From Expectation to Demand: A Coming Conflagration?
1. Lewis, C.S., Screwtape Proposes a Toast and Other
Pieces. London and Glasgow: Collins (Fontana Books) 1974, p. 18, 25
2. Stein, Rob,"Health
Workers' Choice Debated: Proposals Back Right Not to Treat."
Washington Post, 30 January, 2008. Accessed 2008-11-28.
3. Miller, Jennifer,"Bioethics,
objection of conscience & clinician autonomy." Bioethics International,
30 November, 2007. Accessed 2008-11-28.
Submission to the College of Physicians and Surgeons of Ontario Re:
Physicians and the Ontario Human Rights Code. Protection of
Conscience Project, 12 September, 2008.
5. Smith, Wesley J, Second Hand Smoke,"Speaking
Truth to Power: European Cases Presage Huge "Conscience Rights" Bioethics
Fights to Come." 18 November, 2008. Accessed 2008-11-18.
6. Canning, Cheryl,"Doctor's
faith under scrutiny:Barrie physician won't offer the pill, could lose his
licence."The Barrie Examiner, 21 February, 2002.
of Victoria, Australia demands referral, performance of abortions."
Protection of Conscience Project.
8. Golde, Polo Black,"California
Court Comes Out: The Bioethics of Benitez." Bioethics Forum, 22
August, 2008. Accessed 2008-11-28.
9. Deibert, "Dave,"Sask.
doctors resign over tubal ligation policy." Victoria Times Colonist,
21 December, 2006. Accessed 2008-11-28.
"Woman given settlement after being denied tubal ligation." CBC News,
13 September, 2007. Accessed 2008-11-28.
11. French, Janet,"Region
to control Humboldt hospital." The Star Phoenix, 20 September,
2007. Accessed 2008-11-28.
Maputo Plan of Action for the Operationalisation of the Continental Policy
Framework for Sexual and Reproductive Health Rights, 2007-2010.
African Union, Special Session of the African Union Conference of Ministers
of Health, Maputo, Mozambique 18-22 September, 2006. Accessed 2008-11-28.
to the African Charter on Human and Peoples' Rights on the Rights of Women
in Africa. African Union, 2nd Ordinary Session of the Assembly of
the Union, Maputo, 11 July, 2003 Accessed 2008-11-28.
made in mainstreaming gender equality into Poland's national legislation,
women's anti-discrimination committee told." UN General Assembly
WOM1591, Dept. Of Public Information, 16 January, 2007. Accessed 2008-11-28.
"Portugal moves to legalize abortion." Catholic Culture, Catholic
World News Feature Stories, 12 March, 2007. Accessed 2008-11-28.
15. Hoffman, Matthew Cullinan,"Portuguese
Government Orders Doctors to Remove Anti-Abortion Restrictions from Code of
Ethics: Portuguese Bar Association denounces decision as 'arrogant and
overbearing.'" LifeSiteNews.com, 22 October, 2007. Accessed
2008-11-28. Almeida, Henrique,"Portugal
doctors stand by anti-abortion principles." Reuters, 15 November,
2007. Accessed 2008-11-28.
16. Hoffman, Matthew Cullinan,"Portuguese
Government to Prosecute Doctors Group Over 'Illegal' Anti-Abortion Ethics
Policy." LifeSiteNews.com, 22 November, 2007. Accessed
17. Hoffman, Matthew Cullinan,"Portuguese
Physicians Capitulate to Pressure to Change Ethical Code to Allow
Abortions."LifeSiteNews.com, 11 July, 2008. Accessed 2008-11-28.
"Spanish Party Platform Challenges Abortion Conscience Clause." Catholic
Culture, Catholic World News Feature Stories, 28 February, 2008.
"Church in India
Condemns Judge's Sterilization Order." Zenit, 23 February, 2006.
"Catholic nurses under pressure to assist abortions." Spero News,
18 May, 2006. Accessed 2008-11-28.
21. Wilkinson, Isambard,"Nurse
raped for refusal to carry out abortions." The Telegraph, 27
February, 2006. Accessed 2008-11-28.
"Hospitals must provide euthanasia." Expatica, 18 April, 2007. Accessed
28 November, 2008.
23. Murphy, Sean,"Belgium:
mandatory referral for euthanasia." Protection of Conscience Project,
24. R Sparrow, Right of the living dead? Consent to
experimental surgery in the event of cortical death. J. Med. Ethics, Oct
2006; 32: 601 - 605.
S Curry, Living patients in a permanent vegetative state as legitimate
research subjects. J. Med. Ethics, Oct 2006; 32: 606 - 607.
H Draper, Research and patients in a permanent vegetative state. J.
Med. Ethics, Oct 2006; 32: 607.
J Thompson, Relatives of the living dead. J. Med. Ethics, Oct 2006;
32: 607 - 608.
N Levy, A Ravelingien, J Braeckman, F Mortier, E Mortier, and I Kerremans,
Respecting rights ... to death. J. Med. Ethics, Oct 2006; 32: 608 -
25. "Sister Frances described Mr Wallis as "delightful,
intelligent and aware young man". "I know that some people will say 'You are
a Christian foundation. What are you thinking about?'. But we are here for
all faiths and none," she said. "It is not our job to make moral decisions
for our guests. We came to the conclusion that it was our duty of care to
support Nick emotionally and to help ensure his physical safety." Payne,
helped dying man lose his virginity." The Telegraph, 31 January,
2007. Accessed 2008-11-28.
26. Choy, Heather Low,"Sex
visits organised for disabled men." news.com.au, Tasmania News,
28 September, 2005.
27. Dooley, D.
"Conscientious refusal to assist with abortion" (Editorial). BMJ
1994;309:622-623 (10 September) Accessed 2008-11-30.
28. The Spanish pro-life group Provida reported that, a
year after abortion was legalized in Spain, only 2 out of 100 gynaecologists
in a Madrid hospital were willing to perform them. By 2004, abortions had
been performed by only one doctor at the largest hospital in Valencia."96%
of gynecologists in Spain refuse to perform abortions". Catholic News
Agency. Accessed 2006-06-13.
"Abortion-Care Education Is Deficient in U.S. Health Professional Training".
Joint Announcement from Ibis Reproductive Health, the National Abortion
Federation, and the Abortion Access Project, 9 May, 2006. Accessed
Finer, Lawrence B., and Henshaw, Stanley K., "Abortion Incidence and Service
in the United States in 2000." Perspectives on Sexual and Reproductive
Health, Vol. 35, No. 1 January/February, 2003
Ceci Connolly , Ceci,"Number
of Abortion Providers At Its Lowest in Three Decades." Washington
Post, 22 January, 2003. Accessed 2006-07-02.
30. What constitutes a late term abortion is a somewhat
subjective question. If we take fetal viability as a marker for what
constitutes a 'late term' abortion, statistics in the United Kingdom show
that as many as 50 babies survive abortions each year in the United Kingdom.
"Fifty babies a year are alive after abortion." The Sunday Times,
27 November, 2005. Accessed 2006-06-13.
Consider what is implied in the following resolution: "That this Meeting
calls upon the MSC and BMA to work with the GMC, NHS and appropriate Royal
Colleges to ensure that babies born alive as a result of termination of
pregnancy procedures receive the same full neonatal care as that available
to other babies."BMA Annual Representative
Meeting, 2004. Accessed 2006-06-13.
31. A survey conducted in 1998, years afer legalization
of abortion in the United States, found that most of the 1,200 nurses
surveys wanted as little to do with abortion as possible. Poggenpoel, M.,
Myburgh, C., & Gmeineer, A., (1998, September). "One voice regarding the
legislation of abortion: Nurses who experience discomfort." Curationis,
pp. 2-7. Cited in Marek, Marla J., "Nurses' Attitudes Toward Pregnancy
Termination in the Labor and Delivery Setting." JOGNN, 33, 472-479; 2004
32. The reluctance of Scots physicians to provide
abortions after 15 weeks gestation has resulted in women travelling to
England for the procedure. "Ian Jones, chief executive of the BPAS . . .
admitted that it could be difficult to find doctors and nurses, particularly
in the west of Scotland, who were prepared to work at the clinic. He said
the fact that so many women needed to travel to England for late abortions
reflected the fact that medical staff in Scotland do not want to perform
them." Templeton, Sarah Kate,"Private
firm plans Scottish abortion clinic." The Sunday Herald, 19
January, 2003. Accessed 2006-06-13. On the other hand, abortions can be
obtained in some locations very late into pregnancy. Foster, Kate,"Hospital
Admits Abortion At 34 Weeks." Scotland on Sunday, 10 April 2005.
A shortage of willing Canadian physicians caused women from Ontario and
Quebec to go to the United States for late term abortions. Quebec Health
Minister Philippe:"'In Quebec, our doctors at the present time don't feel
comfortable doing abortions later than 22 weeks. From 20 to 22 weeks they're
all done in Sherbrooke, after that we still don't have the capacity to do
hopes to offer late-term abortions." CBC News, 10 September,
2004. Accessed 2006-06-13.
By 2002 there had been a 578 percent increase in the numbers of abortions
performed at 20 to 21 weeks gestation in Canada."Discovery
of birth defects leads to abortions: study." CBC News, 28 March,
2002. Accessed 2006-06-13. The news report, drawing on Statistics Canada
figures, noted that 96.7% of abortions in 2001 were performed before the
16th week. Since there were 105,154 abortions in 2001, about 3,480 abortions
were performed after the 16th week: about nine per day.
11 February, 2005. Accessed 2006-06-13.
Two to three abortions performed up to and beyond 24 weeks gestation were
reported to be occurring each week in an Alberta hospital, many resulting in
live births of infants. [Ko, Marnie,"Down
the Slope to Infanticide: Nurses At Foothills Hospital Rebel Over The
Horrifying Results Of Late-Term 'Genetic Terminations.'" Alberta
Report Newsmagazine. May 3, 1999.
And, for the same reason, a district health board in New Zealand has decided
to subsidize travel to Australia for women who want second trimester
College calls for conscience decision on second trimester abortions."
Radio New Zealand,11 March, 2006. Accessed 2006-03-11.
33. Doctors at a hospital in Lyon, France, resigned en
masse when administrators instructed them to implement a new law raising the
gestational limit for abortion from 10 to 12 weeks. A study by the Jérôme
Lejeune Foundation of the situation in Lyon found "intense reluctance" among
doctors to carry out the later term abortions."French
Doctors Rethinking Abortions in Face of New Law: At One Hospital, Physicians
Quit en Masse." Zenit, 7 November, 2001. Accessed 2006-06-13.
34. "Consultants opposed to the killing of the twin,
who had been diagnosed with a serious but operable heart defect, have
threatened to bring a legal action for unlawful killing against the Royal
Victoria Infirmary in Newcastle."
"Doctors Revolt over Last-Minute Abortion of Twin." British Nursing
News On Line, 10 November, 2002. Accessed 2006-06-13.
35. Dr. Ward's survey of Western Cape physicians found
that half would not do abortions for non-lethal congenital abnormalities.
More important was his finding that 46% would refuse to perform abortions
for socio-economic reasons; less than a third were willing to do so. Ward,
State Doctors in the Western Cape willing to implement the Choice of
Termination of Pregnancy Act of 1996? An opinion survey conducted in the
Western Cape in November 1997. In fulfillment for the requirements
of the FCOG (S.A.) part 2.
95% to 99% of nurses surveyed in the California study I have mentioned would
refuse involvement in sex selective abortion; the rate of objection to
selective reduction in multifetal pregnancies ranged from 71% to 92%. Marek,
Marla J., "Nurses' Attitudes Toward Pregnancy Termination in the Labor and
Delivery Setting." JOGNN, 33, 472-479; 2004. The range in both cases
reflects responses that differed according to gestational age.
36. For example: a study in the United Kingdom found
that nurses developed increasingly negative attitudes to abortion the longer
they worked in units where it was provided. Marshall, S.L., Gould, D. &
Roberts, J. (1994) "Nurses' attitudes towards termination of pregnancy."
Journal of Advanced Nursing, 20, 567-576. Cited in Marek, Marla J., "Nurses'
Attitudes Toward Pregnancy Termination in the Labor and Delivery Setting."
JOGNN, 33, 472-479; 2004.
Abortion had been legal in Britain for over a generation when a third of
junior doctors were reported to be conscientious objectors to the procedure.
Objection to Abortion." Triple Helix, Winter, 2001.
A survey by RN magazine disclosed that the number of nurses who refused to
work in a unit where abortions were performed had increased over ten years
from 48% to 61%.
Ventura, M.J. (1999) "Where nurses stand on abortion." RN, 62(3), 44-48.
Cited in Marek, Marla J., "Nurses' Attitudes Toward Pregnancy Termination in
the Labor and Delivery Setting." JOGNN, 33, 472-479; 2004.
Recent Californian research found rates of conscientious objection among
nurses ranging from 23% to 99%, depending upon the reasons for the
procedures. Moreover, two hospitals declined to participate in the survey
because of fear that it would "stir up negative feelings" among staff: this,
thirty years after the legalization of abortion in the United States. Marek,
Marla J., "Nurses' Attitudes Toward Pregnancy Termination in the Labor and
Delivery Setting." JOGNN, 33, 472-479; 2004.
On the other hand, other researchers have noted that experience has led to
the development of more positive attitudes toward the procedure. See Meta
Hammarstedt, Lars Jacobsson, Marianne Wulff and Ann Lalos, Views of midwives
and gynecologists on legal abortion - a population-based study. Acta
Obstetricia et Gynecologica Scandinavica, Volume 84 Page 58 - January
2005 doi:10.1111/j.0001-6349.2005.00695.x Volume 84 Issue 1: "The more
experience of working with legal abortion, especially current experience,
the less restrictive gynecologists and midwives are in their views. Compared
with previous studies, staffs have become more liberal in their attitudes
toward abortion and the relevant legislation."
37. Sometimes this collision is unintended. In England,
for example, the Royal College of Nursing general secretary has suggested an
expanded role for nurses in abortion. She stated that the organization wants
to increase access to abortion in the early stages of pregnancy "and allow
nurses greater involvement in providing services." While the general
secretary affirmed the right of nurses to refuse to participate, she does
not appear to have recognized that expecting more nurses to participate in
abortion will increase the probability of pressure on conscientious
Says No Need for Change in Abortion Law." RCN News Release, 30
June, 2005. Accessed 2006-06-12.
38. The Center for Reproductive Rights secret policy -
exposed by CFAM, despite threats of civil action - is based on this.
39. Planned Parenthood,
Refusal Clauses: A Threat to Reproductive Rights Accessed
2006-06-13. National Abortion Rights Action League,
Refusal to Provide Medical Services. Accessed 2006-06-13.
40. The Contraception Report: A State by State
Review of Access to Contraception. NARAL Foundation, 2001, p. 11
(Available through http://www.popline.org/docs/274304).
41. Quoting Nancy Yanofsky of the ProChoice Resource
Center. Good, Regan,"Pharmacies
New Reproductive Rights Battleground." Wenews, 13 August, 2002.
42. "Pro-Choice Michigan's executive director, Rebekah
Warren, said 'these big, blanket conscience clauses really could deny
patients access to the medical care that they need, to the information that
they need and to referrals that they need.'" Komp, Catherine,"'Conscience
Clauses' Could Usher Healthcare Access Crisis." New Standard, 29
March, 2006. Accessed 2006-03-30.
43. The executive director of the New York affiliate of
the National Abortion and Reproductive Rights Action League, Ms. Kelli
Conlin, said she wanted to be sure that all of New York's mayoralty
candidates were "committed to ensuring that medical residents at city
hospitals were trained in abortion procedures." Bumiller, Elisabeth,"Abortion
Rights Leader Mulling Endorsement in Mayoral Race." New York Times,
6 April, 2001. Accessed 2006-06-13.
"Joyce Arthur, a spokesperson for the Pro-Choice Action Network in
Vancouver, says all students, including pro-life ones, should be compelled
to learn about abortions and refer patients to pro-choice doctors, whether
they like it or not. 'It's sort of an obligation that they learn about this
basic and very common medical procedure,' she says. She adds that if
prolifers cannot stomach this, then 'they shouldn't be a doctor,' and they'd
have to find a different profession." O'Neill, Terry,"Should
doctors be forced to abandon their faith?" Western Standard Magazine,
A trustee of the Center for Reproductive Rights stated: "Abortion is a
medical procedure and all medical students who are in the OB/GYN specialty
should be required to learn the procedure. Medical school curricula must
address this." The Center for Reproductive Rights: Summary and Synthesis
of Interviews (E2545) (See note 53)
A journalist researching Medical Students for Choice noted that its brochure
outlined the goal of having "all medical students train to be abortionists."
Edwards, Greg J.,Medical
Students for Choice: Pro-choice group at UBC hard to locate, unless you're a
Medical Students for Choice encourages medical schools to include the
following in their curriculum for all students (emphasis
â€¢ didactic instruction on the public health, social and historical context
â€¢ medical and surgical abortion techniques
â€¢ pre- and post-abortion management
â€¢ pregnancy-options and contraceptive counseling.
Medical Students for Choice Policy
on Abortion Training. Accessed 2006-06-13
44. McLeod, Carolyn, "Demanding Referral in the Wake of
Conscientious Objection to Abortion." In Cohen, JC and Keelan, JE (Eds.)
M C I S B R I E F I N G S: Comparative Program on Health and Society, Lupina
Foundation Working Papers Series 2004-2005 (January, 2006). Munk
Centre for International Studies, University of Toronto. Accessed
45. The Abortion Non-Discrimination Act (USA) was added
to an omnibus spending bill, which passed the House of Representatives in
November, 2004. The amendment was attacked by ostensibly 'pro-choice'
groups, including Planned Parenthood, the National Organization for Women
(NOW) and the National Abortion Rights Action League (NARAL).
'Pro-choice' groups attack freedom to choose: NARAL, NOW and Planned
Parenthood (November, 2004). Protection of Concience Project.
46. During a CTV News interview on 2 June, 2001, the
executive director of Planned Parenthood in Calgary, Alberta, claimed that
physicians who object to abortion for reasons of conscience are ethically
obliged to refer patients for abortion. The assertion was false. Murphy,
Parenthood and "Anti-Choice" Rhetoric." Protection of Conscience
47. Toneguzzi, Maria, "Planned Parenthood Targets
'Anti-choice' Docs." Calgary Herald, 19 August, 2004.
Planned Parenthood Alberta,
Aware of Anti-Choice Doctors and Radiologists. Accessed 2004-08-28.
"Abortion groups are launching a campaign to name doctors who refuse to help
women seeking terminations. . . In an even more aggressive move, patients
are being urged to report to the General Medical Council (GMC) doctors who
refuse to play any role in terminations." Templeton, Sarah Kate,"Abortion
lobby in campaign to expose pro-life doctors." The Sunday Times,
17 July, 2005. Accessed 2006-06-13.
Foster, Charles, "Conscientious
objection to abortion - ethics, polemic and law." Triple Helix,
48. For example, the Center for Reproductive Rights
Board of Directors includes:
Executive Committee Members
Nicki Nichols Gamble (Vice Chair), Former President and CEO, Planned
Parenthood of Massachusetts
Francis W. Hatch, III (Vice Chair), Chairman, The John Merck Fund
Betsy K. Karel (Chair), Board Chair, Trellis Fund
Nancy J. Northup (Ex-Officio 1/13/03), President, Center for Reproductive
Laurie G. Campbell (Treasurer and Chair of Finance Committee)
Jane E. Hodgson, MD, MS, FACOG, Founding Fellow, America College of
Sylvia A. Law, Elizabeth K Dollard Professor of Law, Medicine and
York University Law School
Marcie J. Musser, Vice President and Treasurer of the Board, General Service
Nafis Sadik, MD, Special Envoy for United Nations, Secretary General for
in Asia and Pacific
Sheldon J. Segal, PhD, MD, FRCOG (Secretary), Distinguished Scientist, The
Marshall M. Weinberg, Board Member, American Jewish Joint Distribution
The Center for Reproductive Rights Board of Directors - Primary Affiliation
Information (E2547) (See note 30)
In Canada, the following individuals are among those active against
freedom of conscience in health care:
Jocelyn Downie, B.A. (Queen's) 1984; M.A. (Queen's) 1985;
M.Litt. (Cambridge) 1990; LL.B. (Toronto) 1993; LL.M. (Michigan)
1996; S.J.D. (Michigan) 1999
Canada Research Chair in Health Law and Policy
Professor, Faculties of Law and Medicine, Dalhousie University.
Bernard Dickens, LL.B. King's College, University of London,
1961; Barrister, English Bar (Inner Temple), 1963; LL.M. King's
College, University of London, 1965; Ph.D. (Criminology Division of
Law), King's College, University of London, 1971; Barrister &
Solicitor, Ontario Bar, 1977; LL.D. (Medical Jurisprudence)
University of London, 1978.
- Professor Emeritus of Health Law and Policy, Faculty of Law,
University of Toronto
Professor Emeritus, Faculty of Medicine, University of Toronto
Professor Emeritus, Joint Centre for Bioethics, University of
- Chair, Research Ethics Board, Health Canada, Ottawa
Departmental Editor for Ethics, American Journal of Public
Member, Standing Committee on Ethics, Canadian Institutes of
Health Research Member, Committee on Ethical Aspects of Human
Reproduction & Women's Health,
International Federation of Gynaecologists and Obstetricians
Member, Editorial Advisory Board, Bibliography of Bioethics,
Kennedy Institute of Ethics,
Georgetown University, Washington, D.C.
- F.R.S.C. Royal Society of Canada, 1998
O.C. Officer of the Order of Canada, 2006
LL.D. (Honoris Causa), University of Sherbrooke, 2007
Rebecca Cook, J.S.D. 1994, LL.M. 1988 (Columbia University, School of
Law); J.D. 1982 (Georgetown University Law Center); M.P.A. 1973 (Harvard
University, Kennedy School of Government) M.A. 1972 (Tufts University,
Fletcher School of Law and Diplomacy); A.B. 1970 (Barnard College, Columbia
University); Attorney 1983 (Washington, D.C. Bar)
- Faculty of Law Professor in International Human Rights, University
Co-Director, International Programme on Reproductive and Sexual Health
Professor, Faculty of Medicine, Department of Health Policy, Management
- 1999 Fellow, Royal Society of Canada
1998 Ludwik and Estelle Jus Memorial Human Rights Prize, University of
1997 Certificate of Recognition for Outstanding Contribution to the
Promotion of Women's Health, awarded by the International Federation of
Gynecologists and Obstetricians
Sanda Rodgers, B.A. (Case Res.), LL.B. (McGill), B.C.L. (ibid.), LL.M.
(Mtl.), of the Bar of Ontario, Full Professor
Professor and former Dean of the Faculty of Law, University
of Ottawa; Shirley Greenberg Professor in Women and the
Legal Profession; recipient of the Women Lawyers Association
Award for Outstanding Contribution to the Legal Profession
and the Ottawa Women's Choice Award for Outstanding
Contributor to Gender Equity.
- In 2000 she was an Elected Bencher: Law Society of Upper Canada .She
is an expert in Canadian health law, more particularly in women's
reproductive health; an Adjudicator under the Grandview Agreement
between Ontario and the Grandview Survivors Group and was the sole
Adjudicator of the Agreement for Compensation for the Sir James Whitney
School for the Deaf.
- She was a Commissioner, Ontario Law Reform Commission and a
Consultant to the Royal Commission on New Reproductive Technologies and
the Krever Commission on Confidentiality of Health Information, among
others. She is a member of the Board of Directors of the Court
49. ". . . hospital boards should never have been
allowed a choice in the matter. The Government should . . . require
hospitals which receive public grants to establish abortion committees."
Globe and Mail, 18 January 1974. Quoted in de Valk, Alphonse,
Morality and Law in Canadian Politics: The Abortion Controversy. Dorval,
Quebec: Palm Publishers, 1974, p. 137
A Chinese doctor testifying before an Australian Senate Committee in 1999
stated that conscientious objection to the state's "one-child-policy"was not
allowed, and that doctors who refused to perform abortions would go to jail.
Chinese health care workers
and the 'one-child' policy:China (1983-1999) Protection of
"Feminist organizations in Equador have set up tribunals operating within
the legal framework of the government which will investigate violations of
'gender rights' including the 'refusal to perform legal abortions.'" (Inter
Press Service, December 17 1999) Accessed 2006-06-13.
While visiting East Timor in 2000, Dr. Robert Walley of MaterCare
International was alarmed by the conduct of officials from the World Health
Organization and CNRT, and "struck by how aggressive they were in imposing
their views and their values on the people." He found that Timorese doctors
felt "oppressed," and were concerned about the secrecy of WHO and CNRT
activities. "They asked for help in developing a separate Catholic system
which would provide care in accordance with the values of the Timorese
letter from Dr. Robert Walley for help". Catholic Insight,
October, 2000, Vol. VIII, No. 8, p. 4.
Arthur Schafer, director of the Centre for Professional and Applied Ethics
at the University of Manitoba, asserted that conscientious objectors who
refuse "legal services" (ie., the 'morning after pill') to patients who have
nowhere else to go should leave the profession, apparently settling an
ethical problem by appealing to law. Jacobs, Mindelle, "Pharmacists want
right of refusal," Edmonton Sun, 16 April, 2000
In 2001 the French senate passed a law to compel French Polynesia to
publicly fund abortions, despite objections from the Polynesian government
that the law was contrary to the territory's religious traditions. The law
was affirmed by the French Constitutional Council."Parish
court rules French Polynesia must pay for abortion." LifeSiteNews.com,
6 July, 2001. Accessed 2008-11-30
Consider an article in The Guardian newspaper in Britain. None of six
women interviewed had had medical reasons for abortion, and not one of them
said that she had encountered any difficulty obtaining an abortion, but the
author asserted that physicians opposed to abortion are "able to block
access to services on the basis of moral opposition." Shabi, Rachel,"One
in Three." The Guardian, 12 October, 2002. Accessed 2006-06-13.
In 2005 a group of European experts demanded that physicians who object to
abortion for reasons of conscience should be compelled to refer patients to
someone who will provide the procedure. Their opinion concerned a concordat
between the Slovak Republic and the Holy See that would have protected
freedom of conscience in the Republic.
Opinion No. 4-2005: The Right to Conscientious Objection and the Conclusion
by EU Member States of Concordats with the Holy See. EU Network of
Independent Experts on Fundamental Rights, 14 December, 2005, p. 20.
50. The progression is neatly illustrated by the name
changes of a prominent American abortion advocacy group: from the "National
Association for the Repeal of Abortion Laws" (1969) to the "National
Abortion Rights Action League" (1973) to the "National Abortion and
Reproductive Rights Action League" (1993).Key
Moments in NARAL Pro-Choice America's History. Accessed 2006-06-22.
51. Similarly, in Canada, Toronto's Globe and Mail,
advocated legalization of abortion "to enable doctors to perform their
duties according to their conscience and their calling."
"Free the Doctor",Globe and Mail, 18 May, 1965. Quoted in de Valk, Alphonse,
Morality and Law in Canadian Politics: The Abortion Controversy.
Dorval, Quebec: Palm Publishers, 1974, p. 18]. Two years later the Globe
argued that, in the case of abortion, "where religious moralities conflict,
the State should support none, but leave the choice to individual
conscience." "Now the job is to be done, let it be done right", Globe and
Mail, 21 December, 1967. Quoted in de Valk, supra, p. 56
52. The assurance given by a Canadian M.P. to a
parliamentary committee studying her private member's bill to legalize
abortion. Quoted in de Valk, supra, p. 44-45
Similar assurances came from the Canadian Welfare Council: "At the risk
of labouring the obvious, no woman will be required to undergo an abortion,
no hospital will be required to provide the facilities for abortion, no
doctor or nurse will be required to participate in abortion." Standing
Committee on Health and Welfare,
Minutes of Proceedings and Evidence, Appendix "SS": Canadian Welfare
Council Statement on Abortion to the House of Commons Standing Committee on
Health and Welfare. February, 1968, p. 707.
Nor was the Catholic Hospital Association concerned: "We note that there
is no question of [our hospitals] being obliged to change their present
norms of conduct. On the contrary, proponents of a 'liberalized' abortion
law admit that it should exempt those who object to being involved in
procuring abortions." Standing Committee on Health and Welfare,
Minutes of Proceedings and Evidence, Appendix "QQ": Brief submitted by the
Catholic Hospital Association of Canada . . . on the Matter of Abortion.
February, 1968, p. 8058-8059]
Canadian Prime Minister John Turner rejected a protection of conscience
amendment to the government bill legalizing abortion because, he said, the
proposed law imposed no duty on hospitals to set up committees, imposed no
duty on doctors to perform abortions, and did not even impose a duty on
doctors to initiate an application for an abortion.
Debates, 28 April, 1969, p. 8069
53. CRR documents obtained by the Catholic Family and
Human Rights Institute (CFAM) were entered in the United States
Congressional Record (p. E2535 to E2547) on 8 December, 2003, to forestall
efforts by the Center to suppress dissemination of the documents through
litigation. They are available on the
Conscience Project website.
The documents cited herein are:
International Legal Program Summary of Strategic Planning: Through
October 31, 2003 (E2535)
ILPS Memo # 1- International Reproductive Rights Norms: Current
ILPS Memo #2- Establishing International Reproductive Rights Norms:
Theory of Change (E2538-E2539).
Domestic Legal Progam Summary of Strategic Planning Through October
31, 2004 (E2539)
DLPS Memo #1- Future of Traditional Abortion Litigation (E2539-2540);
DLPS Memo #2- Report to Strategic Planning Participants From Systematic
Approach Subgroup (E2540-E2541).
DLPS Memo #3- Report to Strategic Planning Participants From "Other
Litigation" Subgroup (E2541-E2542).
Program Strategies and Accomplishments (E2543)
The Center for Reproductive Rights: Summary and Synthesis of Interviews
The Center for Reproductive Rights Board of Directors - Primary
Affiliation Information (E2547)
54. Which the "Other Litigation Subgroup" believed
undermined the credibility of the CRR with respect to the interests of
"women of colour." DLPS Memo #3, E2541) One of the Center's trustees
also expressed concern that much of the funding from individuals was coming
from donors over 60 years old ( The Center for Reproductive Rights:
Summary and Synthesis of Interviews, E2546)
55. ". . .both the ICPD Programme of Action and the
Beijing PFA reflect an international consensus recognizing the inalienable
nature of sexual rights." ILPS Memo # 1, 2537
56. International Planned Parenthood Federation,Sexual
rights: an IPPF declaration. Adopted May, 2008. Accessed 2008-11-28
57. "Legally binding or ''hard'' norms are norms
codified in binding treaties such as the International Covenant on Civil
and Political Rights (ICCPR) or the Convention on the Elimination of
All Forms of Discrimination Against Women (CEDAW)" ILPS Memo # 1,
58. The Center acknowledges that there is no binding
international legal instrument that recognizes a right to abortion. ILPS
Memo # 1, E2536
59. "The ILP's overarching goal is to ensure that
governments worldwide guarantee reproductive rights out of an understanding
that they are legally bound to do so." International Legal Program
Summary of Strategic Planning: Through October 31, 2003 (E2535)
"Our goal is to see governments worldwide guarantee women's reproductive
rights out of recognition that they are bound to do so." ILPS Memo #1,
E2537; ILPS Memo # 2, E2538.
"The Center needs to continue its advocacy to ensure that women's ability to
choose to terminate a pregnancy is recognized as a human right." ILPS
Memo # 2, E2539
"Advocates use of enforcement mechanisms can help cultivate a "culture" of
enforcement . . ." ILPS Memo #2, E2539
Pursuing the notion that abortion is part of "the fundamental rights strand
of equal protection" is one of the suggestions in the report of the "Other
Litigation" Subgroup, DLPS Memo #3, E2540. To establish abortion as a
"fundamental" right would give it precedence over less "fundamental" rights
in cases of conflict.
60. The norms offer "a firm basis for the government's
duties, including its own compliance and its enforcement against third
parties."ILPS Memo #2, E2538
61. "Supplementing . . .binding treaty-based standards
and often contributing to the development of future hard norms are a variety
of 'soft norms.' These norms result from interpretations of human rights
treaty committees, rulings of international tribunals, resolutions of
inter-governmental political bodies, agreed conclusions in international
conferences and reports of special rapporteurs. (Sources of soft norms
include: the European Court of Human Rights, the CEDAW Committee, provisions
from the Platform for Action of the Beijing Fourth World Conference on
Women, and reports from the Special Rapporteur on the Right to Health.)."
ILPS Memo # 1, E2535
62. ILPS Memo # 2, E2538.
63. Whether or not the effect would be absolute would
depend upon the relative value assigned to freedom of conscience vis a vis a
'right' to abortion. If both were considered equally fundamental, some
tradeoffs might be permitted.
64. The Center also recognizes the importance of public
opinion and public education. "Public education and awareness building" is
identified as one form of advocacy (ILPS Memo # 2, E2539; DLPS
Memo #2, E2540-E2541). The CRR recognizes that it is important to use
arguments that are "appealing and understandable to the public" (DLPS
Memo #2, E2540), and, similarly, the limited appeal of highly technical
or legalistic approaches (DLPS Memo #2, E2541). It is foreseen that
enforcement of new rights might require "sustained public awareness-raising
campaigns" in addition to support from the medical community and others. One
concern raised in the documents is the possibility that to try to formally
establish "reproductive rights" in a new international instrument might, "as
a matter of public perception," undermine CRR's claims that such rights
already exist (ILPS Memo # 1, E2538). It also encourages and takes
advantage of favourable domestic political developments: ". . . the national
political moment may be ripe for change, with or without the influence of
international standards. Such changes. . . particularly in key countries in
a region, may have a catlytic effect on neighbouring countries." (IPLS
Memo #2, E2539).
65. ILPS Memo #2, E2538)
66. The Center seeks ways to bring its agenda "into the
mainstream of legal academia and the human rights establishment"(ILPS
Memo #2, E2539), seeing the media as a way to bring it "to the attention
of relevant international, regional and national normative bodies, including
legislators, other government officials, local and international judicial
bodies, as well as medical bodies that can influence law and policy" (ILPS
Memo #2, E2539).
67. DLPS Memo #1, E2539. Answers suggested in
different parts of the documents include identifying "allies in government
and civil society" (ILPS Memo #2, E2539) "fostering alliances with
members of civil society who may become influential on their national
delegations to the UN," (ILPS Memo #2, E2539), "collaboration with
NGO's engaged in establishing legal norms at the national level" (ILPS
Memo #2, E2539), and "providing input to civil society or government
actors" (ILPS Memo #2, E2539). Consistent with a focus on elites
rather than the public, references to "workshops around the world" are made
within the context of getting input from "key players" and reinforcing the
interest of "allies"(ILPS Memo #1, E2538), not public education.
68. ILPS Memo #1, E2538
69. For example, when the Center seeks sexual autonomy
and access to abortion for children and adolescents, it proposes to work
with "major medical groups" to achieve this end, not organizations
representing parents. (DLPS Memo #2, E2540)
70. Center for Reproductive Rights, Memo #1 -
International Reproductive Rights Norms: Current Assessment, E2538
71. ILPS Memo #1, E2536
72. ILPS Memo #1, E2537 - E2538
73. "Arguments based on the decisions of one body can
be brought as persuasive authority to decisions made in other bodies. . . As
interpretations of norms acknowledging reproductive rights are repeated in
international bodies, the legitimacy of these rights is reinforced." ILPS
Memo #1, E2538
74. ISLP Memo #1, E2535, E2538.
75. "These lower profile victories will gradually put
us in a strong position to assert a broad consensus around our assertions."
ISLP Memo #1, E2538
76. University of Toronto law professors asserted in
the Journal of Obstetrics and Gynaecology Canada that conscientious
objectors "should not practise clinical medicine." Cook RJ, Dickens BM, "In
Response". J.Obstet Gyanecol Can, February, 2004; 26(2)112 The statement was
unsupported by their legal references, and one of which, arguably,
contradicted it. The Journal reluctantly published a response from the
Project, accompanied by a rebuttal from the authors, and thereupon closed
the discussion. The legal claims made in the rebuttal proved to be even more
problematic than their original article, but the Journal has not published a
further review by the Project. So readers of the Journal will never know,
for example, that the leading case cited by the professors against freedom
of conscience actually supports the view that physicians should not be
forced to refer for services that they find morally objectionable. Murphy,
Sean, Postscript for the
Journal of Obstetrics and Gynaecology Canada: Morgentaler vs. Professors
Cook and Dickens. Protection of Conscience Project.
Charo, R. Alta J.D.,
Celestial Fire of Conscience: Refusing to Deliver Medical Care N Eng
J Med 352:24, June 16, 2005. Accessed 2008-09-13.
systems and the professional caregiver." Medical Post, October
19, 2004 Volume 40 Issue 39.
McLeod, Carolyn, "Demanding Referral in the Wake of Conscientious Objection
to Abortion." In Cohen, JC and Keelan, JE (Eds.)
M C I S B R I E F I N G S: Comparative Program on Health and Society, Lupina
Foundation Working Papers Series 2004-2005 (January, 2006). Munk
Centre for International Studies, University of Toronto. Accessed
77. Writing in the Canadian Pharmaceutical Journal in
2000, an ethicist implied that there is no right to conscientious objection,
and insisted that pharmacists must ensure that patients "are provided with
recognized pharmacy services, despite personal religious or moral
objections." The article was cited at a subsequent Canadian Pharmacy
Association conference, where pharmacists who spoke on behalf of
conscientious objectors were told by more than one colleague that they
should leave the profession. Murphy, Sean,
In Defence of the New Heretics: A
Response to Frank Archer. Protection of Conscience Project
At a 2002 ethics conference in Vancouver hosted by regulatory authorities
and professional associations, an ethicist speaking at a plenary session
asserted that abortion was a 'legitimate' medical service, and that a
patient's wish to have one would take precedence over the 'personal
morality' of the physician. When, in private conversation after the session,
the Project Administrator reminded him that the Canadian Medical Association
did not require referral for abortion because no ethical consensus existed
on the subject, the ethicist explained that he had meant to offer only a
personal opinion, and that he could be wrong. Of course, that was not the
impression he had left with the audience. Letter from the Administrator,
Protection of Conscience Project, to the BC College of Family Physicians, 28
public trust and access to medication", Canadian Pharmaceutical
Journal, October, 2004, Vol. 137, No. 8. Accessed 2006-06-13.
78. Romalis, Garson, "Current Abortion Management."British
Columbia Medical Journal, Dec. 1999, Vol. 41, No. 11, p. 554;
"Morgentaler calls decision to halt abortions 'disgusting.'" New
Brunswick/St. John Telegraph Journal, 9 November, 2002
79. Parallel litigation can also be initiated outside
the professions in quasi-judicial forums, like human rights tribunals,
especially if professional regulatory forums are perceived to be less
receptive to the complainant's case.
80. "[Interviewer] Should doctors be allowed to
conscientiously object to performing an abortion? [Morgentaler] Yes. One
fundamental reason is that doctors should not be obliged to do things which
they don't approve of themselves, and secondly, a more practical reason, a
doctor who doesn't believe in it is more likely not to do a good job."
National Review of Medicine, Vol. 5, No. 1,"The
Morgentaler decision turns 20." (Interview with Dr. Henry Morgentaler)
15 January, 2008. Accessed 2008-11-28
Abortion. Canadian Medical Association, 15 December, 1988. Accessed
2008-11-28. Blackmer, Jeff,
the CMA's position concerning induced abortion." CMAJ â€¢ April 24, 2007;
176 (9). doi:10.1503/cmaj.1070035. Accessed 2008-11-28. See also"Responses
to Abortion: ensuring access." Protection of Conscience Project, 2006.