Submission to the College of Physicians and Surgeons of Alberta
Re: CPSA Draft Standards of Practice
Notes
Full Text
1. Ko, Marnie,
"Personal
Qualms Don't Count: Foothills Hospital Now Forces Nurses To Participate In
Genetic Terminations." Alberta Report, 12 April, 1999.
Ko, Marnie,
"Down the Slope to Infanticide: Nurses At Foothills Hospital Rebel Over The
Horrifying Results Of Late-Term 'Genetic Terminations'." Alberta Report, 3
May, 1999.
2. Kretzul, E.,
"Ethical Responsibilities in Dealing with Women Requesting Abortion Services."
The Messenger, Sept. 1999, Issue No. 73, p. 6. Accessed 2008-09-27.
3.
Alberta College of Physicians and Surgeons challenged to think about conscience
rights. Canadian Physicians for Life Press Release, 11 October, 1999.
4. Letter to the Protection of Conscience
Project Administrator from the Assistant Registrar, College of Physicians and
Surgeons of Alberta, 27 March, 2002.
5. Melanie Anderson, Planned Parenthood Alberta, (CTV
News and Current Affairs, 2 June, 2001) . Quoted in Canadian Physicians for Life
Press Release, 5 June, 2001.
6. Canadian Physicians for Life
Press Release, 5 June, 2001.
7. Planned Parenthood Alberta,
Be
Aware of Anti-Choice Doctors and Radiologists. Accessed 2004-08-28
8. Letter from the Protection of Conscience Project
Administrator to the Assistant Registrar, College of Physicians and Surgeons of
Alberta, 13 March, 2002
9. Letter from the Assistant Registrar,
College of Physicians and Surgeons of Alberta, to the Protection of
Conscience Project Administrator, 27 March, 2002
10. Planned Parenthood Alberta,
Be
Aware of Anti-Choice Doctors and Radiologists. Accessed 2004-08-28
11. Letter from the Protection of Conscience Project
Administrator to Dr. Peter Walker, Dean, Faculty of Medicine, University of
Ottawa, 7 January, 2005
12. Letter from Dr. Peter Walker, Dean, Faculty
of Medicine, University of Ottawa, to the Protection of Conscience Project
Administrator, 4 May, 2005
13. Rodgers, S. Downie, J. "Abortion: ensuring
access." CMAJ • July 4, 2006; 175 (1). (http://www.cmaj.ca/cgi/content/full/175/1/9)
Accessed 2008-09-27
14. CMAJ editorial,
"Editorial independence for CMAJ: signposts along the road." CMAJ • August
29, 2006 • 175(5), 453. Published at http://www.cmaj.ca on 3 August, 2008.
Accessed 2008-09-27
15. Blackmer, Jeff,
"Clarification of the
CMA's position concerning induced abortion." CMAJ • April 24, 2007; 176 (9).
Accessed 2008-09-27
16. Rodgers, S. Downie, J.
"Abortion: ensuring access - the authors respond." CMAJ • February 13, 2007;
176 (4). Accessed 2008-09-27
17. Baylis, Françoise (Ed.)
Codes of Ethics:
Ethics, codes, standards and guidelines for professionals working in a
healthcare setting in Canada. Toronto: Dept. of Bioethics, The Hospital for
Sick Children, 1992, Introduction.
18. Cook RJ, Dickens BM, "In Response". J.Obstet Gyanecol
Can, February, 2004; 26(2)112
19. The case is Zimmer v. Ringrose (1981), 124
Dominion Law Reports (3d) 215 (Alberta Court of Appeal).
20. See Dickens, Bernard M. "Informed Consent":
Chapter 5 in Downie, Joceyln, Caulfield, Timothy and Flood, Colleen (Eds.) Canadian Health Law and Policy (2nd Ed.). Butterworths, p. 149.
21. There was some resistance to publishing a first
response from the Project, the editor citing Journal policy against publishing
"letters that are responses to letters of response" and the fact that the
original article had appeared six months earlier (Letter from the Editor in
Chief, Journal of Obstetrics and Gynaecology Canada to the Administrator,
Protection of Conscience Project, 7 May, 2004). The Administrator did not insist
upon publication, but asked if the Journal would publish a correction to the
legal misinformation supplied by Professors Cook and Dickens (Letter
from the Administrator, Protection of Conscience Project, to the Editor in
Chief, Journal of Obstetrics and Gynaecology Canada, 14 May, 2004.)This led to the appearance of the
Project's letter with the rejoinder by Cook and Dickens and the announcement
by the editor that the subject was closed. The Administrator later supplied the
Journal's editor with
Postscript for the Journal of Obstetrics and Gynaecology Canada:
Morgentaler vs. Professors Cook and Dickens, and
repeated his previously expressed concerns about misleading legal claims (Letter
from the Administrator, Protection of Conscience Project, to the Editor in
Chief, Journal of Obstetrics and Gynaecology Canada, 8 August, 2005.
22. "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, Alphonse, Morality and Law in Canadian Politics: The Abortion Controversy. Dorval,
Quebec: Palm Publishers, 1974, p. 56]
23. 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, Alphonse, Morality and Law in Canadian Politics: The
Abortion Controversy. Dorval, Quebec: Palm Publishers, 1974, 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 Justice 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. [Hansard- Commons Debates, 28
April, 1969, p. 8069]
24. 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 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
Assessment (E2535-E2538);
- 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
(E2543-2546)
- The Center for Reproductive Rights Board of Directors - Primary
Affiliation Information (E2547)
25. 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)
26.
". . .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
27. "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, E2535
28. The Center acknowledges that there is no binding
international legal instrument that recognizes a right to abortion. [ILPS Memo #1, E2536]
29. "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.
30. 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
31.
"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
32. ILPS Memo # 2, E2538.
33. 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.
34. 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).
35. ILPS Memo #2, E2538)
36. 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).
37. 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.
38. ILPS Memo #1, E2538
39. 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)
40. Center for Reproductive Rights, Memo #1 -
International Reproductive Rights Norms: Current Assessment, E2538
41. ". . . there is no binding hard norm that
recognizes women's right to terminate a pregnancy. To argue that such a right
exists, we have focused on interpretations of three categories of hard norms:
the rights to life and health; the right to be free from discrimination; those
rights that protect individual decision-making on private matters." ILPS Memo
#1, E2536
42. ILPS Memo #1, E2537 - E2538
43. "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
44. ISLP Memo #1, E2535, E2538.
<>45. "These lower profile victories will gradually put
us in a strong position to assert a broad consensus around our assertions." ISLP
Memo #1, E2538
46. 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
47. Kretzul, E.,
"Ethical responsibilities in dealing with women requesting abortion services."
The Messenger, No. 73, September, 1999.
An instruction published in 2000
by the Ethics Advisory Committee of the College of Pharmacists of British
Columbia included statements that impugned the integrity of conscientious
objectors within the profession by implying that they were dishonest in dealing
with patients. The Registrar of the College later acknowledged there was no
evidence to support the statements, but refused to retract them and apologize.
Project Report 2001-01. RE: College of Pharmacists of British Columbia- Conduct
of the Ethics Advisory Committee (Revised 24 May, 2001)
The President
of the American College of Obstetricians and Gynecologists made the bald
assertion that objectors "should be required to refer patients to other
physicians who will provide the appropriate care." Mennuti, Michael T., Letter
to American Senators from the President of the ACOG, 30 August, 2005.
American College of Obstetricians and Gynecologists Demands Compulsory Referral
48.
Submission of the Ontario Human Rights Commission to the College of Physicians
and Surgeons of Ontario Regarding the draft policy, "Physicians and the Ontario
Human Rights Code." 15 August, 2008. Accessed 3008-08-31
49. "In an emergency in which referral is not
possible or might negatively affect a patient's physical or mental health,
providers have an obligation to provide medically indicated and requested care
regardless of the provider's personal moral objections." ACOG Opinion No. 385,
The
Limits of Conscientious Refusal in Reproductive Medicine, p. 5,
recommendation 5. Accessed 2008-09-24. In assessing the scope of this
claim, it is necessary to note that the statement fails to define key terms:
"emergency," "health," "medically indicated," and "care." The statement is also
notably broad in its unqualified reference to anything that "might negatively
affect" the health of the patient.
50.
Dr. James Robert Brown, a professor of science
and religion at the University of Toronto, said he agrees with prosecuting a
doctor with that sort of conflict. "Suppose someone (doctor) said, 'I'm
uncomfortable with (treating) a minority,' I'd say, 'So long scum'," said Brown.
Brown believes performing abortions and offering other forms of contraception
are necessary and if Dawson won't perform them, then, Brown added, 'Fine - just
resign from medicine and find another job."
"Religious beliefs are highly emotional - as is any belief that is effecting
your behaviour in society. You have no right letting your private beliefs effect
your public behaviour."
Canning, Cheryl, "Doctor's faith under scrutiny:Barrie
physician won't offer the pill, could lose his licence." The Barrie Examiner,
February 21, 2002
51. Asoka ascended his father's throne in 269
BC. Time-Life Books, TimeFrame 400 BC - AD 200: Empires Ascendant, p.
107-109
52. More than 900 out of 5,000 Canadian
soldiers were killed; nearly 2000 were captured. An example of the carnage: of
the Royal Regiment of Canada, half were killed, just 65 of 554 made it back to
England, and only 22 of them were unwounded. Readers Digest, The Canadians at
War 1939/45. Vol. 1, p. 181, 192.
53. "Upon landing on the beach under heavy fire he
attached himself to the Regimental Aid Post . . . During the subsequent period
of approximately eight hours, while the action continued, this officer not only
assisted the Regimental Medical Officer in ministering to the wounded . . . but
time and again left this shelter to inject morphine, give first-aid and carry
wounded personnel from the open beach . . . . On these occasions, with utter
disregard for his personal safety, Honorary Captain Foote exposed himself to an
inferno of fire and saved many lives by his gallant efforts . . . Honorary
Captain Foote continued tirelessly and courageously to carry wounded men from
the exposed beach to the cover of the landing craft. He also removed wounded
from inside the landing craft when ammunition had been set on fire by enemy
shells. When landing craft appeared he carried wounded from the Regimental Aid
Post to the landing craft through heavy fire. On several occasions this officer
had the opportunity to embark but returned to the beach as his chief concern was
the care and evacuation of the wounded. He refused a final opportunity to leave
the shore, choosing to suffer the fate of the men he had ministered to for over
three years." Citation, as reported in The London Gazette, 14 February,
1946. Reproduced on the website of the Royal Hamilton Light Infantry:
Hon LCol John Weir Foote,
VC, CD Accessed 2008-09-05
54. "Realizing the dangerous situation, Scrimger
organized the evacuation of the wounded to the rear, but one of his patients,
Captain H. F. McDonald, had a serious head wound. Any movement before he was
stabilized would likely kill him. Scrimger chose to stay behind. The shells fell
around them and then began to land on the farm. The slight, 5-foot-7-inch
doctor, who weighed only 148 pounds, shielded McDonald's prone body while he
worked over him. During the bombardment, the building was demolished and set on
fire, but both Scrimger and McDonald survived the whirling shrapnel and
exploding ammunition. Blinded by the smoke and heat of the fire, Scrimger pulled
the larger, unconscious infantry officer onto his back and staggered out of the
building. German infantry were advancing on the farm and the only escape was to
cross the moat to the rear. Lurching to safety with McDonald on his back,
Scrimger passed through the barrage, moving from shell hole to shell hole for
cover. Hiding in a nearby ditch throughout the rest of the day, they avoided the
enemy infantry. Captain McDonald later testified that each time the shells
exploded around them, "Captain Scrimger curled himself round my wounded head and
shoulder to protect me from the heavy shell fire, at obvious peril to his life.
He stayed with me all that time and by good luck was not hit."
Canadian War Museum,
Backgrounder: Francis Scrimger, V.C.
Accessed 2008-09-05
55. Kingsmill, Suzanne, Francis Scrimger: Beyond
the Call of Duty. Hannah Institute for the History of Medicine, Dundurn
Press Ltd., 1991, p. 25. See also
"The greatest devotion to duty": Dr. Francis Scrimger and his Victoria Cross.
McCulloch, I. CMAJ. 1994 February 1; 150(3): 414-416. Accessed
2008-09-04
56. Benson, Iain T.,
"There are No Secular 'Unbelievers.'" Centrepoints 7, Vol. 4, No. 1, Spring 2000, P. 3.
57. American College of Obstetrics and Gynecology,
Committee on Ethics Opinion No. 385,
The Limits
of Conscientious Refusal in Reproductive Medicine , p.3. Accessed
2008-09-24
58. For example: "The moral position of an
individual pharmacist, if it differs from the ethics of the profession, cannot
take precedence over that of the profession as a whole." College of Pharmacists
of British Columbia Bulletin, Ethics in Practice: Moral Conflicts in Pharmacy
Practice. March/April 2000, Vol. 25, No. 2, P. 5. For further information
about the bulletin and related issues, see
Project Report 2001-01, College of
Pharmacists of British Columbia: Conduct of the Ethics Advisory Committee, 26
March, 2001.
59. One critic outlines the extent of the
penetration of bioethics principlism, as defined in the American Belmont Report:
"Many colleges and universities already require a course in bioethics in order
to graduate, and most medical and nursing schools have incorporated it in their
curricula. Bioethics is even being taught now in the high schools. And what is
being taught as bioethics are the Belmont principles, or renditions of one or
more of these principles as defined in Belmont terms. Nods may be given to
'alternative' propositions here and there, but in the end it is the language of
principlism which sets the standards." Irving, Dianne N.,
What is "Bioethics"? (Quid est "Bioethics"?). Tenth Annual Conference:
Life and Learning X (in press)University Faculty For Life, Georgetown
University, Washington, V.C. Accessed 2008-09-11
60. "Medical professionalism includes both the
relationship between a physician and a patient and a social contract between
physicians and society." Canadian Medical Association,
Policy: medical
professionalism.
(Update 2005) p. 1 (Accessed 2008-09-06)
"Professionalism is also the moral understanding among medical practitioners
that gives reality to the social contract between medicine and society. This
contract in return grants the medical profession a monopoly over the use of its
knowledge base, the right to considerable autonomy in practice and the privilege
of self-regulation." Canadian Stakeholders Coalition on Medical Professionalism,
quoted in Canadian Medical Association:
Medical Professionalism (Accessed 2008-09-06)
"Professionalism is the basis of medicine's contract with society." "Medical
Professionalism in the New Millennium: A Physician Charter." Annals of
Internal Medicine, 5 February 2002 | Volume 136 Issue 3 | Pages 243-246 (Accessed 2008-09-06)
"In Canada and the United States the social basis of the extraordinary grant of
occupational authority and independence to professionalized occupations such as
medicine and law has been a social contract between the profession and the
public. Professionalism is the moral understanding among professionals that
gives concrete reality to this social contract." Sullivan, William M.,
Medicine under threat: professionalism and professional identity. CMAJ,
March 7, 2000; 162 (5) (Accessed 2008-09-06) Similarly, Cruess,
Sylvia R. and Cruess, Richard L.,
Professionalism: a contract between
medicine and society. CMAJ 7 March 2000; 162 (5).
Accessed 2008-09-06
61. "We also exchanged, or rather subsumed, social
contract and morality into a single term, moral contract. It
seemed to us that the idea of a moral dimension to medicine was important. It
indicated something right and good in relation to the behaviours and actions of
a doctor. The ultimate expression of those behaviours and actions is perhaps
best summed up in the idea of a contract between the public and the profession -
a moral contract. A social contract, while a correct description of the mutual
agreement that exists between the public and profession, seemed too neutral a
term. We wanted to emphasise an ethical edge to that mutual agreement."
Doctors in Society: Medical Professionalism in a Changing World. Royal
College of Physicians Report of a Working Party (December, 2005), para. 2.15.
Accessed 2008-09-06
62. Latimer, Elizabeth J.,
Accidental
patient. A doctor takes a different view. Can Fam Physician. 2002
August; 48: 1295-1296.
Accessed 2008-09-06. James T.C,
The Patient-Physician Relationship: Covenant
or Contract? Mayo Clin Proc. 1996;71:917-918.
Accessed 2008-09-07
63. Honderich, Ted (Ed.) The Oxford Companion to
Philosophy (2nd Ed.) Oxford: Oxford University Press, 2005. p. 174
64. Laidlaw, Stuart,
"College of physicians
debates doctors' rights to refuse treatments." Toronto Star, 18
September, 2008. Accessed 2008-09-21
65. Canadian M.P. Grace MacInnis told a
parliamentary committee studying her private member's bill to legalize abortion
that "nobody would be forcing abortion procedures on anyone else."[Quoted in de
Valk, Alphonse, Morality and Law in Canadian Politics: The Abortion
Controversy. Dorval, Quebec: Palm Publishers, 1974, 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]
66. Canadian Justice 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. [Hansard-
Commons Debates, 28 April, 1969, p. 8069]
67. Ontario Human Rights Commission,
The Duty to Accommodate. Accessed 2008-09-07
68. Cook RJ, Dickens BM, "In Response". J.Obstet
Gyanecol Can, February, 2004; 26(2)112.
69. McInerney v. MacDonald (1992), 93 Dominion Law Reports
(4th) 415 (Supreme Court of Canada)
70. Recalling an earlier case (Canson
Enterprises Ltd. v. Boughton & Co. [1991] 3 S.C.R. 534)
71. Quoting LeBel, J. in
Henderson v. Johnston,
[1956] O.R. 789 at p. 799.
72. Cook RJ, Dickens BM, Access to emergency
contraception [letter] J.Obstet Gynaecol Can 2004; 26(8):706.
73. Dickens, Bernard M. "Informed Consent": Chapter 5
in Downie, Joceyln, Caulfield, Timothy and Flood, Colleen (Eds.) Canadian Health
Law and Policy (2nd Ed.). Butterworths, p. 149.
74.
Riebl v. Hughes (1980), 114 DLR (3rd) 1, (1980) 2
SCR 880, 14 CCLT 1, 33 NR, 361; Hopp v. Lepp (1980), 112 DLR (3d) 67, (1980) 2
SCR 192, (1980) 4 WWR 645, 22 AR 361, 13 CCLT 66, 32 NR 145, followed; Trogun v.
Fruchtman (1973), 207 NW 2d 297; Downer v. Veilleux (1974), 322 A. 2d 82,
referred to.
75. Zimmer v. Ringrose (1981), 124 DLR (3d) 225-226
(Alberta Court of Appeal); Zimmer v. Ringrose (1978), 89 Dominion Law Reports
(3d) 657 (Alberta Supreme Court)
76. Zimmer v. Ringrose
(1981), 124 DLR (3d) 219
(Alberta Court of Appeal); Zimmer v. Ringrose (1978), 89 DLR (3d) 649 (Alberta
Supreme Court)
77. Zimmer v. Ringrose (1981), 124 DLR (3d) 219
(Alberta Court of Appeal); Zimmer v. Ringrose (1978), 89 DLR (3d) 649 (Alberta
Supreme Court)
78. Zimmer v. Ringrose (1981), 124 DLR (3d) 226
(Alberta Court of Appeal)
79. Zimmer v. Ringrose (1978), 89 DLR (3d)
657-658 (Alberta Supreme Court)
80. Zimmer v. Ringrose (1981), 124 DLR (3d) 226
(Alberta Court of Appeal); Zimmer v. Ringrose (1978), 89 DLR (3d) 657 (Alberta
Supreme Court)
81. Lee, Jenny,
"Official slams 'sex selection' blood test: Gender of fetus can be seen five weeks into pregnancy."
Vancouver Sun, 13 August, 2005.
(Accessed 2005-10-10)
82. Ramsay, Sarah,
"Controversy over UK surgeon who amputated
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83. Gawande, Atul,
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2006, 1221-1229.
Accessed 2008-09-08
84. American Medical Association
Policy E-2.06: Capital Punishment (June, 1998)
(Accessed 2008-09-06)
85. Gawande, Atul,
When law and ethics collide -
Why physicians participate in executions. N Engl J Med 354;12 23 March,
2006, 1221-1229.
Accessed 2008-09-08
86. Curfman, Gregory D., Morrissey, Stephen, and
Drazen, Jeffrey M.,
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87. General Medical Council (United Kingdom)
Personal
Beliefs and Medical Practice.
Accessed 2008-09-10
88. General Medical Council (United Kingdom)
Good
Medical Practice (2006).
Accessed 2008-09-10
89.
Joint Statement on Preventing and Resolving Ethical
Conflicts Involving Health Care Providers and Persons Receiving Care (1998)
90. United Kingdom Parliament,
House of Lords Select
Committee on Assisted Dying for the Terminally Ill Bill: Selections from the
First Report
91.
Joint Committee On Human Rights Twelfth Report: Assisted Dying for the
Terminally Ill Bill, Para. 3.11 to 3.16.
Accessed 2005-11-01
92. United Kingdom Parliament,
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93.
Trinity Western University v. British Columbia
College of Teachers (2001) 1 SCR 772
94. Cromwell, Oliver, "Declaration of the Lord
Lieutenant of Ireland." (January, 1649) Carlyle, Thomas, Oliver Cromwell's
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95. Cromwell, Oliver, "Declaration of the Lord
Lieutenant of Ireland." (January, 1649) Carlyle, Thomas, Oliver Cromwell's
Letters and Speeches, with elucidations. Boston: Estes and Lauriat, 1886,
Vol. I, Part 5, p. 18.
96.
American College of Obstetrics and Gynecology,
Committee on Ethics Opinion No. 385,
The
Limits of Conscientious Refusal in Reproductive Medicine. Accessed
2008-09-24
97. Alter, Jonathon, "Time to Think About Torture." Newsweek,
5 November, 2001, p. 45.
98.
Maher's Story.
Accessed 2008-09-08
99. Commission of Inquiry into the Actions of Canadian
Officials in Relation to Maher Arar,
Report of the Events Relating to Maher
Arar: Analysis and Recommendations. (hereinafter, "Arar Inquiry: Analysis
and Recommendations") p. 9.
Accessed 2008-09-08
100. Arar Inquiry: Analysis and
Recommendations, p. 35-36.
Accessed 2008-09-08
101. Deputy Prime Minister Issues Terms of
Reference for the Public Inquiry into the Maher Arar Affair.
Accessed 2008-09-08
102. Re: briefing note for RCMP Commissioner
Zaccardelli: "Assistant Commissioner Proulx states [in the note] that the RCMP
can be considered complicit in Mr. El Maati's detention in Syria. However, Mr.
Proulx testified that it was the media and public who would consider the RCMP's
actions to be complicit. He did not personally believe that the RCMP was
complicit, nor was he referring to complicity in the criminal sense." Commission
of Inquiry into the Actions of Canadian Officials in Relation to Maher Arar,
Report of the Events Relating to Maher Arar: Factual Background, Vol. 1,
(hereinafter "Arar Inquiry: Vol. I") p. 64.
Accessed 2008-09-08.
103. "The Ambassador did not consider that seeking the
fruits of the Syrian interrogation made Canada complicit in obtaining
information that might have been the product of torture. He reasoned that he did
not ask the Syrians to continue interrogating Mr. Arar so that Canada could
obtain information. Furthermore, the Ambassador did not have any evidence that
Mr. Arar was being tortured or held incommunicado.
Arar Inquiry: Vol. I,
p. 271.
Accessed 2008-09-08.
104. "Superintendent Killam was aware that Secretary
Powell had given Minister Graham the clear impression that the RCMP was
complicit in Mr. Arar's deportation. However, Superintendent Killam testified
that, even without making further inquiries in response to the media reports, he
was able to exclude the possibility that the allegation of complicity might be
true, because the allegation was inconsistent with the RCMP position."Arar Inquiry: Vol. I, p. 299.
Accessed 2008-09-08.
105. "Mr. Solomon prepared a draft memorandum for the
Minister . . .which dealt with the upcoming CSIS trip to Syria and
stated . . . "there are concerns as to whether a visit to Arar by Canadian
intelligence officials may make Canada appear complicit in his detention and
possible poor treatment by Syrian authorities."
Arar Inquiry: Vol. I, p.
309.
Accessed 2008-09-08."Mr. Livermore testified that the original statement about the reliability of
the confession and the possible complicity by Canada if CSIS was to meet with
Mr. Arar was "very much on the speculative side" and "it was anticipating
something that we later ironed out with CSIS, namely that they would not seek
access to Mr. Arar."
Arar Inquiry: Vol. I, p. 310.
Accessed 2008-09-08
106. ". . . the intervenors suggest that the
circumstances under which these individuals ended up in Syrian detention raise
troubling questions about whether Canadian officials were complicit in their
detention. The evidence of what happened to them could possibly show a pattern
of misconduct by Canadian officials." 770 Commission of Inquiry into the Actions
of Canadian Officials in Relation to Maher Arar,
Report of the Events Relating
to Maher Arar: Factual Background, Vol. II, p. 770.
Accessed 2008-09-08
107. "Canadian officials did not participate or
acquiesce in the American decisions to detain Mr. Arar and remove him to Syria.
I have thoroughly reviewed all of the evidence relating to events both before
and during Mr. Arar's detention in New York, and there is no evidence that any
Canadian authorities - the RCMP, CSIS or others - were complicit in those
decisions."
Arar Inquiry: Analysis and
Recommendations, p. 29.
Accessed 2008-09-08
"Although decisions to interact must be made on a case-by-case basis, they
should be made in a way that is politically accountable, and interactions should
be strictly controlled to guard against
Canadian complicity in human rights abuses or a perception that Canada condones
such abuses."
Arar Inquiry: Analysis and
Recommendations, p. 35.
Accessed 2008-09-08
"If it is determined that there is a credible risk that the Canadian
interactions would render Canada complicit in torture or create the perception
that Canada condones the use of torture, then
a decision should be made that no interaction is to take place."
Arar Inquiry: Analysis and
Recommendations, p. 199.
Accessed 2008-09-08
"Even if one were to accept that Canadian officials were somehow complicit in
those arrests, that would not change my conclusion, based on the evidence at the
Inquiry, that Canadian officials did not participate or acquiesce in the American decision to send Mr. Arar to
Syria from the United States."
Arar Inquiry: Analysis and
Recommendations,
p. 271.
Accessed 2008-09-08
"Information should never be provided to a foreign country where there is a
credible risk that it will cause or contribute to the use of torture. Policies
should include specific directions aimed at eliminating any possible Canadian
complicity in torture, avoiding the risk of other human rights abuses and
ensuring accountability."
Arar Inquiry: Analysis and
Recommendations, p.
345.
Accessed 2008-09-08
"Clearly, the prohibition against torture in the Convention against Torture is
absolute. Canada should not inflict torture, nor should it be complicit in the
infliction of torture by others."
Arar Inquiry: Analysis and
Recommendations,
p. 346.
Accessed 2008-09-08
108. Smith, Graeme,
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109. Editorial,
"The truth Canada did not wish to see."
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2007.
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merely for the hateful words and actions of the bad people, but for the
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American Medical Association
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114. American Medical Association Policy E.2.067:
Torture.
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115. Canadian Medical Association Policy resolution
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Reviewed, 2004-Feb-28: Still relevant.
116. See American College of Obstetrics and Gynecology,
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The Limits
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4. Accessed 2008-09-24
117.
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120. A practical observation is that ethical advice
"falls squarely into the most contested domain of social and public policy.
Rawlsians and feminists; casuists and communitarians: all have their divergent
visions of what individuals should find life worth living for, or be willing to
live with. And these visions will not always coincide with the wishes of the
patient, much less the consensus of society." Shalit, Ruth,
"When we Were
Philosopher Kings." The New Republic, April 28, 1997. Smith,
Wesley J.,
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The Weekly Standard, 28 May, 2000.
121. Richard G. Frey, "The ethics of the search
for benefits: Animal experimentation in medicine," in Raanan Gillon (ed.), Principles of Health Care Ethics (New York: John Wiley & Sons, 1994), pp.
1067-1075; cited in Irving, Dianne N.,
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122. Bleich, Dr. J. David, "Euthanasia", in Judaism
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123. Maritain, Jacques (John J. Fitzgerald,
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124. King, Martin Luther, Sermon:
The Three Dimensions of a Complete Life. New Covenant Baptist Church,
Chicago, Illinois, 9 April 1967. Accessed 2005-08-02
125. King, Martin Luther, Sermon:
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1954. Accessed 2005-08-02
126. Charo, R. Alta,
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127. Lewis, C.S., "Learning in War Time."
In The
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128. Maritain, Jacques (John J. Fitzgerald, trans.)
The Person and the Common Good. Notre Dame, Indiana: University of Notre
Dame Press, 2002, p. 59; Maritain, Jacques (Doris C. Anson, trans.) The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 3, 9
129. Maritain, Jacques (Doris C. Anson, trans.)
The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 3-4
130. Somerville, Margaret, Death Talk: The Case
Against Euthanasia and Assisted Suicide. Montreal & Kingston: McGill-Queens
University Press, 2001, p. 191-192.
131. Maritain, Jacques (Doris C. Anson, trans.)
The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 3
132. Maritain, Jacques (Doris C. Anson, trans.) The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 18
133. Maritain, Jacques (John J. Fitzgerald, trans.)
The Person and the Common Good. Notre Dame, Indiana: University of Notre
Dame Press, 2002, p. 71; Maritain, Jacques (Doris C. Anson, trans.) The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 14
134. Maritain, Jacques (John J. Fitzgerald, trans.)
The Person and the Common Good. Notre Dame, Indiana: University of Notre
Dame Press, 2002, p. 73; Maritain, Jacques (Doris C. Anson, trans.) The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 15-17, 76
135. Maritain, Jacques (Doris C. Anson, trans.)
The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 11
136. Maritain, Jacques (John J. Fitzgerald, trans.)
The Person and the Common Good. Notre Dame, Indiana: University of Notre
Dame Press, 2002, p. 58
137. Maritain, Jacques (Doris C. Anson, trans.)
The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 65
138. Maritain, Jacques (Doris C. Anson, trans.)
The
Rights of Man and Natural Law. New York: Gordian Press, 1971, p. 45
139. Joad, C.E.M.,
Guide to the Philosophy of Morals
and Politics. London: Gollancz Ltd., (1938), p. 803. Quoted in
R.
v. Morgentaler (1988)1 S.C.R 30 at p. 178. Accessed 2008-09-10
140. Joad, C.E.M.,
Guide to the Philosophy of Morals
and Politics. London: Gollancz Ltd., (1938), p. 805. Cited in
R.
v. Morgentaler (1988)1 S.C.R 30 at p. 178. Accessed 2008-09-10.
See Maritain, Jacques, Man and the State. Chicago: University of Chicago
Press, 1951, p. 13
141. Lewis, C.S., "The Humanitarian Theory of
Punishment." In Hooper, Walter (Ed.) C.S. Lewis: First and Second Things.
Glasgow: William Collins & Sons, 1985, p. 101
142. King, Martin Luther,
Letter from
Birmingham Jail, 16 April, 1963. Accessed 2005-08-02
143. Wojtyla, Karol,
Love and Responsibility. San
Francisco: Ignatius Press, 1993, p. 27
144. Kant, Immanuel,
Fundamental
Principles of the Metaphysic of Morals. Accessed 2008-09-10. Quoted in
The Internet Encyclopedia of Philosophy,
"Immanuel Kant (1724-1804)
Metaphysics" . Accessed 2008-09-10
145.
R.
v. Morgentaler (1988)1 S.C.R 30 (Supreme Court of Canada) Accessed
2008-09-10.
146.
R.
v. Morgentaler (1988)1 S.C.R 30 (Supreme Court of Canada) Accessed
2008-09-10.
147.
R.
v. Morgentaler (1988)1 S.C.R 30 (Supreme Court of Canada) Accessed
2008-09-10.
148.
R.
v. Morgentaler (1988)1 S.C.R 30 (Supreme Court of Canada) Accessed
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149. Murphy, Sean,
Belgium: mandatory referral for
euthanasia
150. "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, E2535
151. ". . . there is no binding hard norm that
recognizes women's right to terminate a pregnancy. To argue that such a right
exists, we have focused on interpretations of three categories of hard norms:
the rights to life and health; the right to be free from discrimination; those
rights that protect individual decision-making on private matters." ILPS Memo
#1, E2536
152. "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.
153. 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
154. "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
155. See Dickens, Bernard M. "Informed Consent":
Chapter 5 in Downie, Joceyln, Caulfield, Timothy and Flood, Colleen (Eds.) Canadian Health Law and Policy (2nd Ed.). Toronto: Butterworths, 2002, p.
149.
156. Report of the Preparatory Commission for the
International Criminal Court, Addendum:
Finalized draft
text of the Elements of Crimes. New York: 2000. Accessed 2008-09-30
157.
United Nations Treaty Collection,
Rome
Statute of the International Criminal Court. Accessed 2008-09-30
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