Readers are responding to Carly Weeks’ articles on what is stopping many Canadians from getting the abortion pill.
Two years ago, Canada was one of the last developed countries to make available a drug hailed as a safe alternative to surgical abortion. But, a Globe and Mail analysis reveals provincial access barriers and widespread reluctance on the part of medical professional to provide abortion care. The Globe found doctors are refusing to write prescriptions, forcing many women to travel to out-of-town clinics to get one.
Since Ms. Weeks’ story ran over the weekend, she has reported on Alberta’s medical regulator calling on the college representing Canada’s family doctors to help boost prescribing rates and how that same group turned down an offer from a national abortion group to provide physicians with a training course to help more women get prescriptions without going to other health-care providers.
Seems to me that all doctors should be required to take and pass the required training related to this medication as a condition of maintaining their license to practice.
Kudos to Hibo Farah for coming forward with her experience and her activism. Kudos to the brave clinicians and physicians who are creating “work-arounds” to support women in suburban and rural communities and ensuring the care which they deserve. Kudos to the SOGC for offering an online training program to enable physicians to learn how to safely prescribe this medication. Why have only 505 of the 43,000 family physicians in Canada taken this training? Why is this medication not the first choice before surgical procedures? To the Canadian Medical Association - where are your clinical guidelines to support better practices? Why is Health Canada not enforcing the principles of the Canada Health Act? Public administration, accessibility, comprehensiveness, universality and portability are the key principles of this Act. Provincial/territorial health insurance plans must respect these conditions in order to receive federal cash contributions. Why are provincial/territorial premiers not ensuring that women in their provinces/territories are being offered these medications? Canada has a fractured, “politics before care” system that relies too heavily on a few front-line clinics.
Not only does the medical profession need to step up but surely Health Canada could allow the tele-health industry to get involved: I can now do a video or audio call with a doctor for a sinus infection, the flu and other things that used to take us to the doctor's office. They have doctors licensed to prescribe in my Province. With a dedicated line for women this should be easy to handle - there doesn't have to be a specialist involved and most times there is no reason for a full physical exam. If Canada really is the modern country we keep claiming it is we should be working to solve this for women who are not in urban centres.
Doctors have this Hippocratic oath and it is supposed to start out: Primo non nocere. Which would create a problem where there is a mother and fetus and the mother wants to medically dispose of the fetus. In fact “first do no harm” was not included in the original Hippocratic oath. Rather 400BC doctors reciting the pledge promised to “give no deadly medicine to any one if asked,” and to “abstain from every voluntary act of mischief and corruption.” "No deadly medicine" Odd phrase as quite a lot of medicine is deadly if we get the dosage wrong. Today, medicine is no longer just the province of individual doctors guarding their patient privacy, but a team effort where the state picks up the bills and sets down the terms of practice. Which raises another issue: if the community is really my medical decision-maker rather than the guy with the stethoscope hovering over me, does the community decide in my interest or its interest and whose interest ultimately gets put first?
It is truly such hypocrisy that Trudeau and many Canadians wag their fingers at the US and other countries regarding the barriers to abortion when we have provinces like PEI and New Brunswick who have made abortions very difficult. Now it is evident that there are many barriers to obtaining Mifegymiso. What good is it in this country that law courts and legislators pass laws allowing the abortions, abortion pills, MAID, etc but barriers established by provincial health systems, doctors, unnecessary rules make utilizing it impossible for most. Canada is far too balkanized which disadvantages many.
There’s two statements that, for me, stand out in this article. ”... the most significant issues are a professional reluctance to be seen as an abortion provider ...” And College (of Family Physicians of Canada) spokeswoman Jayne Johnson declined an interview request.” As a country, we can do better.
If some doctors think it's "too complex" to prescribe the abortion pill, how complex do they think it will be for a 15-year-old to have a baby and then raise it to adulthood? In any case, while it is the doctor's right to decide what is best for the health of his/her patient, it is NOT their right to impose their moral opinions on patients.
I am conflicted about this. While it's okay to promote this idea of better access to abortion pill, we should also consider the case if a doctor has a belief (religious or not) against abortion, we should be able to respect their belief. I think it is perfectly acceptable for doctors to refer their patient wishing for abortion to an abortion clinic so the doctor can do their job without forcing them against their conscience.
There are several assumptions the author is making here: 1. Low prescribing rates outside of cities are primarily due to reasons of poor physician perception/training 2. Individuals living outside of cities are interested in seeing their family doctor for this treatment 3. Populations outside of cities have correlating rates of need for this therapy compared to city populations In any event, it’s great to be reading adult comments and sensible writing about an adult subject. Keep the religiously motivated out of this conversation.
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