Category: Publications

Protection of Conscience Project publications

Planned Parenthood and “Anti-Choice” Rhetoric

Sean Murphy*

A response to Mario Toneguzzi, “Planned Parenthood Targets ‘Anti-choice’ Docs”, Calgary Herald (19 August, 2004)

Planned Parenthood and "Anti-Choice" Rhetoric

In 1999, citing allegations by un-named “individuals,” a Councillor of the Alberta College of Physicians and Surgeons claimed that some physicians who were not “supportive” of women seeking abortions were “rude and bullying to patients.”(1) Canadian Physicians for Life rebuked the Councillor for relying upon “polemical hearsay” and demanded that the College substantiate the allegation.(2) No evidence was forthcoming.

Three years later the Assistant Registrar of the College indicated that complaints about physician ‘moralizing’ were largely hearsay “from groups who provide birth control and family planning counselling to women” – not a bad definition of Planned Parenthood.(3)First-hand accounts from individual patients were a “distinct minority” of the total.(4)

Planned Parenthood Alberta is now recycling the accusation that physicians who object to abortion may “scare” patients with “misinformation” or “impose their moral beliefs.”(5) One of the problems with this kind of generalized smear is that it may be unfairly applied to conscientious objectors to abortion who follow the guidelines of the Canadian Medical Association (CMA) and the College of Physicians and Surgeons of Alberta (CPSA).

The CMA advises physicians to “inform a patient when their personal morality would influence the recommendation or practice of any medical procedure that the patient needs or wants,” and to advise patients of their objections to abortion so that they can consult another physician.(6) The CPSA does not require physicians to advise every pregnant woman that she can have an abortion or put her child up for adoption,(7) but does expect them to provide information to patients seeking abortion so that they can “make informed decisions on all available options for their pregnancies, including termination.”(8)

In following these guidelines an objecting physician must, at all times, be respectful of the patient’s dignity, and must not be threatening, overbearing or abuse his authority by preaching or moralizing in order to influence his patient’s decision. On the other hand, objecting physicians can hardly be expected to present morally controversial procedures as morally uncontroversial, or in such a way as to indicate that they approve of them or are indifferent to them (i.e., to adopt a ‘neutral’ position). Moreover, the information they reasonably believe necessary to permit the patient to make a truly “informed decision” may be more comprehensive or in other respects different from what Planned Parenthood is accustomed to provide its clients.

A third party who was not present during this kind of exchange, especially an interest group like Planned Parenthood, might well stigmatize the discussion as ‘moralizing’ and providing ‘misinformation’. Partisan polemics of this sort do not provide a basis for sound policy making.

Planned Parenthood Alberta suggests that patients who are unsure of their doctor’s position on abortion should contact the organization because it is compiling a list of what it calls “anti-choice doctors”. Asking the doctor directly seems a simpler and more reliable way for patients to resolve such doubts. If it is desirable to help patients find physicians who share their outlook on moral issues, it would be preferable for doctors to identify themselves, perhaps through the College of Physicians and Surgeons or professional associations.

In the meantime, if Planned Parenthood persists in its plan to identify “anti-choice doctors”, it should include in its list the names of physicians who believe that their colleagues should not be forced to provide or facilitate morally controversial procedures.

Notes

1. Kretzul E. Ethical Responsibilities in Dealing with Women Requesting Abortion Services. The Messenger. 1999 Sep; 73: 6.

2. Canadian Physicians for Life. News Release: Alberta College of Physicians and Surgeons challenged to think about conscience rights [Internet]. Powell River: Protection of Conscience Project; 1999 Oct 11.

3. Theman TW. Freedom of Conscience and the Needs of the Patient. Presentation to the Obstetrics and Gynecology Conference “New Developments-New Boundaries”; 2001 Nov 9-12; Banff, Alberta.

4. Theman, Trevor W. (Assistant Registrar, College of Physicians and Surgeons of Alberta). Letter to: Sean Murphy (Administrator, Protection of Conscience Project). 2002 Jan 2. 1 leaf. Located at: Protection of Conscience Project.

5. Be Aware of Anti-Choice Doctors and Radiologists [Internet]. Edmonton: Planned Parenthood Alberta; 2004 [cited 2004 Aug 28].

6. Canadian Medical Association. Induced Abortion [Internet]. CMAJ. 1988 Dec 15 [cited 2020 Sep 16]; 139:12 1176a–1176b. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1268491/pdf/cmaj00181-0059.pdf.

7. Theman, Trevor W. (Assistant Registrar, College of Physicians and Surgeons of Alberta). Letter to: Sean Murphy (Administrator, Protection of Conscience Project). 2002 Mar 27. 1 Leaf. Located at: Protection of Conscience Project.

8. College of Physicians and Surgeons of Alberta. Termination of Pregnancy. 2000 Jun.

Some corrections and clarifications

Project letter to the Calgary Herald

Sean Murphy*

While I am pleased to see that Laura Wershler is willing to accommodate freedom of conscience among health care workers, I must correct some misleading statements included in her article (“The morning after: Pro-life agenda misrepresents the emergency contraceptive pill, or ECP”,Calgary Herald, 13 February, 2004).

In the first place, http://www.consciencelaws.org is the URL of the Protection of Conscience Project, not “Repression of Conscience”. Contrary to Ms. Wershler’s assertion, this is a non-denominational human rights project, not a not a pro-life initiative. Pro-lifers are interested in the Project and sometimes link to our website, but the Project does not take a position on the morality of controversial procedures. It is enough to recognize the controversy, and advocate the accommodation of conscientious objectors. At least one pro-life pharmacist does not use the Project pamphlet about the morning-after pill precisely because the pamphlet does not argue against its use.

Second, Ms. Wershler’s article incorrectly attributes to the Project the use of the terms “abortion drug” and “emergency contraceptive (ECP)”. The Project does not use either term, except when quoting other sources. They are confusing, and complicate articulation of freedom of conscience issues.

“Abortion drug” is an appropriate description of mifepristone (RU486), which is designed specifically to cause the abortion of an embryo that has implanted in the uterus. The morning-after pill has not been designed for that purpose, and does not act in that way.

“Emergency contraception” is a fabulously successful marketing term. However, 94% of the women who take the morning-after pill do not require it to prevent childbirth. This statistic, provided by the drug’s advocates,[1] belies the notion of ’emergency’ that is often used to browbeat conscientious objectors. As to “contraceptive”, Ms.Wershler herself acknowledges that these drugs have three mechanisms of action, one of which may prevent implantation of the early embryo, thus causing its death. This is considered by many conscientious objectors to be the moral equivalent of abortion, a term acknowledged as appropriate by some authorities,[2] though the usage is not uncontested. The Project refers to these drugs generically as the ‘morning-after pill’ because this term is widely understood. We describe the morning-after pill as “potentially abortifacient”, in the sense that it may cause the death of the early embryo, but does not necessarily do so.

A final note to prevent further confusion: the meaning of “abortifacient” in a medical or scientific context is not the same as its meaning in a moral context. In a medical context, a drug that prevents fertilization (acts contraceptively) 95 to 99 times out of a hundred would be called a contraceptive rather than a abortifacient. But in a moral context, when the outcome may be death, a drug may be treated as an abortifacient if there is even a 1% chance of it killing the embryo by preventing implantation. A number of disputes that arise about the morning-after pill are a regrettable consequence of failing to recognize these distinctions.

Notes

1. Apply a calculator to the following statement: “In 16 months of ECP services, pharmacists provided almost 12,000 ECP prescriptions, which is estimated to have prevented about 700 unintended pregnancies.” Cooper, Janet, Brenda Osmond and Melanie Rantucci, “Emergency Contraceptive Pills- Questions and Answers”. Canadian Pharmaceutical Journal, June 2000, Vol. 133, No. 5, at p. 28.

2. Keith L. Moore and T.V.N. Persaud, The Developing Human: Clinically Oriented Embryology (6th ed.) (Philadelphia: W.B. Saunders Company, 1998), p. 532. Quoted in Irving, Diane N., A “One-Act Drama:The Early Human Embryo:’Scientific’ Myths and Scientific Facts:Implications for Ethics and Public Policy, Medicine and Human Dignity.” International Bioethics Conference, ‘Conceiving the Embryo’, Centre Culturel, Woluwe-St. Pierre, Brussels, Belgium: October 20, 2002 (9:30 A.M.)(Revised 23 October, 2002) Note 23.

Project Letter to the Telegraph Journal

New Brunswick, Canada
12 November, 2002

Sean Murphy, Administrator
Protection of Conscience Project

Doctors at the hospital in Moncton have decided to perform only abortions they believe necessary for maternal health, so that scarce health care resources can be dedicated to reducing waiting lists for surgery. Dr. Henry Morgentaler calls this “disgusting”. He also accuses his colleagues of unethical conduct because they appear to be imposing their religious or moral views on patients. (Morgentaler calls decision to halt abortions ‘disgusting’ 9 November, 2002)

It is remarkable that Dr. Morgentaler should be disgusted by physicians who perform abortions for ‘health’ reasons, but not abortions for which there is no medical justification. When he decided to break the law against abortion, it was because he decided to follow something he called his “medical conscience”.1 His Moncton colleagues, while they will break no law, are doing the same thing. Baseless diatribes about ‘imposing moral beliefs’ are unfair and do nothing to improve health care in New Brunswick.

Dr. Morgentaler has also misrepresented the Code of Ethics of the Canadian Medical Association by implying that it obliges doctors to provide abortions. It does not, nor does it require physicians to referfor abortions or other morally controversial procedures.

Finally, Dr. Morgentaler clearly applies his own moral views in his own medical practice. Upon what basis would he deny his colleagues the same freedom?

Notes: 1.  Pelrine, Eleanor Wright, Morgentaler: The Doctor Who Couldn’t Turn Away. Canada: Gage Publishing, 1975, p. 29

Ontario College of Physicians and Surgeons accommodates Christian physician

 Sean Murphy*

The Ontario College of Physicians and Surgeons has accepted a suggestion from Dr. Stephen Dawson that has resolved complaints lodged against him. Dr. Dawson, a Christian physician who practises in Barrie, Ontario, was charged for professional misconduct because he refused to prescribe birth control pills to four unmarried women.

Dr. Dawson now posts a policy statement in his waiting room that includes a statement that he will not prescribe birth control pills to unmarried women nor Viagra to unmarried men, nor will he arrange for abortions. He will not offer further information about his religious convictions except in response to queries from patients. [Full text]

 

Who is “imposing morality” in Barrie?

Winnipeg, Manitoba
5 April, 2002

Sean Murphy,  Administrator
Protection of Conscience Project

The Canadian Broadcasting Corporation (CBC) is Canada’s publicly funded state radio and television broadcaster. The following was sent to the CBC in Winnipeg, Manitoba, asking whether or not it would be accepted for broadcast in the same region where Dr. Goldman’s editorial was aired. The CBC did not  reply.

In an editorial broadcast on CBC Radio on 7 March, 2002, Dr. Brian Goldman criticized Dr. Frederick Ross of Winnipeg, Manitoba, and Dr. Stephen Dawson of Barrie, Ontario. Dr. Ross had told his patients to stop smoking or find another doctor, while Dr. Dawson had refused to prescribe birth control pills or Viagra to single patients.

It does not seem that Winnipeg’s Dr. Ross believes that treating smokers is wrong, nor that it would be wrong to refer a smoker to another physician. His public statements do not preclude the possibility that he would treat smokers on an ad hoc basis (while standing in for an absent partner, for example).

In contrast, Dr. Dawson refuses to help single patients obtain birth control pills and Viagra under any circumstances, because he believes that by doing so he would be a party to immoral activity (i.e.,extramarital sex). Dr. Goldman was more sympathetic to this position, but criticized Dawson because he would not refer patients to other physicians who would prescribe the drugs.

Dr. Goldman recognized that his colleagues were acting for different reasons, but in drawing his conclusions he failed to maintain this distinction or recognize its significance. It is one thing to refuse to do something because it is inconvenient, difficult, frustrating, or pointless; it is quite another to refuse to do something because it is wrong. Grasping this distinction is the key to understanding the difference between the case of Dr. Ross, which does not seem to involve conscientious objection, and that of Dr. Dawson, which plainly does.

What some characterize as Dr. Dawson’s inflexibility actually illustrates the normal human reaction to a request to do something wrong. For example, a fifty year-old man who wanted to have sex with a fourteen year- old girl might be refused the use a friend’s apartment for that purpose. Nor would it be surprising if the unco-operative  friend also refused to refer the lecher to a more ‘flexible’ apartment owner.

We see the same principle at work in criminal law. It is an offence not only to commit a crime directly, but to counsel, aid or abet a crime committed by someone else. Again: many people who engage in ‘ethical investment’ do so because they do not want to be implicated, even indirectly, in business practices to which they object for reasons of conscience, even if the practices aren’t illegal.

Now, no one is suggesting that consensual extramarital sex between adults is morally equivalent to criminal activity. But when Dr. Dawson refused to provide birth control for single patients, he reacted exactly as an ‘ethical investor’ might react if asked to purchase shares in a company that exploits child labour. He reacted exactly as an honest man would act were he asked to help someone lie or cheat. In other words, he  acted as if extramarital sex really is wrong, and that its wrongness is not merely a matter of opinion or taste. That, in truth, is what has upset many of his critics; he has disturbed their repose in their  comfortable pews.

Of course, one may criticize a physician for causing needless distress to a patient by offering a poorly articulated or inappropriate explanation of his moral position. But that was not Dr. Goldman’s concern. Instead, he complained that Dr. Dawson had acted upon his own beliefs.

In fact, Dr. Goldman does exactly the same thing. He believes that he does nothing wrong by providing single patients with contraceptives and Viagra, and he acts upon that belief by writing prescriptions. Why should Dr. Goldman be allowed to act upon his beliefs by writing prescriptions, while Dr. Dawson is forbidden to act upon his by refusing  to do so? Is it because “the true north strong and free” is afraid of religious believers?

A physician who refuses, for reasons of conscience, to do something he believes to be wrong – falsifying a diagnosis, amputating a healthy limb, or prescribing contraceptives – does not force a patient to conform to his moral code. He is not “imposing morality.” To see what  “imposing morality” really means, watch this month when the Ontario College of Physicians and Surgeons tries to force Barrie’s Dr. Stephen Dawson to give up his Christian convictions, on pain of professional excommunication.