Access to abortion

If Sanda Rodgers and Jocelyn Downie1 hold that the Supreme Court decision2 establishes a positive legal right for women to have abortions, we believe that they have exaggerated the decision. But is that what they really 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 matter 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 that 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 for pre- and post-natal teaching and assessment? It troubles our conscience that our system of universal health care has isolated wait times for cataract surgery and hip replacement 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, and 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 preconception, prenatal, obstetric, and maternal and newborn health care is something we all could make a matter of professional conscience.