PUBLICATION:
Montreal Gazette
DATE:
2004.05.16
EDITION: Final
SECTION:
Editorial / Op-ed
PAGE:
A13
BYLINE:
DEBORAH RANKIN
SOURCE:
Freelance
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Canada
needs informed-consent law on abortion: Fundamental principle of patient care.
Women need complete information when making reproductive choices
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Margaret
Somerville's article in favour of elective C-section as a delivery option,
provided it is based on informed consent ( "The C-section option,"
April 4, 2004 ) is instructive about the need for meaningful consent in
pregnancy decisions, consistent with the standards of patient-centred health
care. She argues since a woman has a right to an elective abortion - one that is
covered by medicare, whether or not it is medically necessary - a pregnant woman
ought to have the same right to choose C-section, for nontherapeutic reasons.
However,
her argument raises as many questions about the abortion decision-making process
as it does about C-section, because there is no abortion law in Canada: No
informed-consent provisions, no health-reporting information, no requirement to
report statistics. There is simply no prohibition against abortion, which is
qualitatively different than any claims made about women's health rights, or
reproductive choice.
Successive
attempts to bring in an abortion law - one that balances competing claims, while
addressing important health and social issues - have failed. Recently, Saskatchewan
MP Gary Breitkreuz introduced a motion calling for informed-consent abortion
legislation. He said his motion would guarantee a woman contemplating abortion
be given complete information about risks associated with the procedure and
provide penalties for any physician who performs an abortion without the
informed consent of the woman.
This
was an important and timely initiative. Typically, women who abort find out
about unwanted side effects the hard way - after the fact. But, the detrimental
effects of abortion are not limited to grief and loss. There are more than 1,200
studies on the adverse psychological and medical consequences of abortion. These
include severe psychiatric symptoms, suicide, breast cancer, infertility, pelvic
inflammatory disease and an increase in pre-term and low-birth weight babies.
Parliament
should have held health hearings on abortion by now, but Breitkreuz's earlier
motion, proposing just that, was defeated last fall. The problem is that many
politicians share an elite consensus that abortion is purely a matter of
personal choice - no more medically or morally complicated than tooth extraction
- and won't listen to any evidence to the contrary.
But,
rather than ensuring reproductive freedom, unregulated access to abortion is a
breeding ground for coercion and defective consent, as documented by numerous
social studies. Support groups for post-aborted women, with names like
Afro-American Women Exploited by Abortion and Victims of Choice, illustrate the
fact many women feel their abortion decisions have been pressured, or made in a
vacuum of real options.
Abortion-on-demand
also gives unstable women the opportunity to medically maim themselves. In the
U.S., where many states have enacted informed-consent laws, the National
Abortion Federation, nevertheless, reports it is seeing women who have had as
many as 14 abortions. Clearly, it will take more than mere regulation to change
this kind of self-destructive behaviour.
Although
informed consent isn't the highest ethical requirement of reproductive choice,
it is a democratic imperative. Those concerned about the democratic deficit in
Parliament must ask themselves how governmental complicity in coercion and
censorship of health-reporting information, furthers their cause.
Is
this what Canadians really want?
The
Leger Marketing firm asked 1,882 survey respondents if they would support
informed-consent laws similar to those in the U.S., which require before a woman
has an abortion, her physician provide her with information about fetal
development, possible complications and alternatives to abortion. A surprising
69 per cent said yes; 24 per cent said no and seven per cent didn't know. These
findings dispel the belief Canadians support abortion-on-demand.
In
Quebec, the CLSC Faubourg has received a provincial mandate to perform late-term
abortions, yet counselling protocols don't normally require a woman considering
an abortion undergo an ultrasound or receive any information about her pre-born
baby's development.
In
a strange twisting of priorities, the Quebec government is wiling to fund
late-term abortions, but won't help families in crisis. By 2005, single mothers
of newborn infants will have to show proof they are actively looking for work to
qualify for social assistance - a move that is sure to increase the number of
late-term abortions.
Federal
politicians' responsibility to bring transparency to the abortion issue is long
overdue. There is no reason why abortion should remain outside the ethical norms
that govern the delivery of health care. It is absurd informed consent is
required for organ donation after death, but not abortion before birth.
Informed
consent is a fundamental principle of patient care and attempts to bypass it
where abortion is concerned are a violation of patients' rights. After the
election, the next federal government, whichever party forms it, must act to
correct the errors of the past by enacting legislation that will truly protect
the health and well-being of Canadian women.
Deborah Rankin is a Montreal writer.