(Publisher’s Page) Physicians as civil servants

David Woods

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The Canadian Medical Association’s position paper on the Hall report is unequivocal about this: proposed restrictions on the patient’s right to retain the advice and services of a physician of his or her choice would help to transform the MD from an independent provider of health care into, in effect, “a government-retained dependent contractor – a de facto civil servant”.

But Dr. Augustin Roy, president of the Corporation of Physicians and Surgeons of Quebec, sees things quite differently. Just because Hall wants to do away with extra billing, says Roy, doesn’t necessarily mean that if he gets his way doctors will become state employees. “That is only true if you have defined work hours and someone to report to.”

Yet surely the point is that the more the medical profession’s freedoms are removed, the more governments pick them up. As CMA President Dr. Bill Thomas has observed, the control of health care, the number of doctors produced in Canada, the number allowed to immigrate here, and the qualifications and education required to obtain a licence to practise medicine are all controlled by government now. . . The question isn’t whether Canada’s physicians will become de facto civil servants, but how they can withstand government’s constant chipping away at professional freedom, which will eventually give MDs no control over their collective destiny.


Woods D. Physicians as civil servants. Can Med Assoc J. 1980 Nov 22;123(10):959.

(Correspondence) Abortion (Amendment) Bill

Norman Chisholm

British Medical Journal, BMJ
British Medical Journal

Extract
The 28-week rule is a medical and scientific, as well as legal, concept that allows the practising doctor to work to about 20 weeks’ gestation with comfortable leeway. To make a 20-week limit would be to reduce the effective maximum for abortion to 16 weeks.


Chisholm N. (Correspondence) Abortion (Amendment) Bill. Br Med J. 1979 Jul 28;2(6184):276.

(Editorial) No case for an abortion bill

British Medical Journal

British Medical Journal, BMJ
British Medical Journal

Extract
Most doctors in practice today can remember when suicide, attempted or completed, was a criminal offence-yet now such a concept seems barbaric. The same incredulity will, surely, soon apply to attempts by the criminal law to control termination of pregnancy in its early weeks. Legal regulation is reasonable later in pregnancy (on the grounds of the duty of the law to respect concepts such as the sanctity of life) but it must be flexible enough to take account of the rapid pace of development in antenatal diagnosis of genetic and developmental disorders.


BMJ. (Editorial) No case for an abortion bill. Br Med J. 1979;2(6184):230.

Abortion laws in Commonwealth countries

Rebecca J Cook, Bernard M Dickens

International Digest of Health Legislation
International Digest of Health Legislation

Extract
Conclusion

The objective of this Report has been to present a synthesis of Commonwealth abortion laws, and a synopsis of their lines of development. . .

The Report identifies factors that those planning change may need to consider, indicates how individual jurisdictions have responded to particular issues, and shows how certain laws have been found to operate.

. . .The ordering of national priorities is a function of government, which best discharges its duties by being sensitive to the spiritual and pragmatic aspirations of those it serves by leading. . .


Cook RJ, Dickens BM. Abortion laws in Commonwealth countries. Int Dig Health Leg. 1979;30(395-502.

(Correspondence) Operation of the abortion law

OA Schmidt

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
[Author is president of Society of Obstetrics & Gynaecology Canada] To one who works in the field of therapeutic abortion, if not by choice, at least by necessity, the [Badgley] report makes fascinating reading and provides a wealth of information – a bonanza bargain at the cost. It is comparable to the 1974 Lane report from Great Britain. Chapter 2 of the report presents a most commendable summary of the therapeutic abortion situation in Canada. This is the underlying basis of the report from which the conclusions may be drawn for further recommendations with respect to therapeutic abortion. [Writer offers three recommendations for progress].


Schmidt OA. (Correspondence) Operation of the abortion law. Can Med Assoc J. 1977 Aug 06;117(3):214.

Analysis: An introduction to ethical concepts – Conscience

Eric D’Arcy

Journal of Medical Ethics
Journal of Medical Ethics

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.


D’Arcy E. Analysis: An introduction to ethical concepts – Conscience. J Med Ethics. 1977;3(2):98-99.

The Badgley report on the abortion law

WDS Thomas

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

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. . .


Thomas WDS. The Badgley report on the abortion law. Can Med Assoc J. 1977;116(9):966.

(Correspondence) Life devoid of value?

Heiko Baunemann

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Dr. Rapp’s distinction between human beings and “potential” human beings is mystifying. . . The fetus is not a “potential” human being; it is a human being with potential. . . the impetus for the mass killing of mental patients came not from the Nazis but from members of the medical profession. . . . the connection between abortion and euthanasia . . . is quite clear to other proabortionists [including] Joseph Fletcher, a member of the Euthanasia Education Council, and the late Dr. Alan Guttmacher, also a member of that council. . . Abortion and euthanasia are related by a common set of basic assumptions – that human life is not an absolute but rather a variable value that is socially determinable, and that it may be terminated. One form of euthanasia makes this particularly clear – the killing of the handicapped newborn. Arguments for abortion of mongoloid fetuses and mercy killing of mongoloid newborns are identical. . . .


Baunemann H. (Correspondence) Life devoid of value?. Can Med Assoc J. 1977;116(6):591-592.

(News) Inequities in abortion law found result of attitudes in people and institutions

JS Bennett

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
[Outline of the findings of the Badgley Committee studying the operation of the abortion law.] A trend seen since 1970 is the reduction in the number of “back street abortions” and the sharp decrease in morbidity and mortality stemming from such procedures. Perhaps the most telling sentence in the 474-page report is this: “The procedure in the Criminal Code for obtaining abortion is in practice illusory for many Canadian women.


Bennett JS. Inequities in abortion law found result of attitudes in people and institutions. Can Med Assoc J. 1977;116(5):553-554.

(Correspondence) The Canadian abortion law

PG Coffey

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Dr. Loveridge states that the examples I quoted in my previous letter “are just not correct”. On the contrary, all the facts and figures I have given are correct and come from respectable sources [Gives details] . . .The reason that illegal abortions are not necessarily reduced in number and that the total number of abortions in- creases when a government legalizes abortion (and seemingly condones it) is that there are always a large number of women who prefer to have an abortion privately and a climate of abortion is created wherein large numbers of women consider abortion who would not otherwise have done so.


Coffey PG. (Correspondence) The Canadian abortion law. Can Med Assoc J. 1977 Feb 05;116(3):238.