Extract James Kopp has been found guilty of murdering New York state obstetrician Dr. Barnett Slepian, but police are still trying to close other cases involving Canadian physicians who were shot. Kopp remains a suspect in the non- fatal shootings of physicians who provided abortions in Winnipeg, Vancouver and Ancaster, Ont. He has been charged in the last case — Dr. Hugh Short was shot in the right arm as he sat in his home Nov. 10, 1995 (CMAJ 1998;159[9]:1153-5) — but there is in- sufficient evidence linking him to the Winnipeg or Vancouver cases.
Abstract The legal approach to abortion is evolving from criminal prohibition towards accommodation as a life-preserving and health-preserving option, particularly in light of data on maternal mortality and morbidity. Modern momentum for liberalization comes from international adoption of the concept of reproductive health, and wider recognition that the resort to safe and dignified healthcare is a major human right. Respect for women’s reproductive self-determination legitimizes abortion as a choice when family planning services have failed, been inaccessible, or been denied by rape. Recognition of women’s rights of equal citizenship with men requires that their choices for self-determination be legally respected, not criminalized.
Extract The number of prescriptions issued for mifepristone (RU-486), the “abortion pill” introduced in the US 2 years ago, is increasing more rapidly than expected, the Planned Parenthood Federation of America (PPFA) says. . . The PPFA says the success of the new method is important because “the lack of abortion providers is an acute problem in the United States.”.
Extract This article focuses on . . . the locus and extent of legal decision-making power as regards the disabled fetus. It does this by exploring how the relationship between the law of abortion and that of wrongful birth affects the scope of a pregnant woman’s decision-making abilities in this context. . . .In order to reflect on how the law shapes and controls a woman’s (or couple’s) autonomy in this context, the article considers both the non- rights-based English legal position on abortion and its rights-based US counterpart, in addition to exploring aspects of the law of wrongful birth in both jurisdictions. It also makes some suggestions as to the value of autonomy in this context and how extensive it should be at law, although the opportunity to do so here is limited. The discussion entails reflection on the role of the medical profession, the relationship between autonomy and reasons and the interests of people with disabilities or impairments.
Abstract The South African Choice on Termination of Pregnancy Act 92 of 1996 gives women the right to voluntary abortion on request. The reality factor, however, is that five years later there are still more ‘technically illegal’ abortions than legal ones. Amongst other factors, one of the main obstacles to access to this constitutionally enshrined human right is the right to conscientious objection/refusal. Although the right to conscientious objection is also a basic human right, the case of refusal to provide abortion services on conscientious objection grounds should not be seen as absolute and inalienable, at least in the developing world. In the developed world, where referral to another service provider is for the most part accessible, a conscientious objector to abortion does not really put the abortion seeker’s life at risk. The same cannot be said in developing countries even when abortion is decriminalised. This is because referral procedures are fraught with major obstacles. Therefore, it is argued that the right to conscientious objection to abortion should be limited by the circumstances in which the request for abortion arises.
Abstract This paper presents an overview of the dimensions of unsafe motherhood, contrasting data from economically developed countries with some from developing countries. It addresses many common factors that shape unsafe motherhood, identifying medical, health system and societal causes, including women’s powerlessness over their reproductive lives in particular as a feature of their dependent status in general. Drawing on perceptions of Jonathan Mann, it focuses on public health dimensions of maternity risks, and equates the role of bioethics in conscientious medical care to that of human rights in public health care. The microethics of medical care translate into the macroethics of public health, but the transition compels some compromise of personal autonomy, a key feature of Western bioethics, in favour of societal analysis. Religiously-based morality is seen to have shaped laws that contribute to unsafe motherhood. Now reformed in former colonizing countries of Europe, many such laws remain in effect in countries that emerged from colonial domination. UN conferences have defined the concept of ‘reproductive health’ as one that supports women’s reproductive self-determination, but restrictive abortion laws and practices epitomize the unjust constraints to which many women remain subject, resulting in their unsafe motherhood. Pregnant women can be legally compelled to give the resources of their bodies to the support of others, while fathers are not legally compellable to provide, for instance, bone-marrow or blood donations for their children’s survival. Women’s unjust legal, political, economic and social powerlessness explains much unsafe motherhood and maternal mortality and morbidity.
Abstract Objectives: To determine emergency department (ED) practitioner willingness to offer emergency contraception (EC) following sexual assault and consensual sex, and to compare responses of practitioners from states whose laws permit the refusal, discussion, counseling, and referral of patients for abortions (often called “opt-out” or “abortion-related conscience clauses”) with those of practitioners from states without these laws.
Methods: Using a structured questionnaire, a convenience sample of ED practitioners attending a national emergency medicine meeting was surveyed.
Results: The 600 respondents were: 71% male, 29% female; 34% academic, 26% community, and 33% resident physicians; and 7% nurse practitioners and physician assistants. Many respondents (88%) were inclined to offer EC to those sexually assaulted by unknown assailants. More practitioners said they were willing to offer EC if the assailant was known to be HIV-infected rather than if the assailant had low HIV risk factors (90% vs. 79%, p < 0.01). More respondents would prescribe EC after sexual assault than consensual sex (88% vs. 73%, p < 0.01). The rates of willingness to offer EC were the same for practitioners in states with “abortion-related conscience clauses” and those from other states.
Conclusions: Most ED practitioners said they were willing to offer EC. Although the risk of pregnancy exists after consensual sex, practitioners were less willing to prescribe EC after those exposures than for sexual assault. “Abortion-related conscience clauses” did not seem to influence willingness to offer EC.
Abstract From a liberationist, feminist, and Catholic point of view, this article attempts to understand the decision of abortion. . . . The paper offers solutions to end the ugliness of the abortion debate by suggesting that we would be able to progress further on the issue of abortion if we looked for the good in the opposing viewpoint. The article continues with a discussion of Catholics For a Free Choice’s position on abortion, and notes firstly that there is no firm position within the Catholic Church on when the fetus becomes a person; secondly that the principle of probablism in Roman Catholicism holds that where the church cannot speak definitively on a matter of fact (in this case, on the personhood of the fetus), the consciences of individual Catholics must be primary and respected, and thirdly that the absolute prohibition on abortion by the church is not infallible. In conclusion, only the woman herself can make the abortion decision.
Extract Conclusion The trend of hospital mergers between religious and non-religious hospitals may continue to threaten access to reproductive health services, especially for patients who already have limited access because they live in rural areas or have low incomes.l” However, as this essay suggests, there are several avenues that concerned citizens and activists can take to try to prevent the loss of these vital services.l ” The creativity and determination of those who commit themselves to ensuring that reproductive health services will continue to be available to all who desire them has resulted in several viable legal and practical methods of intervention. Although I believe it is important to respect the religious rights and beliefs of others. when the expression of these beliefs encroaches on patients’ rights to access basic health services, intervention is appropriate and necessary. I hope that public outcry, in the forms of legal and grassroots action, will persuade state actors, legislatures, hospital administrators, and clergy to properly acknowledge patients’ rights and participate in the creation of acceptable solutions to the financial problems that hospitals increasingly face. We need solutions that do not deny essential health services to any group of people.
Extract Having read the well-written article by Laura Eggertson, I feel that her thrust (and that of Planned Parenthood, the Canadian Abortion Rights Action League, Health Minister Allan Rock, etc.) is that it is a scandal and surprise that a “medically necessary” operation — abortion — is not universally accepted like other procedures You do not hear most of the old debating arguments about abortion any more, but the one that will not go away concerns whether abortion is a medically necessary operation. . . .Abortion is both a moral and a medical issue, and we should not be surprised if people do not regard it as a necessary procedure in the same way they view other operations.
