Why Can Canadian Doctors Still Deny Access To Abortion—And Other Healthcare?

The practice of conscientious objection means doctors can refuse or deflect requests for a variety of services, including abortion—and in many provinces, they're not even obligated to provide a referral.

Tracey Lindeman
Updated July 22, 2021

Chantal had already performed all the mental gymnastics.

About eight years ago, the then-23-year-old woman from southern Alberta had accidentally become pregnant, and weighed her options. She settled on having an abortion, the best choice for her in that moment of her life. She booked an appointment with her doctor, one of only a small handful in her community, to request a referral—a requirement in Alberta then. When the time came to meet, she sat in his office and laid her cards out.

Continued: https://www.chatelaine.com/opinion/canadian-doctors-deny-access-to-abortion/

CONFERENCE REPORT – Decriminalisation of Abortion, Medical Abortion and Advocacy for Change

CONFERENCE REPORT - Decriminalisation of Abortion, Medical Abortion and Advocacy for Change
Oct 26, 2018

Three Discussion Workshops
At: 3rd Abortion & Reproductive Justice Conference: The Unfinished Revolution
Rhodes University, Makhanda, South Africa, 9-12 July 2018

Report by Marge Berer with Christina Boateng and Pauline Diaz, 25 October 2018

This is an informal report of a set of three workshops, facilitated by Marge Berer, that took place over three days with almost 10 hours of in-depth discussion and sharing of information and experience among the participants. This report was written by Marge Berer, International Campaign Coordinator, and is based on notes taken by Christina Boateng, Pauline Diaz and several other participants.

Continued: http://www.safeabortionwomensright.org/wp-content/uploads/2018/10/Report-of-an-International-Campaign-Workshop-Abortion-Reproductive-Justice-Conference-South-Africa-9-12-July-2018.pdf cons

Let’s call ‘conscientious objection’ by its name: Obstruction of access to care and abortion in South Africa

Let’s call ‘conscientious objection’ by its name: Obstruction of access to care and abortion in South Africa

Satang Nabaneh, Marion Stevens and Lucia Berro Pizzarossa
24th October 2018

South Africa has one of the most liberal laws on abortion and constitutionally recognizes reproductive rights as human rights. However, data shows important difficulties translating the legal norms into effective access to services. One of the key challenges is physicians’ refusal to perform abortions invoking an “ad hoc, unregulated and at times incorrect” conscientious objection. The Department of Health is now spearheading a reform of the abortion guidelines aiming to bring them in line with human rights standards and reframing the refusal as “obstruction of access to care”.

Continued: http://ohrh.law.ox.ac.uk/lets-call-conscientious-objection-by-its-name-obstruction-of-access-to-care-and-abortion-in-south-africa/

New Zealand – Abortion case taken to Human Rights Commission

Abortion case taken to Human Rights Commission

Sasha Borissenko of Newsroom.co.nz
Oct 08 2018

Six women who have sought abortion care and the Abortion Law Reform Association (ALRANZ) have taken a complaint to the Human Rights Commission alleging abortion laws discriminate against women and pregnant people.

ALRANZ's complaint to the commission on behalf of the women alleges "people who seek abortion care receive different and demonstrably worse treatment than other people seeking health care", according to ALRANZ president Terry Bellamak.

Continued: https://www.stuff.co.nz/national/health/107674939/abortion-case-taken-to-human-rights-commission

Queensland doctors accused of ‘deep disrespect’ for women seeking abortion

Queensland doctors accused of 'deep disrespect' for women seeking abortion
Ahead of legalisation debate, pro-choice GP says regional doctors ‘dictate to women’

Ben Smee
Sun 7 Oct 2018

Doctors in regional Queensland routinely treat women seeking an abortion with “deep disrespect” and dictate scripture instead of dispensing medical advice, pro-choice GPs in the state say.

“Abortion is a mortal sin and you’ll go to hell,” one doctor reportedly told a woman in Cairns, who had asked about terminating her unwanted pregnancy.
Continued: https://www.theguardian.com/world/2018/oct/08/queensland-doctors-accused-of-deep-disrespect-for-women-seeking-abortion

South Africa – Anti-Choice Culture Is Allowed To Flourish At UCT. Why?

Anti-Choice Culture Is Allowed To Flourish At UCT. Why?

Aug 22, 2018
Temwa-Dango Mwambene

I am not one to write open letters, but I am enraged. I am very tired but unfortunately for “racist cishetero patriarchal Christian torture” not tired enough (yet) to take action. I am tired of the University of Cape Town (UCT), particularly the Faculty of Health Sciences, taking ethically weak stances on issues that they are meant to be at the forefront of advocating for, writes TEMWA-DANGO MWAMBENE.

I have been at UCT for four years and I remember the then vice-chancellor Dr Max Price welcoming us on the first year MBChB registration day and speaking about how UCT is a place for rigorous academic debate and contrasting views and as an example invited us to participate in the upcoming ‘Israeli-Apartheid’ week. A week, if UCT had any ethical integrity, that should rather be dedicated to collective initiatives around awareness and actions in support of the Palestinian liberation struggle. But this open letter is not about UCT’s inability to take a pro-Palestine position but about abortions.

Continued: http://www.thedailyvox.co.za/anti-choice-culture-is-allowed-to-flourish-at-uct-why-temwa-dango-mwambene/

Unconscionable: Health workers’ right to refuse abortions vs women’s right to choose

Unconscionable: Health workers' right to refuse abortions vs women's right to choose
When religion trumps science in medicine, women's bodies and Constitutional rights may be caught in the crossfire.

21 Jun 2018
Marion Stevens, Mandi Mudarikwa

South Africa‘s Choice on Termination of Pregnancy Act legalises voluntary abortion at different stages of pregnancy. Although viewed as a generally liberal law, the Act has not effectively enabled broad and consistent access for women seeking to terminate their pregnancies.

One of the reasons has been some health providers’ and facilities’ refusal to treat women who need abortion care.

Continued: http://bhekisisa.org/article/2018-06-21-00-unconscionable-a-doctors-right-to-refuse-abortions-versus-a-womens-right-to-choose

Ireland – No GP should be allowed opt out of abortions

Newton Emerson: No GP should be allowed opt out of abortions
Conscientious objection amounts to saying ‘We don’t serve your sort around here, love’

Thu, Jun 14, 2018
Newton Emerson

The UK supreme court sat for the first time in Belfast last month, hearing an appeal into the “gay cake” case, among others.

“People will of course not expect an answer any time soon,” the president of the court said upon reserving judgment.

Another thing nobody expects is for the court to let bakers opt into a register of those willing to ice gay cakes, comprising only a handful of bakers in the country, with people obliged to travel to find them.

Continued: https://www.irishtimes.com/news/politics/abortion-referendum/newton-emerson-no-gp-should-be-allowed-opt-out-of-abortions-1.3529281

USA – How The Administration’s Proposed ‘Conscience’ Rule Undermines Reproductive Health and Patient Care

How The Administration’s Proposed ‘Conscience’ Rule Undermines Reproductive Health and Patient Care

Adam Sonfield,Guttmacher Institute
First published on Health Affairs Blog: March 21, 2018

On January 19, the Trump administration proposed new regulations to interpret and enforce more than 20 federal statutory provisions related to “conscience and religious freedom.” Collectively, as interpreted by the administration, these statutes would grant broad powers to individuals and organizations in the health care field and beyond to refuse to provide or be involved with services, information, and referrals to which they have religious or moral objections. That includes services related to abortion, contraception, end-of-life care, global health care assistance, vaccination, and much more. The proposed regulations and steps to enforce them have real potential to undermine existing legal and ethical protections for patients’ access to sexual and reproductive health information and services, and other critical care.

Continued: https://www.guttmacher.org/article/2018/03/how-administrations-proposed-conscience-rule-undermines-reproductive-health-and

There is no defense for ‘conscientious objection’ in reproductive health care

There is no defense for ‘conscientious objection’ in reproductive health care

by International Campaign for Women's Right to Safe Abortion
Aug 8, 2017

by Christian Fiala, Joyce H Arthur  

European Journal of Obstetrics & Gynecology and Reproductive Biology


“A widespread assumption has taken hold in the field of medicine that we must allow health care professionals the right to refuse treatment under the guise of ‘conscientious objection’ (CO), in particular for women seeking abortions. At the same time, it is widely recognized that the refusal to treat creates harm and barriers for patients receiving reproductive health care. In response, many recommendations have been put forward as solutions to limit those harms. Further, some researchers make a distinction between true CO and ‘obstructionist CO’, based on the motivations or actions of various objectors.

This paper argues that ‘CO’ in reproductive health care should not be considered a right, but an unethical refusal to treat. Supporters of CO have no real defence of their stance, other than the mistaken assumption that CO in reproductive health care is the same as CO in the military, when the two have nothing in common (for example, objecting doctors are rarely disciplined, while the patient pays the price). Refusals to treat are based on non-verifiable personal beliefs, usually religious beliefs, but introducing religion into medicine undermines best practices that depend on scientific evidence and medical ethics. CO therefore represents an abandonment of professional obligations to patients. Countries should strive to reduce the number of objectors in reproductive health care as much as possible until CO can feasibly be prohibited. Several Scandinavian countries already have a successful ban on CO.”

The main text of the paper opens by saying: “Remarkably, pro-choice researchers and ethicists who support CO in reproductive health care rarely try to defend the practice beyond a simple assertion that individual conscience is an important right. Certainly this is true for everybody in general, but in the field of reproductive health care, there has been little or no recognition of how CO unjustly privileges doctors’ conscience over patients’ conscience, not to mention their life and health[1]. The granting of CO also gives legitimacy to the religiously-based assumption that abortion is wrong − however, providing safe abortion is an ethical practice that has saved the lives and protected the rights of millions of women. Moreover, doctors have obligations to their patients and the public. They occupy a privileged position of trust and responsibility in our society, and profit from a monopoly on the practice of medicine.”

An important argument they put forward is that the “largely religious and non-verifiable basis of CO makes the laws and policies that try to limit its exercise impossible to enforce”. Later, they continue: “Anyone can cite CO and lie or exaggerate. Or be sincere. Who knows? The only way we can judge is in rare evidence-based situations, such as when doctors in Italy and Poland are caught exercising ‘CO’ in public hospitals while doing abortions for profit in private clinics.”

But the crucial question they pose is: Is it possible to protect providers’ claimed right to refuse to treat patients and patients’ right to health care at the same time? Their answer is: the more objectors there are, the less possible it is to protect patients’ right to health care. So they argue that “as a first step towards mitigating the harms of CO, countries could at least require all publicly-funded hospitals to provide abortions, as Portugal has done”. Finally, they call for countries “to steadily reduce the number of objectors and eventually abolish CO, not save it.”

Source: International Campaign for Women's Right to Safe Abortion: http://www.safeabortionwomensright.org/there-is-no-defense-for-conscientious-objection-in-reproductive-health-care/