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Open Letter to
Health Minister Keith Norton
regarding medically-insured
free-standing abortion clinics
Hon. Keith Norton
Minister of Health
Queens Park, Ontario
September, 1983
We, the undersigned medical practitioners in the province of Ontario,
wish to state our support for the establishment of medically-insured,
free-standing abortion clinics in Ontario.
As physicians we know that there is no completely reliable method
of birth control and that not every method is suitable for every
woman. We have seen the devestating results of unwanted preqnancy
-- to the child and the mother. Until birth control techniques and
the dissemination of birth control information greatly improve,
we face an undesirable but necessary choice -- that of abortion.
As physicians, we are all too familiar with the obstacles confronting
many women seeking abortion in Ontario. Accessibility to abortion
has been compromised by several factors. Section 251 of the Criminal
Code of Canada states that all abortion requests must be screened
by a Therapeutic Abortion Committee in an accredited or approved
hospital. Many hospitals, particularly in rural and smaller urban
centres, in response to minority but powerful anti-choice pressure,
have not established such committees.
In larger centres, the number of abortions being performed has
been severely limited by quotas limiting the operating space allocated
to the abortion procedure. For example, the clinic in the Toronto
General Hospital receives approximately 75 calls daily from women
requesting abortions and only six are booked daily. Calls are accepted
only during certain restricted hours, with that single line being
busy for hours on end.
Finally, many private gynecologists levy a fee to the patient of
over two hundred dollars in addition to the OHIP rate. This has
recreated a two-tiered system of selection whereby wealthier patients
are able to obtain abortions earlier and more easily through private
services.
These circumstances conspire to force many women to wait unnecessarily
long periods of time to obtain procedures (often three weeks or
more). The result is an increased medical risk to women. In addition,
many women must travel long distances from all areas of the province,
from smaller centres to larger centres for a simple procedure, and
increasingly to Quebec to the Morgentaler Clinic or across the border
to Buffalo or New York (often from Toronto, itself).
We believe as well, that as a result of these delays and obstacles,
an unnecessary number of second trimester abortions are being performed.
As physicians, we feel that the present lack of guidelines governing
therapeutic abortion committees often leads to humiliation for women
already facing a crisis in their lives. Whereas one committee may
utilise the broad definition of health given by the World Health
Organisation, another may grant abortion only on the strict grounds
of serious impairment of health.
Ontario women need access to early, medically safe and medically-insured
abortions. This access in not guaranteed by present legislation
and practice. We believe that free-standing abortion clinics could
serve this purpose. The safety of these clinics has been demonstrated
already in Quebec and the United States. They can also offer a supportive
environment for women which hospitals seem unable to do. Clinics
have the potential to make the procedure more humane and offer more
comprehensive care in the form of birth control counselling and
psychological support and thus have a more preventive role.
In order to combat the resurgence of the two-tiered system of medical
care delivery we must ensure that these clinics will be fully covered
under medicare. We suspect that in the end such clinics would be
much less expensive than the hospital situation and certainly decrease
the number of second trimester abortions being performed.
To reiterate, as physicians concerned with the health care of women
in this province, we support the establishment of free-standing
abortion clinics that are medically insured.
Subject Headings: Abortion
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