What made me flinch wasn't those weekend reports that UK cancer patients are turning to Canadian online pharmacies for drugs they cannot yet get on the NHS.

What made me flinch wasn't those weekend reports that UK cancer patients are turning to Canadian online pharmacies for drugs they cannot yet get on the NHS.

It is several years since I reported here that middle class Americans living near Canada were driving to Montreal to buy cheaper products.

Now they can save on the petrol, although, as with online gambling, President Bush has tried to squash the trade in order to protect US big pharma. In a globalised, consumerist world he is wasting his time. It may be medically risky, but risks are what ill people take, always have done.

What made me flinch, however, were 'Doctors: let us kill disabled babies' headlines in the Sundays. Such crudely, emotive words usually spell trouble, despite the fact that no less a body than the Royal College of Obstetricians and Gynaecology was using its evidence to the Nuffield Council on Bioethics to debate euthanasia for severely disabled newborns.

Sure enough, next day's Daily Mailwas quoting nice Jim Dobbin, a Labour MP who is an NHS microbiologist by trade (but also a Catholic), who likened the proposal to Nazi eugenics. That easy comparison is rarely useful since it usually exposes the speaker's ignorance.

To its credit, the Mailrecalled the case of Charlotte Wyatt, kept alive despite severe brain damage and pain after costly High Court actions by the parents to overturn medical advice. They have since split up because of the strain and are seeking to have the child fostered. As the RCOG suggests: 'A very disabled child can mean a disabled family.'

I once heard a wise Scottish woman GP explain that in the old days there was little choice: badly disabled babies were quietly left to die.

As with drugs or that hip op we are - in theory anyway - spoiled for choice now. That is why defenders of our abortion laws describe themselves as 'pro-choice' to counter the 'pro-life' campaigners, whose activist wing includes a high proportion of Catholics and evangelical Protestants like President Bush.

Mr Bush spent the last few days of the US mid-term elections playing the 'culture wars' card on the campaign trail, desperately deploying abortion, gay marriage and the rest of the agenda to lure the faithful to the voting booth - despite Iraq, debt and the latest gay-bashing gay preacher.

It is always a good card in the Bible Belt, although a US friend of mine recently remarked: 'I am a rock-ribbed Republican, but worry that it will be hard to get the genie we have unleashed back into the bottle.' I thought of this at Westminster the other day as I listened to angry exchanges when Nadine Dorries, Conservative MP for Mid Bedfordshire, tried to introduce another bill to reduce the legal limit of termination from 24 to 21 weeks.

We all know the arguments: babies are increasingly viable, say the pro-lifers; they are sentient at 18 weeks; and (a new detail to me) are subject to a lethal injection ('foeticide') in the womb. The RCOG and others disagree.

Ms Dorries, herself a Catholic, is no slouch at publicity (visit her website to read Spanish articles on her bill), and did a deft job. But she was outgunned by Labour's Chris McCafferty, a doughty feminist and disability worker.

Only 0.6 per cent of abortions take place after 22 weeks (that is still almost 1,000 by my calculations), usually in desperate circumstances, the Calder Valley MP told colleagues. This 'cynical, cruel, ill-informed and inhumane bill' would only hurt the most vulnerable. The bill duly fell by 187 to 108 votes with all parties splitting both ways as usual.

Neither side denies these things are tricky. A new biography of Kingsley Amis recalls how the novelist and his future first wife, Hilary, planned to get an abortion in the grisly 1950s, but eventually recoiled and married, as people did. That was choice too, '50s style.

In Europe, we have avoided American culture wars of this kind (and have a low birth rate to prove it), although the debate over Islam has highlighted the ethical terrain in a new way. Tory leader David Cameron has a severely disabled child, but Andrew Lansley, his moderate health spokesman, deliberately issued no statement on the RCOG report .

I detect little enthusiasm to 'do a Bush' on this one - not yet.

Michael White is assistant editor (politics) ofThe Guardian .

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