Journal Editorials Archives - Page 3 of 4 - Protection of Conscience Project Library

(Editorial) A Nurse’s Conscience

Leah L Curtin

(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

Abortion: 3. Therapeutic abortion committees and third parties

Bernard M Dickens

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
The recent incident in Nova Scotia concerning Mr. Hulme, who tried to prevent his estranged wife from having an abortion (see part 2 of this series), resulted in only secondary and indeterminate litigation. . . Mr. Hulme had taken legal action against the Victoria General Hospital in Halifax, whose therapeutic abortion committee had approved the abortion. . . . A therapeutic abortion committee’s alleged liability to judicial reversal suggests it is making a judicial or quasi-judicial decision; however, this is doubtful. . . . Indeed, the only third parties whose interests the committees may have to consider are guardians of the mentally incompetent and parents of minors. . . . hospitals that permit pressure from a third party to interfere with treatment of their competent, consenting adult patients for whom there is a danger to life or health may incur legal and ethical liabilities to such patients. . . Physicians may also face disciplinary charges of professional misconduct. . . .The best solution may be to remove the legal requirement of committee approval and to trust the judgement and good faith of physicians. . .

Dickens BM. Abortion: 3. Therapeutic abortion committees and third parties. Can Med Assoc J. 1981;124(4):362-363. 384.

Abortion: 2. Fetal status and legal representation

Bernard M Dickens

Extract
It has long been accepted that, legally, “personhood” begins with live birth and that a fetus therefore has no legal status. . . . generally, the rights of the fetus are not recognized, even though the property interests of an unborn child may appear to be protected. . . .This legal procedure simply postpones the distribution of property until the gestation period is over. Similarly, if a fetus is injured in utero and is subsequently found, when born alive, to be affected by the injury, legal action can be taken. However, this is the right of a human being, not of a fetus. . . . On the other hand, if a child is unborn or its life ends in utero, no legal action can be taken on its behalf. [quoting Dehler v. Ottawa Civic Hospital]. . . . [Discusses unresolved 1979 case in Nova Scotia in which an estranged husband and an anti-abortionist prevented an abortion using an injunction and guardianship application] . . . .It seems that Canadian society must rely on such judicial decisions to develop the law on fetal status, protection and legal representation. Politicians and legislatures are wary of the abortion-related furore these topics trigger.

Dickens BM. Abortion: 2. Fetal status and legal representation. Can Med Assoc J. 1981;124(3):253-254.

Abortion: 1. Definitions and implications

Bernard M Dickens

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.

(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.

(Editorial) Wilful exposure to unwanted pregnancy?

Carol A Cowell

Extract
The WEUP syndrome (otherwise known as “Wilful Exposure to Unwanted Pregnancy”) has been well documented in a number of psychiatric publications. . .

. . . Abortion is not an emergency procedure and the lowering of the legal age of consent has had virtually no effect on the availability of the operation to the adolescent patient. . . .

. . . .does the “open approach” and provision of effective contraception mean to young people that you personally endorse premarital sexual experimentation and does this influence their behaviour? My answer is an unequivocal “No”; they make their own choice with or without your approval, and whether or not they are “outfitted” beforehand with effective contraception.

. . To the question “What was your main reason for having an abortion?” the following answers were given: “too young” (55%), “wanted to finish school” (15%), “wanted a child but couldn’t keep it” (12%), “pressure advice from parents (7%), “don’t want the kid (child)” (7%), other (4%). From our follow-up data regarding the girls’ assessment of what for them was the best solution (i.e. term delivery or abortion), 93.3% said that abortion was the best solution, with some 4.3% saying that it was not and 2.4% providing no answer. . .

Cowell CA. (Editorial) Wilful exposure to unwanted pregnancy?. Can Med Assoc J. 1974 Nov 16;111(10):1045, 1047.

(Editorial) Attitudes to Abortion

British Medical Journal

Extract
Abortion for a wide range of indications is, however, now an established part of conventional medical practice in Britain and the committee seemed a little impatient with those who would not recognize that fact. A conscience clause was manifestly essential when the Act came in, since many gynaecologists had sincere moral or ethical objections to abortion on some of the grounds introduced by the new Act. Seven years later the situation has changed. As the committee points out,the number and attitude of gynaecologists are important in determining the level of service which can be provided, so that “it is inevitable that the health authorities should prefer for appointment to certain posts those who see abortion as properly part of clinical gynaecological practice.” What this implies is that a young doctor may find some difficulty in taking up a career in gynaecology in the N.H.S. if he is fundamentally opposed on ethical grounds to abortion in the terms of the Act.

BMJ. (Editorial) Attitudes to Abortion. Br Med J. 1974;2(5910):69-70.

(Editorial) Issues of Conscience

Thelma M Schorr

Extract
The reality of the situation is that since 1966, with the liberalization of abortion laws in a number of states, the number of abortion patients has been steadily increasing. This means that an increasing number of patients will seek care that most nurses have not been educated to render. . . . There are many nurses who see an abortion as an unconscionable act, and certainly they should never be placed in the position of having to nurse patients who have chosen to have their pregnancy terminated. Just as a patient’s freedom to choose must be respected, so must a nurse’s. But it is also that nurse’s responsibility to protect both the patient’s freedom and her own by refusing to work in a situation which she finds morally offensive.

Schorr TM. (Editorial) Issues of Conscience. Am J Nurs. 1972 Jan;72(1):61.

(Editorial) The abortion situation

CMAJ

Extract
One certainty at least about the situation as regards the liberalization of abortion in Canada is that the problem it presents is not going to go away. . . . one cannot but conclude that the dilemma posed by this state of affairs cannot be dismissed by the ingemination of ready-made phrases such as “rights of the fetus” and “reverence for life”, no matter how respectable these may sound. One suspects that sometimes such phrases are used to rationalize inflexible attitudes and spare a probing of deeper motivation. In some instances they may well suffice for individual physicians who wish to dissociate themselves completely from the issue. But they will not satisfy society at large, to whom another set of slogans (“every baby a wanted baby” and “a woman has the right to the control of her own body”) has a stronger appeal. . . Has not the time come, therefore, for society, including the medical profession, to admit the state of affairs that prevails and face up to its obligations? . . . No serious person believes that abortion should be considered as an alternative to the regular practice of birth control. The by-no-means negligible morbidity associated with abortion and the occasional fatality, apart from the demands it makes on hospital and medical staff, make it much too costly when simple means of conception control are readily available. . . the escape from this dilemma is not in saying that birth control should have been used. . . [advocates sex education as described in Brave New World]. . . as long as human beings are sometimes careless and irresponsible, even if they are no longer ignorant, unwanted pregnancy will occur and the question of its termination, if we have the respect for motherhood we profess, will have to be faced.

CMAJ. (Editorial) The abortion situation. Can Med Assoc J. 1971 May 22;104(10):941.

(Editorial) Abortion in Canada

CMAJ

Extract
Canadians, including those within the medical profession, range from a truly “liberal” pole, which views abortion within the first 12 weeks of gestation as simply a means of secondary birth control, to a truly “conservative” pole, which views interruption of pregnancy in any circumstances as murder. . . In a just Canadian society in the year 1970 it would seem appropriate that occupants of neither polar position should be allowed to impose their moral attitudes on the rest of the country. . .

Parenthetically one must question why any group requires the assistance of state law to ensure that its members adhere to its ethical, moral or religious code. Certainly proponents of the truly “liberal” position have no intention of trying to force any woman to have an abortion against her will. . .

. . . Doctors should not be obliged to assume the function of gatekeepers to decide which unwanted children should be allowed into this overpopulated world and which ones should not. The moral aspect of this question should reside solely with the patient and not with the physician. His role should be to ensure that the patient really does want the pregnancy terminated and to make sure that the procedure is carried out early and safely. If the doctor’s moral position on this question precludes his providing her with the care required, he is now ethically bound by The Canadian Medical Association’s code of ethics to inform her that this is so, while making it clear that this is his own personal attitude. . .

CMAJ. (Editorial) Abortion in Canada. Can Med Assoc J. 1970 Aug 01;103(3):298-299.