(News) The abortion issue in Newfoundland: a province divided

Barbara Yaffe

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The adjectives range from “bloody outrageous” to “appalling and disgusting”, for just about no one is satisfied with a therapeutic abortion service that annually prompts hundreds of Newfoundland women to leave the province to get abortions. . . many women cannot get abortions in Newfoundland, in part because most of the province’s doctors won’t perform them, and in part because community standards are conservative. . . Dr. Carl Robbins, medical director of the General Hospital, thinks local doctors are unwilling to perform abortions because of personal conviction and the influence of values developed while training.


Yaffe B. The abortion issue in Newfoundland: a province divided. Can Med Assoc J. 1987 Apr 15;136(8):865-866.

(News) Canadian obstetric care system among finest in world, major CMA study finds

Patrick Sullivan

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Canada’s standard of obstetric care is excellent, and although some improvements can be made, they can be carried out within the existing system. That is the main finding from a major CMA study on obstetric care, the first of its kind in Canada, which has been sent to association members with this issue of CMAJ. . . . There is no reason for Canada to introduce a midwifery system since there is neither a calculable need nor a significant demand, the CMA has concluded.


Sullivan P. Canadian obstetric care system among finest in world, major CMA study finds. Can Med Assoc J. 1987;136(6):643, 646, 648-649.

Artificial Reproduction and Child Custody

Bernard M Dickens

Canadian Bar Review
Canadian Bar Review

This article considers general principles of child custody law in regard to children born following artificial reproduction that employed donated sperm, ova
or embryos, and the law applicable when women give birth to children conceived in order to be surrendered to others (notably their biological fathers). Claims to parental rights raise the issue of who the legal parents are, and may conflict with the apparent best interests of such children and the state’s view of its responsibility. The article considers interests of the unconceived child, the embryo and fetus in utero, the embryo extra uterum and a child born of donation, and the status of sperm, ovum and embryo donors and of “surrogate” mothers. Particular attention is given to the Ontario Law Reform Commission’s Report on Human Artificial Reproduction and Related Matters (1985), which is the first Canadian report to make wide-ranging recommendations on these issues .


Dickens B. Artificial Reproduction and Child Custody. Can Bar Rev 1987 Mar; 66(1): 49-75.

(Correspondence) Newfoundland has no legal abortion services

Louis A Aubé

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Dr. Carl Robbins finds the fact that abortions are not available in his province “disgraceful, bordering on the unethical” (Can Med Assoc J 1986; 135: 910). He must be a young man, because it wasn’t long ago that it was disgraceful for a doctor to do abortions – besides which, it was a crime. As for Dr. Robbins’ call to ethics, I wonder what he is using for the basis of his code. Certainly not the Judeo-Christian formula. It must be the new “situation ethics”, which as applied to our general conduct is producing frightening results.


Aubé LA. (Correspondence) Newfoundland has no legal abortion services. Can Med Assoc J. 1987;136(4):324.

(Correspondence) Abortion: an issue that won’t go away

Ernest A Johnson

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
I have, as I am sure do many doctors, a framed version of the Hippocratic Oath prominently and proudly displayed in my waiting room. . . I had a very busy general medical and surgical practice, and during that time it was understandably considered ethical to do a truly therapeutic abortion when this very occasional truly medical necessity arose. . . .Times have changed, but there are some things that cannot change if we are to retain our self-respect as professionals.


Johnson EA. (Correspondence) Abortion: an issue that won’t go away. Can Med Assoc J. 1986 Nov 15;135(10):1062-1064.

Prenatal diagnosis and female abortion: a case study in medical law and ethics

Bernard M Dickens

Journal of Medical Ethics
Journal of Medical Ethics

Abstract
Alarm over the prospect that prenatal diagnostic techniques, which permit identification of fetal sex and facilitate abortion of healthy but unwanted female fetuses has led some to urge their outright prohibition. This article argues against that response. Prenatal diagnosis permits timely action to preserve and enhance the life and health of fetuses otherwise endangered, and, by offering assurance of fetal normality, may often encourage continuation of pregnancies otherwise vulnerable to termination. Further, conditions in some societies may sometimes render excusable the inclination to abort certain healthy female fetuses. In places where abortion for fetal sex alone is recognised as unethical, however, medical licensing authorities already possess the power to discipline, for professional misconduct, physicians who prescribe or perform prenatal diagnosis purely to identify fetal sex, or those who disclose fetal sex when that is unrelated to the fetus’s medical condition.


Dickens BM. Prenatal diagnosis and female abortion: a case study in medical law and ethics. J Med Ethics 1986 Sep; 12(3): 143-144.

Will the “Conscience of an Institution” Become Society’s Servant?

Joan Mclver Gibson, Thomasine Kimbrough Kushner

The Hastings Center Report
The Hastings Center Report

Extract
(Overview of accomplishments and future direction of hospital ethics committees) Overall, there is a modest sense of satisfaction with present mechanisms for dealing with ethical dimensions of patient care decisions, and a cautious optimism about the future. This is tempered by a growing, though as yet unfocused concern that emerging issues of cost, access, and quality of care will press ethics committees, now the “consciences” of institutions, into service on behalf of the community at large. . .


Gibson JM, Kushner TK. Will the “Conscience of an Institution” Become Society’s Servant? Hastings Cent. Rep. 1986 Jun;9-11.

Retention of products of conception after therapeutic abortion

Ellen R Wiebe

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Failure to remove all the products of conception during a therapeutic abortion is an acknowledged complication whose incidence increases with increased gestational age. In the following case, symptoms of an incomplete abortion were experienced for 2 1/2 years after the abortion.


Wiebe ER. Retention of products of conception after therapeutic abortion. Can Med Assoc J. 1986 Mar 1;134(5):505.

The abortion of thinking

Paul de Bellefeille

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The Canadian Medical Association’s policy summary on abortion must be questioned. Although the summary may represent the consensus of some people at the executive level, it does not correspond to the views of the majority of CMA members. . . . medical problems require medical solutions; and when an expectant mother has medical difficulties the medical solution in good contemporary obstetrics is almost never termination of the pregnancy. The solution to socioeconomic problems must also be socioeconomic. To propose medical solutions for socioeconomic problems, and destructive ones at that, is illogical and shows a sad lack of confidence in our society’s ability to care for its own.


de Bellefeille P. The abortion of thinking. Can Med Assoc J. 1986;134(2):115-117.

(Correspondence) “The Silent Scream”: setting the record straight

Carlos Del Campo

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
A newsbrief in CMAJ 1985;132:1301) criticizing the videotape “The Silent Scream” failed to report the opinion of a highly qualified expert. Dr. Ian Donald, the original developer of diagnostic ultrasonography, former Regius professor of obstetrics at the University of Glasgow and honorary research consultant at the National Maternity Hospital in Dublin, spent 4 years filming fetal activity at various stages of gestation. Donald, in a sworn affidavit, wrote: “I have now studied Dr. Nathanson’s video-tape film entitled ‘The Silent Scream’ not less than four times and affirm that I am of the opinion that the fetal activities depicted by ultrasound real- time scanning in this film are not faked [or] the result of artefact intentional or otherwise”.


Campo CD. (Correspondence) “The Silent Scream”: setting the record straight. Can Med Assoc J. 1985 Sep 15;133(6):556-557.