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When caesarian section operations imposed by a court are justified

Eike-Henner Kluge

Abstract
Court-ordered caesarian sections against the explicit wishes of the pregnant woman have been criticised as violations of the woman’s fundamental right to autonomy and to the inviolability of the person-particularly, so it is argued, because the fetus in utero is not yet a person. This paper examines the logic of this position and argues that once the fetus has passed a certain stage of neurological development it is a person, and that then the whole issue becomes one of balancing of rights: the right-to-life of the fetal person against the right to autonomy and inviolability of the woman; and that the fetal right usually wins.

Kluge E-H. When caesarian section operations imposed by a court are justified. J Med Ethics. 1988 Dec;14(4) 206-211.

Abortion: the issue the CMA has refused to address is life

David Knickle

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
The CMA’s new statement shifts the balance very heavily away from the sanctity of human life and places more emphasis on these pregnancy-related problems. Surely this is contrary to our traditional medical ethic of protecting life and curing disease. . .

The issue for our profession should be this: What is medically acceptable? We must set our standards of ethical practice. Surely we are capable of defining what is therapeutic and what is non- therapeutic in life-and-death situations. The issue here is not whether we are pro-choice or pro-life, or for or against abortion on demand. The issue is simply whether we will hold to our traditional medical ethic of protecting life and treating disease.

Knickle D. Abortion: the issue the CMA has refused to address is life. Can Med Assoc J. 1988 Nov 15;139(10):990.

(News) Abortion issue dominates NBMS annual meeting

Lucian Blair

Extract
The NBMS Board of Directors adopted an abortion policy that stated: “The issue of abortion is a personal one between the patient and the physician governed by individual conscience and the law of the land.” . . . Following a protracted and impassioned debate, the statement was adopted. Feelings were running so high that in one case an NBMS member asked another doctor if he wished to “step outside” to discuss the issue.

Blair L. Abortion issue dominates NBMS annual meeting. Can Med Assoc J. 1988;139(8):797.

(News) Women doctors favour time-dependent rules on abortion, survey reveals

Patrick Sullivan

Extract
The survey, which attracted responses from 443 women physicians, found that 60.3% of respondents favoured abortion without restrictions during the first trimester of a pregnancy . . 28.6% for the second trimester, and . . . 3% for pregnancies that had lasted more than 20 weeks. . . .the number . . . wanting some restrictions jumped from 37.4% for the first trimester . . . to 62.9% for the second and 64.6% for the third. Only small fractions of FMWC members – 1.4% and 2.8%, respectively – were opposed to abortion for any reason during the first two trimesters. However, this jumped to 27.1% for pregnancies that had lasted longer than 20 weeks.

Sullivan P. Women doctors favour time-dependent rules on abortion, survey reveals. Can Med Assoc J. 1988;139(7):669-670.

(Correspondence) Abortion: cool common sense

Charles A Simpson

Extract
It was a delight to read the frank and well-written article by Dr. William G. Green (Can Med Assoc J 1988; 139: 325-326) “I have no answer to the abortion issue, but here is the question”. There has been so much heat and emotion surrounding this issue . . . We have heard too much from those at the extremes.

Simpson CA. (Correspondence) Abortion: cool common sense. Can Med Assoc J. 1988 Oct 01;139(7):612.

(News) New abortion policy approved for CMA despite some vocal opposition

Patrick Sullivan

Extract
The approximately 230 General Council members took just over an hour to approve the proposed policy in toto, despite strenuous objections from some doctors. . . .Dr. David Knickle, a Charlottetown obstetrician who raised the loudest voice against the new policy, countered that it “simply is carte blanche abortion on demand”. However, his motion that the association “state its op- position to nontherapeutic abortions” received almost no support. . . . Dr. William MacDiarmid of Winnipeg, a member of the CMA’s Committee on Ethics, spoke against the Knickle motion, arguing that because the CMA is a reflection of society, it has to avoid taking an extreme position. “Many of us are in the middle”, he said.

Sullivan P. New abortion policy approved for CMA despite some vocal opposition. Can Med Assoc J. 1988;139(6):542-544.

(Correspondence) Abortion: it is time for doctors to get off the fence

CE Cragg

Extract
In response to Dr. Myre Sim’s shopworn fulminations (Can Med Assoc 11988; 138: 742- 743), I am one doctor who has been off the fence and on firm ground for some time on the matter of abortion. . . The key to reducing the problem of ethically troublesome abortions remains quick, easy access to abortion, which includes improvement in the early identification of genetic defects. The key to reducing the numbers of abortions includes increasing awareness of the still dire need of children for information about sex, sexuality and birth control and increasing promotion of ethics as an object of study in school.

Cragg CE. (Correspondence) Abortion: it is time for doctors to get off the fence. Can Med Assoc J. 1988 Jul 16;139(2):99.

(Correspondence) Mr. Sullivan replies

Patrick Sullivan

Extract
It was Dr. Robbie Mahood who suggested that physicians have a duty to speak out on abortion and other health care issues. I merely reported his comments. On the lack of response by pro-choice physicians to the Supreme Court decision, I was making a statement of fact. . . .

Sullivan P. (Correspondence) Mr. Sullivan replies. Can Med Assoc J. 1988;138(12):1088. Available from:

(Correspondence) Abortion: Is it time for doctors to get off the fence? Dr. Sim responds

Myre Sim

Extract
All medical procedures should have proper medical indications; and when these indications are being abused strict guidelines are laid down by the profession; those who ignore them are censured. . . .Bart would have abortion specifically excluded from such guidelines, yet abortion carries certain death for the fetus as well as hazards for the pregnant woman. Medical ethics are specifically designed to curb unwholesome and dangerous medical practices. . . abortion on nonmedical grounds, which includes most, is a male- inspired maneuver. . .

Sim M. (Correspondence) Abortion: Is it time for doctors to get off the fence? Dr. Sim responds. Can Med Assoc J. 1988 Jun 15;139(4):1085.

(Correspondence) Abortion: Is it time for doctors to get off the fence?

John Bart

Extract
I was present at the death of a woman whose uterus had been torn open and infected by a coat hanger. Anything is better than that: she died through poverty and ignorance, and her whole family suffered. . . .Medical ethics are an extension of personal ethics, not an abstract entity with a special name. I believe what I believe, and he believes what he believes. Sim should not force his opinions upon others. That is what the Nazis did. . . . We are not on the fence, Dr. Sim. We are exercising our free will and not interfering with that of others. We believe that women are capable of decisions without an avuncular physician’s approval. We think that freedom from unwanted pregnancy is a cornerstone of feminine freedom. Without that, society is male dominated, unequal and the poorer for it. Please do not equate abortion with euthanasia. The two are not synonymous. Please do not equate your opinion with moral rectitude either. Anything is better than that.

Bart J. (Correspondence) Abortion: Is it time for doctors to get off the fence? Can Med Assoc J. 1988;139(4):1085.