New Brunswick, Canada
24 February, 2002
Dr. Monica Brewer’s characterization of physician referral for morally controversial purposes as a “black and white” issue is the result of inadequate reflection.(“MD’s Morals Restricting Birth Control Access,” February 9, 2002) Her suggestion that doctors who object to the morning-after-pill and contraception “should pair with doctors to whom they can refer” is a suitable solution only for those whose objections are simply matters of professional judgement or personal preference.
For example: physicians who know that 94% of the women who are sold the morning-after-pill do not actually require it to prevent pregnancy (the numbers are provided by those who support its widespread use1) may be unwilling to prescribe it for that reason. However, they might well refer a patient who wants the drug to a doctor who will.
Similarly, some physicians believe that women’s health and social interests are better served by learning to recognize their natural fertility cycles, so that they need not be dependent upon physicians or drug companies to plan or avoid pregnancy. These physicians may not prescribe birth control pills for ‘ecological’ reasons, but probably wouldn’t object to referral.
Finally, an obstetrician who thinks that aborting Down syndrome infants is a good idea, but finds performing abortions a traumatic experience, would probably welcome the opportunity to refer a patient to another colleague.
The situation is quite different when physicians are asked to refer a patient for something to which they have grave moral objections. They believe that by referring patients they are themselves morally culpable for facilitating the wrong that is done. Strange? Not at all.
Consider Newsweek columnist Jonathan Alter’s suggestion that, since physical torture is “contrary to American values”, the US should turn terrorist suspects who won’t talk over to “less squeamish allies.”2 No one would seriously argue that this would relieve the US of moral complicity in torture.
Of course, moral complicity in abortion, contraception and the morning-after-pill are not issues for people like Dr. Morgantaler and his associate, Judy Burwell, who think these are good things, and that those who think differently are mistaken. But it is surprising that they view freedom of conscience as a problem to be solved by abolishing it, at least for those who don’t agree with them.
After all, Dr. Morgantaler justified his defiance of Canadian abortion law in a 1970 article titled, “A Physician and His Moral Conscience.” 3
Notes (provided for editorial verification)
1. “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. See also Valpy, Michael, “The Long Morning After”, Globe and Mail, 15 December, 2001)
2. Alter, Jonathon, “Time to Think About Torture”. Newsweek, 5 November, 2001, p. 45.
3. The article appeared anonymously in The Humanist. Quoted in Pelrine, Eleanor Wright, Morgantaler: The Doctor Who Couldn’t Turn Away. Canada: Gage Publishing, 1975, P. 79