New Brunswick Right to Life
P.O. Box 113, Station A, Fredericton, NB E3B 4Y2
Tel. (506) 459-8990 or toll-free 1-888-796-9600. Fax (506) 454-8093. Email nbrl@nb.aibn.com
Office: 562 Brunswick St., Fredericton, NB. Website: www.nbrighttolife.ca
Life for All. Love for All.
April 15, 2009
The Hon. Michael B. Murphy, QC
Minister of Health
Province of New Brunswick
PO Box 5100
Fredericton NB E3B 5C8
Dear Mr. Murphy:
I regret to write that I am dismayed by your March 10, 2009 response to my correspondence of February 3, in which I urged you to take action to
curb the practice of de facto abortion on demand which has arisen under provincial auspices at the Chaleur and Dumont hospitals.
Your letter expresses no concern about the loss of 370 babies’ lives at these two institutions during a one-year period. For those of us who as parents
and grandparents have invested a good part of our lives caring for our young while in the womb, an apparent lack of concern in the face of such great
human tragedy seems chilling. The way you also pass over in silence our contention that respect for life should, in the Hippocratic tradition, be a
hallmark of any health care system is anything but reassuring.
Despite our submission on this matter, you evince no recognition that some physicians are performing abortions on demand in contravention of
government policy on Medicare-insured procedures. You cling to the explanation that “the increase [in abortions at the two hospitals] reflects a change
in service delivery whereby the provision of therapeutic abortions is now concentrated in fewer hospital facilities in the province.” With respect, that
explanation is just not credible.
Hospital abortions in this province have always been concentrated largely in one or two regional hospitals, with other regional hospitals performing few
or none. The true explanation for that is that a very small number of physicians (as few as one or two) at one or two hospitals were allowed to do
abortions on demand, whereas obstetrician-gynaecologists at other hospitals followed a much stricter definition of a “medically necessary abortion.”
For years the big problem was at the Moncton Hospital, due largely to one physician. The hospital did more than 10 times the number of abortions at
the Atlantic Health Sciences Corporation in Saint John, serving a similar-sized population. Why? Because of the radically different interpretations of
“medically necessary.” In 2002, Dr. David Kogan announced the Moncton Hospital was largely curtailing abortions, and adopting an approach similar
to the hospital in Saint John (news article enclosed). [Note: Insiders consider that the latter’s strict approach stems in good part from the influence of one
outstanding physician, the late Joe MacDougall.]
After the change in Moncton the Chalmers Hospital in Fredericton became a center for abortion on demand, performing a similar number to the Moncton
Hospital, due again largely to one physician. We found that a board of directors submission in 2004 by the late Dr. Don Morgan (then chief of staff) suggested
that abortions were being done up to 12 weeks gestation at the request of the patient. We therefore publicly alleged that physicians billing Medicare for
effective abortions on demand were committing fraudulent acts (news article enclosed). In 2006, to our relief, abortions stopped at the Chalmers.
But now abortion on demand once again has found a hospital home, only this time at two facilities. Again a small number of physicians are involved. The
total numbers are comparable to the Chalmers situation. Once again the system is being abused.
This, Mr. Minister, is the reality that calls for your intervention. If you still refuse to act, observers may be forgiven for wondering if it is because you genuinely
see no problem, or because you have a case of wishful thinking stemming from a lack of political will to do what is right.
You know me, Mr. Murphy. I think you know that I choose my words carefully. I try not to cry wolf. I write out of deep conviction, based on long experience
and careful observation, that we have a very real and serious problem involving the needless loss of innocent lives. You will forgive me if I find that, in the
face of such a problem, any stonewalling around the status quo just is not acceptable.
You are not the first health minister to have an abortion problem. But that is no excuse for inaction.
The enormity of the problem almost cannot be overestimated. Since abortion was first legalized in 1969, for undefined “health” reasons, almost 25,000
induced abortions have taken place in New Brunswick! And fully two-thirds were in hospitals! Can you and the government not see what a
staggering loss of infant life this has been for the province?
Everyone is now decrying our demographic crisis. Yet to a considerable extent the Province has brought this on itself, through its lack of policy support
for unborn life. And still we have not learned our folly?
As if the past and present were not tragic enough, an uncritical embrace of the status quo spells much worse in the future. There is little in the present system
that would prevent New Brunswick’s situation deteriorating to the dramatically worse level of hospital-based abortion on demand we see in Nova Scotia.
There, over 1,900 abortions take place a year (almost twice our provincial rate!), all in hospitals (largely one, in Halifax) and all under the guise of “medical
necessity.” That is where ignoring abuse can take us. Surely you and the government are not comfortable with that trajectory?
But is the government truly opposed to abortion on demand? We have always understand that to be a key reason the Morgentaler clinic in Fredericton is
not publicly funded. Yet as this story about our hospitals comes out, people will rightly ask, “How can we justify not funding the clinic when the same kind
of practice is already paid for in hospitals?”
The government’s laissez-faire approach with respect to hospitals has resulted in more and more blurring of the line with private abortion clinics. The number
of procedures at the Morgentaler facility has, in fact, diminished in recent months. Why? Precisely because unwanted pregnancies can now more readily be
terminated in hospitals!
What’s more, continued non-intervention could easily result in the same scenario that unfolded in Nova Scotia: Morgentaler closed his Halifax clinic because
abortion had in reality - despite all the legalese about “medical necessity” - become available on demand in the hospitals! Is that the type of legacy your
government wishes to leave to New Brunswick?
With respect, Mr. Minister, washing your hands of this problem will not do. Action is needed, now.
At the very least you should undertake an immediate investigation of what it happening. This should be a non-partisan, extra-departmental study of the
extent to which (a) definitions of “medically necessary abortion” vary among the obstetrician-gynecologists of the province; (b) induced abortions are,
or have been, occurring in the hospitals based essentially upon the request of the woman or upon her indication that the pregnancy is unwanted. An
accurate answer to (b) should provide you with an effective gauge of abortion on demand.
The very fact such an investigation is conducted would, moreover, serve as a deterrent to unscrupulous physicians. On the other hand, your avoidance
of such a study would suggest indifference as to whether a problem in fact exists. I hope we will be spared such a disappointment.
In your letter you do acknowledge the “potential for abortion on demand in the publicly funded health care system” [my emphasis]. But you maintain that
the current Medicare Regulation contains “appropriate safeguards to minimize” that potential. With respect, your confidence appears naive, uncritical, and
does not withstand scrutiny. It reminds me of the farmer who declares the chickens are safe when the fox is in the henhouse.
The Regulation did not prevent years of abortion on demand at the Moncton Hospital. It did not prevent it at the Chalmers. And it is not preventing it now
at the Dumont and Chaleur hospitals.
Any thinking person can understand how giving two physicians complete discretion to determine medical necessity in the case of abortion, as the current
Regulation does, easily allows personal “pro-choice” views to colour their assessment, so that any, or virtually any, unwanted pregnancy is considered
grounds for a “therapeutic” abortion. When that happens, you have Medicare-funded abortion on demand!
Serious studies have amply demonstrated how the lack of definition of terms like “therapeutic”, “medically necessary” or “risk to health” with respect to
abortion creates a loophole big enough to drive the proverbial truck through. Thus, as far back as 1977, the federal Badgely Report found that abortion on
demand was practised by physicians despite the law then permitting only “therapeutic” abortions (Report of the Committee on the Operation of the Abortion
Law, p. 29).
It’s an old problem, admittedly. But just because abuse is common doesn’t mean it should be ignored or tolerated, and especially not when innocent lives
are at stake. And it’s not as if there is no solution. “Medically necessary” can and should be defined in the Regulation.
That term should mean something, rather than, as is now the case, anything a doctor wants. With other procedures “medical necessity” may be
straightforward, hence no need for legal definition. Abortion, however, is complex and not straightforward. Governments in various countries have
therefore given legal meaning to “medically necessary abortion.” There is no reason why New Brunswick is incapable of doing likewise. It is the
responsible course of action.
As outlined in my February 3 letter, the government has the authority to make such a definition, and we have outlined several alternative approaches
to remedy the situation. We urge you to reconsider these proposals.
Even before undertaking such an amendment, you as Minister could write to the obstetrician-gynecologists of the province (about 50 in number). You
could remind them that Medicare funds abortions only in the case of genuine medical necessity. You could clarify that abortions performed on the basis
of patient request, or because of an unwanted pregnancy, would, in the absence of other serious medical indications, not satisfy the criteria of medical necessity.
Such a clarification could help ensure that some physicians act more responsibly than they otherwise might be inclined. It could help prevent abuse of the
system. I urge you, as the gatekeeper of the system, to take such action.
The real solution, however, is to amend and enforce the Regulation. The other track that needs to be pursued, as mentioned in my previous letter, is to
provide more services to pregnant women in need, so that demand for abortion decreases.
The immediate challenge for you as Minister is to recognize that all is not well in the hospitals on this file. It must be a constant temptation for government
ministers to deny that problems exist in order to avoid responsibility for fixing them. I hope that is not the case here.
You and the government have shown decisiveness in addressing the need for reforms within the health care system. I hope that zeal has not yet been exhausted.
The abuse of Medicare for abortion must be addressed.
It is not so much about the waste of public funds. It is more about how those funds are used to needlessly end the lives of children. May I suggest that is the
type of thing where, in the light of history, once the winds of political correctness have subsided, negligence by the relevant authorities will not be lightly
regarded.
Yours sincerely,
Peter Ryan
Executive Director
Encl.
cc: The Hon. Shawn Graham, Premier
The Hon. David Alward, Opposition Leader
