Dr. Henry Morgentaler, Canada's outspoken abortion-rights crusader, has filed papers in the New Brunswick Court of Queen's Bench claiming women are being denied full access to abortion (see CMAJ 2002;167 [11]: 1277).
Although Morgentaler maintains that this is a violation of the Canadian Charter of Rights and Freedoms and the Canada Health Act, Justice Minister Brad Green says he is confident the province's legal position will stand up in court, and he is prepared to defend it as far as the Supreme Court of Canada.
Under New Brunswick's Medical Services Payment Act, abortions and physicians' fees for performing them are covered only if the woman is in the first 12 weeks of pregnancy, if 2 physicians certify that the abortion is medically necessary, and if the abortion is performed in a hospital. Morgentaler, who operates 8 privately operated abortion clinics, says the government should also pay for abortions performed in such clinics. “I accuse the government of New Brunswick of being sexist, male chauvinists [and] of victimizing and oppressing women,” said Morgentaler, 79. “By not paying for abortions, the New Brunswick government has been saving money on the misery of women.”
But Dr. Ed Schollenberg, registrar of the College of Physicians and Surgeons of New Brunswick, says the issue of paying for abortions in private clinics is a double-edged sword because there is a general reluctance to fund private medical services of any kind. “A lot of what is privately offered elsewhere in Canada is not available here, and if it is, those services are not covered [by the provincial insurance program],” he told CMAJ.
Schollenberg also notes that abortion remains an emotional issue in the province. “There have been special approaches developed regarding abortion,” he says. “There has been a history of restricting access.”
In 1985, the provincial government amended its Medical Act so that any doctor who performed an abortion outside a hospital would be guilty of professional misconduct. That provision was deemed unconstitutional by the court in 1994, the same year Henry Morgentaler opened a private clinic in Fredericton.
Access to abortion is an important issue for many women in New Brunswick, particularly those in smaller communities and rural areas. Lack of access in rural areas will be exacerbated by reduced access in urban centres. In 2002, the Moncton Hospital, one of the largest in the Maritimes, announced that it would perform only emergency abortions beginning in 2003. It had been performing more than 300 abortions a year, about half the provincial total. — Donalee Moulton, CMAJ