Extract The assumption that abortion is the treatment of choice for a neural tube defect, regardless of its severity, is implicit in both the physician’s offering the screening service and the parents’ acceptance of it. . . . If the physician was prepared to take the child’s life before birth, can he legitimately refuse to do so after birth if requested? . . . prenatal decision-making cannot be disassociated from post-natal decision-making. They are of the same order logically and ethically. To my mind both abortion and infanticide are unacceptable and represent a concept that is a huge step backwards for the medical profession . . . .
Paul Cameron, May Cohen, Linda Rapson, Wendell W Watters (Doctors for the Repeal of the Abortion Law)
Canadian Medical Association Journal
Extract Mr. Geekie explains that the ethics committee changed the code to prevent patients from being “abandoned – a result that was not in keeping with the tenets of the profession.” . . . If the profession follows Mr. Geekie’s guidelines the new code will result in a lower level of care for Canadian women faced with unwanted pregnancies. Antiabortion physicians now have an ethical green light to send such women on an endless round of pointless, time-consuming referrals until it may be too late to interrupt the pregnancy. . . .If ambiguity exists in the present code of ethics it should be eliminated, if necessary by return to the old code, which allowed women to find their own way to help without this form of “assistance”.
Extract The CMA has the audacity to “place responsibility” on the physician who acts in accordance with his intelligence and informed conscientious judgement in the matter. It is not true to state that a physician abandons a patient if he informs her that his moral principles preclude his becoming involved in referring her for an abortion. No patient has the right to anything other than what a physician can in his conscience do. To ask for more is to ask for his cooperation in performing an act that he deems an act of killing an innocent human being. The CMA, in supporting this type of request, is bringing pressure to bear on the physician to cooperate. By including it in the code of ethics the CMA has also put the physician who does not publicly object in the position of appearing to agree with the CMA. His intellectual and moral integrity are challenged by this action. . . .If the government were to make abortion on demand legal, I have no doubt the CMA would make another change in the code that would “place responsibility” on the physician to cooperate in this also. I find it intolerable that the CMA is telling me I may not follow my conscience in this most serious matter.
Extract .. . . the wording in the pertinent paragraph of the code of ethics represents an amendment to the recommendation of the committee on ethics, moved from the floor of General Council and subsequently passed. In discussing this paragraph the mover of the motion stated that the medical profession must stand by its ethics and, in so doing, has a responsibility to patients, who should not be abandoned in any regard. He went on to state that the medical profession is based on compassion and help and that every physician has a responsibility to a patient, even when he does not agree with a particular form of therapy. . . In suggesting changes in the code of ethics the CMA’s committee on ethics attempted to underline the right of the patient to have other opinions, and the responsibility of the physician to indicate to the patient that she has that right. General Council, in its wisdom, strengthened the recommendation and indicated that, in its view, the physician has a broader responsibility not to abandon the patient or impede her from obtaining help from other sources of assistance.
Extract Mr. Geekie’s interpretation of this section is most disturbing in that some of the phrases he uses suggest a derogatory attitude to physicians engaged in abortion referral. . . . It seems to me clearly unethical for a physician with moral conflicts of interest to refer a patient who consults him about an abortion to a clergyman. . . .It seems that what appeared to be a step forward in ensuring that patients receive unbiased professional judgement in each individual case has become just the opposite.
Extract The code means that a physician who has a conflict of interest between duty to a patient and personal belief shall refer the patient to someone who is not burdened by this conflict of interest, but the code states that a physician who has a conflict of interest between duty to a patient and personal belief shall refer the patient to someone who will provide the treatment the patient desires.
Extract Kordig denies that the dictates of one’s conscience are always either obligatory or morally permissible. With this thesis I have no quarrel. The recognition that a person’s conscience can be mistaken, sometimes dangerously so, is at least as old as Hobbes and has been maintained by philosophers as diverse as Hegel, Royce, and Nowell- Smith. Still, people do appeal to conscience in moral disputes and, as I will attempt to show, do so in a manner that is philosophically justifiable. My goal is not so much to attack what Kordig has said as it is to argue that his discussion is incomplete: some appeals to conscience are bogus but some are not.
Extract Many people believe in conscience that a pregnant woman has supreme rights over what happens in her own body. Others believe in conscience that the right of the unborn child to life is as good as that of any other human being. In some countries, the law, in the name of the former right, discriminates against an obstetrician who, in the name of the latter, refuses to destroy that life. This is a serious contemporary issue which tests the sincerity of governments that profess respect for conscience.
Extract Within months [of legalization] physicians across Canada were beset by requests for therapeutic abortion in numbers they had never faced before. Some hospitals established abortion committees; others “did not. Some committees were liberal in their interpretation of the new law; others were restrictive. Soon facilities at many hospitals became overloaded owing to the increased demand for therapeutic abortion, and the waiting period for elective surgery grew longer. Hospital personnel were suddenly confronted with the prospect of caring for patients undergoing voluntary termination of pregnancy, and for some persons this was a difficult task, but they either accepted it or moved to other areas. . .
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.”. . .
