Happily, not every doctor or physician is in favour of abortion, but what challenges are those who oppose it faced with in Canada? Sean Murphy, Administrator for the Protection of Conscience Project, is an advocate for the exercise of freedom of conscience in health care who was kind enough to answer my inquiries into the situation for physicians.
1) What (if any) discrimination exists for physicians whose religion/beliefs restricts them from performing an abortion?
Many physicians decline to provide abortions, especially those done after about 14 to 16 weeks gestation. The Canadian Medical Association prohibits discrimination against physicians who refuse to provide or assist in abortions. The CMA sates: “Respect for the right of personal decision in this area must be stressed, particularly for doctors training in obstetrics and gynecology, and anesthesia.”
Generally speaking, abortion activists do not believe that objecting physicians should be compelled to provide abortions themselves. Henry Morgentaler, for example, opposes such coercion because “doctors should not be obliged to do things which they don’t approve of themselves” and “a doctor who doesn’t believe in it is more likely not to do a good job.”
Thus, open and direct discrimination against physicians who refuse to participate in surgical abortions has not been evident in Canada, though it has occurred elsewhere. Anecdotal reports indicate that physicians may occasionally encounter pressure to participate in abortions and that objecting physicians may sometimes experience adverse reactions among colleagues. The more common problem is a demand that objecting physicians dispense potentially abortifacient or embryocidal drugs or devices, or facilitate abortion by referral or by some other means.
Medical students, junior practitioners, nurses and other health care workers are more vulnerable to coercion and have experienced discrimination in Canada, including denial of employment and dismissal.
2) What (if any) legal obligations does a doctor have when a women requests an abortion that they themselves will not perform?
In Canada, if a woman who is pregnant requests an abortion or seems adverse to having a child, her physician is obliged to disclose and discuss all legal options, including adoption and abortion, so that she is aware of legal choices available to her and the benefits and harms associated with them. The physician is obliged to tell her if he is unwilling to provide an abortion for reasons of conscience or for other reasons, so that she can seek the assistance of another physician who is willing to assist.
Except in Quebec, a physician is currently under no obligation to facilitate a procedure to which he objects by providing referrals or other assistance in locating a service provider. Some physicians would object to providing such assistance because of concern that it makes them morally complicit in the procedure. The Project’s view is that the demand for referral for abortion that is made by the Collège des médecins du Québec is unacceptable. Like all standards of practice and codes of ethics developed by provincial regulatory authorities, it is subject to a challenge under human rights legislation.
Over the last number of years, abortion activists have been making increasingly strident demands that objecting health care workers facilitate abortion by referral. To this end, they are attempting to use human rights theory and legislation as weapons to attack freedom of conscience in health care.
I am grateful to Mr. Murphy and the Protection of Conscience Project for their work and continued support for physicians, because not every doctor is on the side of Dr. Garson Romalis whose delivery of this message at the University of Toronto leaves me speechless (the medical student’s choice of words is remarkable).
I want to tell you one last story that I think epitomizes the satisfaction I get from my privileged work. Some years ago I spoke to a class of University of British Columbia medical students. As I left the classroom, a student followed me out. She said: “Dr. Romalis, you won’t remember me, but you did an abortion on me in 1992. I am a second year medical student now, and if it weren’t for you I wouldn’t be here now.”