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Philip G. Ney, MD, MA, FRCPC, RPsych
© September 17, 2007
Re: Abortion as Medicine: Response to Andrea Mrozek’s piece in the National Post
Ms. Mrozek made a brave attempt to tackle a very touchy subject but missed some essential features. The most salient and most often forgotten of these is that because abortion is a medical procedure, performed by medical personal, in medical facilities and paid for by medical funds, it must come under all the constraints imposed on the practice of medicine by the medical profession and by the government. It should, but for some curious reason it doesn’t.
These constraints are that any medical procedure: 1) is necessary because without it the patient will die or become chronically ill or disabled. 2) is indicated for those that suffer from the disease in question and for the particular patient for whom the procedure is recommended. 3) has scientifically verifiable benefit. 4) has relatively few and no lethal side effects. 5) is clearly recommended with logical reason’s in a language that that the patient can comprehend and consider. 7) is not performed until an informed consent is freely given. 8) is not performed until other less invasive or potentially harmful methods have been offered and tried without success. 9) the physician who is about to perform the procedure is practicing in good conscience having weighed the available evidence and been convinced by his skill and the results of this practice on his previous patients. 10) is not performed if these constraints are not met for then the practitioner must first do no harm.
It must also be remembered that the onus of proof rests upon those who support, pay for, refer to or perform the procedure. There is an obligation on other physicians to show if and what are the deleterious effects of a procedure if they suspect it is not therapeutic. However, that obligation is less onerous than the one on those who perform to show benefit. If nothing else they can say to those who support or perform abortions, “Prove it”. “You must show me the benefit of abortions and that the fetus is not a person. Until you do, I am under no obligation to refer for or perform an abortion. The only responsibility I have is to warn my patients that abortion has no proven benefit and that the evidence to date show abortions to do considerably more harm than good”.
If those who promote or perform abortion can scientifically show benefit etc., then every physician is obligated to use that procedure if and when it is necessary and if there is no one else to do it. With respect to abortion, any prolife physician can feel secure in the knowledge that the evidence is strongly on his/her side. I have for many years challenged those who promote abortion to find the evidence, patient and situation, which would require me to do an abortion. It isn’t because they haven’t wanted to call my bluff and embarrass me that this has not happened.
What is distressing to many physicians is that abortion seems to be an exception to these well-tried and historic medical rules. Those who perform abortions have not seriously tried to show that abortion is better than no treatment. The supporters of abortion hide behind what appears to be public and political support and if ever challenged, too often resort to name-calling rather than address the real issues inherent in the practice of evidence based medicine.
There are many and a growing number of good scientific studies that show abortions do more harm than good. Amoung them are the research done by Readon et al (South Med J 2002, 95:834-41) on 186,000 Medicaid recipients in California. When previous psychiatric admissions were controlled for, we found that when comparing women who had an abortion with women who had babies, the former had significantly higher rates of suicide, homicide, increased drug abuse, psychiatric admissions, and death from heart attacks and strokes. In Victoria we found (Ney et al, Soc Sci Med 1994 38: 1193-200) that women visiting their family doctors and who are representative of the general Canadian population who had a pregnancy loss, were less well. Those who had an abortion suffered statistically greater ill effects.
Sincerely,
Philip Ney MD FRCP(C)
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