MDs, pharmacists should follow conscience

B.C. Catholic, 25 June, 2001
Reproduced with permission

"Even doctors ethically must make referrals for abortion services whether they morally support that or not," Melanie Anderson, a spokeswoman for Planned Parenthood Alberta, told CTV June 2.

However, Dr. Will Johnston, president of the pro-life doctors, says correspondence with the Alberta College of Physicians and Surgeons registrar Dr. Larry Ohlhauser clearly states that "physicians do not have a professional obligation to refer a patient for an abortion."

Dr. Johnston noted that, while the Alberta College of Physicians, as well as the Code of Ethics of the Canadian Medical Association, requires that physicians inform a patient when their own moral code would influence the recommendation or practice of any medical procedure that the patient needs or wants, the idea that physicians must refer patients for abortion services "is not true."

Pro-life physicians, he added, should declare their personal views to a pregnant patient considering an abortion "in order to place the subsequent discussion in context.

"The doctor then has every right, indeed, a responsibility, to outline the potential mental and physical risks of abortion just as he or she would before prescribing a drug or weighing the merits of surgery."

The risks of an abortion, said Dr. Johnston, include a higher than normal incidence of breast cancer. More than 30 studies, he noted, indicate abortion increases breast cancer risk by at least 30 per cent, and considerably more in the case of first pregnancies. According to one report, said Johnston, teenagers who abort their first pregnancy increase their risk of breast cancer by six times.

That idea was rejected by Planned Parenthood's Anderson, who said that such statements by Canadian Physicians for Life are "irresponsible and full of misinformation."

"There is no significant correlation," said Anderson, "between abortion and breast cancer." She went on to add that post-abortion stress syndrome is not backed by scientific data.

Dr. Johnston vehemently disagreed, noting that post-abortion emotional trauma is a real event. He suggested that "most doctors do not inform pregnant women of abortion's proven dangers.

"Are patients being warned that some physicians' ardent pro-abortion beliefs bias the counselling process? For a woman to make a truly informed decision, she must be presented with the facts of human embryology of her unborn child so that she will know that what she is aborting is a human being, not just a clump of cells or a piece of her own tissues. Withholding basic information shows disrespect for women and is both dishonest and patronizing, since it implies that women are too weak to know the truth."

He went on to say that the suggestion that the "morally troublesome issues need only be referred to a colleague is oblivious to the principled objections of pro-life physicians."

Increasingly "exotic" reproductive technologies, he added, "may eventually offend even the most laissez-faire physicians. There may come a day where no physician feels free from coercion to violate his or her conscience."

The issue of freedom of conscience is also affecting pharmacists who object on moral grounds to dispensing the "morning-after" pill, according to B.C. Concerned Pharmacists for Conscience spokeswoman Cristina Alarcon.

Last December, under the former NDP government, this province's pharmacists became the first in Canada to receive sanction to hand out the abortifacient without a doctor's prescription.

Alarcon noted that her group had made a presentation last October to the B.C. College of Pharmacists requesting that the body's Code of Ethics be changed to allow pharmacists to follow their consciences if they had moral objections to dispensing any prescriptions. A majority of the delegates, however, voted against the proposal.

"We now feel that we have no choice but to turn to the media to tell our story as the appropriate venues to state our concerns have not been successful. It is of public interest that pharmacists are prescribing this drug regimen for either immediate or for future use. If for future use, this defeats the purpose of having a pharmacist oversee that the drug is being used under the right conditions. We will be lobbying our colleagues, helping them to realize the dangers of giving out medications for which no controlled clinical studies have been carried out with respect to safety of repeated use."

She says she disagrees with the conclusions drawn by the B.C. College of Pharmacists that the morning-after pill doesn't cause abortion.

"While it is true that the morning-after pill will not dislodge an implanted human embryo, it can nevertheless destroy it by preventing it from reaching its nesting place. It does therefore qualify as a chemical abortifacient. This is the information that should be made available to the public and to pharmacists who are being trained to prescribe these pills."

Like pro-life doctors, pro-life pharmacists object to being asked to refer their patients to colleagues who will dispense the drugs. Alarcon says her group is especially concerned that a requirement to do so may one day become a condition of employment.

Speaking at an anti-abortion conference organized by Campaign Life Coalition of Nova Scotia, Ontario philosophy professor Dr. Donald DeMarco urged pharmacists to refuse to fill prescriptions for the morning-after pill if they are anti-abortion.

Dr. DeMarco, who teaches at St. Jerome's University in Waterloo, Ont., said that society has been legally and historically inconsistent by allowing only some people to act with a moral conscience.

"I think our society is very confused. It wants conscientious people, but not people with conscience. I think it's a contradiction."

Concerned Pharmacists for Conscience, meanwhile, says it will continue to fight to have the right to refuse to dispense abortifacient drugs recognized and respected.