Electronic letters to:
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eLetters: Electronic letters published:
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Is RU486 an only solution?
- Val E. Ginzburg (22 September 2006)
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rural abortion access
- nancy humber (11 September 2006)
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Women's Human Rights Matter!
- Andrée Côté (17 August 2006)
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Moral Desensitization
- Renata Leong (26 July 2006)
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Accessing more than abortion
- James E Read (25 July 2006)
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Offering alternative choices.
- Daniel T Holmes (20 July 2006)
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Physician Autonomy and the Ethics of Intolerance
- Stephen J. Genuis (19 July 2006)
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The unwanted child-when things go wrong.
- Jeevan P Marasinghe (19 July 2006)
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Re: "Abortion: ensuring access"
- Philip G. Ney (13 July 2006)
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balanced journalism needed
- Rene Leiva (13 July 2006)
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Abortion access editorial worrisome
- Williard P Johnston (11 July 2006)
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Abortion laws discriminate against women
- Joyce Arthur (10 July 2006)
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Re: Response to "Abortion: ensuring access"
- John B. Shea (10 July 2006)
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Response to "Abortion: ensuring access"
- Catherine Ferrier (5 July 2006)
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Val E. Ginzburg University of Toronto, NYGH
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val.ginzburg{at}utoronto.ca Val E. Ginzburg
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I have read with great interest an editorial by S. Rodgers and J. Downie “Abortion: ensuring access” in July, 2006 issue of CMAJ. I support their efforts to educate health care community regarding ethical and professional responsibilities towards women considering an abortion. Likewise, I agree that the provincial and territorial governments should provide affordable hospital or outpatient abortion services. It is also very important to provide patients with an alternative for early pregnancy terminations such as mifepristone. However, I believe that neither introduction of mifepristone as an alternative to metothrexate that is already used for termination of early pregnancy nor emphasizing of professional responsibilities will significantly decrease teens-pregnancies or increase number of abortions performed. I believe that the lack of training to perform abortions by the Family Medicine residents, who will be providing care in the underserviced communities, is a significant barrier to affordable and accessible abortion services in the future. In order to improve access to abortion services provincial and territorial governments should fund training of interested Family Medicine residents to perform abortions as a part of their residency training. Sincerely, Val E. Ginzburg MSc MD PGY2 Family Medicine University of Toronto, NYGH Conflict of Interest:None declared |
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nancy humber ubc clinical associate professor
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saffron2{at}telus.net nancy humber
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I read with interest the guest editorial entitled, “Abortion: ensuring access”. As a rural physician for 10 years, I have seen that abortion access is particularly difficult in rural areas. Teens, single, non-white women already find access difficult. Rural populations face additional barriers such as isolation, cultural differences, transportation and low socioeconomic status. Often rural women require three visits to a referral center for a pregnancy termination: One visit for a dating ultrasound, a second for specialist consultation and a third for the surgical procedure. Issues such as transportation, financial burden and accompanying support people for each visit are compounded with each visit. Many of these women lose continuity of care and never follow up with the operator completing the termination nor with any other physician. Rural GPs are in an excellent position to provide appropriate counseling and continuity of care for patients facing the decision of an unintended pregnancy. Many GP’s are interested and, with appropriate training, could also be in a position to offer pregnancy termination. Pregnancy terminations are an uncomplicated procedure which could easily be incorporated into a rural GP’s skill set. Many rural GP’s already offer D&C in their scope of practice and have access to operating room time. Provincial pregnancy termination program standards and protocols are easily transferable to other sites. Unfortunately, there is still resistance within health authorities and hospital administrative staff to offering pregnancy termination service. Rural GP’s can easily play a significant role in narrowing the gap in access to pregnancy termination services. Interested physicians should consider adding this service to their local scope of practice. Health authorities should do their utmost to encourage and support local hospitals and physicians to execute this. Finer LB Henshawsk, Abortion incidence and services in United States, 2000, Perspectives on Sexual and Reprod Health, 2004 Rosoff, JI, Resolving the Abortion Contreversy, Health Matrix. 1989, Summer;7(2):22-4 Darroch JE, Adolescent pregnancy trends and demographics, Curr Womens Health Rep.2001 Oct;1(2):102-10 Humber, N, On becoming a Canadian trained Gp Surgeon, 2002. unpublished Raymond E Kaczorowski J Smith P Sellors J Walsh A, Medical abortion and family physicians. Survey of residents and practitioners in two Ontario settings. Can Fam Physician,2002. Mar;48:538-44 Chiasson P, Roy P. Role of the general practitioners in the delivery of surgical and anesthesia services in rural Western Canada. CMAJ 1995; 153 (10):1457-1452. Ferris LE Mcmain KleinM Iron K. Factors influencing the delivery of abortion services in Ontario – a descriptive study. Fam Plann Perspect. 1998 May-June; 30(3):1348. Conflict of Interest:None declared |
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Andrée Côté, 1066 Somerset West #303 Ottawa, On National Association of Women and the Law
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andree{at}nawl.ca Andrée Côté
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I am deeply disturbed by the negative responses to the guest editorial entitled "Abortion: ensuring access", (July 4, 2006). Most articulate an uncompromising ideological position in favour of the right to life of a foetus and completely ignore the basic human rights of women who, presumably, are their patients. Most writers show a complete disregard for the consequences for women who are refused access to abortion services. The authors would do well to read the reports of the horrendous consequences of the criminalization of abortion for women’s physical and mental health, indeed their very right to life (see for example: Janet Walsh and Marianne Mollman, “International Human Rights Law and Abortion in Latin America”, Human Rights Watch , July 2005, available at www.hrw.org).. They should recall the experiences of Canadian women who, for lack of legal and accessible services, resorted to back alley abortions across Canada in the last century (see: Badgley Report,Canada, Report of the Committee on the Operation of the Abortion Law (Badgley Report) (Ottawa: Supply and Services Canada, 1977. The lack of historical context evidenced by the writers is striking. They ignore the importance of sexual and reproductive autonomy for women. In a society where wives were once “covert” or “incapable”, where women could not vote, prevent pregnancy by using contraception, or file criminal charges of rape against their husbands who benefited from “marital immunity”, access to abortion goes to the very citizenship of women. Denying abortion services to a woman who does not want to carry a pregnancy to term is to make her the instrument of someone else’s will. Freedom of conscience was invoked by several of your writers. Why should we allow a doctor’s personal, ideological or religious bias against abortion, to negatively impact on all of his or her female patients? Why, in a rural region or a small town, allow these views to control the access to health care of a whole community? Why should an individual doctor's personal beliefs trump the legal definition of “person” and of “human being”, violate the constitutionally entrenched rights of women to sexual and reproductive autonomy, and violate international human rights? In the face of the demonstrated resistance of individual doctors to offer adequate abortion services in most institutions and regions across Canada, the medical profession has a collective responsibility to ensure access to abortion. Andrée Côté Director of Legislation and Law Reform National Association of Women and the Law Conflict of Interest:None declared |
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Renata Leong DFCM, St. Michael's Hospital; Assistant Professor, DFCM, University of Toronto
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rmw.leong{at}utoronto.ca Renata Leong
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To the editor: The July 4th editorial by Rodgers and Downie can be interpreted as a universal call for Canadian physicians to participate in abortion services in an “on demand” fashion - be it directly, through referring or by lobbying “provincial/territorial governments”3. The “cost” necessary to implement what they suggest, however, is not discussed in the article. The crux of the abortion debate centres on the different notions of beginning of life. Many healthcare providers hold for both scientific and moral reasons that human life begins at fertilization. To these health care professionals, a mandate to promote or participate in abortion services on demand is no different from a mandate to take the life of another human being. A call for the silencing of one’s inner voice of conscience is not without cost. Research on medical education has documented moral distress and moral desensitization when trainees witness or participate in what they perceive as unethical acts, such as making derogatory comments about patients 1,2. One can only imagine the hundredfold impact of this phenomenon when a healthcare provider is faced with a perceived demand to promote or participate in the taking of another’s life. With that in mind, one must ask the authors to clarify what they propose as an appropriate alternative moral compass for healthcare professionals. Short of a satisfactory answer, one wonders if Rodgers and Downie’s suggestions for Canadian physicians represent yet another force in medicine’s informal curriculum urging professionals to silently “go with the flow”. Sincerely, Renata Leong, MDcM, CCFP, MHSc 1. Coldicott Y, Pope C, Roberts C. The ethics of intimate examinations-teaching tomorrow's doctors. BMJ. 2003 Jan 11;326(7380):97- 101 2. Feudtner C, Christakis DA, Christakis NA. Do clinical clerks suffer ethical erosion? Students' perceptions of their ethical environment and personal development Acad Med. 1994 Aug;69(8):670-9. 3. Rodgers S, Downie J. Abortion: ensuring access. CMAJ • July 4, 2006; 175 (1). Conflict of Interest:None declared |
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James E Read
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james_read{at}can.salvationarmy.org James E Read
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The July 4th guest editorial by law professors Rodgers and Downie (1) has already generated extensive comment, but we offer several further points that we believe salient. If Rodgers and Downie hold that Morgentaler (2) establishes a positive legal right for women to have abortions, we believe that they have exaggerated the decision. But is that what they really have said? The title of the editorial and its opening paragraph speak to questions of access, and we believe that the Supreme Court did speak to this in 1988. The existing abortion law was struck down because therapeutic abortion committees of the day were unpredictable and often unavailable. The whole structure had begun to unravel by 1988, and it’s no surprise it could not withstand a Charter challenge. But if Rodgers and Downie are truly exercised about women’s access to good medical attention around issues of “reproductive health,” we think that their net should be thrown wider. Is it only access to abortion referrals and abortion services that is wanting in Canada? How difficult is it for women to see a family physician, an obstetrician, or a public health nurse for good contraceptive advice, or pre- and postnatal teaching and assessment? It troubles our conscience that our system of universal health care has isolated wait times for cataracts and hip replacements and plans strong guarantees that Canadians won’t have to wait for these procedures, but has said nothing about access to the less exotic care that is needed by women as they make decisions about whether to have a baby. The differences about the ethics of abortion are deep, and these differences should not be minimized. That there are health professionals who may feel bullied into compliance is disturbing. We ourselves hold conservative views. We may never see eye-to-eye with Rodgers and Downie on the ethics of abortion. But surely we can all agree that the number of unwanted pregnancies in Canada is not a matter to celebrate. Better assured access to pre-conception, prenatal, obstetrical and maternal- newborn health care is something we all could make a matter of professional conscience. James E. Read, Ph.D. Winnipeg MB Beverley J. Smith, MD, CCFP, FCFP Toronto ON References: 1. Rodgers S, Downie J. Abortion: ensuring access. CMAJ 2006;175:9. 2. R. v. Morgentaler, [1988] 1 S.C.R. 30 Conflict of Interest:None declared |
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Daniel T Holmes Univesity of British Columbia
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dtholmes{at}interchange.ubc.ca Daniel T Holmes
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Dear Editor, In the July 04, 2006 edition of the CMAJ appeared an invited editorial from Rodgers and Downie, professors of law at the University of Ottawa and Dalhousie University respectively (1). As non-physicians, neither Rodgers nor Downie would be likely to understand what experiences in medical school and residency shape a physician’s decision to take a pro -life stance in their personal life and give pro-life counsel to their patients. I give my own experience, not specifically to rebut their position, but to help them and others to understand the pro-life physician’s perspective. As part of my residency training in laboratory medicine (which started with two rotations in anatomical pathology) I was responsible, under the supervision of staff physicians, for the gross and microscopic description of surgical specimens from abortions – both “therapeutic” and medically-emergent. In this process I measured and counted the limbs and appendages of many fetuses and I can state unequivocally that, contrary to what is frequently told patients, much of what comes from abortions is not merely “tissue”. It was a disturbing experience but it gave me a very concrete perspective on this issue. Experiences like these have led pro-life physicians to the conviction that participation in the process of fetal termination in a therapeutic abortion is participation in the killing of a human being. This, coupled with the fact that many patients suffer with guilt and grief after abortion, leads physicians like me to counsel others, yes even unsolicited, to thoughtfully consider choices other than abortion. Would Rogers and Downie not provide unsolicited advice to someone whom they thought was about to make a decision that they might deeply regret? As an aside, dare I ask what fraction of patients is offered fair, rapid and equal access to counsel regarding adoption as an alternative to abortion? Dr. Daniel Holmes, MD, FRCPC Department of Pathology and Laboratory Medicine St. Paul’s Hospital Vancouver, BC References 1. Rodgers S, Downie J. Abortion: ensuring access. CMAJ 2006;175:9. Conflict of Interest:None declared |
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Stephen J. Genuis Associate Clinical Professor, University of Alberta
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sgenuis{at}ualberta.ca Stephen J. Genuis
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Physician Autonomy and the Ethics of Intolerance After reading the guest editorial about ensuring access to abortion, it is apparent that lawyers may not be fully cognizant of the practical realities, evidence-based science and the ethics of clinical medicine just as physicians may not appreciate the intricacies of practicing law. In order to winnow ideology and interests from science and medical fact, it may be preferable to have credible physicians debating conflict-ridden medical issues rather than sanctioning special interests outside the profession to expound unilaterally in scientific journals. One point of note in response to the editorial: physicians often decline participation in selected interventions such as abortion-on-demand or other controversial procedures for reasons other than just ‘personal beliefs’ or self-interest; ethical physicians avoid interventions they sincerely believe - rightly or wrongly - are harmful and detrimental to patients. The recent medical literature, for example, has raised serious concern about potential complications and damage to some recipients of therapeutic abortion.<1> Furthermore, from the vantage point of primary doctors, to knowingly carry out a consultation to another practitioner or clinic who they anticipate will proceed in a way the primary doctor feels is damaging or deleterious to the health of the patient, is to be complicit in harm. Patient autonomy is not the only consideration in medical practice – refusal to accede to patient request, for example, also occurs when doctors refuse to participate in other potentially harmful procedures such as female feticide or female circumcision, procedures which have been requested of some physicians in this country. The policy of coercing ethical doctors to do what they feel is unethical – whether it is by threat of lawsuits or disciplinary action – displays intolerance of diverse views and choice; it goes against the CMA code of ethics which explicitly exhorts health professionals to "Resist any influence or interference that could undermine your integrity"<2>; it violates the ‘freedom of conscience’ considered a basic human right according to the UN Universal Declaration of Human Rights<3>; and it may have a profound adverse impact on the health, well-being, and behavior of competent doctors.<4> Such a draconian authoritarian policy of coercion may not be in the best interests of physicians or patients, but admittedly it may generate much import and activity for our friends in the legal industry. The medical community should not tolerate such intolerance. 1. Fergusson DM, Horwood LJ, Ridder EM. Abortion in young women and subsequent mental health. J Child Psychol Psychiatry 2006; 47:16-24. 2. Canadian Medical Association. Fundamental Responsibilities: Article #7. Code of Ethics of the Canadian Medical Association (Update 2004). 3. General Assembly of the United Nations. Universal Declaration of Human Rights. (Article 18) December 10, 1948. 4. Genuis SJ. Dismembering the ethical physician. Postgraduate Medical Journal 2006; 28:233-8. Stephen J. Genuis MD FRCSC DABOG, Associate Clinical Professor, University of Alberta. Conflict of Interest:None declared |
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Jeevan P Marasinghe
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jeevanmarasinghe{at}yahoo.com Jeevan P Marasinghe
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Unwanted children and back room abortions are global problems and these children can retain drastic consequences to the society. They tend to demonstrate poor physical and psychological development. Children whose parents had requested an abortion but had not been granted permission have developed nutritional deficiencies compared to a control group (1,). Women who choose abortion, compared to those who had term unwanted pregnancies, tended to suffer less serious long term consequences (2, 3) and most of them had only mild or temporary stress. Each and every act of abortion is associated with a high degree of maternal mortality and morbidly and it almost always goes hand in hand with septic abortion. It is not unusual to see severe consequences of septic abortion in countries like Sri Lanka and other third world countries where abortion is only permitted when the physical and mental health of the mother is in danger due to pregnancy. But hundreds of amateur abortionists are running their back room practices, giving rise to all sorts of complications. Legalizing the abortion would have well reduced this social problem in which we see only the tip of the iceberg. So the abortion should be made safe and legal and women should be well guided and well aware of the facilities for abortion. State funding of abortion should be offered to couples who are too poor to spend money on it. This would clearly reduce a cohort of violent rebellions from the society. Relaxations of the laws relating to abortion are warmly welcome, while emphasizing the importance of good education programs and effective delivery methods of modern contraceptive devices. Sandra Roberts et al‘s view on it as an essential component of women’s reproductive health care (4) should be regarded as an issue of human rights. References. (1)Veil B.The risk of unwanted pregnancy. A Latin American perspective.IPPF Med Bull 1989 Feb; 23(1):1-3. (2)Lemkau JP.Emotional sequelae of abortion: implications for clinical practice.Psychol Women Q.1988 Dec; 12(4):461-72. (3)Turelle SC, Armsworth MW, Gaa JP.Emotional response to abortion. Critical review of literature. Women Ther 1990; 9(4):49-68. (4)Sanda Rogers, Jocelyn Downie.Abortion ensuring access.CMAJ July 4 2006; 175(1) Conflict of Interest:None declared |
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Philip G. Ney
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pgney{at}telus.net Philip G. Ney
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Before definitively forming an opinion on the editorial “Abortion: ensuring access” by Rodgers and Downie, I would like to ask them a few questions; 1) Why is abortion considered a “key component” to women’s health? 2) What is the scientific evidence that abortion is good and/or essential for women? 3) How can abortion be a “constitutionally protected right” for women, and at the same time, the practice of abortion be “regulated like any other medical procedure”? 4) If abortion is regulated like any other medical procedure, why are they complaining that women “require referrals”? 5) Do doctors have a dual obligation to treat and to warn where the evidence is weighty enough, as in smoking cigarettes? 6) How does dispensing of the Morning After Pill without prescription or examination jibe with “regulated like any other medical procedure”? 7) I note that Rogers and Downie think the physicians “must” or “should do” on 9 occasions. How would members of the legal profession feel about physicians telling the legal profession how to conduct their affairs? 8) If the medical profession is a self regulating, autonomous body which practices evidence-based medicine, why does not the judiciary or the legislators insist medical scientists do as many proper scientific evaluations as necessary on the efficacy and safety of abortions? 9) Would they agree that the burden of proof for any medical procedure lies with those who perform, refer to or recommend that procedure, to show beyond reasonable doubt its safety and efficacy? 10) Can they explain why this should not apply to abortion? Sincerely, Dr. Philip Ney. Conflict of Interest:None declared |
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Rene Leiva SCO Health Centre Ottawa
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rene.leiva{at}mail.mcgill.ca Rene Leiva
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I found the Guest Editorial in this week’s issue of CMAJ to be partial and misleading. (Abortion: ensuring access, CMAJ 175(1): July 4, 2006). One of the main issues is the false statement by the guest editors that physicians should refer to abortion even against their conscience: ‘Even if not willing to provide abortion services themselves, physicians should ensure that patients receive the referrals they require, and in a timely fashion’. At the center of this is the debate of conscientious objection. The conscience is that internal voice that tells us what is right and what is wrong. Is a notion of right and wrong no longer valid? Certainly not, especially for those of us who, whether for moral or religious reason, object to what we believe is terminating a human person. It seems that behind this article is a movement to take away this basic right. The CMA’s Code of Ethics protects the physician who refuses to refer to an abortion (1). I would hope the CMAJ invites a guest editorial who would present the other side of the debate. It is plain balanced journalism. 1. Mackay B. Sign in office ends clash between MD's beliefs, patients' requests. News. CAMJ. Jan 7, 2003, 168(1).p. 78 http://www.cmaj.ca/cgi/content/full/168/1/78-a Conflict of Interest:None declared |
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Williard P Johnston President, Canadian Physicians for Life
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willjohnston{at}shaw.ca Williard P Johnston
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It is disturbing that Rodgers and Downie have teaching contact with medical students on the topic of access to abortion. It seems clear to me that two of their central points are plainly false. First, the 1988 Morgentaler decision flunked the existing system because it was capricious, not because the judges discovered a constitutional right to abortion in the Charter of Rights and Freedoms. In fact, the judges said clearly that Parliament could create a new law protecting the unborn child. Second, the CMA policy on referral for abortion is unequivocal: a physician must make his or her position, and the right to consult another physician, clear to the patient but is in no way obliged to provide a referral for any procedure. Outside a life-threatening situation, the issue of delay is a red herring: the time it takes for the patient to see a second physician is not within the control of the physician whose judgment leads him or her to decline to participate. I assume that these editorialists are lawyers. They may be passionate partisans of abortion, but their agenda needs to be questioned. Sincerely, Will Johnston President Canadian Physicians for Life Conflict of Interest:None declared |
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Joyce Arthur Abortion Rights Coalition of Canada
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joycearthur{at}shaw.ca Joyce Arthur
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Abortion is indeed a “constitutionally-protected right.” The Supreme Court in 1988 made it clear that the enforcement of Canada's abortion law resulted in inequitable access and arbitrary obstacles for women, thus violating their constitutional right to security of the person, as well as their liberty and freedom of conscience rights. Many subsequent court decisions have cited or built on the Morgentaler decision, further entrenching abortion access as a constitutional right for women. Canada’s Charter has a gender equality clause to protect women from discrimination as a historically disadvantaged group. Since only women get pregnant, any regulation of pregnancy is inherently discriminatory, because such laws place a special burden on women that is not placed on men. There is absolutely no justification for regulating abortion via criminal or civil law, regardless of public or even medical opinion about it — especially since such opinion may be rooted in stereotypical assumptions about women’s “proper” role as childbearers. Canada’s status as the only democratic country in the world with no legal restrictions against abortion should be emulated by other countries. Since 1988, we’ve shown that a lack of laws actually leads to earlier and safer abortions. About 90 percent of abortions for Canadian women are done by 12 weeks, and about 97 percent by 16 weeks, a better record than in the U.S., where numerous legal restrictions serve mainly to delay abortions and increase the medical risk. Moreover, Canadian women have almost one- third fewer abortions than American women, and at rates comparable to countries in western Europe. Canada also enjoys one of the lowest maternal mortality and complication rates for abortion in the world. Abortion restrictions in other liberal countries are holdovers from the days of criminal abortion, or recent products of religious ideology. Such laws do nothing to reduce abortions and have many negative consequences. They institutionalize the stigma of abortion and foster prejudice against women who need one. They marginalize abortion outside the healthcare system and remove medical discretion from doctors, giving it to lawmakers instead. Physicians should never work under the threat of criminal prosecution simply for providing medical care. As for physicians who do not provide abortion care, they have a professional obligation to help women access services without delay, regardless of their own personal beliefs. (Ref: Abortion statistics, gestation times, Statistics Canada 2005: www.arcc-cdac.ca/StatsCan-gestation-times-1995-2003.xls) Conflict of Interest:None declared |
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John B. Shea Rouge Valley Health Care System
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jbshea{at}rogers.com John B. Shea
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July 7, 2006 To the Editor: The use of the phrase "reproductive health care" in relation to abortion is misleading. First, abortion is anti-reproductive. Second, the health of the unborn is not cared for as he or she is killed. Third, the health of the mother is endangered by abortion. For example, abortion is contraindicated in the following diseases when they complicate pregnancy: severe hypertensive disease, cardiac failure, liver, kidney or psychiatric disease. Abortion is associated with an increased risk of pre-term delivery and an increased risk of brain damage in the newborn. Women who abort require more psychiatric help, have more psychological problems, are more suicidal, and suffer from more alcohol and drug abuse that women who do not abort. Finally, abortion is known to cause a significantly increased incidence of cancer of the breast. Natural law ethics forbids the killing of the innocent. Abortion is the killing of an innocent member of the human species and is objectively morally wrong. Even Cicero understood that natural law,the human reason's understanding of divine law, holds true for all time and that the law of the land is valid only if it is coherent with the natural law. The notion that the Canadian Charter of Rights and Freedoms, or Canadian law, can morally justify abortion is ultimately based on the principle that the changeable law of the land establishes what is morally right and on the intellectually incoherent assumption that the only objectively true moral principle is that no moral principles are objectively true. Those who would justify abortion and call on all physicians to acceed to their demands base their notion of ethical behaviour on the will and not on reason and the empirical and philosophical facts about our human nature. Sincerely, John B. Shea MD FRCP(C) Conflict of Interest:None declared |
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Catherine Ferrier McGill University Health Centre
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catherine.ferrier{at}muhc.mcgill.ca Catherine Ferrier
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July 5, 2006 To the editor: I would like to take exception to the Guest Editorial in this week’s issue of CMAJ (Abortion: ensuring access, CMAJ 175(1): July 4, 2006). The guest editors take the extreme position that there should be no legal restrictions or medical limits to the availability of abortion. There is no consensus among Canadian physicians that unlimited access to abortion is a good for patients or society. Nor is there such a consensus among Canadians as a whole: according to this week’s Maclean’s magazine (July 1, 2006, page 37), only 43% of those polled in 2005 supported abortion on demand. In this poll, the support for abortion only increased substantially in cases of medical indications or rape. If I understand correctly (and here I risk entangling myself in a discussion with two law professors about legal issues), the 1988 Supreme Court ruling in no way established a “constitutionally protected right to abortion”. It only stated that the law as it then stood was at odds with the Canadian Charter of Rights and Freedoms. A new law should have been enacted, but was not. For almost twenty years Canada has been almost unique in the developed world in having no law limiting access to abortion in any way. The appeal to the rights of women who are poor, young, immigrant, disabled and so on is an old trick of the pro-abortion lobby. These groups have more difficulty accessing most health services, especially those requiring specialized technology or skills, and abortion has no unique status in this regard. As for the remarks about physicians who disagree with their position and do not refer all patients for abortion who request it, I can only say that they reflect an impoverished “one size fits all” understanding of physician integrity and the doctor-patient relationship. Catherine Ferrier, MD, CCFP, FCFP Conflict of Interest:None declared |
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