National Abortion Federation (American Association of Abortion Providers )- Calls on Canadian Medical Association to Change their Abortion Referral Policy
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Wednesday, May 9, 2007
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National Abortion Federation Calls on Canadian Medical Association to
Change their Abortion Referral Policy
The CMA should not allow physicians to treat abortion referrals
differently than referrals for other health care services.
Victoria, BC/Washington, DC -Today, the National Abortion Federation
(NAF) sent a letter to the Canadian Medical Association (CMA) calling
on them to change their policy of allowing physicians to refuse to
refer patients for abortion services noting that, "a physician's
religious and moral beliefs should not jeopardize a patient's access
to needed care." The complete letter follows:
Dear Dr. Colin McMillan, Dr. Louise M.C. Cloutier, and Dr. Jeff
Blackmer:
The Canadian Medical Association's (CMA) policy of allowing physicians
to refuse to refer patients for abortion services is a violation of
CMA's own Code of Ethics, which requires physicians to first consider
the well-being of the patient; to practice medicine in a manner that
treats the patient with dignity; to disclose and resolve conflicts of
interest in the best interest of patients; not to discriminate against
any patient on grounds such as gender or medical conditions; and to
provide patients with information they need to make informed decisions
about their medical care. Your policy treats women unfairly and
impedes women's access to critical health care guaranteed through the
Canada Health Act.
As you know, abortion is a safe, legal, and insured service under the
Canada Health Act and should be treated the same as all other medical
procedures. In fact, all provinces and territories have recognized
that abortion is a medically necessary procedure. A physician's
religious and moral beliefs should not jeopardize a patient's access
to needed care.
If doctors do not wish to refer and inform patients about their
comprehensive medical options, including abortion care, then they
should not participate in the public system. Refusing to refer women
for abortion care could result in delays that could force women to
have later abortions at an increased risk to their health.
Women in Canada deserve to have access to a full range of safe
reproductive health care options. The CMA should not allow physicians
to treat abortion referrals differently than referrals for other
health care services. A patient's needs must remain paramount.
The National Abortion Federation (NAF) is the professional association
of abortion providers in Canada and the United States. Our members
include health care professionals at clinics, doctors' offices, and
hospitals, who together care for more than half the women in both
countries who choose abortion each year. We set the standards for
quality abortion care in North America, and we have played a leading
role in advocating for increased access to quality abortion care
throughout Canada.
The National Abortion Federation calls on the Canadian Medical
Association to change your policy to come into compliance with your
own ethical standards. By not doing so, you abdicate your moral
authority to set policies regarding health care in Canada.
Sincerely,
Vicki Saporta
President and CEO
National Abortion Federation
The National Abortion Federation (NAF) is the professional association
of abortion providers in Canada and the United States. Our mission is
to ensure safe, legal, and accessible abortion care to promote health
and justice for women. Our members include health care professionals
at clinics, doctors' offices, and hospitals, who together care for
more than half the women in both countries who choose abortion each
year. For more information, visit our website at www.prochoice.org.
Karen
Jeff Blackmer
Executive Director, Office of Ethics, Canadian Medical Association,
Ottawa, Ont.
Can. Med. Assoc. J., Apr 2007; 176: 1310 ; doi:10.1503/cmaj.1070035
A recent editorial in CMAJ1 and subsequent letters to the editor have
raised several questions about the Canadian Medical Association's
position on induced abortion. I would like to clarify that position
with this illustrative case.
Case: You are a family physician practising at a community health care
centre. A 25-year-old patient recently had a positive pregnancy test
and estimates that she is 7 weeks' pregnant. She asks if you will
perform a therapeutic abortion. If not, will you refer her right away
to someone who will perform it? You are morally opposed to abortion.
What are your obligations to this patient?
Discussion: CMA policy2 states that "a physician should not be
compelled to participate in the termination of a pregnancy." In
addition, "a physician whose moral or religious beliefs prevent him or
her from recommending or performing an abortion should inform the
patient of this so that she may consult another physician."
You should therefore advise the patient that you do not provide
abortion services. You should also indicate that because of your moral
beliefs, you will not initiate a referral to another physician who is
willing to provide this service (unless there is an emergency).
However, you should not interfere in any way with this patient's right
to obtain the abortion. At the patient's request, you should also
indicate alternative sources where she might obtain a referral. This
is in keeping with the obligation spelled out in the CMA policy:
"There should be no delay in the provision of abortion services."
Footnotes
Editor's note: We received a large number of letters in response to
the editorial by Rodgers and Downie, with particular regard to the
CMA's policy on induced abortion. We asked the CMA to assist our
readers by clarifying their position using a case-based example, which
they have provided here. We will not publish any further letters on
this topic, unless they present new information or state a new
position on this matter.
REFERENCES
Rodgers S, Downie J. Abortion: ensuring access [editorial]. CMAJ
2006;175(1):9.[Free Full Text]
Induced abortion [CMA policy]. Ottawa (ON): Canadian Medical
Association; 1988