Ethics Archives - Page 68 of 81 - Protection of Conscience Project Library

Abortion (Policy Statement)

Canadian Medical Association

Abstract
The Canadian Medical Association (CMA) recognizes that there is justification for abortion on medical and nonmedical socioeconomic grounds and that such an elective surgical procedure should be decided upon by the patient and the physician(s) concerned. Ideally, the service should be available to all women on an equitable basis across Canada. CMA has recommended the removal of all references to hospital therapeutic abortion committees as outlined in the Criminal Code of Canada. The Criminal Code would then apply only to the performance of abortion by persons other than qualified physicians or in facilities other than approved or accredited hospitals. The Canadian Medical Association is opposed to abortion on demand or its use as a birth control method, emphasizing the importance of counselling services, family planning facilities and services, and access to contraceptive information. . . the association also supports the position that no hospital, physician or other health care worker should be compelled to participate in the provision of abortion services if it is contrary to their beliefs or wishes. CMA also recommended that a patient should be informed of physicians’ moral or religious views restricting their recommendation for a particular form of therapy.

Canadian_Medical_Association. Abortion (Policy Statement). Can Med Assoc J. 1985 Aug 15;133(4):318.

Civil disobedience, conscientious objection, and evasive noncompliance: a framework for the analysis and assessment of illegal actions in health care

James F Childress

Abstract
This essay explores some of the conceptual and moral issues raised by illegal actions in health care. The author first identifies several types of illegal action, concentrating on civil disobedience, conscientious objection or refusal, and evasive noncompliance. Then he sketches a framework for the moral justification of these types of illegal action. Finally, he applies the conceptual and normative frameworks to several major cases of illegal action in health care, such as “mercy killing” and some decisions not to treat incompetent patients.

Childress JF. Civil disobedience, conscientious objection, and evasive noncompliance: a framework for the analysis and assessment of illegal actions in health care. J Med Philos. 1985 Feb 01;10(1):63-83.

(Editorial) Abortion denied – outcome of mothers and babies

Carlos Del Campo

Extract
The children of women who have been denied an abortion are at risk of certain disadvantages, but such problems could be alleviated by better adoption and social programs. Since well educated women have the most “liberal” attitudes towards abortion’4 and are the least likely to have economic reasons for wanting an abortion, programs to prevent abortion should be directed towards changing their attitudes. Also, women who have been denied abortion should be followed up, both for the child’s sake and to prevent further requests for abortion.

Campo CD. (Editorial) Abortion denied – outcome of mothers and babies. Can Med Assoc J. 1984 Feb 15;130(4):361-362, 366.

(Correspondence) The CMA abortion survey

PG Coffey

Extract
The CMA should have asked prolife physicians “Do you believe that the threat to a woman’s life should be the only indication for abortion?” In my experience most pro-life advocates believe not that there is absolutely no indication for abortion, but that abortion is indicated only in serious circumstances.

Coffey PG. (Correspondence) The CMA abortion survey. Can Med Assoc J. 1983 Dec 15;129(12):1260.

(Correspondence) The CMA abortion survey

Donovan Brown

Extract
I am saddened and a little shocked to find that nearly 50% of the medical profession in Canada would terminate pregnancy at the wishes of the patient. We are supposed to be a profession, but what do we profess to do?

Brown D. (Correspondence) The CMA abortion survey. Can Med Assoc J. 1983;129(12):1260.

(Correspondence) The CMA abortion survey

Paul de Bellefeuille

Extract
I find the CMA abortion survey disturbing and completely unsatisfying. Without exception, all the questions assume that abortion is acceptable and can therefore be neatly compartmentalized to facilitate its performance. Nothing could be further who initially did not want their babies did want them once they were born,’ some individuals may ignore this normal evolution of maternal feelings. . . . slightly more than half of the respondents would refuse to terminate a pregnancy solely at the “woman’s request”. . . . Everyone knows that few, if any, terminations of pregnancy are therapeutic, although many are pathogenic. . .

de Bellefeuille P. (Correspondence) The CMA abortion survey. Can Med Assoc J. 1983;129(12):1259-1260.

(Correspondence) Abortion

WJ Kazun

Extract
I disagree with Dr. Morton S. Rapp on a number of the points he made in his letter . . . Dr. Rapp must realize that no one compels any woman or man to become a parent. He must also realize that there is no ethical choice when an innocent life is destroyed. . . Abortion is a violent act and the ultimate in child abuse. Dr. Rapp must agree that child abuse has increased markedly with the increase in abortions and presumably the birth of only wanted children. A study done by Dr. Philip Ney, a well known children’s psychiatrist, proved that the increase in abortions has led to an increase in child abuse and frequently to abuse of wanted children.

Kazun W. (Correspondence) Abortion. Can Med Assoc J. 1983 Aug 15;129(4):320.

(Correspondence) Paternalism and the Physician’s Conscience

Julia E Connelly

Journal Extract
I read Dr. Thomasma’s article (1) with skepticism. All models for the doctor-patient relationship are shortsighted as they do not acknowledge systems of relationships beyond that of the physician and the patient. Despite this inherent shortcoming, Thomasma’s model contains two characteristics that distinguish it from other such models. Both the strength of his physician conscience model and its greatest limitations exist in these two characteristics. First, his model requires that physicians assess beliefs, attitudes, and emotions they recognize in response to their patients in an effort to determine how these factors influence the health care they provide. . .

Connelly JE. (Correspondence) Paternalism and the Physician’s Conscience. Ann Intern Med. 1983 Aug 01;99(22):276.

Beyond Medical Paternalism and Patient Autonomy: A Model of Physician Conscience for the Physician-Patient Relationship

David C Thomasma

Abstract
Medical paternalism lies at the heart of traditional medicine. In an effort to counteract the effects of this paternalism, medical ethicists and physicians have proposed a model of patient autonomy for the physician patient relationship. However, neither paternalism or autonomy are adequate characterizations of the physician patient relationship. Paternalism does not respect the rights of adults to self-determination, and autonomy does not respect the principle of beneficence that leads physicians to argue that acting on behalf of others is essential to their craft. A model of physician conscience is proposed that summarizes the best features of both models-paternalism and autonomy.

Thomasma DC. Beyond Medical Paternalism and Patient Autonomy: A Model of Physician Conscience for the Physician-Patient Relationship. Ann. Intern. Med.. 1983;98(2):243-248.

(Editorial) A Nurse’s Conscience

Leah L Curtin

(This lengthy editorial was repeated verbatim in 1993. It includes the following)
Extract
“No nurse should be required to give any drug if (a) she is not competent to give it or (b) she has problems of conscience with regard to its administration. If, for these reasons, a nurse refuses to give a drug, another nurse may do so. The original nurse should receive inservice and/or counseling. If she still has conscientious objections, she should not be coerced. The patient’s right to have/refuse a drug should be protected by meticulous adherence to the principles and procedures of informed consent. However, his right to the drug is not greater than another human being’s (the nurse’s) obligation to practice with integrity. Therefore, if one nurse will not give the drug – the head nurse, coordinator or supervisor should give the drug.” If none of these nurses can, in conscience, administer the drug, then the physician who ordered it must give It himself or find another physician who will do it for him..

Curtin LL. (Editorial) A Nurse’s Conscience. Nurs Manag. 1983 Feb;14(2):7-8