(Correspondence) Unwanted pregnancy and abortion

CW Kok

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
. . . A common error made by physicians is that they assume a responsibility that is not theirs. When a healthy woman becomes pregnant it is her responsibility and it is certainly not the duty of the physician to terminate the pregnancy. . . . .

. . . If it is a depression one has to treat the depression, not the pregnancy. We are using the wrong diagnosis to escape from a difficult decision. To justify an abortion one must be sure that health will be permanently damaged, as in a patient with chronic nephritis or one at risk of heart failure. . . .

. . . .The lack of guiding principles has created a very disturbing situation. A most disturbing thought is that those who are unwanted can be disposed of. This happened to the Jews in Nazi Germany and it happens in all totalitarian states. . . .Throughout history, people were first dehumanized, not regarded as people, then used or killed. . .

. . . Physicians’ attention must be focused on preventing the occurrence of those situations in which abortion may be justifiable. . . The Oath of Hippocrates should serve as a means of drawing the members of the medical profession together irrespective of religious or philosophical differences. As it is now, we are the passive onlookers of a debate between fanatically rigid groups.


Kok C. (Correspondence) Unwanted pregnancy and abortion. Can Med Assoc J. 1975 Feb 22;112(4):419-420.

(Correspondence) Wilful exposure to unwanted pregnancy

Carol A Cowell

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
. . . the term unwanted pregnancy . . . I use . . . simply to denote a pregnancy in a patient who does not want a baby. . . If he is implying that some of these patients use pregnancy as a club with which to beat their parents over the head, I would certainly agree. . .The “wilful exposure to unwanted pregnancy” syndrome certainly must be one of psychodynamic origin. . . . when are our psychiatric colleagues going to come forward with positive, practical steps to help alleviate it?


Cowell CA. (Correspondence) Wilful exposure to unwanted pregnancy. Can Med Assoc J. 1975 Feb 08;112(3):274.

(Correspondence) Therapeutic abortion

PG Coffey

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The country that liberalizes abortion creates an atmosphere that encourages abortion. . . Is abortion really no different than any other operation? The people who see no difference are the same people who see all the difference in the world between feticide and infanticide. . . .Dr. Watters refers derisively to the “pro-life” group as the “Canadian Crusaders for Compulsory Pregnancy. . . Is it so difficult to understand that in certain circumstances principles come before expedients? . . . Killing has always been one of the most tempting ways for man to achieve his immediate ends. The numerous complications that may result from abortion, especially the long-term ones, provide good medical reasons for encouraging a pregnancy to continue.


Coffey PG. (Correspondence) Therapeutic abortion. Can Med Assoc J. 1975 Feb 08;112(3):283.

(Correspondence) Composition of the General Council (Response)

CMAJ

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The 1974 CMA General Council membership was composed of some 250 members of the association. Over two thirds of General Council, 170 members, were representatives of provincial divisions. Twenty-four were members of the CMA Board of Directors or chairmen of statutory CMA councils or committees. Thirty were representatives of affiliated societies. . . . In addition there were 21 individuals who, by virtue of having held office in the CMA (past-presidents, etc.), were members of General Council. The remaining three members were the surgeon general of the Canadian Armed Forces, the director general of the treatment services branch of the Department of Veteran Affairs and the deputy minister of national health, Health and Welfare Canada.


CMAJ. (Correspondence) Composition of the General Council. Can Med Assoc J. 1975 Jan 11;112(1):27.

(Correspondence) Therapeutic abortion

Heiko Baunemann

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The history of the Nazi era reminds us of the tendency in man to abuse and enslave his brothers. . . Canadian doctors have performed approximately 150 000 abortions. They are acting freely and voluntarily. I do not believe that their actions can be defended by moral men. It is true that there are good men among them, men who are motivated by the highest ideals, but as a social group I view them as mass killers.


Baunemann H. (Correspondence) Therapeutic abortion. Can Med Assoc J. 1975;112(1):27.

(Correspondence) Therapeutic abortion

WF Baldwin

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
I support Dr. Roseborough’s stand that most therapeutic abortions are essential, remedial and generally humane (Can Med Assoc J 111: 645, 1974) and I see no advantage in debating the issue further. . . . It has been my experience that sympathetic counselling combined with a few days’ delay results in a certain number of unwise or unwanted terminations being avoided. I do not deny (or mind) that some patients suffer anxiety from delay, but if termination of pregnancy in ambivalent patients is avoided, I believe the checks are valuable. . .My personal approach is that we must return to some form of sensible and responsible morality. Sex has now become one of the most discussed subjects of modern times. The Victorians pretended it did not exist at all, whereas the so-called moderns pretend nothing else exists. We have discarded the first attitude as being unrealistic and it is now time that we discarded the second.


Baldwin W. (Correspondence) Therapeutic abortion. Can Med Assoc J. 1974;111(12):1299, 1301.

Hill-Burton Hospitals After Roe and Doe: Can Federally Funded Hospitals Refuse to Perform Abortions?

Eugene L Berl

Review of Law & Social Change
Review of Law & Social Change

Extract
Conclusion

Public hospitals, by reason of the mandate of Roe and Doe, cannot categorically refuse to perform abortions. Similarly, under the state action doctrine, hospitals receiving federal funds pursuant to the Hill-Burton Act cannot refuse to perform abortions, notwithstanding the Health Programs Extension Act of 1973. The inter-relationsip of state and the hospital in the Hill-Burton program, with all the rights, duties and obligations incidental thereto, and the fact that the state and the hospital are joint participants in a state project undertaken for the benefit of the public, support the finding of state action. The Roe prohibition against state interference in a woman’s abortion decision, to be more than a mere cipher, must extend beyond state abortion statutes to the unwarranted refusal to perform abortions by hospitals with which the state is intimately involved.


Berl EL. Hill-Burton Hospitals After Roe and Doe: Can Federally Funded Hospitals Refuse to Perform Abortions? New York U Rev Law & Social Change. 1974;4(1):83-97.

Uterine injuries complicating hypertonic saline abortion

JJ Willems

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Author Summary
Two cases of uterine injury complicating midtrimester abortion induced by hypertonic saline are described, one with an extensive laceration of the cervix and the other with a rupture of the lower uterine segment extending into the vault of the vagina. The etiology, diagnosis and possible obstetric sequelae are discussed. With the increasing number of therapeutic abortions being performed in North America there is a concomitant increase in associated complications being reported in the literature. This report describes two of the more uncommon and potentially more important complications encountered when amnioinfusion is employed for the induction of midtrimester abortion. [Details of 19 year old and 15 year old patients at 16 and 18 weeks gestation respectively].


Willems J. Uterine injuries complicating hypertonic saline abortion. Can Med Assoc J. 1974 Dec 07;111(11):1223-1226.

(Editorial) Wilful exposure to unwanted pregnancy?

Carol A Cowell

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The WEUP syndrome (otherwise known as “Wilful Exposure to Unwanted Pregnancy”) has been well documented in a number of psychiatric publications. . .

. . . Abortion is not an emergency procedure and the lowering of the legal age of consent has had virtually no effect on the availability of the operation to the adolescent patient. . . .

. . . .does the “open approach” and provision of effective contraception mean to young people that you personally endorse premarital sexual experimentation and does this influence their behaviour? My answer is an unequivocal “No”; they make their own choice with or without your approval, and whether or not they are “outfitted” beforehand with effective contraception.

. . To the question “What was your main reason for having an abortion?” the following answers were given: “too young” (55%), “wanted to finish school” (15%), “wanted a child but couldn’t keep it” (12%), “pressure advice from parents (7%), “don’t want the kid (child)” (7%), other (4%). From our follow-up data regarding the girls’ assessment of what for them was the best solution (i.e. term delivery or abortion), 93.3% said that abortion was the best solution, with some 4.3% saying that it was not and 2.4% providing no answer. . .


Cowell CA. (Editorial) Wilful exposure to unwanted pregnancy?. Can Med Assoc J. 1974 Nov 16;111(10):1045, 1047.

(Correspondence) CMA policy on abortion

CMAJ

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
While the CMA has recommended the removal of the requirement for hospital therapeutic abortion committees from the Criminal Code, it has supported the retention of the balance of sections 251 and 252. The purpose of this stand is to retain the more serious implications of a violation of the Criminal Code as compared with a violation of provincial medical acts regarding the performance of abortions by non-qualified persons or by qualified physicians outside approved hospitals. This policy also reflects the association’s opinion that some provincial medical acts, and the means of enforcing them, are less than adequate.


CMAJ. (Correspondence) CMA policy on abortion. Can Med Assoc J. 1974 Nov 02;111(9):905.