Protection of Conscience Project Library
Service, not Servitude
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Most Canadian women who have abortions are single, but a recent Statistics Canada study indicates that more than a quarter of them (26.7%) were either married or in a common-law relationship.
Buske L. Abortion and the married woman. Can Med Assoc J. 1998;159(4):992.
Abstract
The majority of residents responding to a 1995 survey of program directors and chief residents at 244 family medicine residency programs in the United States reported they had no clinical experience in cervical cap fitting, diaphragm fitting or IUD insertion and removal. For all family planning methods except oral contraceptives, no more than 24% of residents had experience with 10 or more patients. Although 29% of programs included first-trimester abortion training as either optional or routine, only 15% of chief residents had clinical experience providing first-trimester abortions. Five percent of residents stated they certainly or probably would provide abortions, while 65% of residents stated they certainly would not provide abortions. A majority (65%) of residents agreed that first-trimester abortion training should be optional within family practice residency programs. Residents were more likely to agree with inclusion of optional abortion training and with the appropriateness of providing abortions in family practice if their program offered the training.
Steinauer JE, DePineres T, Robert AM, Westfall J, Darney P. Training family practice residents in abortion and other reproductive health care: a national survey. Fam Plann Perspect. 1997;29(5):222-227.
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Conclusion
Tennessee Formal Ethics Opinion 96-F-140 attempts to disconnect morality from the lawyer’s work. The Board’s disregard of the lawyer’s moral and religious objections to accepting the appointment suggests either a hostility to the particular religious beliefs asserted by the inquiring lawyer or a willingness to demand lawyers accept being treated as mere means to clients’ and courts’ ends. Hostility to religious beliefs is deeply troubling when exhibited by those who are charged with providing lawyers’ guidance in discerning their professional obligations, but the second possible interpretation of the opinion is equally chilling. To the extent that the Board’s opinion represents the members’ considered judgment that lawyers are obligated to act as amoral facilitators of any action not proscribed by positive law, the power of the state is dramatically enlarged and the power of the individual and other social institutions dangerously diminished. This result cannot be tolerated under the terms of the First Amendment, nor can it be reconciled with the lawyer’s basic human rights.
Collett TS. Professional Versus Moral Duty: Accepting Appointments in Unjust Civil Cases. Wake Forest Law Review. 1997;32: 635-670.
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. . . For people with genuine morals, right and wrong do not change with popular public opinion . . . Before we congratulate our society on its social evolution over the last 50 years, we should reflect on the outcome of the society in history that practised throwing people to the lions, or perhaps the society of the 1940s that practised execution of races believed to be inferior.
[Dr. Waugh planned to respond to these letters but was unable to do so before his death on Apr. 18, 1997. In this issue, CMAJ features a tribute to Waugh (page 1524) as well as an article on issues surrounding access to abortion services (page 1545). — Ed.].
Cuddy TJ. (Correspondence) Some final responses to Dr. Waugh. Can Med Assoc. J. 1997 Jun 01;156(11):1529.
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We can ask ourselves: Where will we stand in 30 years if there are amendments to the Criminal Code in regard to the taking of human life, as are now being discussed? If mercy killing, physician-assisted suicide and euthanasia became legal activities — even under certain restricted guidelines — there would be inevitable progression until widespread acceptance of these practices would be accompanied by major changes in attitudes. [Dr. Waugh planned to respond to these letters but was unable to do so before his death on Apr. 18, 1997. In this issue, CMAJ features a tribute to Waugh (page 1524) as well as an article on is- sues surrounding access to abortion services (page 1545). — Ed.].
Adams PV. (Correspondence) Some final responses to Dr. Waugh. Can Med Assoc J. 1997;156(11):1529.
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When I was a medical student in the early ‘40s, and for a considerable time after that, the artificial termination of pregnancy was considered an unspeakable crime. . . . No one knew for certain how widespread the practice was, but enough patients turned up in emergency departments or in the morgue for us to know it was going on, and to arouse the ire and indignation of society’s moralists. . . . The credit for bringing the revolution about certainly belongs to Dr. Henry Morgentaler, but it is clear that Canada’s social climate had been changing slowly for several years before he defied the law by opening his first abortion clinic in Montreal . . . True, the anti-abortion campaign is not yet dead, but its force has become so attenuated the impact is limited.
Waugh D. Abortion and our changing society. Can Med Assoc J. 1997 Feb 01;156(3):408.
Abstract
I propose that a woman who becomes pregnant with the intent to abort will be treated as an initial aggressor, and as such she will be denied the “abortion exception” that will be granted to the woman who aborts an accidental, unwanted pregnancy. Moreover, I shall argue that a woman should not be allowed to designate the donee of the fetal tissue from her abortion, even though her pregnancy was accidental. Without this restriction, a woman who intends to become pregnant and abort may simply claim her pregnancy was accidental, and thereby claim the exception. Central to this study is the question of fetal worth, and the value to be ascribed to beings not like us, that is, not like human beings who have been born. Although I argue for a moral justification of elective abortions, I intend to show that such a justification should be a narrowly drawn exception to the prima facie duties neither to harm nor to instrumentalize others. I shall also argue that prohibiting a woman from becoming pregnant in order to abort is necessary because such a situation does not fall within the narrow exception for elective abortions, and that such a restriction is crucial to preserving our respect for those with no voice. Finally, I shall argue that the prohibition against becoming pregnant with the intent to abort does not vitiate a woman’s right to terminate an unwanted pregnancy. Rather, this restriction is a necessary condition of the prima facie duties of nonmaleficence and non-insturmentalization.
Kinney JH. Restricting Donative Choice: Fetal Tissue Transplantation and Respect for Human Life. J. Law Health. 1996;10(2):259-286.
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these Bills (one in the House of Representatives and a less wild version in the Senate) are unnecessary and deceptive. . . .The Bills would allow residents and programmes to abstain from abortions on any grounds, not just religious or moral. . . .So what is their objective? It is the de facto ending of abortion in the USA. By allowing more residents and more programmes to opt out of abortion training, safe termination of pregnancy in America will become even more difficult to obtain. Already, the number of competently trained graduates has fallen dramatically. Access to doctors and clinics has shrunk, and too many American women wanting an abortion already face a long and sometimes dangerous search for help. This is an attack on women’s choices and an interference in medical education. If it passes Congress, President Clinton should veto it immediately.
The Lancet. (Editorial) A de-facto end to abortion in USA? The Lancet. 1996;347(9008):1055.
Abstract
Objective: To determine the outcome and side effects of a new drug protocol to induce abortion.
Design: Case series.
Setting: An urban primary care practice.
Patients: One hundred consecutive patients who requested elective termination of pregnancies of less than 8 weeks’ gestation.
Intervention: Subjects received methotrexate (50 mg/m2 body surface area, administered intramuscularly) and, 3 days afterward, misoprostol (800 pg, given vaginally).
Outcome measures: Number of abortions induced within 24 hours and within 10 days of misoprostol administration, number of surgical aspirations conducted because of incomplete abortion, mean amount of bleeding and pain and the number of women who, if faced with the same situation, said they would again choose a drug-induced abortion over a surgical one.
Results: Abortion occurred within 24 hours of misoprostol administration among 48 women and within 10 days among 69 women. In total, 89 women had an abortion without surgical aspiration. Of these women, 71 said they would choose a drug-induced abortion if faced with the choice again.
Conclusion: Abortion induced with methotrexate and misoprostol appears to be a feasible alternative to surgical abortion and deserves further study.
Wiebe ER. Abortion induced with methotrexate and misoprostol. Can Med Assoc J. 1996 Jan 15;154(2):159-164.
Abstract
PIP: This article is a reflection on the Fourth World Conference on Women in Beijing in September 1995, including its preparatory meetings. Delegates from 187 nations negotiated and decided on the disputed passages of the draft Platform of Action, which comprised 40% of the 150 page document. The atmosphere prior and during the conference was not peaceful. The UN and China disputed over the location of the nongovernmental organizations’ (NGO) forum that took place at the same time of the conference. The US and Chinese governments squabbled about China’s detention of a Chinese-American human rights activist. The US First Lady attended the conference and the NGO forum, promoting human rights. Most delegates had decided that this conference would not be a retreat from the Cairo conference. In comparison to Cairo, the Vatican delegation had toned down its opposition. US based antiabortion groups and conservative women’s groups arrived in greater numbers in Beijing than in Cairo, in hopes to reverse actions taken in Cairo. They had few victories. A contentious issue was parental rights and responsibilities, specifically adolescents’ access to confidential health services. Compromise wording was worked out in two paragraphs. All other references to parental rights were deleted or there was a reference to the compromise wording. The Beijing platform was the first universal document recognizing the right of a woman to say no to sexual intercourse. The references in the Beijing document recognizing sexual rights as human rights were a major accomplishment. Debates over the issue of abortion took place: the proposed conscience clause and a call for the review of laws containing punitive measures against women who have had an illegal abortion. The vocal delegates from developing countries are silencing the accusation that radical Western women are thrusting women’s rights on the rest of the world.
Johnson JH, Turnbull W. The women’s conference: where aspirations and realities met. Fam Plann Perspect. 1995 Dec;21(4):155-159.