Abortion and Prince Edward Island
Group encourages complaints against objecting physicians
The attempt to characterize the exercise of freedom
of conscience by physicians as 'professional misconduct' may surprise
Islanders who remember the promises made when abortion was legalized in
Canada over forty years ago.
While there is nothing to prevent physicians and hospitals from providing
abortion on Prince Edward Island, abortions have not been performed there
for almost thirty years. The province has a population of only about
141,000 people, and it seems likely that one of the reasons that abortion is
not available on the Island is opposition to the procedure among island
residents, including health care workers. Women seeking abortions must
go to Halifax, Nova Scotia, or Frederiction, New Brunswick, each about a
four hour drive from the centre of the Island. The province will pay
for abortions only if done in a Halifax hospital and if a woman is referred
by two physicians, one of whom is an administrator who signs off on
out-of-province surgery. Women who have abortions in private clincs in
Halifax or Frederiction must pay for the procedures themselves (between $650
and $800) and are not reimbursed. The province does not cover travel
In early November, 2011, the
Rights Organization (PEIRRO) was formed to lobby for easier access
to abortion.2 The group is
supported by the province's Green and New Democratic Parties, the Canadian
Civil Liberties Association and the Abortion Rights Coalition of Canada.3
Proposals least likely to impact freedom of conscience for health care
workers involve dropping the requirement for physician referrals, paying for
abortions done in clinics and paying the associated travel costs.
However, PEIRRO not only seeks access to abortion from those willing to
provide or facilitate the procedure, but targets those who are not. It
encourages people to make complaints of professional misconduct against
physicians who decline to refer for abortion for reasons of conscience.4
Its website links to a publication5 from
an American group, the National Abortion Federation.6
The publication claims that the Canadian Medical Association's support for
physician freedom of conscience in the case of referral7
is contrary to its own Code of Ethics. The claim is false.8
The attempt to characterize the exercise of freedom of conscience by
physicians as 'professional misconduct' may surprise Islanders who remember
the promises made when abortion was legalized in Canada over forty years
In 1967 the Globe and Mail applauded a government decision "that
where religious moralities conflict, the State should support none, but
leave the choice to individual conscience," adding that the policy "should
also be followed with abortion."9
Two years later, in supporting the bill to legalize abortion,
the Canadian Welfare Council commented, "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."10
And during the Commons debate, Justice Minister John Turner rejected a
protection of conscience amendment - proposed by a "pro-choice" opposition
member - 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
Such statements probably convinced many in the medical profession that
they had nothing to fear from legalization of abortion. Forty years
ago they could not have imagined that physicians unwilling to provide or
facilitate abortion would be called "scum" and told to "resign from medicine
and find another job."12
Yet this is precisely the attitude that recently led an
'expert panel' of the Royal Society of Canada to recommend
that objecting physicians be forced to refer for euthanasia
and assisted suicide, should these procedures be legalized.
According to the report, physicians who are unwilling to
provide what it delicately terms "certain reproductive
health services" are obliged to refer patients to others who
will. Therefore, physicians who refuse to provide (legal)
euthanasia or assisted suicide for patients "are duty-bound
to refer them in a timely fashion to a health care
professional who will." 13
The logic of the panel is impeccable, but the conclusion
depends on the validity of the first premise: that objecting
physicians are obliged to refer patients for abortion.
Encountering this serenely confident assertion in the
report, one would never know that it is contradicted by the
Canadian Medical Association14
and flatly denied or hotly contested by others. When one of
the members of the expert panel, Jocelyn Downie, made such
claims in the Canadian Medical Association Journal, she was
soundly rebuked by physicians, and the CMA responded with an
affirmation that referral for abortion is not required.15
The response of all physicians to a woman considering an abortion ought
to be compassionate, demonstrate care and concern for her and provide
sufficient information about legal options to permit her to make an informed
decision. An objecting physician must, in addition, do this in a way
that does not involve complicity in a patient's decision to choose abortion,
something that some may find challenging. Discussion of such difficulties
with sympathetic or like-minded colleagues may suggest approaches that will
overcome them, benefiting patients and physicians alike.
With some imagination and political will, it ought to be possible to
provide access to abortion for PEI residents without suppressing the
fundamental freedom of health care professionals. In fact, a
legislated guarantee of that freedom could contribute to a resolution of the
current controversy. In the meantime, the chances of a resolution will not
be improved by specious accusations of professional misconduct.
1. Campbell, Kerry.
"No barrier to abortion on P.E.I." CBC News, 23 November, 2011
"Abortion rights lobby launches on P.E.I."
CBC News, 8 November, 2011 (Accessed 2011-12-30).
"Green Party supports access to abortion services in province." Green
Party news release, 9 November, 2011 (Accessed 2011-12-30).
"Rodd says province doesn't support women." CBC News, 12 November, 2011
"Off-Island abortion costs hidden, P.E.I. warned." CBC News, 22
November, 2011 (Accessed 2011-12-29). Wright, Teresa,
"P.E.I. government could be sued over lack of abortion: national advocacy
coalition." The Guardian, 24 November, 2011 (Accessed
4. P.E.I. Reproductive Rights Organization,
Referrals on PEI" (Accessed
5. National Abortion Federation,
"Has Your Physician Refused to Provide a Referral for Abortion Care? A
Patient's Guide to Action" (Accessed 2011-12-30).
6. NAF's head office is in Washington, D.C.
Two members of its board of directors are from Canada. In 2010, the
expenses for its "Canadian Program" amounted to about 6% of its annual
budget, more than twice what it cost PEI to provide abortions that year.
National Abortion Federation,
Annual Report-2010 (Accessed 2012-12-30).
7. Canadian Medical Association,
Abortion (Accessed 2011-12-30); Code of Ethics (2004), 12.
8. See the discussion under the sub-heading,
"Transcendent ethical duties" in Murphy, Sean,
Postscript for the Journal of
Obstetrics and Gynaecology Canada: Morgentaler vs. Professors Cook and
Dickens. Protection of Conscience Project.
9. "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
10. 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
11. Hansard- Commons Debates, 28 April,
1969, p. p. 8058-8059. The amendment had been proposed by Halifax M.P.
Robert McCleave. See Hansard- Commons Debates, 28 April,
1969, p. 8069.
12. Professor James Robert Brown of the
University of Toronto, quoted in Canning, Cheryl,"Doctor's
faith under scrutiny:Barrie physician won't offer the pill, could lose his
licence."The Barrie Examiner, 21 February, 2002.
13. Report of the Royal Society of Canada Expert
End of Life Decision Making. November, 2011, p. 61-62
14. Canadian Medical Association,
Abortion (Accessed 2011-12-30); Code of Ethics (2004), 12.
15. Blackmer, Jeff,
the CMA's position concerning induced abortion.
CMAJ April 24, 2007 vol. 176 no. 9 (Accessed 2011-12-30);
Re: "Abortion: Ensuring Access", Protection of Conscience Project.