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(Correspondence) Code of ethics

Hugh M Scott

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

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.

(Correspondence) The Code of ethics: abortion referral

John B Shea

Extract
The CMA has the audacity to “place responsibility” on the physician who acts in accordance with his intelligence and informed conscientious judgement in the matter. It is not true to state that a physician abandons a patient if he informs her that his moral principles preclude his becoming involved in referring her for an abortion. No patient has the right to anything other than what a physician can in his conscience do. To ask for more is to ask for his cooperation in performing an act that he deems an act of killing an innocent human being. The CMA, in supporting this type of request, is bringing pressure to bear on the physician to cooperate. By including it in the code of ethics the CMA has also put the physician who does not publicly object in the position of appearing to agree with the CMA. His intellectual and moral integrity are challenged by this action. . . .If the government were to make abortion on demand legal, I have no doubt the CMA would make another change in the code that would “place responsibility” on the physician to cooperate in this also. I find it intolerable that the CMA is telling me I may not follow my conscience in this most serious matter.

Shea JB. (Correspondence) The Code of ethics: abortion referral. Can Med Assoc J. 1978 Apr 22;118(8):890.

(Correspondence) The Code of ethics: abortion referral

RG Wilson(CMA Secretary General)

Extract
.. . . the wording in the pertinent paragraph of the code of ethics represents an amendment to the recommendation of the committee on ethics, moved from the floor of General Council and subsequently passed. In discussing this paragraph the mover of the motion stated that the medical profession must stand by its ethics and, in so doing, has a responsibility to patients, who should not be abandoned in any regard. He went on to state that the medical profession is based on compassion and help and that every physician has a responsibility to a patient, even when he does not agree with a particular form of therapy. . . In suggesting changes in the code of ethics the CMA’s committee on ethics attempted to underline the right of the patient to have other opinions, and the responsibility of the physician to indicate to the patient that she has that right. General Council, in its wisdom, strengthened the recommendation and indicated that, in its view, the physician has a broader responsibility not to abandon the patient or impede her from obtaining help from other sources of assistance.

Wilson RG. (Correspondence) The Code of ethics: abortion referral. Can Med Assoc J. 1978 Apr 22;118(8):895-896.

(Correspondence) The Code of ethics: abortion referral

CA Johnson

Extract
Mr. Geekie’s interpretation of this section is most disturbing in that some of the phrases he uses suggest a derogatory attitude to physicians engaged in abortion referral. . . . It seems to me clearly unethical for a physician with moral conflicts of interest to refer a patient who consults him about an abortion to a clergyman. . . .It seems that what appeared to be a step forward in ensuring that patients receive unbiased professional judgement in each individual case has become just the opposite.

Johnson CA. (Correspondence) The Code of ethics: abortion referral. Can Med Assoc J. 1978 Apr 22;118(8):888, 890.

(Correspondence) The Code of ethics: abortion referral

MA Baltzan

Extract
The code means that a physician who has a conflict of interest between duty to a patient and personal belief shall refer the patient to someone who is not burdened by this conflict of interest, but the code states that a physician who has a conflict of interest between duty to a patient and personal belief shall refer the patient to someone who will provide the treatment the patient desires.

Baltzan MA. (Correspondence) The Code of ethics: abortion referral. Can Med Assoc J. 1978;118(8):895.

Genuine appeals to conscience

Kenneth R Seeskin

Extract
Kordig denies that the dictates of one’s conscience are always either obligatory or morally permissible. With this thesis I have no quarrel. The recognition that a person’s conscience can be mistaken, sometimes dangerously so, is at least as old as Hobbes and has been maintained by philosophers as diverse as Hegel, Royce, and Nowell- Smith. Still, people do appeal to conscience in moral disputes and, as I will attempt to show, do so in a manner that is philosophically justifiable. My goal is not so much to attack what Kordig has said as it is to argue that his discussion is incomplete: some appeals to conscience are bogus but some are not.

Seeskin KR. Genuine appeals to conscience. J Value Inquiry. 1978;12(4):296-300.