Journals Archives - Page 86 of 108 - Protection of Conscience Project Library

Abortion: 1. Definitions and implications

Bernard M Dickens

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Summary
Discusses the difference between definitions in the Criminal Code and regulations promulgated by provincial authorities. Notes that post-coital interception (IUD or pharmaceuticals) may be considered abortions. “The problem may become more acute when ‘morning-after’ contraception and menstrual self-regulation with pills and suppositories become widely available. Recent legislation in New Zealand has established that pregnancy begins not with fertilization but with implantation.6 To keep legitimate contraception from coming under the abortion law in Canada we should make a similar provision. However, the recommendation made in August 1980 by the general council of the United Church of Canada – to decriminalize abortion within the first 20 weeks of pregnancy – may be the best solution.”

Dickens BM. Abortion: 1. Definitions and implications. Can Med Assoc J. 1981;124(2):113-114.

Correction

[CMAJ] An error appeared in the editorial by Dr. Bernard M. Dickens in the Jan. 15, 1980 issue of the Journal. The second sentence in the second column should read (with the correction in italics): “Furthermore, if the life of the unborn child is deliberately ended after labour begins but before it has an existence outside the mother’s body, the act is considered child destruction, which is lawlul when it is done to save the mother’s life (section 221 [2]).” We apologize to Dr. Dickens for this oversight.

Dickens BM. Abortion:1. Definitions and implications [correction]. Can Med Assoc J. 1981;124(7):854.

(Publisher’s Page) Physicians as civil servants

David Woods

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

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.

Appeals to Conscience

James F Childress

Abstract
Unfortunately the phrase “appeals to conscience” is ambiguous. First, it may indicate an appeal to another person’s conscience in order to convince him to act in certain ways. Second, it may mean the invocation of one’s own conscience to interpret and justify one’s conduct to others. Third, it may indicate the invocation of conscience in debates with oneself about the right course of action, conscience being understood as a participant in the debate, a referee , or a final arbiter. Although it is possible to distinguish these three meanings of “appeals to conscience,” they are usually intertwined in our moral discourse. Nevertheless, I shall concentrate on the second meaning, referring to the other two only when it is necessary to fill out the picture.1 Appeals to conscience in the second sense raise important issues of justification and public policy which can be considered apart from the other meanings of appeals to conscience. My concern is with what we might call “conscientious objection”.

Childress JF. Appeals to Conscience. Ethics. 1979 Jul;89(4):315-335.

Abortion laws in Commonwealth countries

Rebecca J Cook, Bernard M Dickens

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) Hazards of prenatal detection of neural tube defects

AT Kerigan

Extract
Dr. Hall highlights what is surely the central issue in abortion because of fetal abnormalities – that is, does one consider the unborn child to be a person, with all the attendant rights we claim for ourselves? Dr. Hall believes that the fetus is not a patient. This is a position many of us in the medical profession profoundly disagree with. The fetus is regarded as a patient worthy of treatment such as intrauterine transfusions. I am not minimizing the problems . . . of a child with spina bifida, especially for the mother. My sympathies lie very much with her, but not to the exclusion of her child. . .

Kerigan AT. (Correspondence) Hazards of prenatal detection of neural tube defects. Can Med Assoc J. 1979 Apr 21;120(8):913-914.

(Correspondence) Code of ethics

Hugh M Scott

Extract
various well-meaning groups believe that something as basic as a code of ethics should be subject to the whim of members of a general meeting acting on an amendment from the floor. . . . I am sceptical of the value of hypnosis therapy for cigarette smoking and obesity, of transcendental meditation for angina pectoris and of acupuncture for all sorts of disorders. Is this because of my beliefs or because of my scientific training? If the latter, is not dedication to the scientific method a “belief”? Therefore, should we be expected to post signs in our offices declaring all our beliefs or scepticisms, and, if confronted with a patient with any of these problems, suggest consultation with a colleague who is more “liberal”? Surely we will never do better than to depend on the good sense and dedication of our colleagues. The use of a code of ethics as an issue in a current political debate is a dangerous precedent and one that I, for one, would wish abandoned forthwith.

Scott HM. (Correspondence) Code of ethics. Can Med Assoc J. 1978 Oct 07;119(7):692. Available from:

(Correspondence) Hazards of prenatal detection of neural tube defects

AT Kerigan

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 . . . .

Kerigan AT. (Correspondence) Hazards of prenatal detection of neural tube defects. Can Med Assoc J. 1978 Oct 07;119(7):696.

(Correspondence) The Code of ethcs: abortion referral

Paul Cameron, May Cohen, Linda Rapson, Wendell W Watters (Doctors for the Repeal of the Abortion Law)

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”.

Cameron P, Cohen M, Rapson L, Watters WW. (Correspondence) The Code of ethcs: abortion referral. Can Med Assoc J. 1978 Apr 22;118(8):890, 895.