Tag: referral

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.

Project Letter to the Western Standard

14 May, 2004

Sean Murphy, Administrator
Protection of Conscience Project

Should doctors be forced to abandon their faith?  by Terry O’Neill  draws attention to the problem of freedom of conscience in health care.

A bit of history is instructive. The first protection of conscience clause debated in the House of Commons was introduced by M.P. Robert McCleave as an amendment to the Omnibus Bill that legalized abortion in Canada in 1969. Mr. McCleave believed that abortion should be  legalized, but also believed that ‘freedom of choice’ should be extended to health care workers.

Compare Mr. McCleave’s notion of ‘choice’ with that espoused by Joyce  Arthur. Speaking for the “Pro-choice Action Network,” she refuses to  respect the choices of health care professionals who do not wish to participate morally controversial procedures. She seems to believe that freedom of conscience is a problem to be solved by abolishing it, at least  in the case of those who don’t agree with her. Arthur’s position is doubly ironic, since Henry Morgantaler justified his defiance of Canadian abortion law in a 1970 article titled, A Physician and His Moral Conscience.1

Referral is not a satisfactory solution for many physicians who have grave moral objections to a procedure. Objecting physicians hold  themselves morally culpable if they facilitate an abortion by referring a  patient for that purpose. Nor is this an unusual view. Consider the controversy in Canada over the deportation and torture of Maher Arar. This suggests that few believe that one can avoid moral responsibility for a wrongful act by arranging for it to be done by someone else.

Certainly, Joyce Arthur does not consider abortion to be a wrongful act. However, she has not explained why others should be forced to abide by her moral views.

Unfortunately, between the writer’s desk and publication, a couple of factual errors were introduced into the story.

In the first place, the Project followed the case from the outset, and the student was provided with the same kind of service extended to others in similar situations. His relationship with the Project has been cordial,  but it is incorrect to describe me as “a friend of the would-be doctor.” We have never met.

More important, the final paragraph attributes to me statements that I did not make. While I am, nonetheless, in agreement with a number of the points made, I did not suggest that a devout Muslim doctor might refuse to  treat women, nor make any statement to a similar effect.

It would be most unfortunate if this falsely attributed statement were  to contribute to the already adverse social pressures experienced by Muslims in North America. Muslim health care workers and students are welcome to contact the Protection of Conscience Project. One of the  Project advisors is Dr. Shahid Athar, a regent and former vice-president of the Islamic Medical Association of North America and the Chair of its       Medical Ethics Committee

Notes

1. 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

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

Project Letter to Telegraph Journal

New Brunswick, Canada
24 February, 2002

Sean Murphy, Administrator
Protection of Conscience Project

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

Canadian Physicians for Life corrects Planned Parenthood Alberta

News Release

CANADIAN PHYSICIANS FOR LIFE

RE:  “Even doctors ethically must make referrals for abortion services, whether they morally support that or not.”  Melanie Anderson – Planned Parenthood Alberta  (CTV News and Current Affairs Sat 02 Jun 2001)

The erroneous allegation that physicians who object to abortion for reasons of conscience are obliged to refer patients for the procedure continues to be promulgated in Alberta.

Our correspondence with Alberta College of Physicians and Surgeons registrar, Dr. Ohlhauser, states clearly that physicians do not have a professional obligation to refer a patient for an abortion.  The College requires, as does the Code of Ethics of the Canadian Medical Association, that physicians “inform a patient when their personal morality would influence the recommendation or practice of any medical procedure that the patient needs or wants.”

A pro-life physician should declare her personal views to a pregnant patient considering an abortion, in order to place her subsequent discussion in context.  The doctor then has every right, indeed, a responsibility, to outline the potential mental and physical risks of abortion just as she would before prescribing a drug or weighing the merits of surgery.

A number of studies report a close correlation between abortion, especially of a first pregnancy, and breast cancer. Are Alberta physicians telling abortion seekers of this threat to their health? Are women being informed of the risk of post-abortion emotional trauma? Are patients being warned that some physicians’ ardent pro-abortion beliefs bias the “counselling” process?

A physician’s duty of care extends to two patients in the case of a pregnant woman – the woman and her unborn child.  For a woman to make a truly “informed decision” she must be presented with the facts of human embryology of her unborn child so that she will know that what she is aborting is a human being, not just a clump of cells or a piece of her own tissues.  Withholding basic information shows disrespect for women and is both dishonest and patronizing, since it implies that women are too weak to know the truth.

The suggestion that morally troublesome issues need only be referred to a colleague is oblivious to the principled objections of pro-life physicians. Increasingly exotic reproductive technologies may eventually offend even the most laissez-faire physicians.  There may come a day where no physician feels free from coercion to violate his or her conscience.

Will Johnston, MD
President – Canadian Physicians for LifeContact: 
Canadian Physicians for Life
10150 Gillanders Road; Chilliwack, BC  V2P 6H4
Phone:  604-794-3772  Fax:  604-794-3960
Email:  info@physiciansforlife.ca
Visit us at:  www.physiciansforlife.ca