Protection of Conscience Project Library

(Correspondence) Physicians and abortion

Lynette E Sutherland

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
After I read the articles on abortion in CMAJ I began to wonder if ready access to abortion is the main issue. Are we faced with a Yes-No decision, or are we looking at a symptom of something deeper? . . . The world is overpopulated, yet more and more children are being born. Despite the efforts of many dedicated people (especially women) to take information on birth con- trol to the most afflicted parts of the world, little progress is being made. All the solutions are “Band-Aid” ones, and almost all – contraceptives, abortifacients and abortion itself – are directed toward women, whose reproductive capacity is certainly the root of so much trouble. To cure these ills, nothing short of a redirection of human nature is necessary. . . .the earth’s mad population increase will surely go on to a cataclysmic end. We can put this off temporarily if we follow the Chinese example (one-child or two-children families) worldwide, with strict supervision of female reproduction.

Sutherland LE. (Correspondence) Physicians and abortion. Can Med Assoc J. 1993;148(8):1276-1277.

(News) Allegations of Nazi past force resignation of WMA president-elect

Patrick Sullivan

Extract
the World Medical Association (WMA) . . . recently found itself caught up in the most controversial problem in WMA history. At issue was the appointment of Dr. Hans-Joachim Sewering, 76, as the WMA’s president-elect. He was to have become president in October. Angry physicians belonging to several WMA member organizations, including the CMA, demanded that the appointment be overturned because Sewering had belonged to the Schutzstaffel, the Nazi elite guard, before World War II. . . . Sewering has been heavily involved in WMA affairs for more than 20 years.

Sullivan P. Allegations of Nazi past force resignation of WMA president-elect. Can Med Assoc J. 1995;148(6):995-996.

Creating Moral Space for Nurses

Leah L Curtin

Extract
(Lengthy 1983 editorial repeated verbatim in 1993 includes the following) “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. Creating Moral Space for Nurses. Nurs Manag. 1993 Mar;24(3):18-19.

(Correspondence) Clinicians who provide abortions: the thinning ranks

Denis Cavanaugh

Extract
Dr. Grimes identifies abortion as “the most divisive social issue of our time,” but he is contributing to the divisiveness by raising these issues in those of us who consider elective abortion a social evil as well as a “distasteful chore.” Abortionists don’t have all the altruism, and if elective abortion were not a billiondollar- a-year business, there would be even fewer volunteers. . .the legal entitlement of a woman to elective abortion cannot be absolute to the extent of suppressing the values and conscience of her physician, so there is no reason why a resident should have an obligation to perform such abortions.

Cavanaugh D. (Correspondence) Clinicians who provide abortions: the thinning ranks. Obst Gyn. 1993 February;81(2):318-319

Conscientious objection and abortifacient drugs

D B Brushwood

Abstract
The legal right to assert a conscientious objection is reviewed, using as an example the dispensing of abortifacient drugs by pharmacists. The three areas of law that most significantly concern the right to assert a conscientious refusal are employment law, conscience clauses, and religious discrimination law. Each of these is reviewed, with descriptions of recent cases. It is concluded that employment law protects refusals that are consistent with public policy, but does not permit an employee’s personal policy to determine how a business will be run; that conscience clauses appear to provide protection for pharmacists who object to dispensing abortifacients, but that the precise meanings of critical words and phrases in some clauses need to be defined; and that even though laws of religious discrimination require that employers accommodate religious beliefs, they may not protect a pharmacist who objects to dispensing abortifacients if the accommodation becomes unreasonably burdensome.

Brushwood DB. Conscientious objection and abortifacient drugs. Clin Therapeutics. 1993 Jan-Feb;15(1):204-212.

Has the Time Come for Doctor Death: Should Physician-Assisted Suicide Be Legalized

Wendy N Weigand

Extract
The implications of legalizing euthanasia for the medical profession and the potential for abuses are very troubling. Before public policy or legislation is formulated, the ethical issues inherent in the practice of euthanasia must be critically examined. . . It is the author’s assertion that the legalization of assisted suicide and/or physician-aid-in-dying is not the proper course of action at this time. There are too many other options available to doctors, nurses, hospitals and other health care institutions which must be exercised to their fullest extent before any form of active euthanasia is legalized.

Weigand WN. Has the Time Come for Doctor Death: Should Physician-Assisted Suicide Be Legalized. J Law Health. 1993;7(2):321-350.

Female circumcision: When medical ethics confronts cultural values

Eike-Henner Kluge

Extract
Canadian physicians cannot consistently accept the principle of respect for people in the name of medical ethics, and then perform procedures they know to be medically inappropriate, harmful and demeaning only because they do not want to offend a misplaced cultural sensitivity.

Kluge E-H. Female circumcision: When medical ethics confronts cultural values. Can Med Assoc J. 1993 Jan 15;148(2):288-289.

(News) Bombing of Toronto abortion clinic raises stakes in bitter debate

Gordon Bagley

Extract
The abortion clinic that Dr. Henry Morgentaler operated on Harbord Street in Toronto was an electronic fortress bristling with hidden cameras, burglary shock sensors and motion detectors, but the security measures were of little use last May 18. At about 3:23 on that Monday morning, a security camera filmed two shadowy characters approaching the clinic’s back door. The visitors, heavily disguised, used a drill to bore through the door lock. They poured gasoline into the clinic, let it aerosolize, and then used a Roman candle to ignite the fumes. In the resulting explosion the entire front wall of the two-storey structure shuddered, buckling building supports and flinging glass, bricks and other debris into the street. Fortunately, no one was injured – the street was deserted. Six months later, Toronto police seem no closer to finding the terrorists. . . . [lengthy article].

Bagley G. Bombing of Toronto abortion clinic raises stakes in bitter debate. Can Med Assoc J. 1992;147(10):1528-1533.

(Correspondence) Readers Advocate Pro-conscience, Not Pro-Choice (Invited response)

Susan Wysocki

Extract
A nurse practitioner’s personal position on this issue is irrelevant in tem1s of the provision of patient care. Our responsibility as nurse practitioners is to provide our patients with information that helps them to make their own decisions based on the constructs of their own beliefs and needs. This does not mean that nurse practitioners who find a patient’s reproductive-health decisions to be in conflict with their own morals and beliefs should be forced to counsel on those choices. Instead, they have a responsibility to ensure that the patient has her needs met with another provider.

Wysocki S. (Correspondence) Readers Advocate Pro-conscience, Not Pro-Choice (Invited response). Nurse Pract. 1992 Oct;17(10):8-9

(Correspondence) Readers Advocate Pro-conscience, Not Pro-choice

(Author reply)

Lynn C Barnard

Extract
“Let those nurses who oppose abortion and choice dedicate their energies to the development of a societal system that truly cares for women and will support their decisions – no matter what they are.”

Barnard LC. (Correspondence) Readers Advocate Pro-conscience, Not Pro-choice (Author reply). Nurse Pract. 1992;17(10):8