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Improving Abortion Access in Canada

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Abstract

Though abortion is legal in Canada, policies currently in place at various levels of the health care system, and the individual actions of medical professionals, can inhibit access to abortion. This paper examines the various extra-legal barriers to abortion access that exist in Canada, and argues that these barriers are unjust because there are no good reasons for the restrictions on autonomy that they present. The paper then outlines the various policy measures that could be taken to improve access.

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Notes

  1. One exception is found in the second section of the paper where I discuss the possibility that moral reasons can be given for limiting women’s autonomy in accessing abortion.

  2. There is currently a bill before parliament (Bill C-484) that would make it a crime to kill a fetus during the commission of a violent act against its mother. Introduced by a Conservative MP, this Bill is clearly an effort to set a precedent for fetal rights, which could lead to an attempt to re-criminalize abortion.

  3. Three Canadian abortion providers have been shot since 1994. The Morgentaler clinic in Toronto was bombed in 1992 [19, p. 848].

  4. On the social and psychological factors that contribute to impeding autonomous choice in reproductive matters, see Baylis [4, p. 789].

  5. For some accounts of the relational determinants of autonomy, see Downie and Llewellyn [17]; Mackenzie and Stoljar [30]; Sherwin [46]; Downie and Sherwin [18].

  6. See Mummery v. Olsson, [33] for a recent case, and a summary of the relevant case law.

  7. Erdman makes this point. See Erdman [21, p. 1144].

  8. The issue of conscientious objection to providing referrals for abortion has been controversial in Canada over the past few years. See the editorial by Rodgers and Downie [42]. See also the resulting letters to the editor [15, 20, 27, 28, 40] and response by the authors [43]. The letters and response provoked a controversial “clarification” by Jeff Blackmer, the Executive Director of the Office of Ethics at the Canadian Medical Association, on the question of the duty to refer patients for abortion [6].

  9. Carolyn MacLeod acknowledges that there may be some room for the conscientiously objecting physician to argue that he/she cannot agree to a compromise that includes the duty to refer for abortion [31]. If MacLeod is right, more argument may be needed than what I have given here in order to prove a moral obligation on the part of physicians to refer for abortion.

  10. For two examples, see British Columbia Civil Liberties Assn. v. British Columbia (Attorney General) [7] and Association pour l’accès à l’avortement c. Québec (Procureur général) [3].

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Acknowledgments

I would like to thank Jocelyn Downie and Susan Sherwin for reading and commenting on several drafts of this paper. This paper was originally presented at the 2007 Canadian Philosophical Association meeting in Saskatoon, and in a Works in Progress session in the Department of Bioethics at Dalhousie University in May 2007. My audiences on those occasions provided many helpful comments. I owe thanks as well to the members of Dalhousie’s Novel Tech Ethics group for reading and discussing various drafts with me.

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Kaposy, C. Improving Abortion Access in Canada. Health Care Anal 18, 17–34 (2010). https://doi.org/10.1007/s10728-008-0101-0

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