(Editorial) Abortion denied – outcome of mothers and babies

Carlos Del Campo

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

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

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

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

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

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

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

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

Annals of Internal Medicine
Annals of Internal Medicine

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

Annals of Internal Medicine
Annals of Internal Medicine

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

Nursing Management
Nursing Management

(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

CMA reviews its position

Normand Da Sylva

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Throughout the 1 970s and early 1 980s the issue of abortion was causing such concern that, at its 1981 meeting in Halifax, General Council directed the association “to review the situation with respect to therapeutic abortions in Canada”. As part of this review, the Board of Directors decided to go to the grassroots or the association and to ask individual physicians what their opinions were, not only on the procedural aspects of the current legislation, but also on the ethical and moral aspects of terminating a pregnancy. . . . With the help of an outside consultant, we then drew the names of 2000 physicians from the associations membership file to get a statistically valid sample, proportionally representative of our membership by province and by specialty.


Sylva ND. CMA reviews its position. Can Med Assoc J. 1983;128(1):57.

(Correspondence) Abortion

MT Casey

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The fetus in the uterus of a pregnant woman is not the body of the pregnant woman; it is the body of someone else. I ask Dr. Wilson: If a woman asked him to provide her with the means to end her own life and used the same logic, that it is her own body and she is entitled to do with it what she wants, would he readily agree?


Casey MT. (Correspondence) Abortion. Can Med Assoc J. 1982 May 01;126(9):1032.