Med School 101: You Must Perform or Refer for Abortion

Paul Ranalli, M.D.*

His face was flaming red, the veins in his neck bulged out from the starched collar of his shirt. He tore into me for my insolence and presumption for writing such a thing on the exam paper. Who did I think I was, he told me? Didn't I realize that women needed abortion, and it was the duty of every doctor to provide service to his patients? . . . "I could fail you for this!"

The ominous influence of the abortion establishment has reached down into medical training, with news that a Canadian medical school plans to deny a medical degree to a young student who has refused to perform or refer for any abortive procedure.

On March 20, a Winnipeg radio station broke the news of a story that had been building quietly at the University of Manitoba since last fall, when its medical school issued a failing grade to a Christian student in his obstetrics and gynecology rotation. The student, who wishes to remain unnamed, has been turned down in three successive appeals, most recently on March 3 by the highest-level appeal committee within the Faculty of Medicine.

This is despite the fact that the student has achieved high grades in every area of study, and is supported by strong words of affirmation from his clinical supervisors, according to Carolee Neufeld, a family friend speaking to LifeSiteNews.com.

The medical student is said to be considering his next moves, including an appeal to the senate of the University of Manitoba, and ultimately a judicial review. He has received support from several pro-life doctors in Manitoba who are concerned about the university's intolerance.

The student's stance sets up potential clash of policy interpretations. Contacted by CJOB Radio News in Winnipeg, Associate Dean Dr. Brian Magwood defended the decision to fail the student. He pointed to university policy that asserts that students are obligated to tell patients about all treatment options which fall within the medical standard of care. (Although liberal conventional wisdom in Canada assumes abortion is a "standard of care," there is no legal right to abortion in Canada.

There is, in fact, a legal void, following a 1988 Supreme Court decision to strike down the previous abortion regulation law on the grounds that unequal access to the procedure threatened a woman's "security of person" under Canada's Charter of Rights and Freedoms.)

The University of Manitoba's stance would seem to conflict directly with the stated policy of the Canadian Medical Association, as posted on its web site (cma.ca): "A physician whose moral or religious beliefs prevent him or her from recommending or performing an abortion should inform the patient of this so she may consult another physician. No discrimination should be directed against doctors who do not perform or assist at induced abortions. Respect for the right of personal decision in this area must be stressed, particularly for doctors training in obstetrics and gynecology, and anaesthesia."

The Manitoba story stirred memories of my own mercifully brief experience as a final-year medical student at the University of Toronto in the spring of 1979. In one of the final clinical rotations of the year before being awarded my M.D. degree, I spent four weeks assisting at deliveries and gynecological surgery at a large downtown Toronto teaching hospital.

Fortunately, the attending staff were careful to point out that student attendance at abortions was purely voluntary. At the end of the four-week session came the examination, a fairly straight-forward 20-question multiple-choice quiz.

Although my interest lay in internal medicine (and eventually the subspecialty of neurology), the test was easy enough. But one question caught my eye. It went something like this:

For a woman with an unwanted pregnancy at 14 weeks gestation which of the following methods of termination would you choose?

• dilation and evacuation (D&E)
• dilation and curretage (D&C)
• saline instillation and extraction
• hysterotomy and evacuation

I drew an "X" through the question (intentionally forfeiting the points for that question) and neatly wrote in the margin, "I would not choose any of the above, as I would not counsel or perform an abortion." I thought this would be the quietest, most respectful method of sidestepping the question out of conscientious objection.

I was naïve. Later that afternoon, as I relaxed between deliveries, I heard the clipped stride of well-polished shoes down the ward corridor. A tall man came around the corner: it was Dr. P., although I could scarcely recognize the transformation in him.

His face was flaming red, the veins in his neck bulged out from the starched collar of his shirt. He tore into me for my insolence and presumption for writing such a thing on the exam paper.

Who did I think I was, he told me? Didn't I realize that women needed abortion, and it was the duty of every doctor to provide service to his patients?

He asked if I was a Catholic. I told him it was not his business to ask, but I had no hesitation in telling him that I was. He then straightened his shoulders and said that he, too, was a Catholic, and so was Dr. B., the chief of the department, and although it wasn't easy for them, they did not shirk from doing their share of abortions.

I'll admit I was at first set back on my heels. But I refused to be intimidated. I was, however, stunned at how raw a nerve seemed to have been touched in the man.

Until that moment, I had not been exposed to the hair-trigger defensiveness of many physicians who make it their practice to commit abortions. Earlier in the rotation I had come to know and appreciate Dr. P., whose story was an interesting one.

He was an obstetrician at a small rural hospital in one of Canada's rustic maritime provinces before applying for the promotion to a big-city university position. It occurred to me later that abortions were likely not allowed at the small hospital where he had earlier practiced, so he could concentrate on his first love: delivering babies.

Perhaps he was already feeling the internal conflict between his professional ambition and the concomitant need to "do his share" of abortions at this large secular city hospital. If so, the guilt must have been awful. I certainly did not envy his position; perhaps he actually envied mine.

As his tirade went on, I began to feel sorry for Dr. P. I surprised myself at how I felt unexpectedly powerful, not a common emotion for a lowly medical student. I snapped to attention at his parting words: "I could fail you for this!"

I quietly responded, "Do what you have to do." He blinked, turned, and strode off.

Of course, I passed. No one ever mentioned the incident again.

A few years later, curiosity got the better of me as I looked up another physician whose name began with the letter P. I flipped the page and looked down the column to find the obstetrician Dr. P. I noted that he was no longer at the big-city teaching hospital. He had moved his obstetrics practice back to a small town.