By Melissa Leong
(National Post, Wednesday, May 10, 2007)
An abortion rights group has launched a challenge of the Canadian policy governing the way physicians respond to abortion requests, adding their voice to an ongoing and divisive debate in the Canadian Medical Association Journal.
The National Abortion Federation, a U.S.-based association of abortion providers which also represents health care professionals in Canada, sent a letter yesterday to the Canadian Medical Association, calling on it to change its so-called conscientious objector policy, which allows physicians to refuse to refer patients for abortions. It is the first time the federation has tried to lobby the CMA on this issue.
The federation says the policy jeopardizes women’s access to publicly funded health care. “We’re hearing from women across Canada and from our providers that this is a problem,” said Vicki Saporta, president and CEO of the National Abortion Federation. “It has reached a critical mass that many women are upset that they haven’t been able to get referrals from their physicians.”
The CMA now finds itself in between the federation and the Canadian Physicians for Life, an organization that wants the medical association to strengthen its policy to further protect physicians who do not want to participate in abortion services.
“The CMA’s policy on induced abortion does not violate our Code of Ethics … Nor does it treat women unfairly or impede their access to critical health care,” CMA President Dr. Colin McMillan said, responding to the abortion federation in a written statement.
The CMA’s abortion policy was passed in 1988 and is “re-confirmed” every year, most recently in February, he said.”Now is not the time for us to be weakening the conscience protection for health care workers with the huge changes we are facing with echnological capabilities,” said Dr. Williard Johnston, a Vancouver family physician and president of the Canadian Physicians for Life.
“Now is the time to be strengthening conscience protections so that people who find themselves uncomfortable with procedures should have their rights protected.”
Ms. Saporta argued that physicians must put their patients’ interests ahead of their “own religious and moral convictions.” Refusing to refer women for abortions could result in delays and lead to women having later abortions at an increased risk to their health, she said.
“It is not within the control of the physician who doesn’t want to participate, how much longer the delay will be,” Dr. Johnston countered. “That is entirely the responsibility of the system at large.”
The issue has attracted fervent debate from both sides, with people flooding the Canadian Medical Association Journal with letters following a guest editorial published last year that mis-stated the CMA policy as it urged physicians to ensure access to abortion. The journal had to print a clarification of its policy on abortion last month to try to stem the letter-writing.
Dr. Jeff Blackmer, the CMA’s ethics officer, suggested to the National Post in an earlier interview that only a few things would force a re-evaluation of the policy: a groundswell from the membership one way or another, a legislative review of the issue by the government or a significant decrease in access to abortions.
Last month, advocates for access to abortion released a report that said abortion services were less accessible in Canada than they were three years ago. The study found that only 15.9% of Canadian hospitals provide abortion services, a reduction from 17.8% that occurred without any change in official regulations or policies.
The issue of access will go before the court later this month: the Morgentaler Clinic is suing the government of New Brunswick over provincial regulations that insist hospital abortions be performed by a gynecologist, be approved first by the gynecologist and another doctor, and does not cover the cost of abortions in clinics.
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