Media Commentary
January-March, 2002

The Editor,
New Brunswick/Saint John Telegraph Journal

Dear Sir/Madam:

Dr. Monica Brewer’s characterization of physician referral for morally controversial purposes as a "black and white" issue is the result of inadequate reflection.("MD’s Morals Restricting Birth Control Access," February 9, 2002) Her suggestion that doctors who object to the morning-after-pill and contraception "should pair with doctors to whom they can refer" is a suitable solution only for those whose objections are simply matters of professional judgement or personal preference.

For example: physicians who know that 94% of the women who are sold the morning-after-pill do not actually require it to prevent pregnancy (the numbers are provided by those who support its widespread use¹ ) may be unwilling to prescribe it for that reason. However, they might well refer a patient who wants the drug to a doctor who will.

Similarly, some physicians believe that women’s health and social interests are better served by learning to recognize their natural fertility cycles, so that they need not be dependent upon physicians or drug companies to plan or avoid pregnancy. These physicians may not prescribe birth control pills for ‘ecological’ reasons, but probably wouldn’t object to referral.

Finally, an obstetrician who thinks that aborting Down syndrome infants is a good idea, but finds performing abortions a traumatic experience, would probably welcome the opportunity to refer a patient to another colleague.

The situation is quite different when physicians are asked to refer a patient for something to which they have grave moral objections. They believe that by referring patients they are themselves morally culpable for facilitating the wrong that is done. Strange? Not at all.

Consider Newsweek columnist Jonathan Alter’s suggestion that, since physical torture is "contrary to American values", the US should turn terrorist suspects who won’t talk over to "less squeamish allies."² No one would seriously argue that this would relieve the US of moral complicity in torture.

Of course, moral complicity in abortion, contraception and the morning-after-pill are not issues for people like Dr. Morgantaler and his associate, Judy Burwell, who think these are good things, and that those who think differently are mistaken. But it is surprising that they view freedom of conscience as a problem to be solved by abolishing it, at least for those who don’t agree with them.

After all, Dr. Morgantaler justified his defiance of Canadian abortion law in a 1970 article titled, "A Physician and His Moral Conscience." ³

Sincerely,

Sean Murphy,
Administrator

Notes (provided for editorial verification)

1. "In 16 months of ECP services, pharmacists provided almost 12,000 ECP prescriptions, which is estimated to have prevented about 700 unintended pregnancies." Cooper, Janet, Brenda Osmond and Melanie Rantucci, "Emergency Contraceptive Pills- Questions and Answers". Canadian Pharmaceutical Journal, June 2000, Vol. 133, No. 5, at p. 28. See also Valpy, Michael, "The Long Morning After", Globe and Mail, 15 December, 2001)  [Back]

2. Alter, Jonathon, "Time to Think About Torture". Newsweek, 5 November, 2001, p. 45. [Back]

3. The article appeared anonymously in The Humanist. Quoted in Pelrine, Eleanor Wright, Morgantaler: The Doctor Who Couldn’t Turn Away. Canada: Gage Publishing, 1975, P. 79 [Back]

The headline on the front page, "MDs' morals restricting birth control access" (Telegraph-Journal, Feb. 9) was eye-catching. Upon reading the piece, I learned the reporter was culling from the Bulletin of the College of Physicians and Surgeons of New Brunswick (CPSNB) in which it was recorded that at its meeting of Nov. 23, 2001, its council discussed the implications of the right of physicians not to participate in a treatment or process to which they morally object.

In other words, the Code of Ethics of the College quite properly permits physicians to practice their profession in accordance with their conscience. The discussion, as recorded in the bulletin, is repeated almost in its entirety in the Telegraph-Journal. It was particularly noted that some patients are not referred for an abortion or do not receive advice on contraception from their doctors. This is followed by comments (not contained in the bulletin) from one physician in Saint John who doesn't have the same moral qualms, and by some remarks from the administrator of the Morgentaler abortion facility in Fredericton.

There is an underlying indignation present in the article more suitable to an opinion piece than to a news report. The writer goes back to Nov. 23 for this information which is given headline treatment on Feb. 9, breathlessly zeroing in on the roughly eight per cent of the text in the college bulletin that considers the case of patients whose doctors refuse to counsel abortion or contraception because of their moral principles.

Nothing about the other important matters the council deliberated upon and which were reported in the pages of the same bulletin. Nothing about the patient who died from a heart attack after being refused treatment for heart disease. Nothing about the instances where allegations of malpractice were lodged against doctors for a variety of reasons that resulted in loss of life or serious illness. Nothing about the extremely difficult choices physicians are faced with every day and the honest efforts the vast majority of them make to serve their patients with integrity and skill, but also with fallibility and occasional failure.

No, the focus, in a somewhat negative and disapproving fashion, on the good news that physicians are acting conscientiously in their professional lives. Indeed I was impressed and heartened by all that I read in the bulletin precisely because it revealed the conscientious manner in which the council of the CPSNB monitors and guides its members.

I doubt very much the CPSNB would wish to change its code of ethics so as to require physicians to disregard their consciences, especially today when there are factions promoting euthanasia and physician-assisted suicide. While the code of ethics of the CPSNB does not allow the doctor to impose his moral views on the patient, it would be equally objectionable to insist that the patient be authorized to impose his or her moral outlook on the doctor. One hears of patients demanding a prescription for this or that drug; should the physician be obliged to comply? There is reference in the newspaper piece to the "morning after pill" that is not really a contraceptive but rather an abortifacient.

Pro-life doctors do not perform or cause abortions nor do they co-operate with others in procuring an abortion. They rightly consider that abortion is the taking of a human life at an early stage in its development.

In today's social and cultural climate, the opposition to contraception is not easily understood, let alone accepted. This is not surprising since the whole idea of any binding moral principles in the area of sexuality is widely rejected. According to the lax standards prevalent in our culture, no sexual behaviour is morally wrong - fornication, promiscuity, adultery, masturbation, homosexuality, bestiality, etc.

With the exception of child sexual abuse, the guiding rationale seems to be a light-hearted "different folks, different strokes!"

If a person adheres to this sexual libertinism, he or she is not likely to be persuaded by any amount of argumentation that artificial methods of contraception are wrong, nor will he or she be able or willing to grasp the distinction between them and natural family planning. He or she will not see that the warm embrace of contraception has led logically and historically to the widespread acceptance of abortion.

While the views of the administrator of the Morgentaler facility were completely predictable, she really demonstrates a lot of nerve in lecturing physicians about ethics. "I think it's very irresponsible of doctors not to be meeting patients' needs, regardless of their personal opinion or religious beliefs," she is quoted as saying. Now this judgment comes from someone who is managing a business devoted to the destruction of babies in the womb!

Talk about the moral high ground! Also, please observe the mentality revealed in this declaration. If the abortionists were in charge, they would require people to act against their conscience. These are the same folks that are always whining about pro-life people who, they say, wish to impose their morality on them. However, it's apparently all right for the pro-abortion people to impose their morality on the rest of us.

She is also reported complaining that "many" women who had been refused birth control pills by doctors were using other methods such as condoms and became pregnant. Was that a slip of the tongue? Doesn't she belong to the school that keeps insisting that condoms should be made available to teens and others so that they won't become pregnant or contract AIDS? What about all that propaganda about "safe sex?" It appears that she knows, as everyone should, that condoms do fail with the result that the woman becomes pregnant or the unaffected partner gets AIDS.

I salute physicians - no doubt the vast majority of practitioners - who refuse to ignore conscience and moral principle in the exercise of their calling. I honour physicians who do not derive their notions of what is right and wrong from popular magazines or from the superficial opinions of "celebrities" or from Hollywood script writers or from harangues by those who operate abortuaries.

Doctors have access to a long and solid tradition of medical ethics. It's encouraging to see that so many continue to draw on that wisdom in the practice of their profession and aren't easily swayed by the fog of moral indifference which covers so much of the world today.

J. EDWARD TROY
Bishop Emeritus of Saint John
Rothesay

[See Project letter on the same topic.]

Sean Murphy,
Administrator