Extract Salaried physicians equal incompetent doctors? Certainly not! Quality medical care depends on a practitioner’s conscience, not the compensation method. . . One acquires professional ethics and satisfaction in one’s work. These things can also be lost, however. Whether the physician charges a fee for service or whether he is salaried, it is his professional conscience that remains his guide, his religion, his motto. . .
Extract The doctor-patient relationship is threatened. Once this association implied only one thing: the doctor above all must protect the patient. . . .
. . . it is not inconceivable that, as Canada moves towards socialized medicine and state control of all health facilities, we, too, may sacrifice the privacy of the doctor- patient relationship that we all once regarded as sacred.
. . . There is much concern regarding the involvement of medical personnel in the use of torture for political purposes. . .
. . . When the Dutch medical community refused to cooperate with the Nazi medical organization, 100 Dutch physicians were sent to concentration camps. Other Dutch physicians did not give in; they took care of the widows and orphans of their colleagues. They did not participate in any Nazi activity; they acted unanimously.
. . . Recently physicians in Portugal studied “the scientific effects” of torture; they examined persons before, during and after torture sessions and evaluated their ability to undergo further torture.
. . .We must therefore each ask what is our duty to our state and what to our profession and to our own sense of moral justice. To what extent might we unwittingly become agents of repression? . . . Physicians in Russia condone beatings; if the prisoner dies the physician complies with government policy and eliminates possible repression by signing the death certificate “cirrhosis of the liver.. or “coronary occlusion.”. . .
Extract I believe that the statement authorized by the Board of Directors after the meeting of General Council regarding our colleague Dr. Henry Morgentaler shows professional bias and unclear thinking tempered with extreme conservatism. . . .The fact that anyone, for whatever charge, can be acquitted twice by a jury and still be in jail is hard to comprehend. The fact that the appeal courts overturned the jury’s verdict and passed sentence without ordering a new trial is a threat to everyone’s liberty.
Extract Medical ethics are the collective conscience of the profession. It is axiomatic of a profession that its ethical standards are decided by its members. A profession sets a standard of conduct for its members and the essence of professional freedom for a doctor is his right to act in professional matters uninfluenced by any consideration other than the judgement of his fellows.
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.
A David Clayman, John R Wakeford, John MM Turner,Brian Hayden
Canadian Medical Association Journal
Abstract The number of therapeutic abortions performed at the Vancouver General Hospital in 1969 was double the average number for the previous four years and in 1970 the total reached 1465. The more liberal attitude towards abortion has resulted in a decided reduction in the number of children available for adoption in the community. This policy has required a streamlining of the duties of the Therapeutic Abortion Committee and an alteration in the pattern of bed and operating-room utilization. By far the greatest number of abortions were performed on psychiatric-social grounds. The complication rate of 17% was influenced chiefly by the advanced duration of the gestation in a high proportion of cases. Gynecologists and hospitals must be prepared to assume their altered role in providing abortion and sterilization in today’s society.
Extract Surely a decision by Parliament in a democracy cannot be described as sinister ” superior orders” echoing Nuremberg 20 years ago (or rather what ended there and then). The boot could be argued to be on the other foot-namely, that doctors are prepared to dictate to the nation.
Extract So the B.M.A., representing most doctors in Britain, had clearly stated its views on the ethics of abortion. Parliament then made it legal for a doctor to terminate pregnancy on wider indications than the B.M.A. thought ethically permissible. Should the Association’s opinions on ethics be altered to bring them into line with the law? Posed with that question last week the Council decided that they should not (Supplement, p. 3), and the Representative Body is to be asked in June to ratify this decision . . . The principle at issue is fundamental if doctors are to preserve their right to call themselves professional men. A profession sets a standard of conduct for its members, and the essence of professional freedom for a doctor is his right to act in professional matters uninfluenced by any considerations other than the judgement of his fellows. Medical ethics are the collective conscience of the profession, and a plea of ” superior orders ” would be a sinister echo of some- thing that ended 20 years ago at Nuremberg.
Extract Dr. Myre Sim (4 November, p. 297) exhorts those of us without religious objections to abortion to heed our medical consciences. He is so convinced of the rightness of his views that he brands any doctor who acts differently as lacking in conscience. I do not agree with this assumption. Many highly conscientious doctors favour abortion on social grounds. . . . For most of us it takes courage to recommend or to perform an abortion. It is an operation from which we shrink with a natural abhorrence. How much easier it is to do nothing, especially if inaction can be condoned by invoking ” medical conscience.”
Extract One point seems clear, and that is the new law will permit a doctor to refuse to recommend or perform an abortion on grounds of conscience. This clause was intended to protect those doctors (and nurses) with strong religious objections to abortion. There are, however, conscientious objections other than religious. There is a medical conscience which dictates that one should not interrupt the process of human life unless there is good evidence that such a measure is entirely justified in order to avert a dangerous situation. . . That the law makes it permissive for doctors who have not got this medical conscience does not remove from the doctor who possesses one the right to act according to it. It would be intolerable for a doctor to be pressurized into what he considers to be bad medical practice in order to conform with a new law.
