Popular Posts

Monday, June 21, 2010

Can of Worms: The New Brunswick Situation and anti-choice doctors (actually two cans of worms)

A blog reader checked out the G&M article about access and was also struck by what it said about the New Brunswick Situation. (Let's call it NBS for short.) Because I know her, she knows how to get through the no-comment facade of this blog (which you may have noticed has been lifted in an experiment on internet civility that may be short lived). Here's the gist of what she said, in a "to-make-matters-worse" sort of way.

"Two doctors must okay an abortion in NB. Did you know that doctors are able to refuse provision of abortion? It's their right as a practitioner. All they do is inform their employer that they're opposed to it/uncomfortable with it. And their motto is 'do no harm.' Discuss."

This comment makes me want to start a new section on the blog called "Can of Worms." And if I knew how, I would. Consider this the first in the "Can of Worms" installments (as if talking about abortion in the first place isn't it's own giant can of worms.)

Is it ethical for a doctor to refuse to provide a medically necessary service? (Those of us in the reproductive justice movement know that all abortions are medically necessary. After all, women can't do it themselves or in non-medical environments without signifcant risk of harm.) It is ethical to force a doctor to do a procedure that goes against their conscience? Or is this part of what they sign up for when they take up the profession? Or is this just a side issue that pales in comparison to the NBS requiring two doctors' approval in the first place?

My own answer is that I find all of it alarming. Firstly, how can NB get away with imposing conditions that the Supreme Court has already decided infringe on a woman's charter rights? (To read everything the Supreme Court had to say on the matter, click here.) This is clearly unacceptable. My sisters in NB don't have the same rights as I do.

And it's not just my NB sisters. Without access, the right to an abortion is moot. Anyone with barriers to access (say women in PEI who have to leave their province for an abortion, rural women, northern women, Aboriginal women and so on) don't have the same rights as I do as a southern, urban Canadian.

Of course, those who don't want anyone to have an abortion know this, and that's why making access difficult is a tool of in the kit bag of the anti-choice. So it's important to pay careful attention to what's happening to access out there, and stand on guard against incremental changes that eat away at access, even if it eats away at access in a way that doesn't yet affect me personally, at least not yet. Because believe me, if "they" can do that to "her," "they" can do that to me. That's one reason why the Canadian stance on funding abortion in foreign aid is a big deal for all of us, not just "other" women who live "over there."

So, we have to be concerned about the NBS, even if we don't live there.

Now, to the second can of worms. To be clear, it's not just doctors in NB who can refuse to provide abortion services. Doctors anywhere in Canada can. The National Abortion Federation's position on this is that in allowing this, the Canadian Medical Association is in conflict with it's own code of ethics. To see more on this, click here.

I wonder how many of us, when we go to our doctors for the first time, ask them if they are pro-choice? Do we make sure that if we find ourselves in need of their help in a difficult time in our lives we will have it? I bet most of us don't. I know I didn't. We have a right to know the limits of our doctor's willingness to care for us. After all, it speaks to their ethics.

And not only that, there are fewer and fewer medical schools even teaching how to perform the procedure. Why would a medical school refuse to make learning a procedure that one third of Canadian women undergo mandatory? It's not a difficult procedure, and given its frequency, you would think a doctor might want to have some skills in this regard. Oh dear. I think I just opened a third can of worms.

As my commenter suggested, "Discuss."

1 comment:

  1. It’s obvious to me that the process put into place for providing and educating Doctors about how to abort in Canada is flawed, thus it’s necessary for policy makers to approach this process differently. Thus, it’s flawed for the woman seeking abortion.

    Theres’s this guy named Richard Thaler, an economist, who has created a theory he’s coined ‘Nudge Theory’, fully explored in the book Nudge: Improving Decisions about Health, Wealth, and Happiness. He discusses how to design environments that make it more likely for people to act in their own best interests.

    ‘Nudge Theory’ is invaluable for public policy makers and all the policy makers have to do is make it more likely for people to act in society’s own best interests.

    How does ‘Nudge Theory’ work?

    “Rather than leave people to their own devices, or give them dos and don'ts, Thaler and other behavioural economists want to highlight the best option, while still leaving all the bad ones open. They argue it's better for everyone to be automatically enrolled in a pension scheme (or more controversially for organ donation), but give them an opt-out.”

    To extrapolate, public policy must dictate the following:
    1. Abortion services provided through government clinics with reasonable catchments.
    2. Abortion education provided to all Doctors in medical programs across Canada. If a Doctor wishes to opt out, they may do so by providing their reasoning in writing.

    Women are then able to automatically access abortion services with an opt-out. That is to say, women are free to not access abortion services.

    At present, the system is set up for Doctors to make no decision and that’s paternalistic in the extreme.


Note: Only a member of this blog may post a comment.