Abortion Archives - Page 22 of 51 - Protection of Conscience Project Library

Abortion: the limits of moral repugnance

Leah L Curtin

Abstract
A 28-year-old married woman, gravida 3 para 2002, was transferred to a tertiary care hospital at 27 2/7 weeks gestation for verification of gross fetal anomalies. Ultra-sonography studies showed the child she carried had a dramatic gastroschises, an enlarged heart, and small limb buds for arms. The patient was informed of her fetus’ condition and, after she discussed the situation with her husband, both parents asked that the pregnancy be terminated.

Using prostaglandin, the physician induced labor prematurely in a labor and delivery room suite. Both parents held the child until shortly before its death.

A voluntary abortion this late in pregnancy for nonlethal birth defects caused considerable concern and even distress among the nursing staff on this unit. As a matter of conscience, almost half of the nursing staff refused to care for any patients having elective abortions, and this case raised even more moral questions than usual. Moreover, this couple—and even their family members—received threatening phone calls and letters while the woman was still in the hospital, and the couple reported receiving even more after she returned home.

Curtin LL. Abortion: the limits of moral repugnance. Nurs Manag. 1994 Oct;25(10):22-25.

(Correspondence) Methotrexate and misoprostol used in abortions (Author responds)

Ellen R Wiebe

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
Of course methotrexate is contraindicated for a wanted pregnancy: it causes abortion in approximately 95% of pregnancies of less than 7 weeks’ gestation. This is why we are using it as an abortifacient. . . . if abortion failed in a women given methotrexate and she refused to undergo surgical abortion, there would be a risk to the fetus. From the experience with RU 486 in Europe we know that women rarely change their minds about abortion in such cases.

Wiebe ER. (Correspondence) Methotrexate and misoprostol used in abortions. Can Med Assoc J. 1994;151(5):518.

(Correspondence) Methotrexate and misoprostol used in abortions

Anthony T Kerigan

Extract
. . . methotrexate is contraindicated during pregnancy. If Wiebe and the University of British Columbia Ethics Committee have information on the safety of this drug during pregnancy perhaps they could share it with readers.

Kerigan AT. (Correspondence) Methotrexate and misoprostol used in abortions. Can Med Assoc J. 1994 Sep 01;151(5):518.

Consequences for patients of health care professionals’ conscientious actions: the ban on abortions in South Australia

Leslie Cannold

Abstract
The legitimacy of the refusal of South Australian nurses to care for second trimester abortion patients on grounds of conscience is examined as a test case for a theory of permissible limits on the autonomy of health care professionals. In cases of health care professional (HCP) conscientious refusal, it is argued that a balance be struck between the HCPs’ claims to autonomous action and the consequences to them of having their autonomous action restricted, and the entitlement of patients to care and the consequences for them of being refused such care. Conscientious action that results in the disruption or termination of health care services, however, is always impermissible on two grounds. Firstly, because it is at this point that the action ‘… invades a patient’s autonomy, puts a patient at serious risk … [and] treats a patient unjustly’ (1) Secondly, because the consequences of such refusals turn them into political acts-acts of civil disobedience. It is arguable that in order for acts of civil disobedience to be legitimate, certain obligations are required of the dissenter by the community. It is concluded that the actions of the South Australian nurses, which have over the last few years both terminated and disrupted second trimester services, are morally impermissible.

Cannold L. Consequences for patients of health care professionals’ conscientious actions: the ban on abortions in South Australia. J Med Ethics. 1994 Jun;20(2):80-86.

(Correspondence) Methotrexate and misoprostol used in abortions

Ellen R Wiebe

Extract
Medically induced abortion rather than surgical abortion has many advantages and could improve access to abortion in Canada . . . In December 1993 I received permission from the University of British Columbia Ethics Committee to start a pilot study of abortion induced with methotrexate and misoprostol; the study is under way. I would like to hear from other physicians who may be interested in this method.

Wiebe ER. (Correspondence) Methotrexate and misoprostol used in abortions. Can Med Assoc J. 1994 May 01;150(9):1381-1382.

(Correspondence) Abortion debate continues

Linda Spano, Michael Brennan

Extract
. . . we all – including Reynolds – operate from a biased set of basic assumptions. Is it really antireligious to suggest that the antiabortion forces are largely motivated by fundamental religious views that represent fixed basic assumptions? We think not. . . . Medical intervention includes helping people achieve their potential according to their own objectives as well as many other “appropriate” activities, such as the therapeutic termination of pregnancy. . . .The abortion debate is not entirely about abortion or religion, nor is it even a debate. . . the argument is about the freedom of choice and the access of all Canadian women to safe, competent medical care and about the refusal of most Canadians to submit to the irrational demands of a vociferous minority. . .

Spano L, Brennan M. (Correspondence) Abortion debate continues. Can Med Assoc J. 1993 Jun 15;148(12):2112-2113.

(Correspondence) Physicians and abortion

Lynette E Sutherland

Extract
After I read the articles on abortion in CMAJ I began to wonder if ready access to abortion is the main issue. Are we faced with a Yes-No decision, or are we looking at a symptom of something deeper? . . . The world is overpopulated, yet more and more children are being born. Despite the efforts of many dedicated people (especially women) to take information on birth con- trol to the most afflicted parts of the world, little progress is being made. All the solutions are “Band-Aid” ones, and almost all – contraceptives, abortifacients and abortion itself – are directed toward women, whose reproductive capacity is certainly the root of so much trouble. To cure these ills, nothing short of a redirection of human nature is necessary. . . .the earth’s mad population increase will surely go on to a cataclysmic end. We can put this off temporarily if we follow the Chinese example (one-child or two-children families) worldwide, with strict supervision of female reproduction.

Sutherland LE. (Correspondence) Physicians and abortion. Can Med Assoc J. 1993;148(8):1276-1277.

(Correspondence) Clinicians who provide abortions: the thinning ranks

Denis Cavanaugh

Extract
Dr. Grimes identifies abortion as “the most divisive social issue of our time,” but he is contributing to the divisiveness by raising these issues in those of us who consider elective abortion a social evil as well as a “distasteful chore.” Abortionists don’t have all the altruism, and if elective abortion were not a billiondollar- a-year business, there would be even fewer volunteers. . .the legal entitlement of a woman to elective abortion cannot be absolute to the extent of suppressing the values and conscience of her physician, so there is no reason why a resident should have an obligation to perform such abortions.

Cavanaugh D. (Correspondence) Clinicians who provide abortions: the thinning ranks. Obst Gyn. 1993 February;81(2):318-319

Conscientious objection and abortifacient drugs

D B Brushwood

Abstract
The legal right to assert a conscientious objection is reviewed, using as an example the dispensing of abortifacient drugs by pharmacists. The three areas of law that most significantly concern the right to assert a conscientious refusal are employment law, conscience clauses, and religious discrimination law. Each of these is reviewed, with descriptions of recent cases. It is concluded that employment law protects refusals that are consistent with public policy, but does not permit an employee’s personal policy to determine how a business will be run; that conscience clauses appear to provide protection for pharmacists who object to dispensing abortifacients, but that the precise meanings of critical words and phrases in some clauses need to be defined; and that even though laws of religious discrimination require that employers accommodate religious beliefs, they may not protect a pharmacist who objects to dispensing abortifacients if the accommodation becomes unreasonably burdensome.

Brushwood DB. Conscientious objection and abortifacient drugs. Clin Therapeutics. 1993 Jan-Feb;15(1):204-212.

(News) Bombing of Toronto abortion clinic raises stakes in bitter debate

Gordon Bagley

Extract
The abortion clinic that Dr. Henry Morgentaler operated on Harbord Street in Toronto was an electronic fortress bristling with hidden cameras, burglary shock sensors and motion detectors, but the security measures were of little use last May 18. At about 3:23 on that Monday morning, a security camera filmed two shadowy characters approaching the clinic’s back door. The visitors, heavily disguised, used a drill to bore through the door lock. They poured gasoline into the clinic, let it aerosolize, and then used a Roman candle to ignite the fumes. In the resulting explosion the entire front wall of the two-storey structure shuddered, buckling building supports and flinging glass, bricks and other debris into the street. Fortunately, no one was injured – the street was deserted. Six months later, Toronto police seem no closer to finding the terrorists. . . . [lengthy article].

Bagley G. Bombing of Toronto abortion clinic raises stakes in bitter debate. Can Med Assoc J. 1992;147(10):1528-1533.