Crisis at Philadelphia Hospital

Highlights The Violation Of Women’s Rights Due To Mismanagement Of Our Health System

NEWS RELEASE

EMBARGO: Immediate Release Date: 26 June 2002

Doctors for Life International

Doctors For Life (DFL), an organisation of about 770 doctors, places the blame for the lack of staff to support women having abortions at Philadelphia hospital, squarely on the shoulders of the South African government. Before the government bulldozed the law to legalise abortion on demand through Parliament, DFL warned via numerous press releases that the infrastructure to implement the law does not exist.

Firstly, there were not enough doctors and nursing staff who did not have conscientious objection against assisting with abortions. The government ignored us even when this fact was repeated in our submissions  before the Select Committee on Abortion in Parliament.

Secondly, the lack of sonographic equipment to determine the gestational age of the unborn baby before an abortion made a mockery of the legislation (the law allowed abortion for a certain gestational age for different reasons).

The biggest survey ever done amongst doctors showed that more than 80% of South African doctors are against abortion on demand. The government was fully aware of this attitude when they forced the members of the ANC to vote against their consciences in support of “Termination of Pregnancy”. They should therefore not be surprised when only 5 of the 27 hospitals in Mpumalanga have staff who are willing to take part in abortions.

In what appears to be a hypocritical move, the government seems concerned when women in the Carte Blanche programme had to deliver their own aborted babies, while the Department of Health is busy introducing the abortion pill (RU486) which will have the same result of causing women to abort at home.

DFL also had special meetings with the Health Professionals Council of South Africa where we explained the  dilemma of pro-life health professionals. We mentioned that it strikes us as unethical that some health professionals are prescribing abortifacients and then tell the patient to go to a hospital, manned by pro-life staff, to have the abortion completed. This appeared like a strategy to force unwilling, ethically sound health professionals to take part in killing one patient (the unborn child) at the request of another (the mother). It boiled down to a doctor starting the procedure and then referring the patient for the “mopping up” of the procedure to pro-life staff.

It is a well-known fact amongst nursing staff that doctors list abortions as sterilisation procedures on theatre lists. Once the staff is in the theatre, scrubbed and half way through the procedure, they discover that the doctor is doing an abortion.

DFL therefore calls upon the government to accept responsibility for the dilemma women find themselves in. Something should be done about the pressure on health workers to take part in the abortion procedure.  The public should be well informed if a certain clinic/hospital is unwilling to perform abortions. Once a hospital is identified as an abortion provider, the Department of Health must make sure that there are enough pro-abortion staff to render a 24 hour service, 7 days a week.

It must, however, be stated once again that health professionals do have the constitutional right NOT to  participate in ANY part of the abortion procedure.


Enquiries: Dr Jay Mannie (Dep. CEO) Mobile phone: +27(0)83 6414 382

Who is “imposing morality” in Barrie?

Winnipeg, Manitoba
5 April, 2002

Sean Murphy,  Administrator
Protection of Conscience Project

The Canadian Broadcasting Corporation (CBC) is Canada’s publicly funded state radio and television broadcaster. The following was sent to the CBC in Winnipeg, Manitoba, asking whether or not it would be accepted for broadcast in the same region where Dr. Goldman’s editorial was aired. The CBC did not  reply.

In an editorial broadcast on CBC Radio on 7 March, 2002, Dr. Brian Goldman criticized Dr. Frederick Ross of Winnipeg, Manitoba, and Dr. Stephen Dawson of Barrie, Ontario. Dr. Ross had told his patients to stop smoking or find another doctor, while Dr. Dawson had refused to prescribe birth control pills or Viagra to single patients.

It does not seem that Winnipeg’s Dr. Ross believes that treating smokers is wrong, nor that it would be wrong to refer a smoker to another physician. His public statements do not preclude the possibility that he would treat smokers on an ad hoc basis (while standing in for an absent partner, for example).

In contrast, Dr. Dawson refuses to help single patients obtain birth control pills and Viagra under any circumstances, because he believes that by doing so he would be a party to immoral activity (i.e.,extramarital sex). Dr. Goldman was more sympathetic to this position, but criticized Dawson because he would not refer patients to other physicians who would prescribe the drugs.

Dr. Goldman recognized that his colleagues were acting for different reasons, but in drawing his conclusions he failed to maintain this distinction or recognize its significance. It is one thing to refuse to do something because it is inconvenient, difficult, frustrating, or pointless; it is quite another to refuse to do something because it is wrong. Grasping this distinction is the key to understanding the difference between the case of Dr. Ross, which does not seem to involve conscientious objection, and that of Dr. Dawson, which plainly does.

What some characterize as Dr. Dawson’s inflexibility actually illustrates the normal human reaction to a request to do something wrong. For example, a fifty year-old man who wanted to have sex with a fourteen year- old girl might be refused the use a friend’s apartment for that purpose. Nor would it be surprising if the unco-operative  friend also refused to refer the lecher to a more ‘flexible’ apartment owner.

We see the same principle at work in criminal law. It is an offence not only to commit a crime directly, but to counsel, aid or abet a crime committed by someone else. Again: many people who engage in ‘ethical investment’ do so because they do not want to be implicated, even indirectly, in business practices to which they object for reasons of conscience, even if the practices aren’t illegal.

Now, no one is suggesting that consensual extramarital sex between adults is morally equivalent to criminal activity. But when Dr. Dawson refused to provide birth control for single patients, he reacted exactly as an ‘ethical investor’ might react if asked to purchase shares in a company that exploits child labour. He reacted exactly as an honest man would act were he asked to help someone lie or cheat. In other words, he  acted as if extramarital sex really is wrong, and that its wrongness is not merely a matter of opinion or taste. That, in truth, is what has upset many of his critics; he has disturbed their repose in their  comfortable pews.

Of course, one may criticize a physician for causing needless distress to a patient by offering a poorly articulated or inappropriate explanation of his moral position. But that was not Dr. Goldman’s concern. Instead, he complained that Dr. Dawson had acted upon his own beliefs.

In fact, Dr. Goldman does exactly the same thing. He believes that he does nothing wrong by providing single patients with contraceptives and Viagra, and he acts upon that belief by writing prescriptions. Why should Dr. Goldman be allowed to act upon his beliefs by writing prescriptions, while Dr. Dawson is forbidden to act upon his by refusing  to do so? Is it because “the true north strong and free” is afraid of religious believers?

A physician who refuses, for reasons of conscience, to do something he believes to be wrong – falsifying a diagnosis, amputating a healthy limb, or prescribing contraceptives – does not force a patient to conform to his moral code. He is not “imposing morality.” To see what  “imposing morality” really means, watch this month when the Ontario College of Physicians and Surgeons tries to force Barrie’s Dr. Stephen Dawson to give up his Christian convictions, on pain of professional excommunication.

Emergency contraception a flawed choice

London Free Press
March 19, 2002

Reproduced with permission

Sharon  Osvald

Tomorrow, the first day of spring, a coalition of American national, state and local organizations will take Walt Disney’s Bambi’s notion of “being twitter pated” to a new level.

March 20 is the kick-off to their first annual “back up your birth control” campaign. On that day, women all over the U.S. will be asked, regardless of their need, to request emergency contraceptives (EC) from their doctors. Doctors will promise to tell their patients about EC; pharmacists will talk to their customers about it and activists will lobby both state and federal legislatures in favour of more access and awareness of EC.

Similar campaigns to support what many call the morning pill have been taking place for a couple of years with radio ads, billboards picturing a broken condom and other literature. The Web site has an image of a young working woman flexing her bicep with a heart-shaped tattoo saying EC.

Preven and Plan B are the two emergency contraceptives approved in Canada, but according to pharmacists I’ve talked to, many doctors have been prescribing concentrated birth-control hormones within 72 hours of sex since the 1970s. If taken in time, it prevents fertilized eggs from implanting on the uterine wall. Advocates for EC call it “a  safe, effective back-up birth control method that can prevent pregnancy after unprotected intercourse or contraceptive failure.” Opponents, however, call it an “abortifacient,” believing conception begins at fertilization and the idea of contraception after the fact is nothing more than wishful thinking.

I am certain the intentions of the majority involved in this initiative are good. After all, even the most pro-choice person knows the fewer full-fledged abortions that take place, the better for everyone. Consider the horrible state of the 15-year-old Brampton girl recently charged with second-degree murder after hiding her pregnancy and injuring her baby girl in an unassisted home birth. In contrast, EC pills seem such a neat little compromise. More radical feminists embrace EC as a tool to empower women against the evil oppressor, men, who make us pregnant in the first place and get off scot-free.
However, aside from my personal convictions about when life begins, this campaign and others like it give me the willies. This is because, in the words of Canadian organization, The Protection of Conscience Project, they are so “well-organized, well-connected and well-funded” and “may directly impact some conscientious objectors, especially if activists decide to target objectors or objecting facilities in order to get media coverage or to initiate complaints of professional misconduct.” In short, these groups bully those who don’t see the world from their point of view and trample on objectors’ rights and freedoms.

Secondly, it seems to me the message of emergency back-up plans is cheap. I mean, if a group is going to take time, energy and resources to imprint a message into the psyche of young women, is this the best message we have to give them? Why not teach them to respect themselves, to be responsible for their actions (even mistakes) and how to form monogamous, lasting accountable relationships, instead of ones that create an emergency if you become pregnant when pre-intercourse birth control fails? Why don’t we hand out planned parenting post cards that say, “Don’t waste yourself on a one-night stand,” instead of, “You have 72 hours to erase last night.” Rather than simply empowering women to be in charge of their bodies, why not teach men and women what a wonderful thing sex can be in the right context? Maybe even, heaven forbid, encourage  them to wait? Then we might not only have less unwanted pregnancies, but also women who are emotionally healthy and truly empowered.

Project Letter to Telegraph Journal

New Brunswick, Canada
24 February, 2002

Sean Murphy, Administrator
Protection of Conscience Project

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


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)

2. Alter, Jonathon, “Time to Think About Torture”. Newsweek, 5 November, 2001, p. 45.

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

Project Letter to the National Post

Toronto, Ontario, Canada
23 February, 2002

Sean Murphy, Administrator
Protection of Conscience Project

A doctor caring for patients in four Ontario cities may be driven from the profession, or from the country,  because he refuses to practise medicine in accordance with the policies of Planned Parenthood (“MD under fire for denying birth control,” National Post, 22 February, 2002). Welcome to the world of single-issue ethics.

Professor Laura Shanner asserts her personal belief that a physician “absolutely must” help patients obtain drugs or procedures to which the physician objects for reasons of conscience. But there is no self-evident reason why her morality should be imposed upon dissenting physicians under threat of  professional excommunication. Nor do mantras like “standard of care” provide useful guidance when the morality of the ‘care’  itself is in issue. Dr. Morgantaler’s standard of care is, in some  respects, markedly different from that of Physicians for Life. The standard of care in Oregon includes assisted suicide, and in the Netherlands, euthanasia.

On the other hand, John Hof is mistaken in his suggestion that conscientious objectors may refuse to  prescribe contraceptives in order to meet the “spiritual needs” of their patients. People do not go to the doctor to  satisfy their spiritual needs, and physicians should not assume the role of spiritual director.

Conscientious objection arises from concern about one’s own moral culpability, not that of others. It is a matter of personal integrity, not an attempt to control someone else’s behaviour. The unfortunate situation in Barrie may be the result of an infelicitous explanation that failed to make this clear.

Disciplinary Hearing of Doctor Who Won’t Prescribe Pill Open to Public

Dr. Dawson Requests Prayers and Letters of Support

Dr. Stephen Dawson, the family doctor who is in danger of losing his medical licence over his refusal to prescribe the birth control pill to unmarried women clarified his position in an interview with LifeSite last night. Dr. Dawson told LifeSite that the initial coverage in the Barrie Examiner suggested he may compromise on the matter. He clarified: “Under no circumstances will I compromise. I would rather lose my licence.”

He said that he would not apologize for refusing to offer the pill to unmarried women but would apologize for the perhaps “overzealous manner in which I presented my case to these women initially.” [Full text]

 

Project Letter to the Barrie Examiner

Barrie, Ontario, Canada
22 February, 2002

Sean Murphy, Administrator
Protection of Conscience Project

Continuing attempts to suppress the freedom of conscience of health care workers like Dr. Stephen Dawson (“Doctor’s Faith Under Scrutiny,” The Barrie Examiner February 21, 2002) give the lie to the claim, oft repeated by Canadian politicians, that protection of conscience legislation is unnecessary. Perhaps their complacent attitude reflects the influence of rigid party discipline that only rarely permits them  the ‘privilege’ of voting according to conscience.

Professor J.R. Brown of the University of Toronto appears to covet the role of party whip, ready to lash or to exile recalcitrant ‘scum’ like Dr. Dawson for daring to let their beliefs affect their public behaviour.

Yet Professor Brown’s private beliefs affected his public behaviour when he asserted that people like Dr. Dawson should “find another job.” Will Professor Brown take his own advice? Or will he continue to speak, act and live in accordance with his own beliefs, even as he denies the same freedom to others who think differently – those whom he characterizes as ‘scum’?

Thoughtful readers will recognize that their relationships and their political and social activities are almost always governed, not by an analysis of empirical evidence, but by deeply held convictions about human dignity and equality, about good and evil, and other equally fundamental concepts. Some of these beliefs may be religious, others not, but all are beliefs. There is no reason, apart from anti-religious bigotry, to allow only atheists and agnostics the freedom to act on their beliefs in public life.

Doctor’s faith under scrutiny

Barrie physician won’t offer the pill, could lose his licence

 Cheryl Canning

Dr. Stephen Dawson faces a discipline committee at the College of Physicians and Surgeons of Ontario in April because he refused to prescribe birth control pills to unmarried women.

A Barrie doctor could lose his licence to practise medicine because of his religious beliefs.

Dr. Stephen Dawson faces a discipline committee at the College of Physicians and Surgeons of Ontario in April because he refused to prescribe birth control pills to unmarried women.

“If a Christian physician must forsake his religious beliefs to maintain his medical licence, we cannot delude ourselves to believe we live in a free country,” said Dawson.

Last summer, four female patients made formal complaints to the college, citing Dawson’s refusal to prescribe birth control to the “unmarried” women as the reason, he said.

Dawson believes that when a doctor prescribes birth control pills to an unmarried woman, he unwittingly promotes sex outside of marriage, because he removes the fear of pregnancy. [Full text]

Project Letter to the BC Medical Journal

British Columbia, Canada
16 February, 2002

Sean Murphy, Administrator
Protection of Conscience Project

The cover of your  January/February 2002 edition highlighting Dr. Roey M. Malleson’s article on ‘emergency contraception’ was unexpected: a brawny, half-naked, Aryan warrior, eyes glinting murderously from under his horned helmet, wielding a copper IUD, crouched to spring and slaughter.

I would like permission to  post the cover on the Project website, and would appreciate it if you would send me seven copies of the issue. The cover is a splendid  illustration of the usual basis for conscientious objection to  potentially abortifacient devices and drugs, and the article provides  an excellent example of moral obfuscation masquerading as science.

Dr. Malleson clearly  believes, as a matter of faith (for it cannot be science), that it is not immoral to destroy an early human embryo by preventing implantation. However, the article fails to explain why this belief should be forced upon those who do not share it. The Journal of the Society of Obstetricians and Gynaecologists, cited to support Dr. Malleson’s threatening accusation of negligence, is not widely acknowledged to be an infallible authority on faith and morals, nor is Dr. Malleson.

Finally, astute readers will recognize that the law is more complex than suggested by the article. Freedom of conscience is recognized as a fundamental freedom that must be accommodated. It is imprudent and unhelpful to publicly incite civil actions against colleagues in order to secure their submission to the moral outlook so aptly expressed by your cover.

Letter to the Telegraph Journal

New Brunswick, Canada
14 February, 2002

J. Edward Troy,
Bishop Emeritus of  Saint John Rothesay

[Comments in the December, 2001, Bulletin of the College of Physicians and Surgeons  came to media attention in February, 2002, generating pressure on conscientious objectors in New Brunswick.  Catholic Bishop J.  Edward Troy responded to the news reports in this letter, reproduced with permission of the author.  – Administrator-]

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.