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News of the Day ... In Perspective


Canadians debate requiring doctors to do abortion referrals

The U.S. based National Abortion Federation has urged the Canadian Medical Association (CMA) to change its conscientious objector policy, which allows physicians to refuse to refer patients for abortions. This policy was passed in 1988 and is “re-confirmed” annually.

In a guest editorial in CMAJ¸ Sandra Rodgers of the University of Ottawa Faculty of Law and Jocelyn Downie of the Health Law Institute write that “not all women in Canada have adequate, or in some cases any, access to abortion.” They complain that some physicians not only refuse to do abortions but decline to provide information or referrals needed to obtain an abortion elsewhere. In their view, this violates current CMA policy on “full and immediate counseling and access without delay.”

The CMAJ was flooded with letters in response, indicative of a “fervent debate” within the organization (National Post 5/9/07). Although Canada is “the only democratic country in the world with no legal restrictions against abortion,” according to Joyce Arthur of Abortion Rights Coalition of Canada, access is effectively restricted by physicians’ choosing not to perform the procedure. Only 15.9% of Canada’s hospitals provide abortions, down from 17.8% in 2003 and 20.1% in 1977.

“Why should an individual doctor’s personal beliefs trump the legal definition of ‘person’ and ‘human being,’ violate the constitutionally entrenched rights of women to sexual and reproductive autonomy, and violate international human rights?” asks Andrée Côté of the National Association of Women and the Law. She thinks that “the medical profession has a collective responsibility to ensure access to this procedure.”

The National Abortion Federation favors forcing physicians to do abortions regardless of their moral beliefs (Ted Byfield, WorldNetDaily 5/12/07). Writing on “physician autonomy and the ethics of intolerance,” Stephen J. Genius of the University of Alberta observes that ethical physicians avoid interventions that they believe are detrimental to patients. Referral to another physician or clinic that will act in a manner deleterious to the patient makes the primary doctor complicit in the harm. The CMA Code of Ethics exhorts professionals to “resist any influence or interference that could undermine your integrity,” and the UN Universal Declaration of Human Rights considers “freedom of conscience” to be a basic human right, he notes.

The letters to CMAJ may be read at: http://www.cmaj.ca/cgi/eletters/175/1/9

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