Canadian Medical Association Journal Archives - Protection of Conscience Project Library

(Editorial) The sacred and the secular: the life and death of Terri Schiavo

CMAJ

Extract
. . . In medical and legal opinion, Terri Schiavo’s cognizance of her self and her life ended in 1990, when she suffered a cardiac arrhythmia and massive cerebral cortical encephalopathy that left her in a persistent vegetative state. Her facial expressions, along with a seemingly “normal” sleep–wake cycle, constituted but one dimension of the cruelty of this condition. . .

. . .More than one commentator has viewed the “right- to-life” fight to prolong Schiavo’s pitiable existence as an anti-abortion campaign “by other means.” . . .

. . . there seems little doubt that, in North America, ideology and religion have begun to seriously distort the type of consensus-building that is the proper business of democratic politics . . .

Where do physicians find themselves in such debates? Medicine is a secular and scientific profession that, for all that, must still contend with the sacred matters of birth, life and death. In practice, physicians must set aside their own beliefs in deference to the moral autonomy of each patient — or else transfer that patient’s care to someone who can meet this secular ethic. . .

. . .The emotionalism and rancour that swirled around the Schiavo case underscores a wider societal duty borne by the medical and scientific community. This is to remain alert to political and legislative tendencies that impose imprecise moral generalizations on the majority, at the expense of reason, scientific understanding and, not infrequently, compassion.

CMAJ. (Editorial) The sacred and the secular: the life and death of Terri Schiavo. Can. Med. Assoc. J.. 2005 Apr 26;172(9):1151.

(Editorial) Unwanted results: the ethics of controversial research

CMAJ

Extract
. . . We are chided for publishing flawed research and told that we should be ashamed of publishing the “opinions” of self-evidently biased researchers. We are accused of doing a disservice to women, medicine and the Journal, of failing to conduct proper peer review, and of not adequately scrutinizing the credentials of the authors.

The abortion debate is so highly charged that a state of
respectful listening on either side is almost impossible to achieve. This debate is conducted publicly in religious, ideological and political terms: forms of discourse in which detachment is rare. But we do seem to have the idea in medicine that science offers us a more dispassionate means of analysis. To consider abortion as a health issue, indeed as a medical “procedure,” is to remove it from metaphysical and moral argument and to place it in a pragmatic realm where one deals in terms such as safety, equity of access, outcomes and risk–benefit ratios, and where the prevailing ethical discourse, when it is evoked, uses secular words like autonomy and patient choice. . .

CMAJ. (Editorial) Unwanted results: the ethics of controversial research. Can. Med. Assoc. J.. 2003 Jul 22;169(2):93.

(Correspondence) Composition of the General Council (Response)

CMAJ

Extract
The 1974 CMA General Council membership was composed of some 250 members of the association. Over two thirds of General Council, 170 members, were representatives of provincial divisions. Twenty-four were members of the CMA Board of Directors or chairmen of statutory CMA councils or committees. Thirty were representatives of affiliated societies. . . . In addition there were 21 individuals who, by virtue of having held office in the CMA (past-presidents, etc.), were members of General Council. The remaining three members were the surgeon general of the Canadian Armed Forces, the director general of the treatment services branch of the Department of Veteran Affairs and the deputy minister of national health, Health and Welfare Canada.

CMAJ. (Correspondence) Composition of the General Council. Can Med Assoc J. 1975 Jan 11;112(1):27.

(Correspondence) CMA policy on abortion

CMAJ

Extract
While the CMA has recommended the removal of the requirement for hospital therapeutic abortion committees from the Criminal Code, it has supported the retention of the balance of sections 251 and 252. The purpose of this stand is to retain the more serious implications of a violation of the Criminal Code as compared with a violation of provincial medical acts regarding the performance of abortions by non-qualified persons or by qualified physicians outside approved hospitals. This policy also reflects the association’s opinion that some provincial medical acts, and the means of enforcing them, are less than adequate.

CMAJ. (Correspondence) CMA policy on abortion. Can Med Assoc J. 1974 Nov 02;111(9):905.

(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.