much of the pro-life movement in the United States and around the world finds support in the Roman Catholic Church, Christian right, the Lutheran Church-Missouri Synod and the Wisconsin Evangelical Lutheran Synod, the Church of England, the Anglican Church in North America, the Eastern Orthodox Church, and The Church of Jesus Christ of Latter-day Saints (LDS).[33][34][35][36] However, the pro-life teachings of these denominations vary considerably. The Eastern Orthodox Church and Roman Catholic Church consider abortion to be immoral in all cases, but permit acts which indirectly result in the death of the fetus in the case where the mother's life is threatened. In Pope John Paul II's Letter to Families he simply stated the Roman Catholic Church's view on abortion and euthanasia: "Laws which legitimize the direct killing of innocent human beings through abortion or euthanasia are in complete opposition to the inviolable right to life proper to every individual; they thus deny the equality of everyone before the law."

The National Association of Evangelicals and the LDS Church oppose abortion on demand; however, the NAE considers abortion allowable in cases with clear evidence of severe fetal deformity, dire threat to the life/physical health of the pregnant woman, or when a pregnancy results from rape or incest.[37][38][39] The Taskforce of United Methodists on Abortion and Sexuality (TUMAS) was formed in 1987 to further the pro-life ministry in The United Methodist Church.[40] The Southern Baptist Convention believes that abortion is allowable only in cases where there is a direct threat to the life of the woman.[37] Other mainstream Protestant denominations in the United States, such as the Episcopal Church, the Evangelical Lutheran Church in America, the Presbyterian Church (U.S.A.), and the United Church of Christ, are pro-choice.[37]

Islam

Attitudes to abortion vary greatly in the Muslim world. There is no agreement as to when life begins; while some hold the medieval view that ensoulment occurs at 120 days, some schools of law hold that abortion before that marker is still illicit, with Hanafi being an exception. However, even the more restrictive paradigms allow some flexibility, due to the roles played by socioeconomic conditions and health.[41]:24 Although there are different opinions among Muslim scholars on the topic of Islam and abortion, most agree that the termination of a pregnancy after four months—the point at which, in Islam, a fetus is thought to become a living soul—is not permissible. Many Islamic thinkers contend that in cases prior to four months of gestation, abortion should be permissible only in instances in which a mother's life is in danger or in cases of rape.[41]

The legal situation in the Muslim world also varies from country to country. In some countries, abortion is legal with no restrictions or with nominal restrictions. In many countries where abortion is illegal except in cases where the pregnancy threatens the woman's life, a woman must nonetheless obtain her husband's consent. Although according to Islamic tradition she is considered to have a right to life, unlike in much Western anti-abortion thought, her rights over her body are restricted by community standards.[41]:73

Hinduism

Although traditional Hindu texts and teachings have opposed elective abortions,[42] a vocal pro-life movement is limited in India, the nation with the largest Hindu population.[43] Most abortions in India are done for sex selection, with boys being favored.[44] As a result, activists who argue against abortion in India are typically women's rights activists. Recently, these pro-life activists took Google, Yahoo, and Microsoft to court, suing to remove web ads that sell products that enable parents to determine the sex of a fetus.[44] Some Hindu institutions oppose abortion,[45] and teach that abortion prevents a soul in its karmic progress toward God.[46] Other Hindu theologians believe personhood begins at 3 months and develops through to 5 months of gestation, possibly implying permitting abortion in extenuating circumstances up to the third month and considering any abortion past the third month to be destruction of the soul's current incarnate body.[47]

Judaism

In Judaism, views on abortion draw primarily upon the legal and ethical teachings of the Hebrew Bible, the Torah, the case-by-case decisions of responsa, and other rabbinic literature. In the modern period, moreover, Jewish thinking on abortion has responded both to liberal understandings of personal autonomy as well as Christian opposition to abortion.[48] Polls of Jews in America report that 88% of American Jews are pro-choice.[49] Prominent Jewish pro-life activist Michael Medved has said, "Jewish law for millennia has been extremely clear, that abortion is only permitted when the life of the mother is directly threatened... To link Jewish tradition to the pro-choice position is 'ludicrous and ignorant'."[50] In Israel, the major pro-life organization is Efrat,[51] which primarily raises funds to relieve the "financial and social pressures" on pregnant women so that they will not terminate their pregnancies.[51]

Current activity

In the United States

The pro-life movement in the U.S. includes a variety of organizations, with no single centralized decision-making body.[5] There are diverse arguments and rationales for the pro-life stance.

There is some disagreement within the American movement over the issue of capital punishment.[10]

There are many socially conservative organizations in the U.S. that support the pro-life movement. Some groups focus solely on promoting the pro-life cause, such as the Susan B. Anthony List, National Right to Life Committee, Americans United for Life, and Live Action, among many others. Other groups support not only the pro-life cause but the broader family values cause, such as Family Research Council, Focus on the Family, American Family Association, and Concerned Women for America, among many others.

In Europe

Contrary to the United States, in Europe abortion has been legalized through parliamentary acts. In Western Europe this has had the effect at once of both more closely regulating the use of abortion, and at the same time mediating and reducing the impact pro-life campaigns have had on the law.[52]

In Israel

In Israel, the major pro-life organization is Efrat.[51] Efrat activists primarily raise funds to relieve the "financial and social pressures" on pregnant women so that they will not terminate their pregnancies.[51] Efrat is not known to do any other kind of activism.[51]

"Consistent Life Ethic"

A major stated goal within the pro-life movement is to "restore legal protection to innocent human life."[54] This protection would include fetuses and embryos, persons who cannot communicate their wishes due to physical or mental incapacitation, and those who are too weak to resist being euthanized.

Some pro-life advocates, such as those subscribing to the philosophy of a Consistent Life Ethic (formerly known as the Seamless Garment), oppose virtually all acts that end human life. They would argue that abortion, euthanasia, capital punishment, and unjust war are all wrong. Prominent organizations advocating a Consistent Life Ethic include Democrats For Life of America (which includes dozens of Congressmen), Sojourners Magazine, and Priests for Life.[55][56]

Others argue that the death penalty can be a fair punishment for murder, justifiably inflicted by lawful authority, whereas abortion is an attack on an innocent. The increasing attention paid to this controversial position may result from the large Roman Catholic membership of the pro-life movement, striving to adhere to Catholic Church teachings on the death penalty.[57]

The debate

In some countries, the abortion issue remains one of the broader and more controversial societal issues. A broad spectrum of positions exists on this issue, from those who advocate abortion-on-demand at any point during a pregnancy until birth on the one end, to those who oppose every form of abortion on the other. Between these two there is a considerable range of positions. Some oppose abortion, but are content to work at reducing the number of abortions through prevention of unwanted pregnancies, a task they accomplish through encouraging abstinence, targeted sex education and/or increased availability of contraception. Current legislation in United States Congress, the Pregnant Women Support Act, seeks to reduce the abortion rate in the U.S. without making any procedure illegal and without overturning Roe v. Wade. There are many who support legal abortion within the first trimesters but oppose late-term abortions. Those who oppose late-term abortions usually take the view that once a fetus has reached the point where it could live independently from the woman, the balance of rights swings in favour of the fetus. Some oppose most abortions but make exception for cases where the woman's life is in serious risk. In this category, some likewise make an exception for severe fetal deformities. Others make exceptions when the pregnancy was not caused by consensual sexual activity or may violate social taboos, as in cases of rape and incest. Some allow for all these exceptions, but stop short of abortion-on-demand.

Another issue is that of mandatory notification and consent. Some believe that a pregnant minor should not be allowed to abort her pregnancy without notifying her parent or guardian because of the risks and possible medical complications. Likewise, some believe that notifying the woman's husband should be required because of parental rights. In a 2003 Gallup poll in the United States, 72% of respondents were in favour of spousal notification, with 26% opposed; of those polled.[58] In many states, such restrictions are mandated by law, though often with the right of judicial oversight. Others believe that the child's biological father must be notified.

Generally speaking, the pro-life position regards abortion as a form of infanticide, and thus seeks legal restrictions on abortions. Pro-life advocates typically argue that if a pregnant woman is unable or unwilling to raise the child, there is the option of placing the child up for adoption.

One analysis suggests that, since pro-life families may be expected to have fewer abortions (and more children) than their pro-choice counterparts and they may pass their beliefs on to their children, this will change the voter demographic of future generations. In this way, legal abortion-on-demand may also serve to increase the dominance of the pro-life position in society. This hypothesis has been called the "Roe effect", and may explain the trend towards more widespread support of the pro-life movement.

The debate is between those who believe fetuses are persons and should therefore have rights, vs. those who believe fetuses are not persons but "future persons" or "potential persons". However, not all pro-choice advocates claim that fetuses are non-persons; there are also those who say that even if fetuses are persons, their position inside the body of another person entitles that other person to kill them anyway. It need not be based only on the fetus' location; it can also be justified by citing the fact that the fetus is taking nutrients from the mother's bloodstream, and injecting metabolic end-products into her bloodstream, and preparing to subject her to a major medical/surgical trauma (childbirth), all of which she is entitled to prevent, even by means of deadly force.[59]

Some pro-choice advocates also point out that, while they too would prefer to see abortion not happen, when abortion is illegal, women who want abortions seek unsafe abortions, placing their own lives at risk.[60]

Legal and political aspects

The United States Republican Party platform advocates a pro-life position,[61] though there are some pro-choice Republicans. The Republican group The Wish List supports pro-choice Republican women just as EMILY's List supports pro-choice Democratic women. The Susan B. Anthony List (SBA List) is dedicated to "increasing the percentage of pro-life women in Congress and high public office,"[62] and seeks to eliminate abortion in the U.S.[63] The Democrats for Life of America are a group of pro-life Democrats on the political left who advocate for a pro-life plank in the Democratic Party's platform and for pro-life Democratic candidates. Former vice-presidential candidate Sargent Shriver, the late Robert Casey, a former two-term governor of Pennsylvania, and former Rep. Bart Stupak (D-Mich), a vocal pro-life proponent and leader of the Democratic pro-life caucus in the United States House of Representatives, have been among the most well-known pro-life Democrats.[64] However, following his vote in favor of the Patient Protection and Affordable Care Act, Marjorie Dannenfelser of the SBA List reported that her organization was revoking a pro-life award it had been planning to give to Stupak,[65] and pro-life organizations accused Stupak of having betrayed the pro-life movement.[66][67][68][69]

The New York Times reported in 2011 that the pro-life movement in the United States has been undergoing a disagreement over tactics. Since Roe v. Wade was decided in 1973, the movement has usually focused on chipping away at Roe through incremental restrictions such as laws requiring parental consent or women to see sonograms, restricting late-term abortions, etc., with the goal of limiting abortions and changing "hearts and minds" until there is a majority on the Supreme Court to overturn Roe. However, some activists are calling for "an all-out legal assault on Roe. v. Wade", seeking the enactment of laws defining legal personhood as beginning at fertilization or prohibiting abortions after a fetal heartbeat is detectable at six to eight weeks in the hope that court challenges to such laws would lead the Supreme Court to overturn Roe v. Wade. They believe that Justice Anthony Kennedy, who nearly decided to overturn Roe in Planned Parenthood v. Casey, is open to rethinking Roe. Others fear that the Court would not only strike down the laws in question but other state laws as well, and take the opportunity to solidify the ruling in Roe. Evangelical Christian groups tend to be in the former camp and Catholic groups in the latter.[70]

Controversies over terminology

Pro-life advocates tend to use terms such as "unborn baby", "unborn child", or "pre-born child".[71][72] Pro-life individuals may also prefer to refer to the pregnant woman as a "mother", while some pro-choice individuals consider this inappropriate, and some in the medical community may see its usage as insensitive and biased in certain narrowly defined contexts.[73]

Both "pro-choice" and "pro-life" are examples of terms labeled as political framing: they are terms which purposely try to define their philosophies in the best possible light, while by definition attempting to describe their opposition in the worst possible light. "Pro-choice" implies that the alternative viewpoint is "anti-choice", while "pro-life" implies the alternative viewpoint is "pro-death" or "anti-life".[74]

The Associated Press encourages journalists to use the terms "abortion rights" and "anti-abortion".[75] In a 2009 Gallup Poll, a majority of U.S. adults (51%) called themselves "pro-life" on the issue of abortion—for the first time since Gallup began asking the question in 1995—while 42% identified themselves as "pro-choice",[76] although pro-choice groups noted that acceptance of the "pro-life" label did not in all cases indicate opposition to legalized abortion, and that another recent poll had indicated that a plurality were pro-choice.[77] A March 2011 Rasmussen Reports poll concluded that Americans are "closely divided between those who call themselves pro-life" and those who consider themselves as "pro-choice".[78] In a February 2011 Rasmussen Reports poll of "Likely U.S. Voters", fifty percent view themselves as "pro-choice" and forty percent "say they are pro-life".[79]

Types of advocacy

Pro-life advocacy involves a variety of activities, from promoting the pro-life position to the public in general, lobbying public officials, or attempting to dissuade individual women to forgo abortions. Some efforts involve distributing literature, providing counseling services, conducting public demonstrations or protests and private or public prayer.

Demonstrations and protests

Counseling

Specialty license plates

In the United States, some states issue specialty license plates that have a pro-life theme. Choose Life, an advocacy group founded in 1997, was successful in securing a pro-life automobile tag in Florida. Subsequently, the organization has been actively helping groups in other states pursue "Choose Life" license plates.[92][93]

Violence

Against abortion providers

Violent incidents directed against abortion providers range from the murders and attempted murders of physicians and clinic staff to arson and bombings of abortion clinics, to ordinary fisticuffs. G. Davidson Smith of the Canadian Security Intelligence Service (CSIS) defined violence related to abortion extremism, animal rights, and environmentalism as "single issue terrorism".[94] Acts of violence against abortion providers and facilities in North America have largely subsided following a peak in the mid-1990s.[95] The National Clinic Violence Survey, conducted by the pro-choice Feminist Majority Foundation, reported in 2006 that severe violence affected 18.4% of abortion providers and facilities in the preceding year, 2005.[96] This figure is lower than at any time since 1994, which is consistent with statistics from the National Abortion Federation that show violence against abortion clinics or providers has steadily decreased since 2001.[83]

A notable example of anti-abortion violence in the United States is the murder of Dr. George Tiller, a physician who provided late term abortions as part of his practice. He was shot and killed in the foyer of the church where he was a member.[97] A large number of pro-life leaders and groups condemned the killing.[98][99][100] The National Right to Life Committee, the largest pro-life organization in the United States, has stated that it "unequivocally condemns any acts of violence used by individuals regardless of their motivation".[101] The American Life League has issued a "Pro-life Proclamation Against Violence".[102]

Nearly all pro-life leaders condemned the use of violence in the movement even before Tiller's death, describing violence as an aberration and saying that no one in their organizations was associated with acts of violence. In the 1990s, the Revered Patrick Mahoney addressed the issue of violence, saying, "I think that extremists opposed to abortion got frustrated, felt they were losing the battle and felt it was incumbent upon themselves to resort to violence." In the same era, the Flip Benham, director of Operation Save America, also addressed the issue, saying "This whole thing isn't about violence. It's all about silence – silencing the Christian message. That's what they want." He also stated, "They screech and scream about us crying fire in a crowded theater. And I agree it is wrong, unless there is a fire. If there's a fire in that theater, we better call it that. Our inflammatory rhetoric is only revealing a far more inflammatory truth."[103]

Against pro-life people

On September 11, 2009, pro-life activist James Pouillon was shot and killed as he was displaying pictures of aborted fetuses in front of a school in Owosso, Michigan.[104] Harlan James Drake was charged with two murders: Pouillon's murder and the murder of a gravel pit contractor against whom Drake bore a grudge. Drake reportedly "didn't like Pouillon's graphic antiabortion signs".[105] Two days after the murder, president Barack Obama issued a statement saying that "[w]hichever side of a public debate you're on, violence is never the right answer".[106]

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  29. ^ "Abortion, mental health and dental disease". British Journal of Psychiatry. http://bjp.rcpsych.org/content/199/3/A11.full#sec-3. Retrieved 1 September 2011. "A comprehensive review of the literature suggests that there is a significant increase in mental health problems after abortion. Coleman (pp. 180–186) suggests that these risks need to be reflected in the delivery of abortion services, and raises the thorny issue that 90% of UK abortions are justified on the presumption that abortion actually reduces the risk to mental health associated with continuing the pregnancy. There is an increasing awareness of increased comorbid physical illness in patients with severe mental illness. Kisely and colleagues (pp. 187–193) found that the levels of advanced dental disease were increased threefold in patients with severe mental illness. The authors suggest that there needs to be improved recognition of this problem – reflected in a more proactive approach to dental hygiene in these patients." 
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