Written by Alex Schadenberg

Yesterday, I received a phone call and then an email from Bernard Stephenson, concerning Joshua (Kulendran Mayandi) the pastor of a small christian church in Brampton Ontario. The email outlined several significant concerns for the Euthanasia Prevention Coalition.

First: Joshua (48), who is not otherwise dying, is being dehydrated to death (euthanasia by omission). This is not a case when hydration and nutrition need to be withdrawn because he is actually dying and nearing death, but rather the decision appears to have been made to intentionally cause his death by withdrawing IV hydration and nutrition probably because he is unlikely to recover from his disability. 

Joshua has otherwise stabilized and would likely live for many years in this condition. Society cannot condone intentionally dehydrating a person to death because of their disability or the potential cost of long-term care. Article 25 (f) of the Convention on the Rights of Persons with Disabilities states: Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability. (http://www.un.org/disabilities/convention/conventionfull.shtml)

Second: It is deplorable that the Consent and Capacity Board in Ontario, the hospital and the lawyer for the hospital, who are all paid by the government and have nearly unlimited resources to pressure people to consent to their will, appeared to appoint a Substitute Decision Maker (SDM) to make decisions on behalf of Joshua, based on that persons willingness to agree to a non-treatment plan, even though there is no proof that the plan of non-treatment represented the values of the person.

The Consent and Capacity Board was established to ensure that consent to treatment is based on the prior wishes or values of a person, before that person became incapacitated to make decisions for themselves. The fact that Joshua did not write down his personal wishes or assign a person to make legal and health care decisions on his behalf in these circumstances, does not negate the fact based on his religious convictions it is unlikely that he would have agreed to death by dehydration.

To pressure a person to agree to intentionally dehydrate a person to death, (euthanasia by omission) based on the cost of continuing the legal battle to defend the values of a person, is unconstitutional and inconsistent with Ontario law.

Everyone needs to strongly respond by sending letters and emails to:
Brampton Civic Hospital - email: This email address is being protected from spambots. You need JavaScript enabled to view it. or call the Communications Hotline at: 905-494-2120, ext. 22505. 

Consent and Capacity Board of Ontario - email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone: 416-327-4142, Fax: 416-924-8873

The letter should state:
I am disgusted with the decision by the Brampton Civic Hospital, its lawyer, and the physician for (Joshua) Kulendran Mayandi, to intentionally cause his death by removing his IV hydration and nutrition even though he is not otherwise dying (euthanasia by omission). If this decision is not reversed, it will create fear among the citizens of Brampton that if they experience a disability that they too would be killed by dehydration and starvation.

For the sake of justice and equality, I demand that you change your policy and once again continue feeding.

The following is the email from Bernard Stephenson:

Joshua is a 48 year old pastor of a small Brampton Church. He was admitted to the Brampton Civic Hospital (William Osler Health Centre), after collapsing in front of the ER on May 29, 2010.

He was revived but not before sustaining a significant cognitive disability.

He remained in the ICU, but after regaining the ability to breathe on his own, he was transferred to the respirology ward, where he remains.

He has regained some ability to communicate despite the fact that he has a significant cognitive disability.

He has progressed from being in a deep coma with signs of decerebration and decortication to almost full movement of his arms and legs and coherent use of mostly one-word answers and occasionally multi-word sentences with his sister over the phone.

He recognizes the family he was living with for the past 10 years, who have been at his bedside from morning to evening, 7 days a week.

From the beginning of his stay in the ICU until now, the doctors have repeatedly asserted that there is no hope of recovery, from a medical point of view, and they have strongly suggested that all life-sustaining treatment be removed.

His family, who live in Sri Lanka, and his supporters here have rejected these suggestions.

Nevertheless, the fact is that he had assigned no Substitute Decision Maker (SDM), and he has no immediate family living in Canada.

His first physician in the ward, removed his feeding tube, without consent, leaving him only IV fluids.

He was in this situation for over three weeks until his supporters appealed to the Ethics Committee adn the Consent and Capacity Board through a lawyer and forced the hospital to restart feeding through a nasogastric (NG) tube. Even though he was entitled to a long term gastric (G) tube the physicians refused the latter option, even though they had initially suggested it, citing that it is 'artificial' and possibly 'harmful'.

Currently, the only option the hospital and his current physician is offering is to withhold all life-sustaining treatment and care including IV fluids, food and medication.

The court first rejected Joshua's sister, Mallika Arumugan, as his (SDM) because they did not consider her capable of making medical decisions for Joshua, but she also did not agree to the demands of the hospital.

After the court rejected Joshua's sister as his SDM, a friend for 25 years became the next option. We were told that this friend would only be accepted as the SDM if he agreed to the preconditions – palliative care with the removal of all medications, IV hydration and nutrition. The alternative was a continuation of the costly legal battle before the Consent and Capacity Board or allowing the Public Guardian to take over. Since we were not able to sustain the costly legal battle and the family did not want Joshua to fall into the hands of the Public Guardian, this friend decided to accept the terms. He was subsequently granted SDM status with those limiting conditions. 

Personally, I disagreed with the decision as it was immoral, unethical, inappropriate and wrong besides being totally useless.

Brampton Civic hospital on August 17 withdrew all life-sustaining treatment and care, including fluids and food, based on the forced agreement between the hospital and the SDM.

I deplore what the hospital and doctors are doing. They have a duty to inform people about quality of life and treatment options in a given situation, such as Joshua's, but they do not have the right to impose their preference for death or to assume that Joshua would not want to live the rest of his life in this condition. The Hospital and doctor's actions are both unethical and inappropriate.

Bernard Stephenson, M.D., M.Div.
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

To contact Alex Schadenberg at the Euthanasia Prevention Coalition call: 519-851-1434 (cell phone)

To order the Life-Protecting Power of Attorney for Personal Care:http://www.euthanasiaprevention.on.ca/lifeprotectingpowerattorney/index.htm

The case of Kulendran Mayandy

You may not have heard the name of Mr. Kulendran (Joshua) Mayandy. Mr. Mayandy passed away on September 6, 2010. However, the hospital care he received was the subject of public discussion and debate for more than two weeks leading up to his death. The hospital maintains that it followed appropriate procedures in Mr. Mayandy’s care. His friends and colleagues disagree.

Kulendran Mayandy, 48, was the pastor of a small church in Brampton, Ontario. Originally from Sri Lanka, where his family still lives, he lived with friends from his church for the past 10 years.

On May 29, 2010, he had a heart attack. He stopped breathing for a few minutes before he was revived and therefore experienced severe brain damage, resulting in a stay in intensive care at William Osler Health Centre in Brampton, Ontario.

When he was able to breathe on his own, Mr. Mayandy was transferred to another unit in the hospital. For the next two months, he was treated and made significant progress, according to his friend, Rev. Bernard Stephenson. [1]

In late June, the William Osler Health Centre stopped providing nutrition to Mr. Mayandy. This means that he received water, but no food. On July 16, friends and family appealed this decision to the Consent and Capacity Board of Ontario. [2] The family won this case, meaning that the hospital would be required to continue supplying him with nutrition through a tube.

Because Mr. Mayandy was not able to speak for himself, a member of his family from Sri Lanka applied to the hospital’s Consent and Capacity Board to be his Substitute Decision Maker (SDM). The family member was rejected by the Board. (When a person is judged incapable of making legal decisions with regards to desires for care a Substitute Decision Maker is appointed.)

The Board appointed another friend of Mr. Mayandy as his SDM on August 13. However, they placed a difficult condition on his appointment; he would need to accept the removal of nutrition tubes:

Mr. __ now consents to PK’s treatment, commencing August 17, 2010, palliative only, including safe removal of NG and IV tubes… [3]

According to the Health Care Consent Act, this condition is within the powers of the Consent and Capacity Board. [4]

Their decision also describes Mr. Mayandy this way:

We were also satisfied, based on the evidence we heard and the agreement of all parties, that the patient remains treatment incapable with respect to all treatments. [5]

Yet his friends insist Mr. Mayandy had regained the ability to speak single words, that he recognized members of his family and the church and was even able to take some small amounts of food by mouth. [6] It is not clear why the SDM accepted these terms.

By the beginning of September, Mr. Mayandy was experiencing kidney failure and had a seizure. He died on September 6. [7]

William Osler Health Center would not confirm or refute any of the details of the case, citing patient confidentiality.

Many questions remain.

Firstly, was the hospital’s treatment of Mr. Mayandy palliative care, as the August 13 order of the Consent and Capacity board stated?

Health Canada defines palliative care as follows:

Palliative care is an approach to care for people who are living with a life-threatening illness, no matter how old they are. The focus of care is on achieving comfort and ensuring respect for the person nearing death and maximizing quality of life for the patient, family and loved ones. [8]

Withholding nutrition, (starvation) is not a comfortable death; giving a patient only liquids does not maximize their quality of life. And, by the accounts of eye witnesses Mr. Mayandy was neither near death nor dying. He had suffered brain damage as the result of a heart attack. It appears as though the hospital was citing this as palliative care in contradiction to Health Canada’s definition.

If the hospital judged Mr. Mayandy’s treatment to be futile and subsequently withdrew food in order to hasten his death, this would be a case of euthanasia, not palliative care. Such an action is not part of palliative care. Dame Cicely Saunders, who founded St. Christopher’s Hospice in London in 1967 and is seen as the founder of the modern hospice movement, described the vow of palliative care workers as “We will do all we can not only to help you die peacefully, but also to live until you die.” [9]

Secondly, why does the Consent and Capacity Board have the authority to make the withdrawal of nutrition a condition of appointment as SDM? In this case, what good is a Substitute Decision Maker if they can’t make decisions?

How many SDMs have been treated similarly by the Consent and Capacity Board? What was the Board's intent in this case? How many family members have been treated this way by doctors and hospitals? A case before the courts shows that this is not an isolated situation. [10] Certainly, patient confidentiality is important, however, it should not be used as an excuse to avoid tough questions. Mr. Mayandy’s family and friends in Canada deserve these answers; so too do Canadians who may experience similar treatment in the event of a medical emergency.

Recommendations

Recommendations from this difficult case include questioning the regulations and procedures governing the Consent and Capacity Board.

The remaining recommendations are for Canadians at large, who need to understand what palliative care is—and is not. Canadians should also make their end of life expectations very clear, well in advance.

Download the full report below

Download PDF: 

Death by starvation in Canada?

ENDNOTES: 

1. Personal communication with Bernard Stephenson, September 7, 2010.
2. The Consent and Capacity Board is an independent body created by the Ontario government to conduct hearings and make rulings into cases like this one under the Health Care Consent Act. 
   Consent and Capacity Board of Ontario. Retrieved September 8, 2010 fromhttp://www.ccboard.on.ca/scripts/english/aboutus/index.asp
3. Consent and Capacity Board of Ontario. (2010, August 13). In the matter of Health Care Consent Act S.O. 1996 c. 2, Sch. A as amended and in the matter of KM, a patient of William Osler Health Centre-Brampton Campus.  Docket Num. 1186, File Num. HA-10-1483, HA-10-1497.
4. Health Care Consent Act, 1996, S.O. 1996, c. 2, Sch. A. Section 33(7). Retrieved September 8, 2010 fromhttp://www.canlii.org/en/on/laws/stat/so-1996-c-2-sch-a/latest/so-1996-c-2-sch-a.html#BK41
5. Ibid.
6. Personal communication with Bernard Stephenson, September 7, 2010.
   Personal communication with Alex Schadenberg, September 7, 2010.
7. Health Canada. (2009). Palliative and End of Life Care. Retrieved September 7, 2010 from 
   http://www.hc-sc.gc.ca/hcs-sss/palliat/index-eng.php
8. Picard, A. (2010, July 21.) There are a lot better places to die than Canada. The Globe and Mail, p. L1.
9. Cribb, R. (2010, September 4). Lawsuit could set precedent about end-of-life decisions. The Toronto Star. Retrieved September 8, 2010 at http://www.thestar.com/news/gta/article/856741--lawsuit-could-set-precedent-about-end-of-life-decisions

 

Article reprinted with permission of the Institute of Marriage and Family Canada.

Say “No” to Euthanasia and Assisted Suicide:
No Special Circumstance Can Justify Them

Abridged version of a brief presented to the Collège des Médecins du Québec, August 30 2009, by Joseph Ayoub, m.d., André Bourque, m.d., Catherine Ferrier, m.d., François Lehmann, m.d. and José Maurais, m.d.. The brief has also been endorsed by a significant number of physicians in the province of Québec.

The issue of decriminalizing euthanasia and assisted suicide has reared its head over and over again in Canada and Quebec for the past 20 years. The proponents of euthanasia justify their position on the need to respect the autonomy and “dignity” of the individual. In recent years some cases have gone before the courts, and the Supreme Court of Canada has reaffirmed the intrinsic value of human life and the limits governing an individual’s freedom to decide to end his or her own life. So the pro‐euthanasia lobby has turned to its only possible legal recourse: an amendment of the Criminal Code by the Parliament of Canada. Bill C‐384, introduced by Bloc Québécois MP Francine Lalonde, is the latest attempt.

It is incredible that as we enter the 21st century, the child in the womb still does not have the status of human being and is denied personhood. In spite of all the technological and scientific advances such as ultrasound and intrauterine photography giving a clear picture of life before birth, our legal system holds fast to the absurdity that the baby in the womb is not a human being. Section 223 of the Criminal code of Canada entitled 'When child becomes a human being" states: 

(1) A child becomes a human being within the meaning of this Act when it has completely proceeded, in a living state from the body of its mother whether or not 
(a) it has breathed 
(b) it has an independent circulation 
(c) the navel string is severed.

According to the criminal code, the baby becomes human only when it has fully emerged from its mother's body.  Therefore, two months, two weeks, two seconds before birth, the preborn child is considered a non-human and receives no protection whatsoever under criminal law.  While some abortion advocates do not deny the scientific evidence proving the humanity of the baby in the womb, they still cling to this piece of legal fiction to defend the right to abortion and maintain that abortion destroys the "products of conception" or a "potential person".  Consequently, no one can be charged with homicide for committing an abortion when the victim is not considered human. In order to decriminalize abortion, it was necessary to have in place a state of legal affairs whereby abortion would be presented as not being a killing act or that there is no human being to be killed by the abortion procedure. 

This is where section 223 provided the convenient definition as to the moment when a child is recognized under the law as a human being. However, the reality still remains that abortion is indeed the killing of a human being.  Canada needs a new definition of human being which will restore personhood to the unborn child for it is now this personhood upon which legal rights depend. The crux of the matter is that the child in the womb is not considered a separate legal entity because "person" in the legal sense means a human being with recognized legal rights. Some claim granting rights to the unborn child diminishes the rights of women.  True equality however consists in giving the same right to life to all members of society. Canada is guilty of discrimination when it refuses to accord personhood and protection to the child in the womb.  Throughout history, the same arguments were used to deny personhood to some members of society, Blacks, Jews, women. Acknowledged only as biological entities, they were treated as a sub-class of humans, deprived of equal rights thus permitting others to exercise power and oppression over them. This refusal to grant personhood to the preborn child is echoed in the Dredd Scott decision concerning the slavery of Blacks in the United States. The decision stated that while slaves were human beings, they were not persons. They were classed as property to be used as the owner wished. During the time of the Third Reich, an entire group of people, Jews, were treated as an inferior species and the highest court in the land deprived them of their legal rights as persons.

Women were also the victims of discrimination by the courts and society. This discrimination and refusal to grant personhood was repeated yet again, in Canada in 1928. Canadian women were not considered persons for the purpose of eligibility to the Senate until the famous Persons case in 1929. A constitutional challenge was launched on behalf of five women: Nellie McClung, Henrietta Muir Edwards, Louise C. McKinney, Irene Parlby and Emily F. Murphy. While recognizing women as human beings, the Supreme Court of Canada declared that women were not persons within the meaning of the British North America Act of 1867. This decision was appealed and judgement was rendered on October, 18th, 1929 by the Privy Council in England affirming that women were indeed persons. Were women "persons" prior to this judgement? Of course, they were! Is the unborn child a person? Yes, he or she is a person. The decision of the Privy Council only marked the moment in history when women were granted legal recognition of their personhood in order to be appointed to the Senate.

No one in society must ever hold absolute power over another human being. As men do not have absolute power over women so women should not have absolute power over the child in the womb. We must uphold the principle of equal rights for all and restore personhood to the child in the womb. It is time to stop depriving the unborn child of the most fundamental right of all - the right to life.

Action Life Online Article

Personhood and Discrimination.

Even a brief overview of history reveals that its darkest moments have occurred when people failed to recognize other human beings as persons and, therefore, as equals. This denial of personhood to particular members or classes within the human family is traditionally associated with attempts to deprive them of their fundamental rights and privileges. Who would deny that it is flagrant discrimination to arbitrarily strip certain human beings of the right to be deemed persons? Take, for instance...

In North America, Native Americans were considered non-persons, referred to as savages, in order to provide justification for the appropriation of their land. We see this again in the slavery issue, when slaves were considered to be property, to be disposed of or used as the slave owner wished. When the injustice of this was taken to court, the Dred Scott decision was handed down. It recognized that the slaves were indeed human beings, but denied that they were persons. Yet it was this "personhood" upon which their legal rights depended.

During the Third Reich, the personhood of an entire group was questioned. Sociologist Irving Louis Horowitz summed up the plight of Jews in that era by saying, "The Jew as a national question; the Jew as a cultural question; the Jew as an economic question, never a person."¹ In May 1923, Adolph Hitler asserted, "The Jews are undoubtedly a race, but not human."² According to Ernst Fraenkel, a German legal scholar, the Reichsgericht, the highest court in Germany, was instrumental in depriving Jewish people of their legal rights. "The Reichsgericht refused to recognize Jews living in Germany as persons in the legal sense."³

Discrimination in Canada.

Canada too has been historically guilty of discrimination; discrimination which in hindsight is recognized as oppressive and arbitrary. Canadian women were not considered persons for the purpose of appointments to the Senate until October 18th, 1929 when the "Five Persons," Nellie McClung, Henrietta Muir Edwards, Louise C. McKinney, Irene Parlby and Emily F. Murphy, finally won a judgement in the famous Persons Case. This decision obtained for Canadian women legal recognition of their personhood and their eligibility to hold seats in the Senate.

Emily Murphy, a police magistrate, had constantly heard in her court that, "women are persons in matters of pain and penalties, but not persons in matters of rights and privileges."⁴ As examples, Mabel French of New Brunswick⁵ and Annie Langstaff of Quebec⁶ could not practise as barristers because they were not persons. A defense lawyer once yelled at Emily Murphy, "You're not even a person! You have no right to be holding court."⁷

In 1928, a constitutional reference was launched on behalf of the five women. The question considered was,

"Does the word 'person' in section 24 of the British North American Act (BNA), 1867, include females...?

The Decision handed down by the Supreme Court of Canada was unanimously answered in the negative. Women were not persons within the meaning of the Act.⁸ This decision was appealed and on October 18th, 1929, the Privy Council in England declared,

"The word person' in Section 24 of the BNA Act,1867 includes members of either sex. "⁹

Modern Discrimination.

In their efforts to depersonalize the human being in the womb, feminists like Michele Landsberg refer to "fertilized eggs" and "to the cult of worship of fertilized eggs."¹⁰ A statement of Concerned Citizens for Choice holds that "a pregnant woman has a group of cells growing within her body."¹¹ Mary Anne Warren, a feminist philosopher, speaks of the preborn child as "an entity far below the threshold of personhood."¹² Doris Anderson and the National Advisory Council on the Status of Women lobbied vigorously to have the new Charter of Rights omit the unborn child. In 1980 the Status of Women attempted to have the wording of the Constitution changed so that the Charter could not be interpreted as applying to unborn children.¹³ The Canadian Abortion Rights Action League (CARAL) argued that under the Criminal Code a fetus does not become a person until it is born. And Laura Sabia, like the defense lawyer of yesteryear, bellows, "It's a fetus with no right in law. It is not a person.'' ¹⁴

The advent of modern medical technology demonstrates how specious these arguments are. In vitro fertilization has allowed us to witness with our own eyes the beginning of human life. During "out of the womb" surgery, legally the preborn baby becomes a person; yet when the child is returned to the womb it loses its legal personhood. Such legal schizophrenia is intolerable.

The past tyranny of some men against women's legitimate rights in order to maintain power for their own convenience has given way to tyranny by some women over the child in the womb for much the same reasons. These women choose to regard the unborn baby as undeserving of personhood - to do so would, of course, interfere with permissive abortion. "Legally. a fetus doesn't have rights" claims Judy Rebick in her time with the National Action Committee on the Status of Women. "I don't think you can talk about rights when you're talking about an entity that isn't an independent being.''¹⁵

Others refuse to grant personhood to the unborn because they wish to maintain the status quo, much like the Supreme Court of Canada did when it reaffirmed that women were not persons. Had it not been for the enlightened and progressive thinking of the Privy Council, the status quo would have won the day.

Today, there exists a deliberate refusal to recognize the child in the womb as a person despite certain knowledge that it is a human being, the youngest member of the human family. Even though an unborn child can sue for damages suffered while in utero (under civil law) it has been consistently refused the right to live (under criminal law) that it needs in order to exercise its rights. In Daigle v. Tremblay, the Supreme Court of Canada ruled that "a fetus is treated as a person only where it is necessary to do so in order to protect its interests after it is born. "¹⁶ Why? The Court did not explain. In 1991, the Supreme Court carried this legal absurdity to greater lengths when it declared in the "Midwives' Case" that a nine-month-old baby in the process of birth (its head had emerged from the birth canal) was not a person within the meaning of the Criminal Code. This decision was hailed by radical feminists.

Were women not persons until the Privy Council declared them to be so? Of course not; they were always persons. Society simply refused to grant them legal recognition. Is the child in the womb a person? Of course! Yet once again person- hood is being used as a device to create a class of human beings who may be discriminated against and thereby deprived of their fundamental rights; in this case, the most fundamental of rights, the right to life

In deciding the "Persons Case" the Privy Council explained:

"The exclusion of women from all public office is a relic of days more barbarous than ours, and to those who ask why the word person should not include females, the obvious answer is, why should it not?⁹

Denying personhood to the preborn child places us in a time of barbarism. To those who ask why human rights should not be granted to the preborn, the obvious answer is, why not?

The court transcript of the Privy Council's Decision in the "Persons Case" reads in part,

"The Constitution is a living tree capable of growth and expansion within its natural limits."⁹

The Canadian Constitution must grow with human under- standing. Our knowledge of the preborn human person has grown to the point that we can no longer refuse to graft these persons upon the living tree described by the Privy Council in 1929.

References.

1. Irving Louis Horowitz, Book Review of Judenat: The Jewish Councils in Eastern Europe Under Nazi Occupation, Commonweal, April 13,1973, p. 139.
2. C.C. Aronsfeld, `The Nazi Design Was Extermination, Not Emigration," Patterns of Prejudice 9, May-June 1975:22.
3. Ernst Fraenkel, The Dual State; A Contribution to the Theory of Dictatorship, trans. E.A. Shils with Edith Lowenstein and Klaus Knorr (New York; Oxford University Press, 1941), p. 95.
4. Grant MacEwan...and mighty women too, (Saskatoon: Western Producer Prairie Books, 1975), p. 133.
5. (1905) 37, N.B.R. 359, at 371, Re Mabel French (1912)1 WWR 488 (B.C.C.A.) and S.B. 1912, 0. 18.
6. (1915)470.S.C. 131,at 142. Affirmed at (1915) 16Q.K.B. 11.
7. Isabel Bassett, The Parlous Rebellion, (Toronto: McCle!land and Stewart, 1975), p. 165.
8. C.J.C. Anglin, Reference as to the meaning of the word `Persons' in Sec. 24 of the BNA Act, 1867, (1928), 5.CR. 276-304.
9. Edwards v AG. Canada, (1930), Appeal Cases, 124-143.
10. Michele Landsberg, Toronto Star, May 17, 1983.
11. Concerned Citizens for Choice on Abortion, A Woman's Choice - A Strategy for the Abortion Rights Movement, Feb. 1982, p. 47.
12. Mary Anne Warren, Commentary on "Can the Fetus Be an Organ Farm?", Hastings Center Report, October 1978, p. 23.
13. Doris Anderson, Globe and Mail, Nov. 15, 1980.
14. Laura Sabia, Toronto Sun, May 17,1983.
15. Globe & Mail, April 29,1991.
16. Daigle v. Tremblay, p. 29.

Dates modified July 2006

Action Life Online Article

It's okay to kill babies after they are born if they turn out to have "defects," says one of the British government's leading advisers on genetics. Professor John Harris, a senior advisor and member of the British Medical Association's ethics committee, said that it was not "plausible to think that there is any moral change that occurs during the journey down the birth canal," suggesting that there was no moral difference between aborting a fetus and killing a baby. His claim is that in some circumstances infanticide is "justifiable."

The professor's comments were made during an unreported debate last week on sex selection, which was held as part of the Commons Science and Technology Committee's consultation on human reproductive technologies. Professor Harris, who is also a professor of bioethics at the University of Manchester, was asked what moral status he accorded an embryo and if he endorsed infanticide in cases of a child carrying a genetic disorder that remained undetected during pregnancy. He replied: "I don't think infanticide is always unjustifiable. I don't think it is plausible to think that there is any moral change that occurs during the journey down the birth canal.

He declined to say up to what age he believed infanticide should be permissible. Professor Harris, who is one of the founders of the International Association of Bioethics and the author of 15 books on the ethics of genetics, was condemned for his remarks.

Professor Harris said he stood by his remarks, which he claimed had been elicited "in response to goading" from pro-life campaigners.

"People who think there is a difference between infanticide and late abortion have to ask the question: what has happened to the fetus in the time it takes to pass down the birth canal and into the world which changes its moral status? I don't think anything has happened in that time."

"It is well-known that where a serious abnormality is not picked up - when you get a very seriously handicapped or indeed a very premature newborn which suffers brain damage - that what effectively happens is that steps are taken not to sustain it on life-support. There is a very widespread and accepted practice of infanticide in most countries. We ought to be much more upfront about the ethics of all of this and ask ourselves the serious question: what do we really think is different between newborns and late fetuses? There is no obvious reason why one should think differently, from an ethical point of view, about a fetus when it's outside the womb rather than when it's inside the womb."

Professor Harris added that it was up to individual families to make a decision on the future of their child and that he was not concerned that such a course of action could lead to infanticide for cosmetic reasons.

The Rev. Joanna Jepson, a Church of England curate who is going to the High Court to try to block late abortions for "trivial reasons" such as a cleft palate case, said: "It is frightening to hear anyone endorsing infanticide but it is shocking when the person is responsible for teaching others."

"This affirms the need for an investigation into the practice of abortion. We have already seen, in the cleft palate case, how the law needs to provide more rigorous protection for such babies but, with medical practitioners such as John Harris at work, there is no question of our fundamental need to reaffirm the human value of every baby's life, no matter what its sex or disability."

A spokeswoman for the British Medical Association said: "These views of Professor Harris are personal views and do not reflect the views of the committee or the BMA, which is utterly opposed to the idea of infanticide."

Editor's Comment: Ironically, Professor Harris points out an important fact, that there is no normal difference between killing a late term pre-born infant and a born child. Morally, the act is identical, precisely because the child is the same being both in the womb and out. Tragically, his reasoning takes him to the absurd position that since it is legal to kill the almost born infant it could be legal to kill the born, instead of the humane and obvious position that the same reason why infanticide is illegal should apply to the late term pre-born baby. This is a stark example of how grotesquely the pro-abortion mentality has twisted the minds of even those reputed to be leaders in the field of ethics.

With excepts from British Medical Association Press Release. This article first appeared in Toronto Right to Life News, Winter 2004. BBC News photo, September 11, 2002

By Gregory Koulk

Those who play the personhood card argue that there is a difference between being a human and being a person. There are, they say, human beings that don't qualify as persons, and therefore should have no legal protection as persons. The unborn is an example of a human who is not a person.

When asked, "What's the difference between a mere human and a human person," which is a fair question to ask, there are three possible answers. First, an unborn child doesn't look like other bona fide human persons who are at different stages of development. "After all," they say, "an acorn isn't an oak." Second, an unborn child doesn't do like other bona fide human persons who are at different stages of development. 

You recall the unfortunate case of baby Theresa in Florida who was born without a cerebral cortex. What was the argument there? She's not a person because she can't think like other babies think (this was used as an argument for infanticide in Florida). She can't do what other real persons do. The law implicitly offers a third distinction. The unborn child isn't located at the right place as are other human persons who are at the same stage of development.

In summary, some human beings aren't worthy of human rights because they don't look like the rest of us, they can't do what the rest of us can do, or they're in the wrong location. My question simply is this: Are any of these factors truly relevant to the issue of human rights? I am presuming here that all unborn children are in fact humans. It cannot possibly be otherwise because they are separate beings in themselves, produced by two other human beings-a mother and a father human being-and according to the law of biogenesis, which has been around for a long time in science, all beings reproduce after their own kind. Two human beings can only reproduce another human being.

Since an unborn child is the conceptus of two human beings, then it must be a human being. That's a foundational point here. The question is, though it is a human being, is it really a person? The answer with regards to unborn children is no, it isn't. When I ask why, people either say that it doesn't look like a person, it doesn't do the things a person does, or it's in the wrong location.

Let's take the last one first. You will understand immediately what I mean. According to our law, if an otherwise bona fide human person is not located at the right place, then the mother has the liberty to take its life for any reason. I'm thinking of a little girl right now. Her name is Rachel. She's the daughter of close friends of mine. Rachel is two months old, but she is still six weeks away from being a full-term baby. Rachel was born prematurely at 22 weeks, in the middle of her mother's second trimester. In other words, Rachel is still mid third-term even though she's almost two months old. When she was born she weighed one pound, eleven ounces, but dropped to just over a pound soon after. She was so small that she could rest in the palm of your hand and you'd hardly know she was there.

Here is the relevant point. It would be murder to take the life of little Rachel if she was lying nursing at her mother's breast today. But if the same Rachel, at the same stage of development, was six inches away resting inside of her mother's womb she could be killed, and in many cases the state would pay for it.

If it's wrong to kill an innocent human child at one location, then it's wrong to kill that same innocent human child six inches away. I take this as obvious and axiomatic. If you take this as obvious and axiomatic-and I don't see how you can refute it, frankly, regardless of your view of abortion-if it would be murder to take the life of little Rachel outside of her mother, it is murder to take the same life of the same person at exactly the same point of development inside of her mother. If this is true, then all mid- to late-term abortions are deeply immoral, because the liberty to kill the child is based merely on location.

But does even development make a difference? What about a person who is disqualified because it doesn't look like or doesn't do like? You could argue that Rachel at 22 weeks did survive and so she was a bona fide human person now and doing things little human beings do and little human persons do. But what about prior to that? Many have said clearly a zygote or a child in its earliest stages of development doesn't look like a human being and it doesn't act like a human being. It is not capable of doing those kinds of things that other human beings do. One could point out that this is circular reasoning. In other words, I could say it certainly looks exactly like a human person does at that stage of development. Let me take it from a different direction.

Regarding the other two issues, I have a very important question here. Do I forfeit my rights as a human person-my rights to life, liberty and the pursuit of happiness-because my body is shaped differently than yours? Do I forfeit my rights as a human person-my rights to life, liberty and the pursuit of happiness-because my body can't do what your body can do?

What if I were smaller than you? Am I any less myself? If I weighed only one pound, or even a few ounces, as long as I was alive wouldn't I still be me? If I had no arms or legs, or my body was terribly misshapen (remember the movie Elephant Man?), as long as I'm alive, wouldn't I still be me? And if body size and shape is the criterion, then do larger people with more attractive bodies have more rights?

That's what this argument asserts regarding the unborn. If a human being is smaller, if it looks different, if it isn't just like me, then it has no rights.

But what if it wasn't what I looked like, but rather what I could do that makes the difference. What if I weren't as smart as you? Am I any less myself? What if I had a lower IQ-an IQ of 70 or 50, or even 10, or 1? What if I could hardly think at all? Wouldn't I still be me? What if I couldn't play basketball, or couldn't write, or couldn't even feed myself? Wouldn't I still be who I am, a human person with rights and value? Do I as a human being become disposable simply because I can't do all that you can do, because I may be helpless and defenseless and dependent? And if this is the case, then do stronger and more capable and more intelligent people have more rights than others? That's what this argument asserts regarding the unborn. If a human being is not as intelligent, if it can't do what others can do, then it has no rights. That's the argument. The unborn doesn't look like other real persons and it doesn't act like other real persons, therefore it is not a real person. My point is, being a real person is not a look-like or an act-like kind of thing. It is a be-like kind of thing. Human beings are persons by their nature.

This was an argument that Lincoln made regarding the Lincoln-Douglas debates against slavery.

Do you begin to see how devastating this argument is to human rights-all human rights, even yours? If personhood is gradual and admits to degrees, then human rights based on personhood are gradual and admit to degrees. If any human being can be disposed of simply because he or she doesn't look just right or can't do what others can do, then the world is only safe for the perfect.

That's what this argument says. Is this the kind of argument you want to stand behind? That is precisely what the personhood argument entails. If so, be very careful, because sooner or later someone is going to discover your imperfection. Then what?

Transcript of a commentary from the radio show "Stand to Reason," with Gregory Koukl. Reproduction permitted for non-commercial use only. ©1995 Gregory Kouk

Reprinted in Action Life News, November 2004.

"In the eyes of the law...the slave is not a person."
Virginia Supreme Court decision, 1858

 "An Indian is not a person within the meaning of the Constitution."
George Canfield
American Law Review, 1881

"The statutory word 'person' did not in these circumstances include women."
British Voting Rights case, 1909

"The Reichsgericht itself refused to recognize Jews...as 'persons' in the legal sense."
German Supreme Court decision, 1936

"The law of Canada does not recognize the unborn child as a legal person possessing rights.
Canadian Supreme Court
Winnipeg Child and Family Services Case, 1997

Sometimes the most important lessons take the longest to learn.

(Quotes compiled by National Campus Life Network)

October 18 - Persons Day in Canada.

1928	2012
Not a person	Not a person
Canadian women were not considered persons until the famous Persons case in 1929. A constitutional challenge was launched on behalf of five women: Nellie McClung, Henrietta Muir Edwards, Louise C. McKinney, Irene Parlby and Emily F. Murphy. While recognizing women as human beings, the Supreme Court of Canada declared that women were not persons within the meaning of the British North America Act of 1867. This decision was appealed and judgement was rendered on October 18th, 1929 by the Privy Council in England affirming that women were indeed persons. Were women “persons” prior to this judgement? Of course, they were! The decision of the Privy Council only marked the moment in history when women were granted legal recognition of their personhood.	It is incredible that, in the 21st century, the child in the womb still does not have the status of personhood under the Criminal Code of Canada. In fact, according to Section 223, the unborn child is not even legally recognized as a “human being” until “it has completely proceeded, in a living state from the body of the mother whether or not (a) it has breathed (b) it has an independent circulation (c) the navel string is severed.” Therefore, two months, two weeks, two seconds before birth, the preborn child is considered a non-human and consequently cannot be legally recognized as a “person”. As a result, this child receives no protection whatsoever under criminal law. Given all the technological and scientific advances, such as ultrasound and intrauterine photography, which gives a clear picture of life before birth, is it not just as absurd in 2002 to deprive the baby awaiting birth status of personhood as it was in 1928 to deny personhood to women?
Isn’t it time to update Section 223 of the Criminal Code to reflect the scientific knowledge of this century?

This ad appeared in the Ottawa Citizen on October 18th, 2002.

Action Life Online Article

Last spring and summer, a flurry of media coverage surrounded the issue of research involving embryonic stem cells. With alarming frequency, news reports heralded potential cures for illnesses such as Parkinson's, diabetes, spinal injury and other diseases through the use of embryonic stem cells.

What are stem cells? They are a sort of master cell that can be made to develop into a variety of cells. The earliest stem cells, referred to as totipotent, have the potential to form a whole human being. A few days later, these cells now called pluripotent begin to specialize and can give rise to most tissu
es and organs found in the human body.

By Mark Pickup 

Some time ago, the National Post carried a commentary by Jeff White called "Don't suffer the little children: Our society appears undecided on the ethics of infanticide." White's muddled thinking seemed to advocate a "new ethic" which, I presumed, would embrace culling the herd of its lame and sick.

I read White's commentary from my wheelchair and shuddered to think about what sort of hostility his "new ethic" has in store for people like me who made it past infancy. Should I embrace his throw-away society's "new ethic" or even exploit it to my own advantage?

Current Clinical Use of Adult Stem Cells to Help Human Patients

Proponents of embryonic stem cell research have created a false impression that these cells have a proven therapeutic use. In fact the embryonic cells have never helped a single human patient; any claim that they may someday do so is guesswork.

A prenatal screening program being pioneered at North York General Hospital in Toronto is being hailed as the new way forward for determining genetic abnormalities in unborn children. The question society should be asking is why is it so important to develop better screening methods. Is it to provide life saving treatment or to eliminate the affected child through abortion because he or she is handicapped?

 Pre-implantation genetic diagnosis is a screening technology used to scan embryos conceived through in vitro fertilization for potential genetic malformations. PGD can screen for diseases such as Duchenne muscular dystrophy, cystic fibrosis, hemophilia, Down‘s syndrome and others.

This method of screening raises many concerns. Prenatal diagnosis which respects the life and integrity of the unborn child and seeks to ascertain which therapies might be beneficial is morally permissible. PGD is used primarily to detect genetic disorders to avoid the birth of human beings with these conditions. When the embryos created through in-vitro fertilization are found to be "defective", they are discarded or donated for research. While we must sympathize with parents who fear passing on an inherited disorder, does anyone have a right to disability-free children or a guarantee to only healthy children?

If you have recently received an adverse prenatal diagnosis for your unborn baby, it is likely you are feeling fearful and confused. It is possible that you have already been counseled to terminate your pregnancy and you are wondering if this is what you should do.

As a parent of a potential special needs child, please know that you are not alone. Many parents have been in the place you are now, and many are there now to help you deal with your fears and questions. Please do not make a hasty decision to terminate, a decision which may leave you with memories you may not want to remember later in life.

As a photojournalist, my job is to tell stories through pictures. The experience of taking this photograph has had a profound effect on me, and I’m proud to share this moment with you.

As a veteran photojournalist in Nashville, Tennessee, I was hired by USA Today newspaper to photograph a spina bifida corrective surgical procedure. It was to be performed on a twenty-one week old fetus in utero at Vanderbilt University Medical Center. At that time, in 1999, twenty-one weeks in utero was the earliest that the surgical team would consider for surgery. The worst possible outcome would be that the surgery would cause premature delivery, and no child born earlier than twenty-three weeks had survived.

The tension could be felt in the operating room as the surgery began. A typical C-section incision was made to access the uterus, which was then lifted out and laid at the junction of the mother’s thighs. The entire procedure would take place within the uterus, and no part of the child was to breach the surgical opening. During the procedure, the position of the fetus was adjusted by gently manipulating the outside of the uterus.

The entire surgical procedure on the child was completed in 1 hour and thirteen minutes. When it was over, the surgical team breathed a sigh of relief, as did I.

As a doctor asked me what speed of film I was using, out of the corner of my eye I saw the uterus shake, but no one’s hands were near it. It was shaking from within. Suddenly, an entire arm thrust out of the opening, then pulled back until just a little hand was showing. The doctor reached over and lifted the hand, which reacted and squeezed the doctor’s finger. As if testing for strength, the doctor shook the tiny fist. Samuel held firm. I took the picture! Wow! It happened so fast that the nurse standing next to me asked, “What happened?” “The child reached out,” I said. “Oh. They do that all the time,” she responded.

The surgical opening to the uterus was closed and the uterus was then put back into the mother and the C-section opening was closed.

It was ten days before I knew if the picture was even in focus. To ensure no digital manipulation of images before they see them, USA Today requires that film be submitted unprocessed. When the photo editor finally phoned me he said, “It’s the most incredible picture I’ve ever seen.”

Action Life Online Article

The fetus's environment Is disturbed by sounds, light, and touch and he responds to these disturbances by moving.

Sound:

Until the late nineteenth century babies were thought to be born deaf as well as dumb. In fact the inner ear of the fetus is completely developed by mid-pregnancy, and the fetus responds to a wide variety of sounds.

He is surrounded by a constant very loud noise in the uterus--the rhythmical sound of the uterine blood supply punctuated by the noises of air passing through the mother's intestine. Loud noises from outside the uterus such as the slamming of a door or loud music reach the fetus and he reacts to them. The fetus also responds to sounds in frequencies so high or low that they cannot be heard by the adult human ear, which suggests that sensory pathways other than the ear are implicated. Movements of the fetus tend to be inhibited by low frequencies and increased by high frequencies.

Doppler ultrasound used for monitoring fetal heart rate appears to provoke fetal activity. Ultrasound used for imaging does not produce a response by the fetus. After birth a mother tends to hold her baby on the left breast. There the infant can hear his mother's heartbeat, which provides the same type of rhythm that was present in the uterus and which appears to have a calming effect. Recordings of the adult heartbeat or of the noise in the uterus have a calming effect on infants when they are played to them.

Vision:

Muscles within the orbit are present very early in pregnancy, and the fetus's eyes move when he changes position and during sleep. In late pregnancy some light penetrates through the uterine wall and amniotic fluid, and fetal activity has been shown to increase in response to bright light.

In pretem infants changes in the electroencephalogram occur in response to light, and the repeated flashing of a light will quieten babies.

Response to Touch:

The fetus can touch parts of his body with his hands and feet, and the umbilical cord also touches all parts of his body. Early in pregnancy the fetus tends to move away from objects he touches; later he moves towards them.

Nine weeks after conception the baby is well enough formed for him to bend his fingers round an object in the palm of his hand. In response to a touch on the sole of his foot he will curl his toes or bend his hips and knees to move away from the touching object. At 12 weeks he can close his fingers and thumb and he will open his mouth in response to pressure applied at the base of the thumb.

At first when his hands touch his mouth the fetus turns his head away, though his mouth opens. Later the fetus may turn his head towards his hands and even put a finger into his open mouth and suck it. This reflex-the rooting reflex-persists after birth. Then it is usually the mother's nipple that touches the baby in this way.

Spontaneous Movements:

Although the fetus starts making spontaneous movements at about seven weeks after conception, mothers do not usually feel their babies moving until about 16 to 21 weeks. The types of movements  include slow squirmy movements, sharp kicks, and small rhythmic kicks. The squirming tends to increase during pregnancy, while the rhythmic kicks continue at a constant rate from the fifth to the ninth month. The sharp kicks increase up to the seventh month and then diminish.

Some of these movements show a cyclical pattern, which might be related to the fetus's sleep pattern. Later in pregnancy the fetus tends to sleep at the same time as his mother.

The fetus's level of activity increases when the mother is under emotional stress. If the stress is prolonged there is a corresponding increase in the fetus's movements--up to 10 times their normal level. The fetus's activity also seems to be increased when the mother is tired.

At 11 weeks after conception the fetus starts to swallow the surrounding amniotic fluid and to pass it back in his urine. He can also produce complex facial expressions and even smile. Towards the end of pregnancy the fetus's chest wall expands and contracts, as if he were breathing. These movements, which occur about 70% of the time, are often interrupted by sighs and hiccups. A decrease in fetal chest and limb movements occurs a few days before fetal death.

Pain:

The fetus needs to be heavily sedated by sedating the mother before intrauterine manipulations such as transfusions. Otherwise he will move away from the needle, which cannot then be inserted into the peritoneal cavity. Fetal heart rate and movement increase for a few minutes after tactile stimuli during amniocentesis. The fetus settles down again within a few minutes of the procedure's ending.

The changes in heart rate and increase in movement suggest that these stimuli are painful for the fetus. Certainly it cannot be comfortable for the fetus to have a scalp electrode implanted in his skin, to have blood taken from the scalp, or to suffer the skull compression that may occur even with sponteous deliveries. It is hardly surprising that infants delivered by difficult forceps extraction act as if they have a severe headache.

HB Valman, MD, FRCP, is a consultant paediatrician, Northwick Park Hospital and Clinical Research Centre, Harrow.  J.F. Pearson, MD, FRCOG, is senior lecturer and consultant obstetrician and gynaecologist, Welsh National School of Medicine, Cardiff.

Extracted from:
The British Medical Journal, 26 January, 1980, "The first year of Life" by H.B Valman and J.F. Pearson.

Action Life Online Article

 The question of when life begins is not an issue of theology or philosophy; it can easily be answered by elementary biology. For more than a century medical science has known conclusively that every individual's life begins at conception.

From the time of conception, the unborn child bears the undeniable stamp of a separate, distinct human being, structurally and totally different from his/her mother with his/her own blood system, nervous system and genetic code.

Fetology, the study of the unborn child or fetus, has become one of the fastest growing and most promising fields in medicine. New techniques and sophisticated instruments have given us a view into the previously hidden world of the unborn child. We can watch the child developing, moving, touching and responding. When ill, in some cases the unborn child has been diagnosed, treated and cured.

HIGHLIGHTS OF THE HUMAN LIFE CONTINUUM

• Conception - when the sperm and ovum unite in fertilization, genetic makeup is complete and a unique individual comes into existence. ("Conception--the start of a baby." See page 35 in brochure Coming to Life, Medical Services Branch, National Health and Welfare, Supply and Service Canada, 1987.)
• 18 days - the heartbeat can be detected.
• 30 days - foundations of brain, spinal cord, nerves and sense organs are complete; the new human being has eyes, ears, a mouth, kidneys, a liver and blood circulation; the mother may not yet know she is pregnant.
• 43 days - brain waves can be detected
• 6 weeks - nerves and muscles begin working together; the skeleton is fully formed but made of cartilage; lips become sensitive to touch.
• 7 weeks - all internal organs are present; stomach produces digestive juices; liver manufactures red blood cells
• 8 weeks - lines of the hands develop and will remain a distinctive feature of the individual throughout life.
• 8 1/2 weeks - the child squints; the fingers close into a fist if palm is touched.
• 10 weeks - thyroid and adrenal glands function.
• 12 weeks - the child kicks, turns his feet and curls and fans his toes; swallows and drinks amniotic fluid; inhales and exhales; sucks his thumb.
• 16-20 weeks - hair grows on head; eyebrows and eyelashes appear; the child sleeps and wakes; he can be aroused from sleep by external noises. As the basic structure of the human being has been in place for some time, all that the unborn child now needs is time to grow.

Supporting References

"A new individual is created when the elements of a potent sperm merge with those of a fertile ovum, or egg." 
Article on "Pregnancy," page 968, 15th Edition, Encyclopedia Brittanica, Chicago, 1974.

"Development begins at fertilization when a sperm fuses with an ovum to form a zygote; this cell is the beginning of a new human being."
Keith L. Moore, The Developing Human Clinicallv Oriented Embryologv, page 1 2, W.B. Sauders, 1974.

"It is the penetration of the ovum by a spermatozoa and the resulting mingling of the nuclear material each brings to the union that constitutes the culmination of the process of fertilization and marks the initiation of the life of a new individual."
Bradley M. Patten, Human Embrvoloav page 43, - McGraw Hill, New York, 1968.

Quotations

"... with the advent of realtime ultrasound in 1976 obstetricians abandoned the trimester concept as a crude and unscientific antique and began to describe pregnancy in the more precise language of weeks..."

"Viability is a pathetically unreliable criterion for protection of a human being under the law; there are so many variables and it is so poorly defined that it is all but useless."
Bernard Nathanson, M.D., Bernadell Technical Bulletin, Vol. 1, No. 1, October 1989, page 1-3, Bernadell Inc., P.O. Box 1897, New York, NY 10011.

"Society and religion, over the centuries, have had differing views on the mores of aborting, of killing an unborn child. Let us not be afraid of the vocabulary."
Hon. Barbara McDougall, Hansard, P. 1 8080, July, 1988

"There is no Bar Mitzvah in the womb."
Bernard Nathanson, M.D.

 Action Life Online Article

By Paul Ranalli, M.D.

Judge Casey had obviously done his homework, for his Memorandum and Order denying the pro-abortion motion itemized several categories of research evidence supporting the conclusion that the fetus feels pain by 20 weeks gestation, a fact well known to readers of NRL News over the past few years.

Since partial-birth abortion is usually done after 20 weeks (4-1/2 months), fetal pain testimony is not only highly relevant but likely to be quite damaging to the pro-abortion cause. Indeed, the testimony on fetal pain awareness is likely not only to harden the disgust felt by most Americans for PBA, but threatens to rip the cover off their denial that there is solid research pointing to fetal pain awareness even before 20 weeks.

The evidence on fetal pain perception has been building for the past 20 years. Pain receptors first appear in the skin of an unborn baby's face at just eight weeks gestation and have gradually covered the body several weeks later. Pain signals are sent from the receptors back along nerves to the spinal cord and then up to the brain's pain relay station, the thalamus, a connection that is fully wired by 14 weeks.
The final connection from the deeply located thalamus up to the cerebral cortex on the brain's surface (where the baby is made aware of pain) is fully wired by 20 weeks. This is the time in pregnancy-the exact half-way point-when scientists have solid evidence of a fully-connected pain system.

While critics have contended that a fetus at this stage does not possess the consciousness necessary to be aware of pain, at 20 weeks the fetus has the full complement of neurons present in adulthood. Brain waves can be recorded at 20 weeks by a standard electroencephalogram (EEG). These findings were reviewed in Dr. K.S. Anand's landmark 1987 article, "Pain and its effects on the human neonate and fetus," in the New England Journal of Medicine. Dr. Anand is the world's foremost authority on research into pain perception in the fetus and newborn child.

And the unborn might feel pain even earlier. It has been known since the late 1980s that blood circulation in the fetal brain changes in response to pain (just as it does in an adult) as early as 16 weeks gestation.

Then a 1994 British study startled the world with its finding that a painful procedure performed on an unborn baby as young as 18 weeks triggers a massive release of stress-related hormones-just as it does in an adult. Dr. Vivette Glover, an English fetal pain researcher, told the BBC in 2000 that "between 17 and 26 weeks it is increasingly possible that [the unborn] starts to feel something ... I think the evidence is that the system is starting to form by 20 weeks, maybe by 17 weeks." The latest research has focused on internal pain chemicals called Enkephlin and Substance P, which have been detected in the fetal brain at 13 and 11 weeks, respectively.

Judge Richard Casey of the Southern District of New York touched upon many of these details in the Order to dismiss the ACLU/National Abortion Federation (NAF) motion challenging the Partial Birth Abortion Ban Act in the U.S. He also mentions research pointing out that the second-trimester fetus not only feels pain but feels more pain than a full-term newborn, or an adult. He states, "At twenty to thirty weeks of gestation, a fetus has the highest density of pain receptors per square inch in human development."

A particularly weak aspect of the motion to forbid Dr. Anand's testimony was the attempt to categorize his evidence as insufficiently reliable. Judge Casey reviewed Dr. Anand's career as a Harvard and Oxford-trained Rhodes scholar whose "opinion on fetal pain is the product of his more than twenty years of work in the field and has not been prepared solely for this case." Judge Casey pointed out that Dr. Anand's work has been published in reputable scientific journals and publications, including numerous peer-reviewed journals. The American abortion establishment is fighting a losing rearguard action on this subject. Their abortion-performing colleagues in Britain and France have already thrown in the towel on fetal pain, acknowledging its likelihood in many second-trimester abortions. England's Royal College of Obstetricians and Gynecologists first broached the subject with a Working Paper in 1997 that was conservative in its estimate of likely fetal pain at 24 weeks gestation. The Working Paper suggested that if abortions were to be done at this stage or beyond the least that could be done was to consider giving anaesthesia specifically for the doomed fetus.

By 1999 this had been updated in the British Journal of Obstetrics and Gynecology with the following statement: "Given the anatomical evidence, it is possible that the fetus can feel pain from 20 weeks and is caused distress by interventions from as early as 15 or 16 weeks."

If the average decent American citizen is repulsed by the thought of the excruciating pain an unborn baby must feel as the back of its skull is stabbed and pried open in a partial-birth abortion, what about the other methods performed on pain-sensitive unborn babies at, or just before, the same stage of gestation?

It does not take a medical expert to imagine the horror of suffocation (hysterotomy and extraction), scalding (saline induction), or being carved apart (dilation and curettage or dilation and extraction) with the full capacity to feel every final moment.

Dr. Ranalli is a neurologist at the University of Toronto and an advisory board member of the deVeber Institute for Bioethics and Social Research.

This article reprinted in Action Life News 2005, with the author's permission.

Given the medical evidence that unborn babies experience pain, compassionate people are viewing abortion more and more as an inhumane act of violence against an unborn child. The pain can be verified by 20 weeks gestation, the age of this unborn child.

The evidence of fetal pain

With the advent of sonograms and live-action ultrasound images, neonatologists and nurses are able to see unborn babies at 20 weeks gestation react physically to outside stimuli such as sound, light and touch. The sense of touch is so acute that even a single human hair drawn across an unborn child's palm causes the baby to make a fist.

• Surgeons entering the womb to perform corrective procedures on tiny unborn children have seen those babies flinch, jerk and recoil from sharp objects and incisions.
• "The neural pathways are present for pain to be experienced quite early by unborn babies."

- Steven Calvin, M.D., perinatologist, chair of the Program in Human Rights Medicine, University of Minnesota, where he teaches obstetrics

The evidence of fetal pain

With the advent of sonograms and live-action ultrasound images, neonatologists and nurses are able to see unborn babies at 20 weeks gestation react physically to outside stimuli such as sound, light and touch. The sense of touch is so acute that even a single human hair drawn across an unborn child's palm causes the baby to make a fist.

• Surgeons entering the womb to perform corrective procedures on tiny unborn children have seen those babies flinch, jerk and recoil from sharp objects and incisions.
• "The neural pathways are present for pain to be experienced quite early by unborn babies."

- Steven Calvin, M.D., perinatologist, chair of the Program in Human Rights Medicine, University of Minnesota, where he teaches obstetrics

Medical facts of fetal pain

Anatomical studies have documented that the body's pain network - the spino-thalamic pathway - is established by 20 weeks gestation.

• "At 20 weeks, the fetal brain has the full complement of brain cells present in adulthood, ready and waiting to receive pain signals from the body, and their electrical activity can be recorded by standard electroencephalography (EEG)."

- Dr. Paul Ranalli, neurologist, University of Toronto

• An unborn child at 20 weeks gestation "is fully capable of experiencing pain. ... Without question, [abortion] is a dreadfully painful experience for any infant subjected to such a surgical procedure."

- Robert J. White, M.D., PhD., professor of neurosurgery, Case Western University

Unborn babies have heightened sensitivities

Unborn children at 20 weeks development actually feel pain more intensely than adults. This is a "uniquely vulnerable time, since the pain system is fully established, yet the higher level pain-modifying system has barely begun to develop."

- Dr. Paul Ranalli, neurologist, University of Toronto

• "Having administered anesthesia for fetal surgery, I know that on occasion we need to administer anesthesia directly to the fetus, because even at these early gestational ages the fetus moves away from the pain of the stimulation."

- David Birnbach, M.D., president of the Society for Obstetric Anesthesia and Perinatology and self-described as "pro-choice," in testimony before the U.S. Congress

The unborn child at 20 weeks

Fetal development is already quite advanced at 20 weeks gestation:

• The skeleton is complete and reflexes are present at 42 days.
• Electrical brain wave patterns can be recorded at 43 days. This is usually ample evidence that "thinking" is taking place in the brain.
• The fetus has the appearance of a miniature baby, with complete fingers, toes and ears at 49 days.
• All organs are functioning - stomach, liver, kidney, brain - and all systems are intact at 56 days.
• By 20 weeks, the unborn child has hair and working vocal cords, sucks her thumb, grasps with her hands and kicks. She measures 12 inches.

Abortion at 20 weeks

Despite the unborn child's advanced development at 20 weeks, the following painful abortion procedures are used:

• Partial-birth abortion (D&X): The unborn baby is delivered feet first, except for the head, which is punctured at the base of the skull with a sharp object. The brain is then suctioned out, killing the child.
• Dilation and Evacuation (D&E): Sharp-edged instruments are used to grasp, twist and tear the baby's body into pieces, which are removed from the womb.
• Saline instillation: Salt water is injected into the womb through the mother's abdomen. The unborn baby swallows this fluid, is poisoned and dies in a process that sometimes takes 24 hours. The toxic saline solution causes severe burns over the unborn child's entire body.

Reprinted with permission from Minnesota Citizens Concerned for Life, 2006.

By William L. Saunders, Jr.

In the ongoing debate about cloning human embryos for research, and about destroying them in order to harvest their stem cells, it is important to keep some basic facts in mind. Our moral analysis must be built upon fundamental scientific truths. If we obscure the facts, then we will not think clearly or act responsibly about these issues.

Every human being begins as a single-cell zygote, grows through the embryonic stage, then the fetal stage, is born and develops through infancy, through childhood, and through adulthood, until death. Each human being is genetically the same human being at every stage, despite changes in his or her appearance.

Embryologists are united on this point. Consider the following statements from standard textbooks: "Human development begins at fertilization.... This highly specialized, totipotent cell marked the beginning of each of us as a unique individual" (Keith L. Moore and T.V.N. Persaud); "Almost all higher animals start their lives from a single cell, the fertilized ovum (zygote).... The time of fertilization represents the starting point in the life history, or ontogeny, of the individual" (Bruce M. Carlson); "Although life is a continuous process, fertilization is a critical landmark because, under ordinary circumstances, a new, genetically distinct human organism is thereby formed.... The embryo now exists as a genetic unity" (Ronan O'Rahilly and Faiola Muller).
Normally, the embryo comes into being through sexual conception, in which the female egg cell is fertilized by a male sperm cell. In sexual reproduction the new individual gets half of its chromosomes from the nucleus of the sperm cell and half from the nucleus of the egg cell. The new organism thus produced is genetically distinct from all other human beings and has embarked upon its own distinctive development.

In addition to this normal process, we have developed laboratory techniques with which to manipulate the procreation of new human organisms. One of these techniques stages the encounter of sperm with egg in a laboratory dish rather than in a woman's body. This is in vitro fertilization (IVF). Another technique is an asexual one in which no sperm is involved. Instead, an egg has its nucleus removed and replaced by a nucleus from another type of cell-a body cell. The egg is then stimulated by an electrical charge, creating a living human zygote. This is cloning, a process in which the body cell that donated the replacement nucleus supplies the chromosomes of the new human organism.

Whether the new organism is produced by fertilization or by cloning, each new human organism is a distinct entity. Twins are genetic duplicates of each other, but no one would deny that each is a distinct human individual. Similarly, a clone would be a genetic duplicate of another human being, but there is no denying that it would also be a separate individual.

 From its first moment, supplied with its complete set of chromosomes, each new zygote directs its own integral functioning and development. It proceeds, unless death intervenes, through every stage of human development until one day it reaches the adult stage. It will grow and it will develop and it will change its appearance, but it will never undergo a change in its basic nature. It will never grow up to be a cow or a fish. It is a human being from the first moment of its existence. As Paul Ramsey has noted, "The embryo's subsequent development may be described as a process of becoming what he already is from the moment of conception."

These are the facts, which we can either affirm or deny. Unfortunately, the denial of inconvenient facts has become quite common during the past several decades. Consider, for example, an editorial published in the September 1970 issue of California Medicine, which was then the journal of the California Medical Association. The editorial invited the Association's members to play a new game called "semantic gymnastics." The first rule of the game was the "avoidance of the scientific fact, which everyone really knows, that human life begins at conception and is continuous whether intra- or extra-uterine until death." The goal was to replace "the traditional Western ethic" respecting "the intrinsic worth and equal value of every human life regardless of its state or condition" with "a new ethic for medicine and society" in order "to separate the idea of abortion from the idea of killing."

In subsequent years, the dehumanization of the unborn was taken a step further when the concept of the "pre-embryo" was advanced. The term referred to the embryo before its implantation in the womb. Certainly the embryo at this point is "pre-implantation," and certainly implantation is a highly significant event. If the embryo does not implant, it will die; if it implants, it will receive nutrition and a suitable environment in which to live, grow, and develop. (Every human being at every stage of life similarly requires nutrition and a suitable environment.) But the critical question is: Does implantation effect a change in the nature of the thing that implants? It is clear from basic facts of embryology that it does not. In the 2001 edition of his leading textbook on embryology, Ronan O'Rahilly writes, "The term ‘pre-embryo' is not used here [because] ... it may convey the erroneous idea that a new human organism is formed only at some considerable time after fertilization. [The term] was introduced in 1986 largely for public policy reasons."

For what public policy reasons was the term "pre-embryo" invented? Princeton biology professor Lee Silver, a noted advocate of all the new biotechnologies, supplies the answer in his Remaking Eden (1997):
I'll let you in on a secret. The term pre-embryo has been embraced wholeheartedly by IVF practitioners for reasons that are political, not scientific. The new term is used to provide the illusion that there is something profoundly different between a six-day-old embryo and a sixteen-day-old embryo. The term is useful in the political arena-where decisions are made about whether to allow early embryo experimentation-as well as in the confines of a doctor's office where it can be used to allay moral concerns that might be expressed by IVF patients.

As Gilbert Meilaender has noted, the "pre-embryo" is merely the unimplanted embryo. In other words, it is already an embryo, and all embryos are, at first, unimplanted. An embryo subsequently implants unless something (or someone) interferes or the embryo is defective. Its life is continuous from its first moment (whether through fertilization or through cloning) until death. The term "pre-embryo" was developed and used largely, if not exclusively, to mislead: to hide scientific facts about the beginnings and unity of human life; to bolster support for a new reproductive technology; and to obtain funding for experiments on human embryos. It has led to a confused jurisprudence that treats the embryo, in certain contexts, more like property than like a human being.

Though the term "pre-embryo" has been rejected in science, the motive for its creation-to dehumanize the early embryo in order to justify its destruction-lives on. It is part of the debate over human cloning and human embryonic stem-cell research.

In the cloning debate, the attempt to deny what "everyone really knows" by finding a more accommodating language has been so convoluted that it would be amusing if lives were not at stake. First, proponents of cloning tried to deny that cloning creates a human embryo. Since, they argued, the new entity does not result from sexual reproduction, it could not be an "embryo." For reasons I have indicated (the nature of the product of cloning as a living, genetically complete, unified, self-integrating human organism in the first stage of development) few were taken in by that ploy. Even prominent advocates of embryonic stem cell research, such as John Gearhart of Johns Hopkins University, have acknowledged that the "thing" created by cloning is an embryo.
Some have asserted that the location of the thing in a Petri dish or in an IVF clinic (i.e., outside a woman's womb) means it is not an embryo. They assert that since it will never be implanted in a womb, it can never be a human being. On the Frequently Asked Questions page of the website of the Federation of American Societies for Experimental Biology we are told that "the cells resulting from nuclear transplantation are grown in a culture dish in the presence of special nutrients for only a few days, when they will comprise a cluster of about 120 cells that can be used to derive stem cells. Therefore, because the cells are never transferred to a uterus they cannot develop into a human being on their own."

The question-begging nature of this assertion should be evident: if the cells are "never transferred to a uterus," it is because the people in the lab choose not to transfer them. It is disingenuous for those who would deprive the embryo of the chance to be born to claim that their action changes the nature and status of the thing considered. This is like the Nazis claiming that concentration camp inmates are not human beings because the Nazis intend to destroy them during lethal experiments. The argument is a variation on the theme of "potentiality"-since the "cluster of cells" lacks the potential to be born, it is not a human being. But the fact is that every human being, including every embryo, is full of inherent potential by virtue of being human. That potential may never be realized or it may be impeded in particular cases. But that potential-to live, to grow, and to develop-is part of what it means to be a living human being.

The advocates of cloning have also posited a distinction between "reproductive cloning" and "therapeutic cloning." Reproductive cloning, we are told, would see the clonal zygote transferred to a uterus and would, all other things being equal, result in the eventual birth of a human being. (This is a scenario that many people fear.) Therapeutic cloning, we are assured, would never approach anything like reproduction: the clonal zygote is simply kept in the lab, an innocuous cluster of cells to be put to good scientific use. But this distinction is groundless. Once a living human zygote has been created, "reproduction" of a member of the human species has occurred, regardless of the purpose (birth or experiment) for which the clone was created. Thus, all human cloning is reproductive cloning.

Nor can the label "therapeutic" be properly applied to the cloning of a human being for the purpose of harvesting "its" useful parts and disposing of the remainder. For a procedure to be "therapeutic," it must be so for the subject of the procedure. (To drain me of my blood in order to stock a blood bank may eventuate in some therapeutic results for someone, but it is not therapeutic for me.) Medical ethics have always insisted that there be greater protection for the subject when the subject is not himself benefited by the procedure. Yet "therapeutic cloning" kills the subject (the embryo) every time (in order to get stem cells). The fact that the distinction between therapeutic and nontherapeutic procedures is so well established, with greater protection accorded subjects in nontherapeutic experiments, makes the decision of cloning proponents to use the term "therapeutic" even more troubling.

After opinion polls revealed that Americans did not like any kind of "cloning," whatever the adjectival modifier, cloning proponents took a bold gamble-they simply decided to re-name the procedure. Instead of "cloning," it would now be called "somatic cell nuclear transfer" or "nuclear transplantation to produce stem cells." But both phrases are simply definitions of cloning. Cloning is a laboratory procedure in which the nucleus from a somatic (body) cell is transferred or transplanted into an egg cell from which the original nucleus has been removed. The attempt to use five long words instead of one short one and to pretend that the five words denote something different is linguistic mischief, not science. Worse, with the phrase "nuclear transplantation to produce stem cells," cloning advocates seek to obscure a crucial fact: the procedure does not "produce stem cells"; it produces an embryo which is later killed so that its stem cells can be removed. Whatever the purpose of any act of embryo-creation may be, whether eventual birth or eventual disaggregation, it is a human embryo and thus a human being that is being produced and killed.

Human stem cells have indeed proven to have great value in the invention of new medical treatments, though it is significant that the only treatments developed to date have involved stem cells acquired nondestructively from nonembryonic sources, including adult donors. Therapies involving the use of adult stem cells are already numerous, whereas therapies derived from embryonic stem cells are still only theoretical (see, for example, Maureen L. Condic's "Stems Cells and False Hopes," FT August/September 2002). Wesley J. Smith has called the media coverage of advances in adult-stem-cell regenerative therapies "grudging," and notes that the favored theme in much media coverage is that embryos hold the key to the future.

Nonetheless, the public is becoming aware that stem cells can be obtained, nondestructively, from adults. And we are also becoming aware that the harvesting of stem cells from embryos cannot be accomplished without causing those embryos to cease to exist as organisms-that is, without killing them. My hope is that we come to understand clearly that it is a matter of scientific fact, and not of opinion, that the embryonic organisms we are being urged to exploit and discard are, like us, human beings.

William L. Saunders is Senior Fellow and Director of the Center for Human Life and Bioethics in Washington D.C. Material in this essay is adapted from a chapter in Human Dignity in the Biotech Century (InterVarsity). 

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By Dr. Paul Ranalli, M.D.

Evidence that newborn babies are not only capable of feeling pain, but may possess a short-term "pain memory," will likely add fuel to the upcoming firestorm over the practice of late-term abortion, particularly partial-birth abortion.

In the new study, published in the August 21 edition of the Journal of the American Medical Association (JAMA), by pediatric pain experts at the Hospital for Sick Children at the University of Toronto, the pain response of newborn babies of diabetic mothers were compared with babies born of non-diabetic mothers.

When a diabetic mother gives birth, her baby's blood sugar is monitored closely over the first 24 hours.  Blood is drawn by the standard "heel lance" method, in which the baby's heel is first cleaned with a swipe from an alcohol swab, then is jabbed with a sharp metal instrument just above the heel, to express a few drops of blood. The heel is lanced one hour after birth, then every 2 to 4 hours afterward, throughout the baby's first day.

After 24 hours, all 42 babies (of both diabetic and non-diabetic mothers) undergo a venipuncture, in which a small needle is inserted into a vein on the back of a hand, to collect blood for a number of routine newborn tests. The pain experts observed and measured the pain response of the babies during the venipuncture, noting the degree of crying, facial grimacing, and body movement.

The result:  the maternal-diabetic babies, who had undergone several painful heel lances over the preceding 24 hours, displayed a larger pain response than babies of non-diabetic mothers, who were being punctured for the first time.

More astonishing yet, 22 percent of the maternal-diabetic babies began to grimace before the puncture, during the preparatory skin cleaning. None of the other babies displayed this anticipatory response.  Dr. Anne Taddio and her colleagues postulated that the skin cleaning had become a sort of conditioned stimulus, and concluded, "These data provide further evidence that infant pain is modulated by experience with pain, as in children and adults."

That newborn babies feel pain is not news to those who have paid attention to pain research over the past one-and-a-half decades. However, until the mid-1980s, newborns were simply assumed not to feel pain, or to perceive it only minimally.  In what is now universally regarded as an erroneously barbaric practice, major surgery used to be performed on newborn babies with little or no anaesthesia.

By 1987, these assumptions were demolished by a growing body of evidence best summarized in a seminal article by pain authority Dr. K.J. Anand, who reviewed the data which measured the changes in heart rate, blood pressure, breathing pattern, and stress hormone secretion in infants suffering pain.

When infants were given proper relief during surgery, not only did these physiological responses settle down, but more babies survived major surgery. Furthermore, several lines of evidence began to reveal that babies born prematurely are even more acutely sensitive to pain than full-term newborns.

What is truly new about this latest study is the revelation of just how sophisticated the newborn baby's brain is, in its ability to register the experience of pain and file it away in a short-term pain memory.  And not just the pain itself, but a memory of heightened awareness of sensations surrounding the pain experience, in this case, the wet stroke of the preceding alcohol swab across the skin. This suggests the oft-reported vivid memory adults describe of sensations associated with a traumatic experience, such as pain, fear, or assault - - a clear memory of an ordinary visual scene, a smell, a sensation. In this case, day-old newborn babies were able to link the subtle sensation of having their heel wiped by an alcohol swab with an anticipated jab of pain.

One of the arguments raised against the significance of data demonstrating fetal pain is that the unborn do not possess adequate enough cerebral cortical development to really "feel" pain beyond a reflex level, and certainly do not have the ability to feel pain in context, compare it with earlier experiences, to have enough brain power to truly experience suffering at a conscious level.

Certainly this is true at an early enough stage in fetal development.  But this current study suggests that a newborn's power of pain perception is highly advanced at day one, including, presumably, premature babies. The question is:  how far back in fetal development does this pain awareness go?

We know from anatomical studies that the entire pain pathway system (the spino-thalamic tract) is assembled by 20 weeks' gestation. Stress hormone release from fetuses has been recorded at 18 weeks, and changes in fetal brain circulation in response to pain have been observed at 16 weeks. At 20 weeks, the fetal brain has the full complement of brain cells present in adulthood, and brain wave recordings are detectable at 19 weeks.

In testimony to Congress in 1995, U.S. pediatric neurosurgeon Dr. Robert White stated, "In summary, then, the fetus within this time frame of gestation, 20 weeks and beyond, is fully capable of experiencing pain."

Since premature newborns are viable, and visibly sensitive to pain, from 23 weeks' gestation onward, the pain system is clearly operating at this stage. Partial-birth abortions target the unborn from 20-26 weeks' gestation.

More recent concepts of pain perception point to the importance of brain chemicals "Substance P" and "enkephalin," which are detectable in the fetal brain at 11 weeks and 13 weeks, respectively. Even among abortion-performing physicians in England and France, a consensus is building that consideration should be given to administer analgesia specifically for the fetus in late-term abortions.

This latest study on newborn pain perception and pain memory draws sharper attention to the awful reality, still too successfully denied by abortion advocates, of the suffering experienced by near-born infants in late-term abortions.  They know that people would be horrified if the truth be known.  No wonder they must deny it. 

Reprinted with permission from the author. 2004

Pain Experience of a Fetus Might Be Even Worse Than Adult Pain
 By Elaine Zettel

The politics of abortion have distorted the science of fetal pain.  The distortion is so drastic that it may come into conflict with modern pediatric medicine.  On October 1^st Dr. Paul Ranalli, neurologist and University of Toronto Lecturer, explained these findings to a gathering of 100 people at the deVeber Institute’s annual public lecture at St. Michael’s College at the University of Toronto.It was only 25 years ago that pediatric medicine failed to recognize the pain of newborn babies, and procedures were performed on these babies without any anaesthesia.  Since that time, our understanding of babies’ pain has drastically increased, and as a result babies in the neonatal intensive care unit now receive much better care including pain relief. Furthermore, Dr Ranalli showed that research has found that the ability to feel pain begins long before birth.“An unborn child is likely capable of feeling pain from the middle point of pregnancy,” Dr. Ranalli said.  New understandings and evidence accumulated over the past two decades show that by the 20^th week of gestation, the fetus possesses everything necessary to feel pain.  However, the systems that help adults inhibit pain are not developed until well after this time period.  Therefore it is possible that the fetus may be experiencing extreme pain during an abortion without the internal coping mechanisms that we take for granted.Evidence of fetal pain exists in three main areas: anatomical, physiological, and behavioural.  Anatomically, the brain, nerves and pain receptors develop throughout the early part of pregnancy.  The parts of the nervous system are connected and operational by the 20^th week.  Physiologically, there is evidence of a hormonal stress response to pain beginning at 18 weeks gestation.  Behaviourally, the fetus has been observed to make movements in response to touch and to respond to sound by 20 weeks gestation or earlier.  Each of these pieces of evidence combined to make a very strong case for fetal pain.Moreover, Dr. Ranalli pointed out that research reviews and guidelines from abortion providers in the United Kingdom and France have called for separate anaesthesia to be given to the fetus to protect it from pain during second trimester abortions.  Some abortionists there have recognized the very valid evidence of fetal pain.In North America, however, there is much denial of the subject, according to Dr. Ranalli.  A review published in the Journal of the American Medical Association (JAMA) in 2005 purported to claim that a fetus could not feel pain until 29 weeks.  The report was criticized for potential bias when two of its authors were found to have links to abortion practice, including the lead author, a former advocate for the National Abortion Rights Action League (NARAL).  Distortion of the science was obvious to Dr. Ranalli, who pointed out that the article’s conclusions relied on a study that had not even tested the potential of fetuses to feel pain before 26 weeks.  By ignoring a large body of evidence on fetal pain, this article came to a false conclusion.The report’s conclusion would imply that premature babies born from the time of viability, currently 23 weeks, would be unable to feel pain for the first 6 weeks of their lives, a concept that was abandoned as barbaric over 20 years ago. Nevertheless, the article continues to be cited by many as authoritative, a practice Dr. Ranalli believes is intended to provide moral cover for abortion providers.  Dr. Ranalli described the article’s conclusions as “so ghastly, the effect would be to set back the humane modern practice of child-centered pediatric medicine 20 years.”To summarize, Dr. Ranalli demonstrated with ample evidence that the fetus can feel pain by 20 weeks gestation, and possibly earlier.  This has been recognized by pain experts in North America and Europe, and even by some abortion providers.  However, some continue to deny the evidence of fetal pain, despite obvious inconsistencies with modern medical practice. Elaine Zetel is the Executive Director of The deVeber Institute, an independent Toronto-based research Institute, which carries out interdisciplinary research in bioethical issues.  Dr. Ranalli is an Advisory Council member of the Institute.

In a recent presentation at the St. Thomas More Society banquet in Ottawa, Dr. Margaret Somerville, head of the McGill Centre for Medicine, Ethics and Law, said the rapid development in new reproductive technologies requires a slow-down of the pace to consider the following questions: How are ethics and law interacting and where are we going?

We have a power no previous generation has ever possessed, the power to intervene and alter the essence of human life. In some ways, scientists have taken over something that previously belonged to God and it  forces us to rethink how we think about life, Dr. Somerville said. These new technologies, in particular research on human cloning, open up the possibility of designing humans. That potential  demands that we ask critical questions: What must we not do with our new science? Are some of the possibilities opening up inherently wrong?

If the techniques involved are inherently wrong, then we must not do them, she stated, no matter how much good might result. We tend to overemphasize the benefits of technological advances, and underestimate the negative outcomes. 

Dr. Somerville explained the two types of cloning research, reproductive and therapeutic. Reproductive cloning  attempts to reproduce a child identical to the cell donor. Therapeutic cloning attempts to clone a cell and manipulate the clone to differentiate and produce organs for transplantation.

Human therapeutic cloning involves intentional destruction of human life, Dr. Somerville stated. Both lines of research rely on the use of human embryos in the very early stages of development, which has led to the intense, ongoing debate on the moral status of human embryos. Opponents of the research say  the human embryo has the same moral status as any human person. Those who support the research argue that the embryo has special moral status, but not yet the same status as the rest of us.

Dr. Somerville mentioned Professor Peter Singer, bioethicist at Princeton University, who claims that any entity that does not have a sense of self-awareness or of its history, such as a newborn baby, does not have the same human status as a fully self-aware human being.

To alleviate ethical concerns over the research and make the technology more acceptable, cloning advocates have manipulated the language to try and overcome ethical difficulties. The human embryo at the very beginning of development is called a "pre-embryo" or referred to as "human embryonic stem cells."

"If a stem cell is not an embryo, do prohibitions on embryo research apply?" Dr. Somerville asked.

Therapeutic cloning opens up the possibility of genetic enhancement and dis-enhancement--gene-rich people and gene-poor people. It commodifies human embryos and shows disrespect for the transmission of human life. As well, cloning is asexual reproduction, which damages the dignity and meaning of human sexuality.

In closing, Dr. Somerville said we need to do "science in ethics time rather than ethics in science time." Science time is immediate. It wants everything done now, as quickly as possible. However, we cannot formulate community ethics with the same degree of speed. She suggested that we rely on the core value of respect for life, and in particular for human life, and that we act to promote and protect the human spirit.

The new reproductive technologies and cloning show a profound disregard for the dignity of human life.The technology relies on the manipulation and destruction of multiple embryos. Cloning modifies the very nature of human beings and undermines the meaning of life itself. These new interventions reduce human beings to laboratory objects to be manipulated and then discarded.  

Action Life Online Article

What is in-vitro fertilization? 

It is a medical technique used to artificially facilitate the conception of a baby. Its name is derived from the fact that fertilization takes place in a petri dish, a glass laboratory container, instead of inside the woman's body.

How is the procedure carried out?

After the woman has been given fertility hormones to encourage the maturation of several eggs (ova) at one time, doctors remove egg cells from her ovary at the exact moment in her monthly cycle when they have reached maturity. The egg cells are placed in a nutrient rich petri dish and the sperm is added to this mixture.

When fertilization occurs, the fertilized eggs divide, creating a cluster of cells called a blastocyst-the genetic package of a new unique individual. Scientists test these blastocysts to determine suitability. The unsuitable ones are destroyed, while the ones who have been permitted to live are inserted via a tube through the woman's cervix into the uterus, which has been treated by hormones to prepare its lining to receive the fertilized eggs. If this is a successful IVF attempt, at least one fertilized egg will implant into the wall of the uterus and start to grow.

What happens to the rest of the embryos?

• Many embryos die in the transfer process since they are fragile.
• Some embryos are unwanted and eliminated because they are considered genetically inadequate.
• Some embryos are stored alive in freezers.
• Some embryos will die during the thawing process.

How many human embryos are lost in IVF?

The Jones Institute, one of the pioneers of In Vitro Fertilization, reports that only 10 to 20% of the human embryos produced by IVF ever result in a normal pregnancy. The Centers for Disease Control estimated that in 1998, 28,000 babies were born through IVF in the United States. This means that 140,000 - 280,000 human embryos remained "unused" for that year alone. Recent regulations have been introduced in Canada regarding IVF; however, these are not protective or respectful of the life of children manufactured by this process.

Why is this wrong?

It is a scientific fact that human life begins at conception/fertilization. From the moment of fertilization, a human embryo has a complete genetic code and his or her growth and development is totally coordinated from within.

Human life must be respected and protected absolutely from the moment of cnoception. From the first moment of its existence, a human being must be recognized as having the rights of a person. Wehn this fundamental moral line is violated or obscured, categories of people become devalued and they become easily used for utilitarian purposes.

Is IVF successful? 

The success rate of IVF treatment is low--72 percent of women who undergo IVF treatments will fail to conceive a child and/or carry it to live birth, according to the latest statistics from the U.S. Centers for Disease Control. 

The CDC  report on Artificial Reproductive Technology success rates for 2004 showed that only 28.7 percent of ART cycles resulted in a live birth--an ART cycle includes all fertility treatments in which both eggs and sperm are handled.

What are the risks for women? 

Because IVF is an experimental procedure, its risks to women are being discovered slowly.

What are the medical risks of drugs used to stimulate the ovaries to produce eggs? One drug, a hormone called buserelin, is suspected of causing cancer. Could it do so in these women?

A common side effect of the hormones used to increase egg production is the development of ovarian cysts. Clomid, the hormone drug most frequently used in IVF to stimulate egg production, has a chemical profile similar to that of DES. This latter drug, given to women in the 1950's and 1960's to prevent miscarriages, was later found to cause cancer in the women who used it and in their offspring.

Facilities have also been criticized for failing to warn couples about the high rate of multiple and premature births and caesarian deliveries associated with the technique. A 1985 Australian study found women who have used IVF to be about three times more likely than other mothers to give birth prematurely and 43% of their deliveries to be by Caesarian section. In the study, ectopic pregnancy rates for IVF were 5% and miscarriages 25% of total pregnancies, three times the national average. Ectopic pregnancies can be life threatening.

What are the risks to babies? 

The numerous manipulations in an unnatural environment that are involved during IVF present real dangers to the developing child. A high percentage of all sperm is thought to be defective, but a woman's cervix screens out the less fit. And distance ensures that only the sperm capable of the most movement will reach the egg. Both increase the chances that the egg will be fertilized by a healthy sperm. Both these screening processes are absent with lVF

To protect themselves from responsibility for the risks of IVF, doctors have contracts with their patients which allow for any "problem" baby to be aborted.

The hazards and risks imposed on the developing child are many and some are even beyond our current ability to comprehend. Analysis of all the Australian and New Zealand IVF births found that IVF is associated with a higher than normal rate of spina bifida and transposition of the great arteries. Six infants had spina bifida compared with an expected number of 1.2. No previous children with spina bifida had been born to these mothers. Four infants had transposition of the great vessels, compared with an expected number of 0.6.

 IVF babies were four times more likely to be stillborn than those conceived normally and to have rates of abnormalities three times that of the Australian national average.

Dr. Ruth Hubbard, professor of biology at Harvard, has condemned IVF as too risky. She compared such research to the precedents of thalidomide and diethyl stilbestrol. The consequences of thalidomide were visible at birth; the diethyl stilbestrol turned into a medical time bomb whose consequences were not seen for more than fifteen to twenty years. Both drugs altered the fetal environment in ways that could not be foreseen. How can we claim to know that the many chemical and mechanical manipulations of eggs, sperm, and embryos that take place during IVF and implantation are harmless?IVF makes babies.

Why are pro-life people opposed to it? 

• Because IVF results in the death of many tiny humans. It is an attack on human life at its origin.
   Hundreds of fertilized eggs (tiny humans) fail to implant or are destroyed for every one child conceived.

• Only promising embryos are selected. At most clinics no more than four embryos are implanted. What happens if there are more than four embryos? They are either frozen for future use (50% die in the freezing-thawing) or, in some cases, "surplus embryos" are used for experiments. This is in direct opposition to the post-World War II Helsinki Declaration which states that the interests of the subjects of medical experimentation must take precedence over the interests of science and society. Using living human embryos and fetuses for cell cultures and organ donors is already here. Gene splicing, cloning, creation of chimeras and "modifying embryos" are on the horizon.

• IVF dehumanizes the child and its parents. IVF regards the embryo and developing baby as a product subject to quality control and manufactured to satisfy desire. Decisions are made about who will be allowed to survive. Humans are regarded as property.

• IVF's purpose is not primarily to provide babies for infertile couples. Those who developed IVF and those who continue to push it appear to be primarily interested in experimentation on the embryos. Dr. C. Jansen of Sydney, Australia said that if experimentation on embryos is stopped, he will "stop the practice of IVF completely." The United States did ban embryo research in 1975. In Australia, the government permits research on "spare embryos" left over from IVF. A British commission allows research on embryos up to 14 days old, and scientists are pushing to extend the limit. The Medical Research Council of Canada has recommended experimentation on living human embryos up to 17 days of age, the most liberal guideline in the world

IVF opens the way to eugenic control.

IVF techniques make possible the sex determination of offspring and. In the sex-selecting application, the embryo of the desired sex is inserted into the uterus and the rest are destroyed as unneeded embryos. In the United States and Canada the eugenics movement talks of reproduction of the "right kind of people". Dr. Joseph Fletcher repeatedly calls for the sterilization of people carrying defective genes. Mr. Graham with his Nobel laureate sperm donors seeks "genetically sound women" to bear better citizens custom-made for intelligence... hopefully. Is the medical profession becoming tamperers with human life? Have we forgotten that at Nurenberg we condemned doctors for implementing eugenic policies?

Are there alternatives to IVF?

There are alternatives--less costly and more successful than I.V.F.--that HELP a woman with her infertility.

A moral and natural technique that is becoming more commonly known among Fertility Care practitioners is Natural Procreative Technolgy or NaPro Technology (NPT). Research indicates that this technique has as many or more live births than IVF clinics, without putting couples through the various humiliating treatments and without creating "extra" embryos that would ultimately die or be killed.

The carbon dioxide laser is consistently reported to be effective in cases of tubal obstruction considered inoperable or difficult by standard microsurgical techniques.

In one study, of 65 women with blocked fallopian tubes, 80% became pregnant following laser surgery. In another study of 230 patients with multiple disease processes contributing to infertility, 40% were able to get pregnant after laser microsurgery.

Remember that in 370 attempts at implantation, the experts at I.V.F., Drs. Steptoe and Edwards, engineered only two successful pregnancies. It is unknown how many unused embryos they "washed down the sink".  

In 230 difficult cases, laser surgery made it possible for 92 women to become pregnant. And they can become pregnant again if they desire for their infertility was CORRECTED. Unlike laser surgery, I.V.F. DOES NOT correct the infertility problem.

Also, reconstructive tubal surgery is more successful in achieving pregnancy than is I.V.F. for women who have undergone tubal sterilization (Ob. Gyn. News, Nov. 15-3Q 1987).

What a woman gets for her money and the trauma of I. V F. experimentation is the likelihood that she will remain childless and the certainty that she will remain infertile. Infertile couples should demand accountability from I.V.F. programs, especially at this time when our medical resources are scarce. An objective cost-benefit analysis of I.V.F. would recommend devoting our resources to the more efficient effective alternatives.

Conclusion:

1. A society which is truly interested in treating infertility will allocate resources to efficient, effective procedures rather than to the patently unsuccessful and costly experimental technique known as I.V.F.
2. A caring society will provide sufficient funding to basic health care for its citizens and for those of the developing world rather than concentrate enormous scarce funds on experimentation that might "benefit" a few.

A truly caring society will not permit a technique which creates innocent life only to destroy it or to experiment on it.   Remember the words of C. S. Lewis: "what we call man's power over nature turns out to be a power exercised by some men over other men with nature as its instrument."

 (Mr. Graham, referred to in the above paragraph, is Robert Graham, founder of the Repository for Germinal Choice in Escondido, Calif. This sperm bank solicits donations from Nobel laureates and other intellectuals.)

Action Life Online Article

By Dr. L.L. deVeber 

We should look carefully at the case in Halifax where Dr. Nancy Morrison killed a terminally ill patient, Paul Mills, with an injection of potassium chloride. Dr. Morrison is a specialist in Respirology (lung diseases), who also worked in Intensive Care where Mr. Mills was transferred due to complications from his cancer and surgery. Potassium chloride in large doses has no place in the management of symptoms in patients, including those who are terminally ill. Dr. Morrison did this to end Mr. Mills "suffering" and, at first, denied doing "anything wrong". Apparently, Mr. Mills had been given "massive" doses of painkillers which apparently did not relieve his pain.

I could find no mention in the articles I read of a palliative care consultation and it is very likely that the so-called "massive" doses of narcotics simply weren't adequate. Also, since Mr. Mills could only communicate by blinking his eyes, we wonder who assessed his pain and how.

Another disturbing feature of the case includes the fact that his wife was not notified of the decision to end his life and, in fact, she said her husband did not believe in mercy killing. Thus, it appears that this was a case of active involuntary euthanasia/mercy killing.

Perhaps the most disturbing feature of this case is the lack of prosecution of Dr. Morrison with the Nova Scotia Supreme Court refusing to hear an appeal by the Crown Prosecutor to allow prosecution to proceed. The Provincial Court judge had previously refused to allow prosecution on the grounds that a jury would never convict her. Apparently, one reason for this decision was that the intravenous line in Mr. Mills may not have been functioning. However, he died within minutes of the fatal infection which means the i.v. line was almost certainly working.

Dr. Morrison was supported by the Provincial Medical Association, although the College of Physicians issued a written reprimand to her for acting "outside the bounds of currently acceptable practice" for using a drug with no pain killing properties to hasten death. She has resigned from the Intensive Care unit where Mr. Mills died but continues to practice and teach at the medical school where she is (or was) "highly respected". She now admits she made a mistake and should have consulted other physicians before her fatal action.

Of course this is not the first time a physician has killed a patient and not received significant punishment. In 1993, Dr. De La Rocha killed a cancer patient in Timmins, Ontario with potassium chloride, pleaded guilty to a charge of second degree murder, received a suspended sentence and had his medical license suspended for 90 days.
Robert Latimer was convicted of murdering his daughter, Tracy, who he said was suffering terribly from her cerebral palsy. From what I can recall the medical/nursing staff looking after her disagreed. He received a very light jail sentence of 2 years which has been appealed by the Crown and is currently waiting to be heard by the Supreme Court of Canada - possibly in the fall, so we will be watching that case carefully.

Thus, it appears that mercy killing by doctors, whether with the patient's consent or without, is being tolerated in Canada without changing the law.

Mercy killing in Holland started with terminal cancer cases who had severe pain and were offered mercy killing as an option. These were reported to the Public Prosecutor but not prosecuted. It is not coincidence that at the time Holland was well known to be far behind other Western countries in the development of hospice or palliative care programmes and Dutch doctors knew little about modern pain control. At some hospitals as many as 50% of cancer patients died from mercy killing. Following the acceptance of this practice by the authorities, mercy killing was offered to other patients with other diseases, such as anorexia nervosa, senility and finally depression and other psychological problems. Increasing numbers of these were involuntary, without the patient's permission. In some parts of Holland senior citizens in institutions were afraid when the doctor came in case they were to be killed. Some senior citizens carried cards saying they did not want to be killed and certain hospitals (usually Christian) were agreed to be "safe". Apparently, doctors were increasingly failing to report cases of euthanasia. And all this in a country where many Dutch doctors died during World War II rather than comply with the Nazi Euthanasia programmes! No wonder that when prestigious groups representing the British House of Lords, the Canadian Senate, the New York State Legislature and the editorial board of the Journal of the American Medical Association returned from a visit to Holland, they all recommended that mercy killing not be legalized. These groups could hardly be called Pro-life! The State of Oregon became the first legislature in the Western world to legalize euthanasia but now is considering revisiting the subject with the urging of the Oregon State Medical Association.

Euthanasia/mercy killing is a complex subject, difficult to study compared to abortion, since cases of mercy killing differ from one another. There is a connection of course between the two, as abortion has been called Antenatal Euthanasia and this applies especially to babies diagnosed before birth with modern techniques such as amniocentesis (which ironically was originally used to save babies with Rh disease). Newborn babies with serious mental defects such as Down's Syndrome or physical defects such as Meningomyelocele have been left to die without necessary surgery and in some cases killed directly. Fortunately, legal decisions in these cases have almost always favored saving the baby and this practice has decreased.

So, what can we do? I believe what is needed is a coalition of Pro-life groups, disabled groups, palliative care associations and churches who can educate the public and politicians and convince them that proper palliative care will practically eliminate severe pain and that patients asking for assisted suicide or mercy killing are really calling out for help. (Patients who have survived attempted suicide generally say they do not want to die - 80% in one study).

One such effort is the Euthanasia Prevention Coalition of Ontario which has a highly respected palliative care nurse and physician as well as myself on the executive.

Albert Schweitzer once said that all that is required for evil to flourish is for good men (and women!) to remain silent. I hope this article will help readers to understand the issues and take some action.

L.L. deVeber MD FRCP (C)
Professor Emeritus U.W.O.
President, The Euthanasia Prevention Coalition of Ontario
President, The deVeber Institute for Bioethical and Social Research.

Action Life Online Article

Can pain be controlled?

Unfortunately it is not well understood by the general public that patients have the common law right to refuse any medical treatment. In fact, the average person is unaware that a doctor who treats a patient against his or her expressed wishes can be charged with assault. We already have personal autonomy with regard to medical treatment.

I don't want to be a "burden" on society

"Watching our loved ones grow old is one of life's lessons. We need to learn how to die, you know, just as we need to learn how to meet every other challenge we face in life. We learn that, as we do almost everything else, from our elders... 
I would not have traded the time I spent looking after my elderly mother for any other time in my life. She was my mother. I loved her dearly. And, just as she taught me about the beginning of life, she taught me too about the end of life. Why would I wilfully cheat my children of such a lesson?"
- Rita Marker, International Anti-Euthanasia Taskforce.

Many people fear a "loss of dignity" and have somehow been convinced that the best means by which they can achieve a "dignified death" is to be killed by a physician. We do not believe that there is any dignity in allowing ourselves to be killed. The following is a better definition of "death with dignity":

"The dignity of human beings is derived from inherent worth, not worth 'for something'. Dignity is, therefore, an endowment that is largely reflected and conveyed in an attitude of respect and tenderness shown by others. Although the process of an illness and decline may significantly change people, it can never remove their dignity unless others allow it to do so. Such dignity can be seen in the forbearance, humour, and grace with which others care for them." 
- Dr. Elizabeth Latimer, Ontario Medical Review, February 1992.

We realize that it is never easy to watch a person die, but it is important to note that through this experience we have the tremendous potential of either affirming or robbing a person of their dignity by the degree to which we accept and care for them through this difficult time.

Positive and compassionate response to a dying patient's needs can be found in good palliative care. Palliative care affirms life while recognizing that death is part of living. Palliative care does not seek to lengthen or shorten a patient's last days but to make them as rewarding and pain free as possible. The emphasis is on comfort rather than cure. The patient has a say in all decisions about treatments and almost all pain can be relieved to allow patients to die with true human dignity.

Action Life Online Article

Introduction.

In ancient times, doctors were both healers and killers. Hippocrates and the Oath which bears his name changed all that : medicine became dedicated to healing alone. The significance of this change was best expressed by Margaret Mead who, in 1961, wrote about the Hippocratic Oath:

"Throughout the primitive world, the doctor and the sorcerer tended to the same person. . . With the Greeks. . . the distinction (between the healing physician and the killing sorcerer) was made clear. One profession, the followers of Asclepius, was to be dedicated completely to life under all circumstances, regardless of rank, age or intellect. . . This is the priceless possession which we cannot afford to tarnish, but society is always attempting to make the physician into a killer - to kill the defective child at birth, to leave the sleeping pills beside the bed of the cancer patient. . . It is the duty of society to protect the physician from such requests."

The Hippocratic Oath: a priceless possession.

From Hippocrates' time until the recent past, the prohibition against killing continued to guide the practice of medicine. The first major break with this long and honourable tradition was the German Euthanasia program - a project planned and supervised by members of the German medical profession - which resulted in the killing of 275,000 of their patients, most of whom were mentally of physically handicapped. As a result of the Nuremburg trials, which revealed to a shocked world this abomination and others committed by German physicians during the Nazi regime, the World Medical Association deemed it necessary to reinforce the Hippocratic Oath with the adoption, in 1948, of the Declaration of Geneva and of the International Code of Medical Ethics. The Declaration of Geneva states in part:

"I will maintain the utmost respect for human life, from the time of conception; even under threat, I will not use my medical knowledge contrary to the laws of humanity."

Two passages of the International Code of Medical Ethics must also be noted:

"Under no circumstances is a doctor permitted to do anything that would weaken the physical or mental resistance of a human being except from strictly therapeutical or prophylactic indications imposed in the interest of the patient. A doctor must always bear in mind the importance of preserving human life."

And yet, after a mere two decades, history began repeating itself. Doctors were again killing some of their patients.

For example, throughout the 60's, the Canadian Medical Association was a major player in the drive to make abortion legal in Canada. And before that decade was over, the drive had succeeded: preborn children were losing their lives by the thousands at the hands of Canadian doctors.

Concurrently, reports were starting to appear of severely handicapped children being starved to death in some of our largest and best pediatric hospitals. And to this day, this practice continues.

It is no coincidence that in the late 60's most medical schools in North America and Western Europe discontinued a treasured tradition: having their students take the Hippocratic Oath at the time of their graduation. In retrospect, this may have turned out to be the `fatal first step'.

Dropping the Hippocratic Oath may turn out to have been the 'fatal first step'.

With more than 100,000 preborn children being killed by abortion each year in Canada, the pro-death lobby now concentrates its energies and resources on the euthanasia front.

The first objective, in this newest offensive against human life, is to make voluntary euthanasia acceptable and eventually legal.

To this end, the pro-death lobby is using a few so-called `hard cases' (preferably cases which involve consenting, articulate and relatively young women, e.g. Nancy B., Sue Rodriguez) in order to shape public opinion so that physician-assisted suicide becomes acceptable.

It would be as naive as it would be dangerous, however, to think that requested (voluntary) euthanasia would not soon be followed by "imposed" (involuntary) euthanasia.

Yielding to Demands for Physician-assisted suicide would be Another Disastrous Step.

In support of this view, there is first, the historical precedent. In this regard, we must remember what Dr. Leo Alexander - who was a special investigator and consultant to the Secretary of War and on duty with the Office of the Chief Counsel for War Crimes in Nuremburg - wrote in the "New England Journal of Medicine" in 1946:

"The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as a life not worthy to be lived (emphasis added). This attitude, in its early stages, concerned itself merely with the severely and chronically sick. Gradually, the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and, finally, all non Germans."

Second, there are the warnings from medical ethicists:

"It would be foolish to think that assisted suicide or direct killing of patients would not be abused for a cost containment agenda. Even withholding or withdrawing of treatment is subject to abuse, and there is clinical evidence to point out to current routine abuse. . . No, the medical profession should not promote as routine or as policy or as medical ethics, the passive or active killing of a patient. The risk to the chronically sick or terminally ill is just too great. It is a realistic risk, not a slippery slope fallacy (emphasis added). We can actually demonstrate the probabilities and the actuality of its happening." (Dr. Colleen Clements, assistant professor of psychiatry, University of Rochester, N.Y. State, in the "Medical Post", June 20, 1989)  

  Involuntary euthanasia will be the unavoidable 
  endpoint, if we descend step-by-step into the hellish
                        world of medical killing.

There are many other good reasons why medical killing must be opposed:

• medical killing is bad for physicians, who risk being perceived as members of a killing rather than a healing profession. This would undermine, perhaps irreparably, the trust which patients have traditionally put in their physicians and which is an essential element of a mutually satisfying and effective physician-patient relationship.
• Medical killing is bad for society, for it leads to the acceptance of the pernicious view that killing can be a solution to social or economic problems.

"If the physician presumes to take into consideration in his work whether a life has value or not, the consequences are boundless and the physician becomes the most dangerous man in the state."
Dr. Christopher Hufeland, German physician and medical writer (1762-1836).

"The prohibition against medical killing serves as a moral beacon, protecting both doctors and patients from the treacherous waters of ethical relativism. The prohibition against medical killing is a fundamental tenet of the medical profession."
Dr. Peter A. Singer, Center for Bioethics, University of Toronto.

"Physicians should never have this intention in their minds or have the will that their patient. . . should die - no matter how extenuatingly pitiful their state. This is to state an inherent and paramount medical ethic: not to will or intend the death of patients, even when they wish it for themselves."
Dr. John B. Dossetor, Division of Biomedical Ethics and Humanities, Faculty of Medicine, University of Alberta

EUTHANASIA IS MEDICAL KILLING - IT MUST NOT BE ALLOWED

Ottawa and District Physicians Who Respect Human Life: modified July 2006 

Action Life Online Article

(It'’s not as if death is optional.)

The RIGHT TO DIE really means: choosing death to solve a problem, doctors killing patients, assistance in suicide. Expedience, even compassion has never been a justification or defence for murder. Canadian law has held that murder is never justifiable. This defence for the vulnerable must not be dismantled. Medical decisions must always be based on medical concerns; not social, cost-cutting or arbitrary ‘quality of life’ reasons.

The RIGHT TO DIE does not refer to the RIGHTS WE’'VE ALWAYS HAD: the patient’s right to refuse treatment, the patient’s right to order treatment to be discontinued, the doctor’s right to abstain from futile or meaningless treatment, the withdrawal of treatment when it no longer serves any therapeutic purpose, giving drugs in doses adequate for pain relief. These have always been recognized under Canadian law as medically appropriate.

Assisted suicide has once again reared its head in Canada. Evelyn Martens of Victoria, British Columbia and a prominent member of the Canadian Right to Die Society has been charged with assisting in the suicides of Leyanne Burchell of Vancouver B.C. and Monique Charest of Duncan B.C. Martens has chosen to be tried before a judge and jury. Her preliminary hearing is set for November 13, 2002. A donation of $5,000.00 US was made by the vice-chairman of an American right to die association called Hemlock Society to Evelyn Marten’s lawyers. Further information as to what Martens did or how is unavailable due to a court ordered publication ban.

It is illegal in Canada to counsel or help someone to commit suicide. Section 241 of the Criminal Code states: Everyone who (a)counsels a person to commit suicide, or (b)aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an offense and liable to imprisonment for a term not exceeding fourteen years.

Disability rights advocate Hugh Scher and legal counsel to the Euthanasia Prevention Coalition said: “These are criminal offenses for good reasons. Particularly, they are there to protect the vulnerable, they are there to protect the victims whose lives will be taken with or without consent.”

We need only look at Holland to know that acceptance of assisted suicide leads to non-voluntary euthanasia. The supposed safeguards in place to protect patients from being killed against their will have been proven ineffective in numerous studies. Patients have been killed without their consent. The results of a study conducted in Oregon where assisted suicide is legal found that 90% of individuals asking for help in dying change their minds. Requesting death is often a plea for help and compassion. We can do better than offer death and killing to the suffering. With scarce health resources, an aging population, quality of life arguments, the right to die will soon become the duty to die. Faye Girsh, executive director of the pro-euthanasia Hemlock Society stated in 1997: “A judicial determination should be made when it is necessary to hasten the death of an individual whether it be a demented patient, a suffering, severely disabled spouse or child.”

She later tried to retract her statement.

Action Life Online Article

I believe that this is a personal tragedy for the Latimer family as any domestic crime involving the loss of life would be a tragedy. Tracy Latimer is a tragic victim of misguided beliefs. But apart from the individuals involved, it stands as a case which can have serious implications for citizens of Canada, and particularly for citizens who have disabilities. In fact, it will measure the values of the society in which we live.

On the surface, we might examine why it is that we feel the need to be here today. A crime was committed. A man was charged and convicted, and now his appeal is about to be heard. That is his right. It would seem the system has worked, so far.

There is something however, in the media reporting of this case, the public reaction to it, and the issues raised by Mr. Latimer in his appeal, that leads me to feel that Canadians with disabilities and all those interested in fundamental human rights have a great need to speak out clearly. We must make it known and understood that one human life must not be valued over another because one person has a disability. Nor must the actions of the perpetrator be judged less harshly because his victim was an individual whom he deemed, "better off dead".

All Canadians are protected by the Charter of Rights and Freedoms. All of us are entitled to equal protection of the laws that govern us.

It must be made very clear that a human life is not to be snuffed out because another person, be they parent  or caregiver or companion, feels that life is no longer worth living. It is not their decision to make. Mr. Latimer makes the point in his appeal that because his daughter was so completely incapacitated both physically and intellectually, that he was entitled to "commit suicide for her".

If such a ground of appeal were to be allowed it would put at risk ANY person with physical and mental disabilities who was unable to communicate his or her desires. Rather, the most vulnerable in our society must be offered the most stringent safeguards.

Since when in Canada do we allow children to choose death? There is much case law in Canada where social service agencies step in to take custody of a child. This is when the child is considered at risk because the parents are refusing treatment for their child's life threatening medical condition.

How could it be claimed that Tracy Latimer would have chosen to die if she could only have made her wishes known? Would we accept such a request from another twelve year old? That anyone could accept such a premise is an indication of their devaluing of the lives of Tracy and other children like her.

Parents do not own their children. They are not chattels or property to be disposed of at the option of their parent. There can be no doubt that bringing about the premature and planned death of one's child is completely contrary to the obligation of providing necessities for children.

The other ground of appeal is that the jury should have been able to disregard the laws of Canada, the Criminal Code, and make a decision based upon their conscience about what a just verdict would be. Were this line of reasoning to be adopted, we could just throw away the laws that govern us in such cases and allow judges and jurors to decide on a case by case basis whether a crime had been committed. Murder or mercy? It is not difficult to see how vulnerable many individuals in our communities would be under a system which allowed abled bodied, abled minded citizens to judge the worth of someone else's life and situation.

Murder is murder. Every human life must be valued. Each individual must be entitled to equal protection of the law. We must not allow a hierarchy of rights to be established whereby the act of killing one individual is met with condemnation while the act of killing someone else is described as "merciful" or compassionate.

There are many in our communities who are willing to admit that an unlawful act took place in the killing of Tracy Latimer, but that a mandatory sentence of ten years is too harsh a penalty. Many have called upon the Minister of Justice for a pardon. The Canadian Civil Liberties Association has said that Robert Latimer shouldn't spend one more day in jail.

Why? Because killing a severely disabled child was no big deal? Because her life couldn't possibly have had any value or meaning for her? This must be the underlying premise. Otherwise, how do we explain the outrage which arose in South Carolina when a distraught mother drowned her two little boys, and the further demand for the death penalty in that case. Why? Because those were "valuable lives" snuffed out?

Mr. Latimer says that this case has nothing to do with disability, only with pain. He states in his appeal that he acted out of necessity to end her suffering. I ask the question: if a parent put to death an otherwise able bodied child who was awaiting surgery to repair a dislocated hip, would the reaction have been to feel compassion for the parents' action and an understanding of his "necessity" to kill her?

Whatever ones own feelings about mandatory sentencing, it must be made clear to our legislators that in determining sentence for the perpetrator of a crime, that the nature of the victim must not be allowed to be taken into account. That is to say, the court or jury shall not be entitled to pass judgment on the quality of the life of the victim. To allow this to occur would be to establish a hierarchy of rights and penalties for victims and perpetrators.

The final outcome must be that Murder is Murder and the public must be educated in this. Every human life must be seen as having equal value; and every Canadian citizen must receive the full protection of the Charter of Rights and Freedoms.

Action Life Online Article

By Jean Echlin, RN, MscN

Nurse Consultant-Palliative Care

Dying with Dignity can only be achieved with expert hospice/palliative care, strong community and institutional health care and compassionate support of vulnerable people. This care must be available for all Canadians.

With 26 years experience as a palliative care nurse specialist and consultant; I have been at the bedside of more than one thousand dying individuals. Thus, I can assure you that persons, who receive timely, appropriate and expert pain and symptom management, including attention to significant socio-spiritual, psychological and emotional issues, do not ask for assisted suicide or euthanasia. With the inclusion of family members as the "unit of care," people want to live as long as possible! In fact, good hospice/palliative care can actually extend the life span. As well, it gives patients an improved quality of life at the end of life.

Over the years of caring for people at the bedside as they face life-threatening or terminal illness, I have found that depression is a common symptom. Depression is treatable even in late stage disease, thus euthanasia and assisted suicide are a threat to people who need both medical and psychological support for clinical depression.

If euthanasia and assisted suicide were legalized, this would adversely affect the priority and need placed on the development of palliative care standards and norms of practice already developed by the Canadian Hospice Palliative Care Association (CHPCA). Expert palliative care requires a commitment of health care dollars. Euthanasia and assisted suicide is a financial, moral and ethical "cop out!" With financial efficiency and expedience a health care priority, these killing methods may catch on quickly in a system strapped for money and resources. Doctors and nurses should not be killers.

Euthanasia treats people as disposable objects. All Canadian should be concerned...even frightened by the possibilities.

Jean Echlin was awarded the prestigious 2004 Dorothy Ley Award of Excellence in Palliative Care by the Ontario Palliative Care Association (OPCA). Published in Action Life News, Summer 2005.

By Wesley J. Smith

First, Dutch euthanasia advocates said that patient killing will be limited to the competent, terminally ill who ask for it. Then, when doctors began euthanizing patients who clearly were not terminally ill, sweat not, they soothed: medicalized killing will be limited to competent people with incurable illnesses or disabilities. Then, when doctors began killing patients who were depressed but not physically ill, not to worry, they told us: only competent depressed people whose desire to commit suicide is "rational" will have their deaths facilitated. Then, when doctors began killing incompetent people, such as those with Alzheimer's, it's all under control, they crooned: non-voluntary killing will be limited to patients who would have asked for it if they were competent.

And now they want to euthanize children.

In the Netherlands, Groningen University Hospital has decided its doctors will euthanize children under the age of 12, if doctors believe their suffering is intolerable or if they have an incurable illness. But what does that mean? In many cases, as occurs now with adults, it will become an excuse not to provide proper pain control for children who are dying of potentially agonizing maladies such as cancer, and doing away with them instead. As for those deemed "incurable"--this term is merely a euphemism for killing babies and children who are seriously disabled.

For anyone paying attention to the continuing collapse of medical ethics in the Netherlands, this isn't at all shocking. Dutch doctors have been surreptitiously engaging in eugenic euthanasia of disabled babies for years, 
 
although it technically is illegal, since infants can't consent to be killed. Indeed, a disturbing 1997 study published in the British medical journal, the Lancet, revealed how deeply pediatric euthanasia has already metastasized into Dutch neo natal medical practice: According to the report, doctors were killing approximately 8 percent of all infants who died each year in the Netherlands. That amounts to approximately 80-90 per year. Of these, one-third would have lived more than a month. At least 10-15 of these killings involved infants who did not require life-sustaining treatment to stay alive. The study found that a shocking 45 percent of neo-natologists and 31 percent of pediatricians who responded to questionnaires had killed infants.

It took the Dutch almost 30 years for their medical practices to fall to the point that Dutch doctors are able to engage in the kind of euthanasia activities that got some German doctors hanged after Nuremberg. For those who object to this assertion by claiming that German doctors killed disabled babies during World War II without consent of parents, so too do many Dutch doctors: Approximately 21 percent of the infant euthanasia deaths occurred without request or consent of parents. Moreover, since when did parents attain the moral right to have their children killed?

Euthanasia consciousness is catching. The Netherlands' neighbor Belgium decided to jump off the same cliff as the Dutch only two years ago. But already, they have caught up with the Dutch in their freefall into the moral abyss. The very first Belgian euthanasia of a person with multiple sclerosis violated the law; and just as occurs routinely in the Netherlands, the doctor involved faced no consequences. Now Belgium is set to legalize neo-pediatric euthanasia. Two Belgian legislators justify their plan to permit children to ask for their own mercy killing on the basis that young people "have as much right to choose" euthanasia as anyone else. Yet, these same children who are supposedly mature enough to decide to die would be ineligible to obtain a driver's license.

Why does accepting euthanasia as a remedy for suffering in very limited circumstances inevitably lead to never-ending expansion of the killing license? Blame the radically altered mindset that results when killing is redefined from a moral wrong into a beneficent and legal act. If killing is right for, say the adult cancer patient, why shouldn't it be just as right for the disabled quadriplegic, the suicidal mother whose children have been killed in an accident, or the infant born with profound mental retardation? At that point, laws and regulations erected to protect the vulnerable against abuse come to be seen as obstructions that must be surmounted. From there, it is only a hop, skip, and a jump to deciding that killing is the preferable option.

Wesley J. Smith is a senior fellow at the Discovery Institute, an attorney for the International Task Force on Euthanasia and Assisted Suicide, and a special consultant to the Center for Bioethics and Culture. This article is reprinted with permission of The Weekly Standard, where it first appeared on 09/13/2004. For more information visitwww.weeklystandard.com.

By Wesley J. Smith

The Netherlands follows in Germany's footsteps.

AT LAST A HIGH GOVERNMENT OFFICIAL in Europe got up the nerve to chastise the Dutch government for preparing to legalize infant euthanasia. Italy's Parliamentary Affairs minister, Carlo Giovanardi, said during a radio debate: "Nazi legislation and Hitler's ideas are reemerging in Europe via Dutch euthanasia laws and the debate on how to kill ill children."

Unsurprisingly, the Dutch, ever prickly about international criticism of their peculiar institution, were outraged. Giovanardi's critique cut so deeply that even Dutch Prime Minister Jan Peter Balkenende felt the need to respond, sniffing, "This [Giovanardi's assertion] is scandalous and unacceptable. This is not the way to get along in Europe."

As is often the case in the New Europe, what is said matters more than what is done. Thus, the prime minister of the Netherlands thinks that killing babies because they are born with terminal or seriously disabling conditions is not a scandal, but daring to point out accurately that German doctors did the same during World War II, is.

That being noted, one wishes Giovanardi had thought twice before raising the Nazi specter. Partly, this is because nothing we are talking about today matches the scope or magnitude of Nazi crimes. As a result, accusing people of Nazi-like behavior allows those amply deserving of moral condemnation to deflect reproaches. Thus, Giovanardi says that killing disabled babies is what the Nazis did, and the Dutch merely retort (correctly) that they are not Nazis.

Still, the "Nazi" analogy is worth exploring, precisely because it is unequivocally true that 
 
German doctors did kill thousands of disabled babies, for which a few such physicians were hanged at Nuremberg. Dutch apologists know this, of course. But they claim that the Netherlands' infant euthanasia program is substantially different: Dutch doctors are motivated by compassion whereas the Germans' were motivated by the bigotry of racial hygiene. Of course it is the act of killing disabled and dying babies that is wrong, not the motivation. But even leaving that aside, the Dutch defense is not as persuasive as Prime Minister Balkenende would like to believe.

German Euthanasia 1938-1945

THE SEEDS OF GERMAN EUTHANASIA were planted in 1920 in the book Permission to Destroy Life Unworthy of Life (Die Freigabe der Vernichtung lebensunwerten Leben). Its authors were two of the most respected academics in their respective fields: Karl Binding was a renowned law professor, and Alfred Hoche a physician and humanitarian.

The authors accepted wholeheartedly that people with terminal illnesses, the mentally ill or retarded, and deformed people could be euthanized as "life unworthy of life." More than that, the authors professionalized and medicalized the concept and, according to Robert Jay Lifton in The Nazi Doctors, promoted euthanasia in these circumstances as "purely a healing treatment" and a "healing work"--justified as a splendid way to relieve suffering while saving money spent on caring for the disabled.

Over the years Binding and Hoche's attitudes percolated throughout German society and became accepted widely. These attitudes were stoked enthusiastically by the Nazis so that by 1938 the German government received an outpouring of requests from the relatives of severely disabled infants and young children seeking permission to end their lives.The key test came in late 1938 when the father of "Baby Knauer," an infant born blind and missing his leg and part of his arm, wrote Hitler requesting permission to have his child "put to sleep." As described by Lifton and other historians, Hitler was quite interested in the case and sent one of his personal physicians, Karl Rudolph Brandt, to investigate. Brandt's instructions from his Führer were to verify the facts of the baby's condition and, if found to be true, to assure the child's doctors and his parents that if he was killed, no one would face punishment. The doctors in the case who met with Brandt agreed that there was "no justification for keeping the child alive." Baby Knauer soon became one of the first victims of the Holocaust.

Hitler later signed a secret decree permitting the euthanasia of disabled infants. Sympathetic physicians and nurses from around the country--many not even Nazi party members--cooperated in the horror that followed. Formal "protective guidelines" were created, including the creation of a panel of "expert referees," which judged which infants were eligible for the program.

Beginning in early 1939, babies born with birth defects or with congenital diseases were euthanized. Their doctors would admit these unfortunate infants to medical clinics, where they would be killed. The practice quickly became systematized. Regulations made it mandatory for midwives and doctors to notify authorities whenever a baby was born with birth defects. These cases would be reviewed by the euthanasia referees to determine if the children 
 
were eligible for euthanasia. Those deemed killable were usually dispatched via an overdose of a drug, most typically a sedative called Luminal. The euphemism of choice for this murder was "treatment." Most, but not all, of this killing was done in secret.

IT IS IMPORTANT TO NOTE that throughout the years in which euthanasia was performed in Germany, whether as part of the officially sanctioned government program or otherwise, the government did not force doctors to kill. Participating doctors had become true believers, convinced they were performing a valuable medical service for their "patients" and their country.

Eventually, the "success" of the infant euthanasia program led to the infamous "T-4" project in which adult disabled German citizens were mass murdered. Hitler eventually canceled the T-4 program in the face of public protests but that didn't matter. From around 1943 until a few weeks after the end of the war, some doctors went on a eugenic killing rampage. Known today as "wild euthanasia," during the later war years German doctors killed any patient they pleased, often without medical examination, usually by starvation or lethal injection.

Dutch Infant Euthanasia

IN 2004, Groningen University Medical Center made international headlines when it admitted to permitting pediatric euthanasia and published the "Groningen Protocol," infanticide guidelines the hospital followed when killing 22 disabled newborns between 1997 and 2004. The media reacted as if killing disabled babies in the Netherlands was something new. But Dutch doctors have engaged in infanticide for more than 15 years. (A Dutch government-supported documentary justifying infant euthanasia played on PBS in 1993. Moreover, a study published in 1997 in the Lancet determined that in 1995, about 8 percent of all infants who died in the Netherlands--some 80 babies--were euthanized by doctors, and not all with parental consent; this figure was reproduced in a subsequent study covering the year 2001.)

As far back as 1990, the Royal Dutch Medical Association (KNMG) published a report intended to govern "life-terminating actions" taken against incompetent patients, including severely disabled newborns. The KNMG approved of pediatric euthanasia if the baby is deemed to have an "unlivable life," a concept disturbingly close to Binding and Hoche's "life unworthy of life."

The "livableness" of a newborn's life is determined by a combination of factors, including the following:

* The expected measure of suffering (not only bodily but also emotional--the level of hopelessness)

* The expected potential for communication and human relationships, independence (ability to move, to care for oneself, to live independently), self-realization (being able to hear, read, write, labor), and the like.

* The child's life expectancy.

If the infant's "prospects" didn't measure up, the child could be euthanized.

The subsequently compiled Groningen Protocol--which is expected to form the basis for the official approval of Dutch pediatric euthanasia--similarly created categories of killable babies: infants "with no chance of survival," infants with a "poor prognosis and are dependent on intensive care," and "infants with a hopeless prognosis," including those "not depending on intensive medical treatment but for whom a very poor quality of life . . . is predicted." In other words, infant euthanasia is not restricted to dying babies but can be based on predicted serious disability.

SO, WAS GIOVANARDI CORRECT in his comparison of Dutch infant euthanasia with that of Germany circa 1938-1945? No and yes. Certainly the breadth and scope of the killing in Germany far exceeded anything that is ever likely to happen in the Netherlands. And, to their credit, the Dutch unquestionably disdain the kind of pernicious social Darwinism that helped fuel the German euthanasia pogrom. Nor does pediatric euthanasia seem to be financially motivated, which also played a part in German infant euthanasia.

But the Netherlands cannot escape this ugly fact: Dutch doctors kill scores of babies each year and justify this fundamental abuse of human rights upon the inherently discriminatory concept that they can decide that another human being's life is of such low quality it has no business being lived.

In this sense, the Dutch infanticide program is explicitly akin to the murder of Baby Knauer in 1938. Unless we decide to revise our historical assessment of that crime and proclaim Hitler's authorization for the baby's euthanasia as compassionate and right, the systematic program of Dutch infant euthanasia should be loudly and universally condemned.

Wesley J. Smith is a senior fellow at the Discovery Institute, an attorney for the International Task Force on Euthanasia and Assisted Suicide, and a special consultant to the Center for Bioethics and Culture.

This article is reprinted with permission of The Weekly Standard, where it first appeared on 03/27/2006. For more information visit www.weeklystandard.com."

Assisted Suicide and Euthanasia: A Deadly Illusion

What is meant by assisted suicide?

Assisted suicide is a self-induced death. The means (drugs or other devices) which cause such a death are provided by a second agent. It could be a doctor or another individual. Although a legal distinction is made between euthanasia and assisted suicide, there is no ethical difference.

It remains a criminal act to counsel, aid or abet a suicide because historically it was recognized that those who consider suicide are especially vulnerable to those who could take advantage of them. It was also recognized that it was impossible to enforce any kind of "limited" assisted suicide and euthanasia without opening the door to all kinds of abuse.

What is euthanasia?

Euthanasia means acting or failing to act in such a way as to cause the death of another human being, where the primary intention is to kill, supposedly for his or her own good. No matter what the reason or method, killing is killing. Euthanasia and assisted suicide is saying: We think you would be better off dead.

Euthanasia and assisted suicide advocates present the practice of having someone "assist" in the death of another as an exercise in compassion. They present killing as an act of mercy--hence the term "mercy killing". It is no kindness or mercy, however, to kill the suffering individual. Compassion does not seek to eliminate the sufferer. For ages, our society has recognized that a request for death was a cry for help.

What about pain?

We must kill the pain, not the patient. Palliative care and pain specialists have at their disposal a vast array of medications to alleviate physical pain in the patient. They inform us that it is possible today to substantially relieve pain in almost all circumstances. Breakthroughs in pain management ensure that patients can be made comfortable.

Suffering and pain wear many faces and require different treatments. Palliative care seeks to answer all the needs of the patient: emotional, physical and spiritual. The response to emotional distress is comfort and reassurance. The solution for depression is mental health treatment. Studies have shown that when the needs of patients are met and their fears addressed, the request for death vanishes.

The choice is not, as it is so often presented, one of accepting life with unrelieved pain or death by assisted suicide/euthanasia. Pain specialists acknowledge that some medical professionals are lacking in their assessment and management of pain. Some patients refuse adequate pain control due to unfounded fears of addiction. Contact your local palliative care association to learn more about the services available in your community.

• Adequate pain relief is available. We need to improve the care of patients, not kill them.
• In common law, patients have always had the right to refuse treatment.
• The assisted suicide and euthanasia movement acknowledges that physical pain and suffering are not the main arguments for assisted suicide. Their main arguments are autonomy and self-determination.

What if we legalize assisted suicide or euthanasia?

The Netherlands tolerated euthanasia for nearly thirty years prior to legalization in 2002. The evidence then as now shows that patients were and are killed without their consent. A 1991 study conducted by the Dutch government in which physicians were granted anonymity revealed that 1/4 of physicians admitted to terminating the lives of patients without an explicit request from the patient. The safeguards of which euthanasia/assisted suicide advocates so often speak have offered no protection to the weak and vulnerable in that country. Once these practices are accepted, the experience in Holland has clearly shown that involuntary euthanasia will follow.

Groningen Hospital announced last December its guidelines for the euthanasia of infants. Evidence of other pediatric euthanasia in Holland was documented in the British medical journal The Lancet in 1997. The legislation enacted in 2002 has made euthanasia/assisted suicide available for sixteen to eighteen year old adolescents without parental approval. Twelve to sixteen year olds who request it may be euthanized if a parent or guardian gives consent.

• The legalization of physician assisted-suicide and euthanasia will fundamentally alter the role of physicians.
• Doctors are for healing, not killing.
• Killing is never a medical treatment.
• Many physicians oppose such measures.
• The promise of greater patient autonomy is nothing but a deadly illusion. Others may decide when you die.

What about the right to die?

Terms such as "right to die", "choice in dying", and "aid in dying" are all euphemisms for euthanasia.  Death is not a actually a right nor a choice but a reality that none of us will escape. The right to die may become an obligation to die.

The acceptance of euthanasia and assisted suicide threatens the lives of others. It is not a simple matter of individual freedom, as the practice involves a second party in assisting or causing your death. Such measures further weaken respect for human life and abandon the most defenceless. The disabled and other vulnerable individuals fear these actions. Some ethicists argue that even patients with Alzheimer's disease, which impairs cognitive abilities, are no longer persons since they lack "self awareness". How can we as a society embrace killing and call it compassion? Killing is not loving. True dignity in death comes about when human life is valued and cared for until its natural end. Those who suffer need to know that they are not a burden. Let us offer love, support and embrace a culture of life!

Produced by Action Life Ottawa (Inc.)

When Patricia Ommerli took her garbage out from her apartment blockhouse, she always made sure she timed it carefully. She didn’t want to meet a corpse in her elevator.

Ms. Ommerli is not an actor in a B horror movie. According to the July 13 issue of the UK paper, The Guardian, she was one of many residents unhappy about sharing living quarters with Dignitas, an assisted-suicide organization in Zurich, Switzerland. “Because the lift is too small for coffins, the bodies are transported in bags, which are then propped up in the corner of the elevator...It’s horrid,” complained another resident to the British Medical Journal last month. Fed up with their ghoulish neighbours and chance encounters with body bags, tenants filed complaints, and authorities have since ordered Dignitas to move its grisly business elsewhere.

Dignitas, has become the so-called “suicide tourist” centre of Switzerland, helping 700 people to kill themselves in the past nine years. That number is growing. Between 1998 (when Dignitas first opened its doors) and 2002, about 125 people died by assisted suicide at the clinic. But in the past eight months alone, about 200 have been helped to kill themselves. Charging $5,000-$7500 per “customer”, Dignitas caters especially to the international community which has stricter laws governing assisted suicide.

One of their recent “clients” was 38 year-old Winnipeg, Nova Scotia resident, Elizabeth Jeannette MacDonald.  Mrs. MacDonald was diagnosed with Multiple Sclerosis (MS) in September 1998. By 2007, she was confined to a wheelchair and was beginning to have difficulty swallowing.   Accompanied by her husband, retired Anglican priest Eric MacDonald, Mrs. MacDonald travelled to Switzerland, where assisted suicide is legal, and killed herself with the help of Dignitas staff on June 8. She is believed to be at least the fifth Canadian to commit suicide at the Swiss clinic.

Following Mrs. MacDonald’s death, the Euthanasia Prevention Coalition (EPC) contacted the RCMP to investigate her case. The mainstream media had a field day with the story. The Hants Journal published a lengthy and sympathetic interview with Mr. MacDonald who angrily called the EPC a “bunch of busybodies.” Alex Schadenberg, Executive Director of EPC, defended the group’s actions, “We had no idea if anyone was involved...We saw information [thanking Dignitas staff] in [Mrs. MacDonald’s] obituary and we asked the police, ‘Was the law broken here in Canada?’” Canadian law prohibits aiding, abetting, or counselling someone to commit suicide to help protect them during a particularly emotionally fragile period in their lives. The investigation, however, concluded that no laws had been broken.

“The media wanted to make it an issue of an Ontario group going after this clergyman,” added Mr. Schadenberg. “We came back and made the case that you shouldn’t be shooting the messenger. You should be looking at the issue...People who [request] euthanasia or assisted suicide...become very vulnerable to others.” The EPC requested an investigation, Mr. Schadenberg asserted, to ensure that, at the very least, Mrs. MacDonald was not encouraged to kill herself, especially if she was suffering psychological or emotional distress as a result of her physical condition.

In June, the U.S. journal, Health Psychology, released results of one of the most comprehensive and widespread surveys on assisted suicide involving patients receiving palliative care for advanced cancer. The  Canadian National Palliative Care Study, sponsored by the Canadian Institutes of Health Research, revealed that while 62.8% of those surveyed thought assisted suicide should be legal and 40% said they might consider it in a “worst-case scenario” situation, only 5.8% (22 of 379) indicated that they would “definitely initiate a request to end their lives right away,” if it was legal. Even more telling, 10% said that, at one time, they would have killed themselves but had since changed their minds. In other words, only a very small percentage of the terminally ill were seriously considering suicide and that number could change their minds.

In a Canadian Press interview, lead researcher, Dr. Keith Wilson concluded from the survey that physical pain was not the main factor motivating patients to consider suicide. “In the mind of the general public, euthanasia and assisted suicide are intricately tied up with the relief of uncontrollable pain. The reality is the circumstances are much more complicated than that...People who said they would request suicide were not necessarily closer to death and were not in significantly more pain, but they were much more likely to be experiencing drowsiness, general malaise, depression, and a feeling of being a burden to others. ”

Dr. Wilson, who is an associate professor of Medicine at the University of Ottawa and a psychologist at the Ottawa Hospital Rehabilitation Center, added, “We also found that those people who reversed their desire for suicide may have done so because their physical and mental symptoms subsided, either on their own or through treatment.” He added, “Patients diagnosed with terminal cancer may assume they will experience profound suffering, but our results show that this is not necessarily the case, at least not when there is access to adequate palliative care,”

Dr. Rene Leiva, an Ottawa-based family physician with formal training in geriatric and palliative care, notes that the current focus of the euthanasia or assisted-suicide debate is on the terminally ill. He remarks, “There’s a lot of work to be done to help [the terminally ill] to discover new meaning in their lives...It’s our job to offer them everything we can--medically, psychologically, socially, spiritually-- to alleviate their suffering. That is what makes us human. They fear being abandoned, being in pain, being a burden etc. and it’s our challenge to help them so their needs are addressed in a human way...That’s why palliative care is so important.”

Mark Pickup, a Canadian writer and advocate for the disabled who has suffered from MS for thirty years (almost three times as long as Mrs. MacDonald), agrees. “There were times when my family lifted me up as someone of value even when I didn’t think that I was,” remarks the triplegic who is confined to a wheelchair and only has limited use of one arm.  “That is what a family and a community is about...We lift people up when they’ve sunk beneath the waves of circumstances.”

Mr. Pickup sees support for euthanasia and assisted suicide of the disabled, in particular, as a demonstration of societal prejudice. “You wouldn’t help someone to kill themselves if they were healthy,” he said. “Why is it different if the person is disabled?” Mr. Pickup recalled a poll reporting that 70% of Canadians supported euthanasia or assisted suicide for the terminally ill or the severely disabled. “That means 7 out of 10 of my fellow citizens think I’m better off dead,” said Mr. Pickup. “They would not stand up and defend me if I was suicidal. It’s kind of hard to feel kinship with citizens like that.”

But once you accept euthanasia or assisted suicide for the terminally ill, explains Dr. Leiva, you are on a “slippery slope” toward advocating it for the disabled, the mentally impaired, or anyone lacking the will to live. Dignitas brought a case before the Swiss Supreme Court, on behalf of a manic-depressive patient who wanted to kill himself. That Court ruled in February 2007 that assisted suicide should be legal for the mentally ill as well as the terminally ill. The Netherlands passed a similar law over ten years ago.

These laws fail to consider what a July American Journal of Psychiatry study revealed: the depressed are less likely to attempt suicide following appropriate medical or psychiatric intervention.

“You don’t make a decision at your worst moment,” said Mr. Pickup. “So much is affected by the climate a person finds themselves in. If it’s a life-affirming climate, they’re less apt to give up.”

Dignitas founder, Ludwig Minelli has a different view. “Life is a sexually transmitted disease,” he told British Parliament members in 2005. And as for his claims of offering “death with dignity”, his apartment house “clinic” has been likened to a “backstreet abortionists’” with dirty facilities, insensitive and non-medical staff, and shoddy treatment, according to relatives of a now-deceased client.  Paul Clifford told the Daily Mail in January that he was even offered a “cut-rate” price to take his own life, if grief over his mother’s suicide at the clinic became overwhelming. In one bizarre episode, The Times reported, a doctor involved with the Dignitas clinic killed himself upon hearing that he had authorized the assisted suicide of a German woman. The woman had falsified medical reports to say she was suffering from terminal cancer when she was, in fact, just depressed.

A nurse and her husband, a former director of Dignitas, both left the organization in disgust in 2005. Clients would briefly see a doctor in the morning to confirm their illness and their sanity, explained Soraya Wernli to the Sydney Morning Herald, “And by 4 pm they would be dead. It was against my morality. In that time, how can you be sure they really wanted to die?” She added, “I could not accept what he [Mr. Minelli] was doing. He was not interested in their diagnosis, just their money,”

Dignitas is currently seeking new quarters. Mr. Minelli’s lawyer told The Guardian that lacking a suitable site, Dignitas may relocate to “a caravan”, making them more accessible to the suicidal.

Meanwhile, in Canada and most of the U.S., “right to die” advocates continue to push for the legalization of euthanasia and assisted suicide. Mark Pickup offers the following poignant words to sum up the debate: “”We choose to include or exclude. We choose to lift up or put down. I choose to lift up.”  

In the September 1970 edition of California Medicine, a publication of the Western Journal of Medicine, an article entitled "A New Ethic for Medicine and Society" explained that the traditional western ethic has always placed great emphasis on the intrinsic worth and equal value of every human life regardless of its stage or condition.

This ethic has its roots in the Judeo-Christian tradition and has, in fact, provided the basis for most of our laws and much of our social policy. In this article, it was suggested that the Judeo-Christian ethic is being gradually eroded in order to validate the pragmatic solutions which would accommodate the expansion of social engineering. They also warned that in order for a dilution of this ethic to be successful, it would be necessary to separate the idea of killing from such acts as abortion and death control (assisted suicide and euthanasia).

Psychiatric Times February 2004 Vol. XXI Issue 2

Euthanasia is a word coined from Greek in the 17th century to refer to an easy, painless, happy death. In modern times, however, it has come to mean a physician's causing a patient's death by injection of a lethal dose of medication. In physician-assisted suicide, the physician prescribes the lethal dose, knowing the patient intends to end their life.

Giving medicine to relieve suffering, even if it risks or causes death, is not assisted suicide or euthanasia; nor is withdrawing treatments that only prolong a painful dying process. Like the general public, many in the medical profession are not clear about these distinctions. Terms like assisted death or death with dignity blur these distinctions, implying that a special law is necessary to make such practices legal--in most countries they already are.

 Eighth Annual Report on Oregon’s Death with Dignity Act

By Gudrun Schultz 

Thirty-eight people died in Oregon in 2005 after taking lethal medication given to them by their doctors. Only two were given psychiatric evaluations to determine the state of their mental health.

By Martha Jones 

Consider for a moment the following situation.  A 28 year old woman finds out she is expecting her third child.  She is single and the mother of a 10 year old boy and a 3 year old girl.  She lives with her mother and works in the laundry department of the local hospital.  Her mother has been helping her raise the two children but she is now 60 years old. Her father passed away when she was just a little girl and money has always been very tight for them. In addition, she has a history of broken relationships with men which has left her somewhat emotionally unstable. This pregnancy resulted from a brief affair with a member of the armed forces who was temporarily posted to the town where she lives.  By the time she learns of her pregnancy he has already returned to his home base and there has been no further contact between them.

What Is Adoption? 

Adoption is the legal means by which the child of one set of parents permanently becomes the child of another set of parents. Provision for adoption appears to have been made as far back as the earliest recorded histories. The Babylonian Code of Hammurabi establishes the existence of adoption practices more than 4,000 years ago. The Bible refers to adoption as does ancient Roman civil law, and the early Spaniards had an adoption law. In Canada every province has legislation regarding adoption.

Dr. John C. Wilke

 There is a worn-out argument that has been used over the years against protecting unborn babies. They say there have always been abortions, and there will always be abortions. If you forbid the legal and "safe" abortions, you will merely return to illegal and "unsafe" abortions. If and when the pro-life movement moves closer to its goals, we will hear this argument voiced louder and longer.

It seems logical enough on the surface. However, there are no documented studies to prove this claim. That doesn't seem to matter to pro-abortion spokes people nor to a biased media. What is needed is the actual experience in the field. What has happened in a major nation when abortion has been forbidden? Have illegal abortions increased? Have more women died or more women been injured? Well, guess what. We have had a proving ground in a major nation, which is there for all to see. The nation is Poland.

It's time for the facts to be known...

Myth: Abortion is basically a private matter.

Fact: Not really. Abortion involves more than a woman and her doctor. Even more directly and intimately involved is a third human being: the mother's unborn child; the doctor's unborn patient. And the father? Presently, he has no say in the fate of his offspring.

Abortion has broad consequences for the whole of society. How can one pretend that the very acceptance of the large scale killing of innocent, defenceless, unborn human beings through abortion does not foster the creation of a psychological climate favourable to the development of other forms of violence which are becoming a characteristic trait of our times (child abuse, infanticide and physician-assisted death)? More than 100,000 abortions are performed in Canada every year.

Rape is often used as an argument for abortion. Many will say they are opposed to abortion except in cases of rape or incest. Rebecca Wasser Kiessling put a face to the issue at the International Pro-Life Conference, “Creating a Culture of Life”, held in Toronto in October. She was conceived in rape.

By Janet Podell 

When people on different sides of the abortion issue engage one another in debate, sooner or later the argument touches upon the question of what to do when pregnancy is the result of rape.

By Gudrun Schultz 

Almost all abortions take place because a child would be inconvenient, too expensive, or too difficult to cope with, according to a new study by the Alan Guttmacher Institute, abortion provider Planned Parenthood's research affiliiate. In a 2004 survey of 1,209 American women at 11 major abortion clinics, women revealed that neither health problems, rape, incest, nor coercion by family members or partners were the primary or even secondary reasons for seeking an abortion.

By Barbara McAdorey

Criticizing Health critic Rob Merrifield for making the suggestion that third-party counselling would be "valuable" to women contemplating abortion, Deputy Prime Minister Anne McLellan revealed just how disturbing and frightening our country is becoming when she said, "The notion of state-imposed, third-party counselling as if we are children, as if we are not able to make our own decisions about our health and our bodies, is to me, at the beginning of the 21^st century, profoundly disturbing and, dare I say it, is very frightening."

By Gudrun Schultz

Abortion advocates object fiercely to the use of ultrasound machines by crisis pregnancy centres. The centres have been accused of emotionally manipulating women by showing them images of their unborn children, causing them greater suffering when they decide to continue with the abortion.

By Lyn Smith

There is a public perception that when abortion is legal, abortion is safe. The media seldom focuses on the long term psychological and physical effects on a woman's health should her pregnancy be interrupted by induced abortion.

Nevertheless, in a 1994 article in the Ottawa Citizen, registered nurse and journalist, Nancy Lloyd, quoted Dr. Norman Barwin, infertility specialist and past president of Planned Parenthood Canada, as saying, "Abortion is an invasive medical procedure. Every patient should be told of the risks and benefits of the procedure. It is often too late afterwards to have guilty feelings and regrets." He observed that there can be medical complications from abortion. The complications can be caused by the abortion technique, secondary infection and bleeding which can result in subsequent infertility. Dr. Myron K. Denney, in a discussion of the various risks of abortion says in his book, A Matter of Choice:An Essential Guide to Every Aspect of Abortion, "Even without injury, abortion taxes the normal bodily protective mechanism."

Evidence has begun to surface in the English scientific literature that research which dates as far back as 1957 indicated that there was another risk to women's health: women who have undergone an induced abortion before a full term pregnancy have an increased risk for developing breast cancer (Japan, Segi et al - GANN). In 1981 a landmark study was conducted by Malcolm Pike, M.D. and colleagues at the University of Southern California. Abortion had been legalized in the U.S. in 1973 and Pike's data collection period covered 1972-1978. The study was restricted to women less than 33 years old who aborted before a first full pregnancy. Pike found these women to be 2.4 times more likely to develop breast cancer than those with no history of induced abortion.

Researchers acknowledge that one in nine (1 in 9) Canadian and American women will be diagnosed with breast cancer in her lifetime. Despite improved methods for early diagnosis and a rigid emphasis on self-examination and mammography, the number of new cases of breast cancer continues to rise each year. There are some universally accepted risk factors for the development of breast cancer: never having a child, delayed child bearing, early menstruation and late menopause, family history of breast cancer, and aging. Even so, "The very grim fact remains that in 60 to 70% of women diagnosed with breast cancer not one of the risk factors is present." (1992 Canada Report of the Standing Committee on Health and Welfare, Social Affairs, Seniors and the Status of Women: Breast Cancer: Unanswered Questions).

Is there a new factor in the medical histories of Canadian women? Abortion was decriminalized in 1969. We know that the number of new breast cancer cases has risen every year and this rise is paralleled by the increasing numbers for induced abortions reported each year by Statistics Canada. Abortions increased from 69,499 in 1984 to 106,255 in 1994. The number of new breast cancer cases reported for the first time nationally in 1984 was 10,321 and rose to 17,000 in 1994. It was estimated that in 1996 there would be 18,600 new cases of breast cancer and that 14 Canadian women would lose their life to breast cancer each day. Most abortions are done in the first trimester when the breast cells are the most unstable and over 50% are done on women who have no prior pregnancy so that they are without the protection of a full term pregnancy. In the last 20 years, the share of abortions has increased for women who had been pregnant less than 13 weeks, for women in their 30's and for those women who had at least one prior induced abortion. Statistics Canada now estimates (1994) that one woman in three will have an abortion in her lifetime.

Scientists agree that the earlier in a woman's life that her breast cells reach maturity due to a full term pregnancy, the more protected she is against the possibility of developing breast cancer. Breast cancer is believed to originate in undifferentiated or primitive cells. Prior to conception a woman's breasts consist mostly of connective tissue surrounding a branching network of ducts with relatively few milk producing cells. At conception there is a surge of oestradiol or estrogen production and the milk buds begin to develop a duct-like form preparatory to lactation at birth. During the first trimester the breast cells are in a 'transitional' or undifferentiated stage and are vulnerable to cancer until the cells begin to differentiate or 'specialize' in the second and third trimester under the direction of other hormones produced in the later stages of pregnancy. At full term pregnancy, the stabilized cells result in mature breast tissue which will never again be as vulnerable to breast cancer.

Estrogen exposure is known to promote tumour growth. Induced abortion may independently increase the risk for breast cancer because of the tumour promoting effect of the considerably raised estrogen (oestradiol) concentrations in early pregnancy. At the same time, an abortion would deny a woman the benefit of the differentiating hormones during late pregnancy. As well, induced abortion may enhance the estrogen mediated proliferation of normal but primitive cells, resulting in the presence of more cells which are vulnerable to subsequent primary carcinogenesis. On the other hand, subnormal levels of maternal oestradiol are found to be the most reliable predictor of first trimester miscarriage (spontaneous abortion). Many retrospective studies have failed to distinguish between the physiology of spontaneous abortion and that of induced abortion.

In 1994 the National Cancer Institute funded an interview study of 1800 women over a seven year period. It focused specifically on induced abortion and breast cancer making the distinction between spontaneous and induced abortion and also addressed the issue of 'response bias'. The published results of the research of Janet R. Daling, Ph.D. et al of the Fred Hutchinson Cancer Research Centre, Seattle, Washington, instantly became an object of attack by the media, special interest groups and fellow researchers. Overall, the Daling study determined that women under age 45 who had an induced abortion had a 50% greater risk for developing breast cancer than did 'matched' women who had been pregnant at least once and never had an abortion. Among women who first terminated a pregnancy before age 18, the risk of breast cancer was 150 % higher. Among women who experienced an induced abortion after age 30, the risk was 110% higher.

At the Centre for Biostatistics and Epidemiology, Dept. of Pharmacology, Pennsylvania State University, Dr. Joel Brind Ph.D. and his research colleagues took two years to prepare a meta-analysis of the 23 independent and previously published international studies which made the distinction between spontaneous and induced abortion to determine whether induced abortion could be an independent factor for increasing a woman's risk of developing breast cancer. Their review appeared in the prestigious Journal of Epidemiology and Community Health - Great Britain, in October 1996. Dr. Brind's team used the records of over 60,000 women. They found a 30% increased risk for the development of breast cancer independent of any other factor except induced abortion. They found a 50% increased risk for the development of breast cancer if the abortion was done on a first pregnancy. The abortion/breast cancer link was demonstrated in white, Asian and black women. The data suggests that the risk is even greater for women with a family history of breast cancer, especially for those teenagers who may not be aware of their family history. The increased risk for developing breast cancer was seen in populations of different ethnicity, diet, socioeconomic and lifestyle patterns.

The research team expressed the hope that their meta-analysis would clarify directions for future research, eliminate any confusion regarding spontaneous vs. induced abortion and most significantly, it would ultimately help women contemplating an abortion to be fully informed of the risks for their health. They said, "...there exists the more present need for those in clinical practice to inform their patients fully about what is already known."

Women cannot control their family history, their environmental surroundings, the onset of menstruation or menopause or the aging process; however, induced abortion is an elective medical procedure which can be rejected in favour of other options. Legal abortion is never safe for children waiting to be born and it is not always safe for their mothers.

For additional information about current scientific research and the connection between abortion and an increased risk for developing breast cancer, please contact Action Life (Ottawa) Inc.

Action Life Online Article

By Angela Lanfranchi, MD, FACS

On May 13, 2004, Ellen Goodman, in a column in the Boston Globe entitled "Just the Schmacks, Ma'am," stated that the research linking breast cancer to abortion "keeps reappearing no matter how many scientists drive a stake through its heart."1 She reported that even though the government web site at the National Cancer Institute had "expunged" the abortion-breast cancer (ABC) link, the information continues to appear on pro-life web sites. Goodman's column illustrates the reason there is such widespread misinformation about the ABC link. She claims
that the link is merely a pro-life "scare tactic." It is not. It has a proven scientific basis.2

Unfortunately,the popular press does not seem willing to convey accurate information about this issue. The media erroneously reported that one hundred scientists meeting at the National Cancer Institute in February 2003 had "unanimously" arrived at the conclusion that there was so little evidence for the ABC link that it need not be studied further.3 The conclusion was not unanimous. The dissenting opinion by scientist Joel Brind, who was at the February meeting, can be found on the web sitehttp://www.bcpinstitute.org/.4

More recently, a study published in the Lancet's March 27, 2004, issue5 has become the latest "stake" picked up with great fanfare by the press. The Atlanta Journal Constitution quoted Valerie Beral, the study's first author, as saying, "Scientifically, this is really a full analysis of the current data."6 Nothing could be further from the scientific truth. Instead, it illustrates Dr. Donald DeMarco's recent thoughts regarding the inappropriate influence of wishes and beliefs on the outcomes of "scientific research" and medical information.7
Beral's own words, as reported by the Associated Press, were that "The totality of the worldwide epidemiological evidence indicates that pregnancies ended by induced abortion do not have adverse effects on women's subsequent risk of developing breast cancer."8 This conclusion is scientifically inaccurate for many reasons. Selection bias in choosing studies for reanalysis, the unproven assumption of recall bias in retrospective studies, and the choice of a scientifically invalid control group all resulted in a very flawed reanalysis.

My article examines and refutes the conclusions of the Lancet paper. My hope is that as many women as possible will read this critique so that they will not be deceived by the media into thinking that there is no link between abortion and breast cancer.

Selection Bias
Studies that take data from many previous studies and "reanalyze" them (or put them into a meta-analysis) need to have sound scientific reasons for excluding some published studies. Without valid exclusion and inclusion criteria, the results can be skewed and inaccurate because they may allow an author's personal bias to consciously or subconsciously enter the selection process, thus corrupting the conclusion. Undoubtedly, this sort of bias is what has led some observers to call epidemiology a pseudoscience. For instance, if many studies were to show a
positive association between breast cancer and abortion, but were eliminated so that only those showing no or a negative association remained, then obviously the result would show little or no association of abortion with breast cancer. Therefore, it is essential that studies be eliminated solely for rigorously scientific reasons; for example, if the data were not collected properly, or the study was proven flawed after peer review.

Of the forty-one previously published, peer-reviewed studies that could have been included in her reanalysis, seventeen were excluded: fourteen for invalid, non-scientific reasons. Of these fourteen, four published studies were simply not acknowledged to exist,9 even though three of them were coauthored by members of Beral's collaborative group. 
Let us look at the reasons some of these studies were excluded:
1. Four studies10 were excluded because the "principal investigator (PI) could not be found." These four studies were published an average of over twenty years ago (1978-1986). It is not unreasonable to assume the PI might be retired, expired, incapacitated, or unreachable. Those circumstances would not make his study unimportant or scientifically invalid.
2. Three studies were excluded11 because the PI could not find the original data. Certainly that does not make the published data inaccurate. One of those studies 12 had gotten its data from the New York State Department of Health records and a fetal death registry. An additional two studies13 were excluded because the PI did not want to participate. This preference would not invalidate their studies.
3. One study14 was excluded because the PI felt his "information was unreliable." One would want to know why that study went through peer review and had been published.

Looked at from another angle, Beral eliminated ten of sixteen statistically significant published studies showing an association between abortion and breast cancer. If all fourteen of the excluded studies were combined, they would show approximately an 80 percent increase in the risk of breast cancer with abortion.

Other studies which should have been correctly omitted due to scientific flaws, such as the 1997 Melbye15, 2001 Goldacre16, and 2003 Erlandsson17 studies, were included. All three studies have been demonstrated to have major methodological flaws. For example, the 1997 Melbye study misclassified sixty thousand women as not having had abortions when governmental records show that they did. In addition to the twenty-four published studies Beral used for her reanalysis, she chose to include twenty-eight unpublished and therefore non-peer reviewed studies. This again was a very questionable decision. Published studies undergo scrutiny by other researchers who may uncover serious flaws that invalidate the conclusions, as illustrated by the Melbye study. Unpublished studies have not undergone the same level of scrutiny and therefore may be less reliable.

Assumption of Recall Bias
In the interpretation section of the summary of her paper, Beral states that studies of breast cancer using retrospective recording of induced abortion yielded misleading results. Her study found that there was an 11 percent increased risk of breast cancer when she evaluated the retrospective data from thirty-nine worldwide studies. She decided to exclude this data because of "recall bias." The theory of recall bias holds that, when women are interviewed, those with breast cancer will more accurately recall and report their abortion history than those who
have not had breast cancer, thereby skewing the results. However, when recall bias in the case of abortion has been studied (and it has been studied several times), it has not been found to influence the results, or, for that matter, even to exist. 
For example, the 1991 Lindefors-Harris study18 showed only a 16 percent recall bias effect in which women without breast cancer "under reported" their abortions compared to women with breast cancer. This small effect is not enough to change the outcome of a large study, and in fact, in this same study, 27 percent of the women admitted to abortions that were not recorded in an abortion registry, thereby "over-reporting" their abortions. Lindefors and Harris claimed the "over-reporting" women were admitting to abortions they never had because they were
not in the abortion registry used by them. Peer review caused them to retract that obviously flawed opinion. In another study by Ye in 2002,19 the researchers found the same risk of breast cancer when they used medical records as when they used retrospective interviews of the same patients, proving that recall bias did not exist.

Beral's blanket assumption that the recall bias theory calls into question the results of all retrospective studies that involve the questioning of people about potentially embarrassing behavior such as abortion has never been applied to other studies investigating the number of sexual partners, type of sexual behavior, and the amount of alcohol consumed as it relates to disease. The association of cervical cancer with increased number of sexual partners, HIV
infection with sodomy, and heavy drinking patterns with liver disease has not invalidated retrospective studies that show positive associations. Why then does the potential for recall bias invalidate thirty-nine studies that show an association between induced abortion and breast cancer?

Inappropriate Comparison Group
Another error in Beral's study design occurs in the inappropriate choice of control group for the reanalysis. Beral charts the relative risk of breast cancer by comparing the effects of having had a pregnancy that ended in an induced abortion with the effect of "not having had" that pregnancy.
As soon as a woman becomes pregnant, even before implantation occurs, her estrogen levels start to rise. This affects her breast tissue by causing the number of Type 1 and Type 2 lobules in her breast to increase. She is physiologically different from a woman who has never been pregnant because, as a result of her pregnancy, however long, her breast tissue will have changed in a way that affects her breast cancer risk. If she completes that pregnancy to term she will have lower breast cancer risk, as her breast tissue will have matured to predominantly Type 3 lobules, which are resistant to carcinogens. If that pregnancy is interrupted, either through induced abortion, late miscarriage, or premature delivery before thirty-two weeks, she will have increased numbers of Type 1 and 2 lobules due to the hormonal stimulation during her pregnancy. Both Melbye and Hsieh, in two studies published in 1999, showed that premature deliveries before thirtytwo weeks more than doubled breast cancer risk.20

The only valid comparison that Beral et al. should have chosen as a proper control group for pregnant women who end their pregnancy with induced abortion is pregnant women who do not end their pregnancy with induced abortion. Including in the comparison group women who are not pregnant or who never have been pregnant skews the results.

By choosing a scientifically invalid control group, Beral invalidated her study's outcome. When the effect of hormone replacement therapy (HRT) on breast cancer risk was studied, postmenopausal woman taking HRT were compared to postmenopausal women not taking HRT. This resulted in the finding that HRT increased breast cancer risk. If the investigators had chosen to compare postmenopausal women taking HRT to premenopausal women taking HRT, no increase would have been found. Both groups would have risk elevation and no difference between the groups would have been apparent. Only by comparing physiologically equivalent groups of women can breast cancer risks be discerned.

Epidemiology and Biology
Epidemiological associations are studied to give scientists a place to start when investigating the biologic principles of disease. In fact, even as the National Cancer Institute discounted the ABC link, it did so while also admitting an "epidemiologic gap," as they put it, concerning premature deliveries before thirty-two weeks and an increase in breast cancer risk. This is not a "gap" that is inexplicable if one is aware of breast physiology as described by standard texts. Over 80 percent of all breast cancers are ductal cancers and arise in Type 1 lobules. At puberty, when estrogen levels rise, the breast enlarges partly by increasing the number of Type 1 lobules. When estrogen
levels again rise during pregnancy, a woman's breast further enlarges by making increased numbers of Type 1 and 2 lobules. The longer she is pregnant before thirty-two weeks, the more Type 1 and 2 lobules she forms.

After thirty-two weeks her breasts stop enlarging and the Type 1 and 2 lobules develop into Type 3 lobules in preparation for breast-feeding. These Type 3 lobules are resistant to carcinogens. This is the reason that women who have given birth have a lower breast cancer risk than women who have never been pregnant.

The reason that premature delivery before thirty-two weeks more than doubles breast cancer risk is the same reason that induced abortion increases breast cancer risk. The breast has developed more Type 1 and 2 lobules. There are now more places where breast cancers can start.
In reply to Ellen Goodman's mock surprise that the ABC link is alive and well, despite the "stakes" of many scientists and the National Cancer Institute, I would simply state that facts can be very persistent things. I would also add that the sorts of manipulations discussed above reinforce my general concurrence with Disraeli's statement that there are three kinds of lies: lies, damnable lies, and statistics.21

Notes
1. Ellen Goodman, "Just the Schmacks, Ma'am," Boston Globe, May 13, 2004.
2. Angela Lanfranchi, "The Abortion-Breast Cancer Link: What Today's Evidence Shows," Ethics & Medics 28.1 (January 2003): 1-4.
3. Joel Brind, "Breast Cancer and Scientific Integrity: The National Cancer Institute Meeting," Ethics & Medics 28.5 (May 2003): 1-2; Joel Brind, "Early Reproductive Events and Breast Cancer: A Minority Report, March 10, 2003," Ethics & Medics 28.5 (May 2003): 2-4.
4. Joel Brind, "Early Reproductive Events and Breast Cancer: A Minority Report," March 10, 2003, http://www.bcpinstitute.org/nci_minority_rpt.htm (Breast Cancer Prevention Institute).
5. Valerie Beral et al., "Breast Cancer and Abortion: Collaborative Reanalysis of Data from 53 Epidemiological Studies, Including 83,000 Women with Breast Cancer from 16 Countries," Lancet 363.9414 (March 27, 2004):1007-1016.
6. David Wahlberg, "Study: Breast Cancer Not Tied to Abortion; Group Backs Up Institute's Earlier Findings," Atlanta Journal-Constitution, March 26, 2004, A9.
7. Donald DeMarco, "Abortion-Breast-Cancer Malpractice: New Legal Developments," Ethics & Medics 29.5 (May 2004): 3-4.
8. Associated Press, "Study: Abortion, Breast Cancer Not Linked," March 26, 2004.
9. E. Luporsi, study in meta-analysis of N. Andrieu et al., "Familial Risk, Abortion and Their Interactive Effect on the Risk of Breast Cancer-a Combined Analysis of Six Case-Control Studies," British Journal of Cancer 72.3 (September 1995): 744-751; L. Bu et al., "Risk of Breast Cancer Associated with Induced Abortion in a Population at Low Risk of Breast Cancer," American Journal of Epidemiology 141 (1995): S85 (abstract 337); D.G. Zairdze, study in meta-analysis of N. Andrieu et al., "Familial Risk, Abortion and Their Interactive Effect on the Risk of Breast Cancer-a Combined Analysis of Six Case-Control Studies," British Journal of Cancer 72.3 (September 1995): 744-751; A. Laing et al., "Reproductive and Lifestyle Factors for Breast Cancer in African-American Women," Genetic Epidemiology 11 (1994): 300.
10. V.V. Devorin and A.B. Medvedev, "Role of Reproductive History in Breast Cancer Causation" (in Russian) in Methods and Results of Breast Cancer Epidemiology (Moscow: Oncology Science Center of the USSR Academy of Sciences, 1978), 53-56; B. Burany, "Gestational Characteristics in Women with Breast Cancer" (in Croatian) Jugoslavenska Ginekologija i Opstetricija 19.5-6 (September-December 1979): 237-247; F. Nishiyama, "The Epidemiology
of Breast Cancer in Tokushima Prefecture" (in Japanese) Shikoku Ichi [Shikoku Medical Journal] 38 (1982): 333-343; V. F. Levshin and A.D. Chepurko, "Reproductive Anamnesis and Breast Cancer" (in Russian) Sovetskaia Meditsina 6 (1986): 15-21.
11. T. Hirohata et al., "Occurrence of Breast Cancer in Relation to Diet and Reproductive History: a Case-Control Study in Fukuoka, Japan," National Cancer Institute Monograph 69 (December 1985): 187-190; B.M. Harris et al., "Risk of Cancer of the Breast after Legal Abortion during
the First Trimester: a Swedish Register Study," British Medical Journal 299.6713 (December 9, 1989): 1430-1432; H.L. Howe, "Early Abortion and Breast Cancer Risk Among Women Under Age 40," International Journal of Epidemiology 18.2 (June 1989): 300-304.
12. Howe, "Early Abortion."
13. J. R. Palmer et al., "Induced and Spontaneous Abortion in Relation to Risk of Breast Cancer," Cancer Causes and Control 8.6 (November 1997): 841-849; L. Rosenberg et al., "Breast Cancer in Relation to the Occurrence and Time of Induced and Spontaneous Abortion," American Journal of Epidemiology 127.5 (May 1988): 981-989.
14. M.A. Rookus and F.E. van Leeuwen, "Induced Abortion and Risk for Breast Cancer: Reporting (Recall) Bias in a Dutch Case-Control Study," Journal of the National Cancer Institute 88.23 (December 4, 1996): 1759-1764.
15. M. Melbye et al., "Induced Abortion and the Risk of Breast Cancer," New England Journal of Medicine; 336.2 (January 9, 1997): 81-85.
16. M. J. Goldacre et al., "Abortion and Breast Cancer: a Case Control Record Linkage Study," Journal of Epidemiology and Community Health 55.5 (May 2001): 336-337.
17. G. Erlandsson et al., "Abortions and Breast Cancer: Record-Based Case-Control Study," International Journal of Cancer 103.5 (February 20, 2003): 676-679.
18. B. M. Lindefors-Harris et al., "Response Bias in a Casecontrol Study: Analysis Utilizing Comparative Data Concerning Legal Abortions from Two Independent Swedish Studies," American Journal of Epidemiology 134.9 (November 1, 1991): 1003-1008.
19. Z. Ye et al., "Breast Cancer in Relation to Induced Abortions in a Cohort of Chinese Women," British Journal of Cancer 87.9 (October 21, 2002): 977-981.
20. M. Melbye et al., "Preterm Delivery and Risk of Breast Cancer," British Journal of Cancer 80.3-4 (May 1999): 609-613; C. C. Hsieh et al., "Delivery of Premature Newborns and Maternal Breast-Cancer Risk," Lancet 353.9160 (April 10, 1999): 1239.
21. The Oxford Dictionary of Quotations, 3rd ed. (New York: Oxford University Press, 1980), 246.

First published in Ethics and Medics, a commentary of The National Catholic Bioethics Center on Health Care and the Life Sciences, 
November 2000.

Permission to reprint granted by: The National Catholic Bioethics Center, 6399 Drexel Rd., Philadelphia, PA
19151, 215-877-2660; visit www.ncbcenter.org.

NEW The Abortion-Breast Cancer Link…by Joel Brind, Ph.D. 

Part One of Four

By Joel Brind, Ph.D

The resurgence of the abortion-breast cancer debate—this time prompted by the introduction of bills in three states that would require warning women seeking abortion about the link between induced abortion and breast cancer—has again generated vicious and dishonest denials that any link exists. The worst example—but only one of many—was produced by Eric Zorn, writing in the Chicago Tribune.

In the face of Zorn’s malicious invective (he calls proposed “women’s right to know” acts now pending in New Hampshire, Kansas, and New Jersey “Activists’ Right to Lie to Women” acts), it’s a good time to set the record straight with accurate, scientific facts.

In this first of three articles on the ABC link, I’ll chronicle the history of epidemiological data going back over 50 years that shows a consistent statistical connection between a history of induced abortion and a higher incidence of breast cancer among women all over the world. I’ll also briefly talk about the curious logic used by deniers of the ABC link.

By way of background, abortion raises a woman’s risk for breast cancer in two ways; the debate is over the second, not the first. Scientists have long understood that the risk of breast cancer is reduced when a woman completes a full-term pregnancy. This “protective effect of childbearing” is lost with an abortion. The second way abortion increases the likelihood of breast cancer is that an abortion leaves a woman with more cancer-vulnerable breast tissue than she had before she became pregnant.
~~~~~~~~~~~~~~~~~~~~~

In 1957, a nation-wide study in Japan published in  the Japanese Journal of Cancer Research found that women who had breast cancer reported having had three times as many pregnancies end with an induced abortion. Of course, there were few studies in those days, as induced abortion was neither legal nor common in most of the world—and breast cancer was not that common either!

Most studies, in fact, did not distinguish between induced abortion and spontaneous abortion (what we usually refer to as miscarriage), a natural event that generally does not increase the risk of breast cancer. I will talk about the importance of this distinction in Parts Two and Three. Then there were the results of a very prominent series of World Health Organization-sponsored studies in the late 1960′s. Led by a Harvard research team, the WHO study looked at women from four continents to find out whether early pregnancy reduces breast cancer risk. That turned out to be true for full-term pregnancies. But they also found that the results “were in the direction which suggested increased risk associated with  abortion — contrary  to  the reduction in risk associated with full-term births.”

The famous 1970 paper that summarized these WHO findings firmly established that full-term pregnancies confer protection against breast cancer. It has been unequivocal for over 40 years that a pregnant woman who chooses abortion will end up with a higher long-term risk of breast cancer than if she chooses instead to let nature take its course.

Every reasonable standard of informed consent requires a doctor to warn a patient of any adverse health consequences of having the intervention in question—abortion in this case—compared to not having the intervention. That alone defines a duty for abortion practitioners to inform their patients of the increase in future breast cancer risk.

But the ensuing four decades of research around the world, a world with an ever increasing number of women having had an induced abortion, have shown that it is even worse: Women who choose abortion are more likely to get breast cancer than if they had not gotten pregnant in the first place.

This trend, known among epidemiologists as the “independent risk” of abortion, has been the center of the controversy raging in the public square. Evidence of this independent risk of abortion first showed up among American women in a prominent study from USC published in 1981 in the British Journal of Cancer. Another dozen American studies showed the independent effect during the 1980′s and 90′s, as well as another dozen studies from Europe and Asia.

In 1996, along with colleagues from the Penn State Medical College, I published, in the British Medical Association’s epidemiology journal, a meta-analysis of all 23 studies then extant. Our paper proved that the average 30% increase in breast cancer risk among women who have had an induced abortion was “statistically significant”: in other words, this increase was more than 95% certain not to be due to chance. In the last five years, studies continue to emerge from nations where both abortion and breast cancer used to be rare–China, Iran, Turkey, Armenia—showing a clear and significant independent ABC link.

Yet strangely—and tragically—to all the world’s most prominent purveyors of public health information, from the U.S. National Cancer Institute, American Medical Association and the cancer charities such as the American Cancer Society and Komen, to Health Ministries around the world and the WHO itself, the ABC link does not exist!

And the argument upon which all the denials are based boils down to something called variously, “reporting bias” or “response bias.” It goes like this.

When a study population of women is interviewed to determine their reproductive history, the argument is that healthy women will be more reluctant to admit they had an abortion, whereas women with cancer are more likely to tell the truth about their abortion history.

If this is true, then studies which rely on interviews that look back in time (retrospective studies) will overestimate the association of induced abortion with breast cancer patients, compared to healthy women. Proponents of this hypothesis go on to claim that only a study based on medical records, or one which follows women prospectively in time– i.e., a study in which the abortions are recorded before anybody knows who will get breast cancer–can give accurate results.

As much of a stretch as the response bias hypothesis seems–flying in the face of a half-century’s worth of data from studies on women from all over the world conducted by long-standardized epidemiological methods–it is a testable hypothesis. In fact it has been tested again and again, and found wanting, but that has not muted the chorus of official denial of the ABC link.

That leads to part II of this series, in which we will segue from the ABC link as the focus of our inquiry, to the world-wide cover-up of the ABC link, and its now over 40-year-long trail of published evidence.

The abortion-breast cancer link (ABC link): Those stubborn facts again!
Part Two of Four

By Joel Brind, Ph.D.

In Part I of this three-part series of articles on the link between abortion and breast cancer (the ABC link), I described the two primary ways in which abortion increases a woman’s future risk of breast cancer:

1. via loss of the protective effect of an otherwise full-term pregnancy, and

2. via the increase in cancer-vulnerable tissue produced by the pregnancy hormones, making women who choose abortion more likely to get breast cancer than if they had not gotten pregnant in the first place.

There is no debate about the former. Scientists have long understood that the risk of breast cancer is reduced when a woman completes a full-term pregnancy. This “protective effect of childbearing” is lost with an abortion.

The latter trend, known among epidemiologists as the “independent risk” of abortion, has been the center of the controversy raging in the public square. Hence, it has been the main area in which scientific evidence has been systematically covered up for some 40 years now. This cover-up is the subject of our inquiry in the present essay.

Evidence of this independent risk of abortion first showed up among American women in a prominent study from Malcolm Pike and colleagues at USC, published in 1981 in the British Journal of Cancer. They found an elevated risk of 140%, a result Pike himself would attempt to minimize years later.

The first study clearly aimed at covering up this result appeared in the same journal the following year. The 1982 study was conducted by the group led by Sir Richard Doll. Doll’s then impeccable reputation as Oxford’s top epidemiologist was enough to repress the red flags raised by Pike’s prominent study.

In their study, the Doll group claimed—right in the study’s abstract—that their “results are entirely reassuring, being, in fact, more compatible with protective effects (of abortion vis-à-vis breast cancer) than the reverse.” They also claimed a much larger and older study population than Pike’s—1,176 women aged 16-50, compared to only 163 women under age 33—implying a much more statistically reliable study.

Like all epidemiological studies, statistical tables full of numbers dominated the pages. But note, the actual number of women who had had an induced abortion was nowhere to be found; the lone descriptor was “only a handful.”

Hence, far from being “entirely reassuring” about the safety of abortion, the Doll study was in reality, entirely irrelevant. Almost all their data were derived from spontaneous abortion (miscarriage), a natural phenomenon which does not elevate breast cancer risk.

To this day, the conflation of spontaneous and induced abortion is used by health authorities worldwide to dilute the connection with induced abortion to render it insignificant. It is one of the major ways by which the ABC link is dismissed.

Not surprisingly, the successors of the very same group at Oxford constitute one of those prominent authorities. They have published at least five ABC-link cover-up studies. The most prominent principally authored by Valerie Beral, appeared in the prestigious journal The Lancet in 2004. (I wrote about this study at length in the May 2004 edition of National Right to Life News.)

Some background is needed to understand the central role of the 2004 Beral “reanalysis.” In 1996 my colleagues at Penn State Medical College and I published a “comprehensive review and meta-analysis” of the independent ABC. At that time, there were 23 extant published studies from around the world. Putting them all together revealed a statistically significant, 30% overall increased risk of breast cancer among women who had had any abortions.

By 2004, the number of published studies with ABC link data had risen to 41, but Beral’s Lancet “reanalysis” assembled data from 53 studies, many of them not previously published. One would think, logically, that Beral’s study comprised the 41 extant published studies and another 12 as yet unpublished ones.

In fact that would be way off the mark. Beral’s “reanalysis” was actually of 52 studies. Only 24 of them had been previously published while 28 studies (more than half) not previously published. Knowledge of the criteria for exclusion (of the previously published) and inclusion (of the previously unpublished) is crucial.

On what basis were 17 published studies excluded from the Beral “reanalysis”? Eleven were excluded for the following four dubious reasons:

“Principal investigators…could not be traced”

“original data could not be retrieved by the principal investigators”

“researchers declined to take part in the collaboration”

“principal investigators judged their own information on induced abortion to be unreliable” (even though it had been vetted by peer review and published in a prominent medical journal—and never retracted).

In addition another four previously published studies were simply never mentioned at all. Only two were excluded for legitimate scientific reasons.

The fact that the majority of the previously unpublished studies had not stood the test of peer review is troubling enough. But a closer look at the results of studies Beral et al. excluded is even more revealing.

Of the 41 previously published studies, 29 show increased risk of breast cancer among women who have chosen abortion. (Epidemiologists call this a “positive association.”)

Sixteen were “statistically significant,” which means there is at least a 95% certainty that the results cannot be explained by chance. But Beral excludes 10 of these for reasons that simply are not supportable.

If we average all of the 15 studies that Beral inappropriately excluded, they show an average breast cancer risk increase of 80% among women who had chosen abortion. By selectively eliminating studies that show an ABC link, Beral is able to find there is no significant effect of abortion on the risk of breast cancer.

Having thrown out studies that contradict her thesis, she then included studies that are plagued with serious deficiencies.

Beral divided them into two types: (1) those which used retrospective methods of data collection (i.e., interviews of breast cancer patients versus women who had not had breast cancer), and (2) those which used prospective methods (i.e., medical records taken long before breast cancer diagnosis).  

Beral told the Washington Post at the time that retrospective data-based studies are thought to be less reliable. Women with breast cancer, she said, “are more likely than healthy women to reveal they had an abortion, leading to the conclusion that there are more abortions among this group.” This “reporting bias” or “response bias” is a key to Beral’s argument.

But something you’d never know is that this hypothesis has been disproved over and over again in studies as far flung as Japan, the United States, and Greece!

There is only one study that  claims direct evidence for such a reporting/response bias— a Swedish study, conducted by a group headed by Olav Meirik of the World Health Organization (WHO). They did so based on an assumption that breast cancer patients had “overreported” abortions (i.e., imagined abortions that had never taken place!).  However,  in 1998 the authors  publicly retracted that assumption!

Notwithstanding this retraction Beral and others who deny the ABC link  continue to cling to the original 1991 study as evidence of reporting bias! Meanwhile, other studies in the U.S. clearly showed no such bias in ABC link research.

In Part Three I will review the unseemly parade of about one fraudulent ABC link paper per year between 1997 and 2008. They issued from such prestigious institutions as Oxford (again and again!), Harvard and the Karolinska Institute in Sweden, where the Nobel Prizes come from.

All were based on prospective data, so they could be touted as superior in design and execution. But you won’t believe some of the garbage that passed as science, in a clear effort to convince the world that the ABC link is a fiction.

The “dagger under the table”–The Abortion-Breast Cancer link (ABC link) 
Part Three of Four

By Joel Brind, Ph.D.

In part II of this series of articles on the link between abortion and breast cancer, I described how the “reporting bias” or “response bias” argument has been systematically used by the most prominent medical research authorities in the western world to deny the reality of the ABC link. It is as hugely important to critics as it is demonstrable false. The argument goes as follows.

When you compare the reproductive histories of breast cancer patients to healthy women (“retrospective” data-based studies), the cancer patients will be more truthful about their past abortions than healthy women. If true, this would result in breast cancer falsely appearing to be more common among post-abortive than non-post-abortive women, thus incorrectly indicating an increased risk with abortion.

The argument continues, to prove whether there is a reporting bias that results in an ABC link, studies are needed which do not rely on women’s recall and reporting of their reproductive histories. Rather those studies which rely on medical records of abortion and/or which follow cohorts of women in time after their abortions, are sure to be free of possible of reporting bias. Epidemiologists refer to this latter type of data as prospective, i.e., data on abortion exposure are gathered before it is known who will end up being a breast cancer patient and who will not. Such studies as these, it is contended, are far superior to those which rely on retrospective data.

About a dozen prospective data-based studies emerged from some of the most high profile institutions and journals during the period 1997 to 2008. All of them showed no ABC link, fueling the official denial of the link far and wide, a wall of denial still essentially in place.

But, in fact, just because a study is based on prospective data, it is not necessarily scientifically sound. Those dozen studies are largely provably false. In Part Three, I provide a taste of what has passed for science in official circles–scientific merit being adjudged strictly according to whether a study supports the “safe abortion” narrative.

It is more than interesting that the first solid prospective data-based study had actually been published back in 1989. Based on fetal death certificates filed for abortions done in New York State, the study found the politically incorrect results that women who’d had an abortion nearly doubled their breast cancer risk. Since this does not fit the “safe abortion” narrative, the authors of the recent spate of prospective studies have systematically misrepresented the New York study. Some ignore it altogether, some mischaracterize it as being subject to reporting bias, and some flat-out claim no such study exists!

In 1997, a prospective study on Danish women (funded by the U.S. Department of Defense) was published in the top American medical journal, the New England Journal of Medicine and found  precisely zero effect of abortion on breast cancer risk. It’s timing is significant because that was exactly three months after my group’s “comprehensive review and meta-analysis” gained substantial media traction. We had found an overall increased breast cancer risk of 30% among post-abortive women worldwide.

The Danish study was widely touted as definitive because it was so big: based on 1.5 million women, representing an aggregate of over 370,000 abortions and over 10,000 cases of breast cancer.

But upon closer examination, the Danish study reads like a manual of how to distort the data in order to achieve a desired outcome. Among the more egregious examples was the use of breast cancer records dating back to 1968, but including abortions only from 1973 onwards. This is a violation of the most basic scientific rule: Cause must precede effect! But apparently, not when you are trying to prove abortion is safe for women.

Yet more effective at covering up the truth was the omission of legal abortion records dating back to 1940, when abortion was legalized in Denmark, and then writing  as if the date of legalization were in 1973.

Then there is the trick that has been used in most of the prospective studies purporting to show that there is no ABC link: Limiting the follow-up period after abortion. You see, one of the strengths of retrospective studies is that typically, older women are interviewed about their reproductive histories years or even decades after their abortions.

This is hugely important because it often takes 10-20 years for cancer to develop after an abortion. But in the 1997 Danish study, fully one fourth of the subjects were still under the age of 25 at the end of the study! Of course, these young women had lots of abortions, but almost no breast cancer.

But not only was this lack of follow-up time used as a device to eliminate the evidence of increased breast cancer risk with abortion in prospective study after study, a very diverse bag of tricks can also be found at work.

For example, one of the many ABC cover-up studies published by the Oxford group of epidemiologists, published in 2001, showed no ABC link. But the medical records they used had clearly missed over 90% of the abortions performed on women during the study period. Buried deep in the paper’s discussion section was the following curious revelation: “Our data on abortions are substantially incomplete…” That alone should have convinced the journal to discard the study on the spot!

Then there is the “dagger under the table” technique. The “dagger” is the printed dagger that signifies a footnote. There was a pivotal footnote that appeared under the key data table in the prestigious Harvard Nurses Study II, published in 2007.

The daggered footnote signifies, in that case, that a key statistical adjustment to the data on abortion was omitted from the overall result. Hence, the authors could (misleadingly) report no significant ABC link in the overall conclusion, rather than a significant risk increase of at least 10% that they had actually observed.

Finally, another key trick now used by just about all ABC-link deniers is the complete omission of cases of breast cancer in situ, the type of breast cancer which appears earliest, and the incidence of which type has also dramatically risen in the US by some 400% in recent decades!

At this point one may seriously ask: How on earth can the medical research establishment get away with such a widespread, systematic cover up of a serious health risk from an elective procedure? Of course there is the media complicity, but there is also the ability of a small cohort of well-placed individuals in key positions of agencies such as  the US National Cancer Institute (NCI), which funds most of the cancer research in the US. Scientists who don’t toe the party line can lose their research grants.

In the final installment of this series, I’ll describe the biology that underlies the ABC-link.

The Stubborn Biological Facts regarding the Abortion-Breast Cancer link
(ABC link) Part Four of Four

By Joel Brind, Ph.D.

In the three previous installments of this series, I documented the epidemiological evidence for the abortion-breast cancer link (ABC link), and the ongoing wall of denial from the official purveyors of public health information, including the National Cancer Institute (NCI). In this final installment, I’ll go over the basic, underlying biology of how and why abortion interferes with normal breast development and breast health, thus leading to a higher risk of breast cancer later in life for women who have chosen abortion.

Everyone knows that a woman’s breasts, as part of the reproductive system, do not develop until puberty. But most people—even doctors—do not know that the breasts really do not develop substantially even at puberty: they essentially just grow in size. What that means is that from the time of puberty, a girl has a lot more breast tissue capable of growing—and capable of becoming cancerous—than she had before puberty. Thus does puberty open what breast cancer researchers call the “susceptibility window.”

The susceptibility window—when potentially cancer-causing mutations can collect in vulnerable breast lobule cells—only closes when a woman has her first full-term pregnancy. It is in fact at about 32 weeks of a normal pregnancy that most of the primitive, growing cells of the breast become differentiated into cells that can actually produce milk.

Why are these mature cells resistant to becoming cancerous? Because their ability to proliferate has been turned off. That explains not only the epidemiological evidence showing abortion’s link to future breast cancer risk, but also the fact that a live birth before 32 weeks gestation also increases risk; the effect on the mother of “terminating” a normal pregnancy  is the same, regardless of the fate of the child.

A little more detailed look at what happens to the breasts during pregnancy clearly shows two major ways in which abortion raises the risk of future breast cancer.

The future milk-producing structures in the breast that multiply during puberty are called Type 1 and Type 2 lobules. It is Type 1 and Type 2 lobules where almost all breast cancers start. Microscopically, these lobules look rather like trees in winter, with the branches bare except for small buds. After puberty but before first pregnancy, almost 100% of the lobules are Type 1 and 2—to emphasize again, where almost all breast cancers begin.

When a woman becomes pregnant, the hormones estrogen and progesterone surge and cause a massive growth spurt in the breasts, doubling the size of the lobular tissue by mid-pregnancy (20 weeks gestation). But by 32 weeks gestation, only about 20% of the lobules are still cancer-vulnerable Type 1 and 2. Most have matured to Type 4 and can produce colostrum (milk).

Putting all this together in terms of breast cancer risk, we can see that putting off childbirth until a woman is older results in a greater likelihood of getting breast cancer, because the susceptibility window is open much longer. This fact has been well established, ever since a definitive, international multi-center study commissioned by the World Health Organization (WHO) was published in 1970.

Moreover, it is widely known to be responsible for most of the difference between the high rate of breast cancer incidence among women in North America and Europe—who typically wait until they are in their late 20′s or 30′s to start having children—and the much lower cancer breast cancer incidence rates among women in Asia and Africa. Thus there is no controversy about the fact that the longer a woman waits to start having children, the higher her future risk of breast cancer. Importantly, by delaying the closing of the susceptibility window, abortion abrogates the protective effect of full-term pregnancy.

But abortion does more damage than merely postponing first childbirth, nullifying the protective impact that comes because immature and cancer-prone breast tissue have matured. The surging estrogen and progesterone of a normal pregnancy multiplies the number of Type 1 and 2 lobules. If the pregnancy is aborted, this creates more places for cancers to start, because the third trimester maturation to type 3 and 4 lobules never is allowed to happen.

That is why dozens of published epidemiological studies from around the world, starting as far back as 1957, continue to emerge which show increased breast cancer risk among women who have chosen abortion. This trend even showed up in the WHO report back in 1970, wherein the authors noted that their results “suggested increased risk associated with  abortion — contrary  to  the reduction in risk associated with full-term births.”

Finally, it should be noted that there are two more ways—indirect ways—in which abortion can increase a woman’s future breast cancer risk which often are overlooked.

First, abortion increases the risk of premature birth in subsequent pregnancies. Not only does this have devastating consequences in terms of increasing the incidence of such congenital disabilities as cerebral palsy and autism, but (as noted above) premature deliveries before 32 weeks gestation increases the risk of breast cancer, the same as later-term abortion does.

Second, it is also well established that breast feeding reduces the risk of future breast cancer, and breast feeding is of course not possible after the baby is aborted.

Clearly, nothing reduces the risk of future breast cancer like starting childbearing early. That’s a big reason why teenage and early 20-something mothers in particular should be advised against abortion. Young motherhood will drive their future breast cancer risk way down, while abortion will drive it way up. It really is as simple as that.

But what about abortion of subsequent pregnancies? Again, half a century’s worth of data confirms that the independent effect of abortion–above and beyond the effect of postponing first childbirth—is the same for abortion of any pregnancy. That would be about a 30% increased risk on average.

I suspect few women would be willing to take that risk, if only they knew about it.

http://www.nationalrighttolifenews.org/news/2012/05/four-part-series-on-the-abortion-breast-cancer-link-abc-link/#.VCG_pMItD5o

For another excellent resource explaining the link between abortion and the subsequent development of breast cancer, see abortionbreastcancer.ca

By Dr. Joel Brind 

It looks like "déjà-vu all over again": A supposedly definitive study of immense statistical power, published in a top medical journal, has once again proven the abortion-breast cancer link (ABC link) nonexistent.

This time (March 25 of this year) it was "a collaborative reanalysis of data from 53 epidemiological studies, including 83,000 women with breast cancer from 16 countries".

It was authored by a prestigious group of Oxford researchers, and published in the Lancet, one of the most prominent medical journals in the world. And lead author Valerie Beral wasted no time hyping her group's findings in a frenzy of pre-publication interviews. For example, she told the Associated Press: "The totality of the worldwide epidemiological evidence indicates that pregnancies ended by induced abortion do not have adverse effects on women's subsequent risk of developing breast cancer". "Scientifically, this really is a full analysis of the current data", Beral told the Atlanta Journal-Constitution, suggesting a truly comprehensive review of the data.

To say that the Beral study is seriously flawed and that its conclusions do not stand up to close scrutiny is to understate seriously the magnitude of what is really going on here. For starters, the claim that this is a "full analysis" is flatly false. Let's just do the simple math. We start with 41 studies which showed data on induced abortion and breast cancer, dating as far back as 1957. Then how do we get to 53 sudies? (Actually, the total is 52 studies.) We add 11 studies worth of unpublished data, right? That might be okay, but it wasn't what was done. What Beral et al. actually did was:

Throw out 2 studies for the scientifically appropriate reason that "specific information on whether pregnancies ended as spontaneous or induced abortions had not been recorded systematically for women with breast cancer and a comparison group." Specifically, one such study from Sweden in 1989 used general population statistics for comparison, instead of a control group, and one US study from 1993 ascertained abortions only indirectly, by subtracting the number of children from the number of pregnancies.

Throw out 11 more perfectly good studies for reasons such as: "Principal investigators ... could not be traced" (We can't find Professor Einstein, either. Does that mean we throw out relativity?); "original data could not be retrieved by the principal investigators", "researchers declined to take part in the collaboration", or investigators "judged their own information on induced abortion to be unreliable" (even though it had been published in a prominent medical journal).

Finally, 4 studies' worth of data (one on French women, one on Chinese women, One on Russian women, and one on African-American women) were simply not even mentioned, even though they had been previously published as abstracts or included in other reviews.

That brings the total down from 41 to only 24 studies. Now we add 28 studies worth of unpublished data, and Voilà! We have 52 studies. The fact that the majority of studies have not stood the test of peer review is troubling enough. But a closer look at the excluded studies is even more revealing.

Of the 41 studies which have been previously published, 29 actually show increased risk of breast cancer among women who have chosen abortion. (Epidemiologists call this a "positive association".) 16 of these are statistically significant, which means there is at least a 95% certainty that the results cannot be explained by chance. Getting back to Beral's "full analysis", 10 of the 16 significantly positive studies in the literature were excludied for one of the unscientific reasons cited above. In fact, if we average all of the 15 studies Beral excluded for unscientific reasons, they show an average breast cancer risk increase of 80% among women who had chosen abortion.

So if we just add up all the studies Beral's group decided selectively to include, we get no significant effect of abortion on breast cancer risk. But we haven't even gotten to Beral's main argument yet. She actually divided the included studies into two types; those which used retrospective methods of data collection (i.e., interviews of breast cancer patients v. control subjects), and those which used prospective methods (i.e., medical records taken long before breast cancer diagnosis). The retrospective data-based studies are thought to be less reliable, because, as Beral told the Washington Post, women with breast cancer "are more likely than healthy women to reveal they had an abortion, leading to the conclusion that there are more abortions among this group".

Readers may recognize this "reporting bias" or "response bias" argument, used for over a decade now to dismiss the overwhelming majority of studies (which are retrospective data-based) which reveal an abc link. It is actually a hypothesis worthy of testing. The trouble is, tests for such bias have proven negative over and over and over again in the published literature, in studies as far flung as Japan, the US and Greece. In fact, Beral still reaches back to a 1991 Swedish study, which was the only one ever to claim direct evidence of such "reporting bias". However, that study's conclusion depended upon the assumption--since publicly retracted by the original authors--that breast cancer patients had "overreported" abortions (i.e., reported abortions that had never taken place.)

That brings up another serious flaw in the Beral study, specifically, the exclusion of any published critiques of studies she found acceptable. She included uncritically, for example, data from a 1990 study on Norwegian women which study had found no link. However, in 1998 our own group published a rigorous, mathematical proof that those data were incorrectly compiled, and had actually indicated increased risk among Norwegian women.

Getting back to the reporting bias argument, Beral separately compiled all the studies that used prospective methodology (13 studies) and those that used retrospective methods (39 studies), and found the results to be significantly different. Specifically, the former showed a significant overall 7% decrease in risk with abortion, while the latter showed a significant overall 11% increase in risk.

Beral's conclusion? "We have demonstrated that a certain group of studies (the ones with retrospective data) are unreliable and can't be trusted,", she told the Washington Post." There are only two things wrong with that conclusion. 

First, it is completely illogical to leap to the conclusion that, just because there is a difference in the overall results reached by the two types of studies, that the difference is caused by reporting bias. This is especially true in light of the fact that such bias has been repeatedly demonstrated NOT to exist. 

Second, at least three of the prospective data-based studies are so seriously flawed themselves as to merit exclusion from the Beral study on the basis of information on abortions having "not been recorded systematically" (see above.) Specifically, these studies included the 1997 Melbye study from Denmark, in which ALL the data on legal abortions before 1973 were missing (only 80,000 abortions on 60,000 women!), A 2001 study in the UK (an Oxford University study, no less), in which over 90% of the abortions in the study population were unrecorded and a 2003 Swedish study, in which data on all abortions after the most recent childbirth were missing. (In Sweden, where abortion is used predominantly to limit family size, that means most of the abortion records for women in the study were missing.) We have published detailed critiques of these studies but, as noted above, these critiques are not cited in Beral's "full analysis".

Another telling aspect of the Beral paper is the graphic depicting the compilation of studies. As noted above, most of the studies which showed significant elevations in risk with induced abortion were inappropriately excluded from the analysis. Then, by combining certain groups of studies and graphing them as "other", it is made to look AS IF NO STUDY EVER FOUND A RELATIVE RISK HIGHER THAN 1.4! In fact, 6 studies (two on Japanese women, two on African-American women, one on Chinese women and one on Australian women) have reported overall relative risks greater than 2.0 (i.e., more than a 100% risk increase with abortion. Finally, I believe an editorial note is in order, because the knee-jerk reaction of so many is to put credence in studies that come from such high places as the Lancet or the New England Journal of Medicine or the National Cancer Institute. As one who has been doing battle on the ABC link in medical and scientific journals and in other public fora for over a decade, nothing has been more obvious to me than the systematic denial of the link from organized science and medicine. In fact, the first study which was specifically designed to "reassure" the public about the safety of abortion vis-à-vis breast cancer was published way back in 1982, and originated from the same cancer research epidemiology unit at Oxford's Radcliffe Infirmary as Beral's "full analysis". 

But if the reader would remain skeptical of this writer's observations and conclusions, consider this. It is undisputed--even by Beral herself--that a full-term pregnancy lowers a woman's long term risk of breast cancer, and that this protection is not afforded by a pregnancy that ends in induced abortion. Yet Beral and most of mainstream science and medicine would refuse to say that abortion is therefore a risk factor. In fact, the studious avoidance of characterizing abortion in this way is obvious in the very caption of Beral's summary chart: "Relative risk of breast cancer, comparing the effects of having had a pregnancy that ended as an induced abortion versus effects of never having had that pregnancy." If the same convoluted standard were used in characterizing hormone replacement therapy (HRT) for postmenopausal women, it would also not show up as a risk factor. Specifically, using the same standard would mean comparing postmenopausal women using HRT to premenopausal women of the same age. The conclusion of such a study would be that women using HRT have no greater risk of breast cancer, compared to not having gone into menopause. Instead (and this is no more clearly stated than in Beral's own "Million Woman Study" on HRT and breast cancer, published last year), the study is restricted to postmenopausal women, with those taking HRT thus compared to women who get virtually no estrogen and progesterone at all, from inside or outside. So of course HRT shows up as a risk factor--as well it should.

Everyone knows--including Beral--that a woman who chooses abortion will end up with a higher long term risk of breast cancer than would result from the childbirth choice. Still, unethical and outrageous as it is, it is politically incorrect to inform women seeking abortion of this undeniable truth.

First printed on the website of the Coalition on Abortion/Breast Cancer, April 8, 2004 (see www.abortionbreastcancer.com)

(Valerie Beral photo courtesy of www.esi-topics.com)

By Lyn Smith 

"Hitting the glass ceiling" is a phrase frequently used by career oriented women who feel frustrated when their efforts to have corporate board room doors opened to them are thwarted. "Hitting the glass ceiling" is beginning to be the cry of many of us as we are systematically thwarted by those responsible for collecting, analysing and releasing the annual statistics for abortions performed in Canadian hospitals and clinics. Abortion statistics are becoming a closely guarded secret.

In 1969 the abortion law was liberalized to allow therapeutic abortions in cases where "the continuation of the pregnancy...would likely endanger the life or health of the mother" (health was not defined). Statistics Canada was given the responsibility of compiling accurate and (anonymous) data in terms of the demographics and medical details for the the provinces: the age and marital status of the mother, the gestational age of the child, the method of abortion, the number of previous pregnancies, the number of previous miscarriages, the number of previous abortions, concurrent sterilization, and any complications (haemorrhage, perforation of the uterus etc.) arising from the immediate surgery. This data would provide a complete profile of the pregnancy termination. Initially this was done very efficiently; however, in 1978 when Quebec began to report the numbers for clinic abortions there were no medical details supplied.

Dr. Ivan Fellegi became Chief Statistician of Canada in 1985 and in 1986 it was he who recommended to the Minister responsible for statistics, Stewart McInnes, that they cease compiling abortion statistics because "they did not give a precise and worthwhile picture of therapeutic abortions done in Canada". David Bray, Director of Health Services, issued an August 1986 directive to the hospital administrators requesting that they discontinue sending the annual Therapeutic Abortion form to Statistics Canada as a "cost cutting measure" and that "the figures weren't relevant to most Canadians". This, despite the fact, that the number of abortions reported in 1986 had escalated to 69,572 from the 11,000 reported in 1971.

There was such a public outcry from various groups interested in the impact of abortion on Canadian society that the new Minister Responsible for Statistics, the Honourable Monique Vézina, reversed the decision. She promised the House of Commons that: "The method of compiling the (abortion) figures will be changed to provide a more precise picture of the therapeutic abortions performed in Canada". Chief Statistician of Canada, Ivan Fellegi was advised to continue the annual collection of abortion statistics.

Each year the number of abortions and repeat abortions continues to rise. The number of reported abortions performed in provincial clinics has also risen to represent one third of all abortions. Not only has the quality of the hospital data continued to deteriorate but, as well, the details about therapeutic clinic abortions are not provided, despite the promise of a more "precise" picture. The time period between the release of current statisitics is lengthening: for example, the 1994 stats were released in September 1996 and the 1995 figures were released in November 1997 (a record number of 106, 658 abortions). As of February 1999 we still await the data for 1996!

Understandably, Action Life was alarmed by the trend toward less and less information about a medical procedure which will affect 34% of Canadian women in their lifetime (1 in 3) if the 1993 first abortion rate prevails (Family Planning Perspectives: Jan/Feb 1997, Vol. 29, No. 1). Even the (late) abortion activist, Dr. Marion Powell noted that according to Statistics Canada, the most frequently performed surgery in Canada is induced abortion. She was concerned that "because of the lack of consistency in the reporting of abortion statistics, the actual number of abortions performed in the clinics can only be estimated" (Can. Med. Assoc. J 1st. June, 1997; 156 (11)).

There was a new development when it was announced that the Canadian Institute for Health Information (CIHI) had been created and would take over the role of the Hospital Medical Records Institute which had compiled the figures for hospital procedures and channeled them to Statistics Canada for analysis and publication from 1970 to 1993. CIHI was described as a non governmental organization with the mandate to "provide a comprehensive and integrated system of health information". CIHI's Executive Committee Members would represent " both government and non-government partners" and Dr. Fellegi would serve as Vice-Chairperson of the Board of Directors. CIHI would collect the statistics for the 1995 abortions.

Our efforts to meet with both the Minister of Health and the Minister for Statistics began. In July 1996 we wrote to request a meeting with the then Minister of Health, the Hon. David Dingwall to no avail. Not until two years later, after repeated requests, did we achieve a meeting with the Senior Policy Adviser to the Hon. Allan Rock, Mr. John Dossiter (July 1998). Dr. Joel Brind Ph.D. accompanied us. After outlining our concerns about the need for women to be informed about the negative psychological and physical effects of abortion (including post abortion trauma, depression, infertility, sterility etc.), Dr. Brind effectively defended the accuracy of the 1996 meta analysis of 23 international studies which demonstrate the direct link between induced abortion and breast cancer. A woman who aborts her first pregnancy increases her risk for developing breast cancer by 50% independent of any other recognized risk factors. This causal link alone validates the need for accurate medical histories and detailed statistical data. Mr. Dossiter promised that this exchange of opinions would be brought to Mr. Rock's attention.

Beginning in July 1996 we tried to meet with John Manley, Minister Responsible for Statistics. We followed the recommendation from his office that we meet with the Director of CIHI, Carol Acorn and with representatives from the office of Janet Hagey, Director of Health Statistics Division, Statistics Canada. They did agree that abortion was elective surgery, warranting the compilation of complete medical information but felt it might be an invasion of privacy. We suggested that medical histories are routinely taken before any surgery. Since Dr.Fellegi could stop the compilation of statistics surely he had the clout to request compliance? They suggested that the best avenue to take was to meet with both the Minister of Statistics and the Minister of Health.

In September 1996 Mr Manley responded to say that we should continue our discussions with Janet Hagey of Statistics Canada. We then met at the Action Life office with Ms. Hagey and the Chief of Health Care Statistics, Cyril Nair. They reassured us that CIHI would do a better job of gathering data and asked that we await the publication of the 1995 statistics to judge their quality. These were published in November 1997 with less data than ever before!

Once again we were advised to meet with Mr. Manley to whom Dr. Fellegi is accountable. In our letter of April 1998 we wrote Mr. Manley outlining all the steps followed and once again requested a personal meeting. To our surprise as his reply in June 1998 we received a letter from Dr. Fellegi basically saying that everything was fine! In June 1998 we wrote again requesting a personal meeting with Mr. John Manley and after numerous telephone calls were promised a meeting before Christmas 1998 with an assistant. As of February 1999 this promise has not been honoured.

The matter is urgent. British Columbia is no longer providing medical details for the hospital abortions and Ontario, which accounts for 43% of all abortions, is dragging its feet in producing the abortion figures. The specific medical details for clinic abortions are unknown or sparse. Nancy Miller Chenier (Political and Social Affairs Division, Research Branch of the Library of Parliament) described her attempt to calculate the cost of abortion to taxpayers as a "complex and inexact process". Using the conservative figure of 100,000 abortions for the fiscal period 1992-93, Ms. Chenier estimated the cost for same day hospital and clinic abortions to be a very "relevant" $51,646,926.00!

Each day the Statistics Canada Daily prints current statistics on their web site for such matters as the crop yield reports for various grains, the number of light bulbs produced, the number of asphalt shingles produced annually, the number of toilet seats manufactured etc. Under the Statistics Canada Act, Mr. Manley has the authority to request compliance for the complete abortion figures, the demographics and the medical details for therapeutic abortions performed in Canadian hospitals and clinics.

The former Health Minister, Monique Bégin, said in the Globe in Mail, August 26, 1996 in reference to personal responsibility for the tainted blood scandal, "blame me". She said, "The notion of 'ministerial responsibility' is the cornerstone of our executive government". By assuming this responsibility, Mr. Manley can "break the glass ceiling" so that the public may have full access to this vital information about abortion and its effect on the health of Canadian women.

Lyn Smith is a member of Action Life Ottawa (Inc.)

Action Life Online Article

The 10 Provinces, the Yukon and the Northwest Territories reported to CIHI that in 1998 there were 110,331 therapeutic abortions performed on Canadian women. The number of induced abortions recorded for every 100 live births rose to 32.2.

Table 1: Annual Therapeutic Abortions and Abortion Rates for Canadian Women from 1970 - 1998.

Notes:

Figures for 1970 to 1995 are taken from Table 11, Pg.17). Figures for 1996, 1997 and 1998 from Statistics Canada website (www.statcan.ca), December 18, 2000, as sourced by CIHI.

All induced abortions are classified as "therapeutic" whether they are performed in a hospital or in a clinic. As of 1995, therapeutic abortion data are collected from reporting areas within and outside the country by the Canadian Institute for Health Information (CIHI). The data is then transferred to Statistics Canada for analysis and publication as catalogue number 82-219-XPB, Therapeutic Abortions 1995.

Since 1970, abortion figures have been compiled for hospital abortions. In 1978, Quebec began to report some figures for clinic abortions. In 1990, the clinic figures reported related to Quebec, Newfoundland, Nova Scotia, Ontario, Manitoba and British Columbia. In 1991, published clinic data included figures reported from Alberta. In 1994, clinic data included figures from New Brunswick.

The numbers under "From U.S.A." are for legal abortions performed on Canadian women visiting the states along the Canada-United States border. Some states do supply numbers on request from Statistics Canada but in some states, legal abortions performed in clinics may not be reported to state authorities and reporting for non-residents is not mandatory. The figures printed represent a minimum estimate.

Summary.

It is increasingly difficult to formulate a profile of the women who undergo the abortion procedure because of incomplete demographic and medical case data.

In 1998 selected demographic and medical information was available for only 68.8% of hospital site abortions and for only 48.7% of clinic site abortions.

Overall, using combined hospitals and clinic figures, we learn that selected demographic and medical information is now available for only 61.08% of the110,331 induced abortions performed on Canadian women in 1998!

CLINICS: Although 37.85% % of the abortions were performed in clinics (41,761), only 2 provinces, Ontario and Alberta, provided some selected demographic and medical characteristics. Ontario accounts for 38.5% of all abortions reported in Canada (42,452 in 1998).

HOSPITALS: The trend continues for hospitals to no longer fully report items such as: age of the mother, marital status, previous deliveries, number of previous abortions, gestational age of the child at the time of abortion, nature of the abortion procedure, complications etc. Canadian hospitals reported 68,273 abortions in 1998 and database details are missing for 21,302 of these abortions (31.2%). Ten years ago, in 1988, the hospitals reported 66,137 abortions and case items were missing for 5,484 of these hospital cases (8%).

From the incomplete data obtained by the Canadian Institute for Health Information, Statistics Canada, Health Statistics Division reported that in 1998:

• 37.85% of induced abortions were performed in Canadian clinics (41,761).
• 62.05% of induced abortions were performed in Canadian hospitals (68,273).
• 297 Canadian women underwent legal abortions in the United States mostly along the Canadian-U.S. border.
• Hospital figures indicate that 310 girls under 15 years of age had abortions and a total of 464 girls under 15 were aborted in 1998.
• 83% of the women who had abortions in 1998 were not currently married at the time of their abortion.
• Approximately one half of the women undergoing an abortion in Canada had no other children.
• 20.6% of women (13,846) having clinic and hospital abortions were between 10-19 years old. This is the first time the age breakdown has started at 10 years of age.
• 51.3% of women (34,480) having clinic and hospital abortions were 20 to 29 years old and 24.8% of women (16,669) were 30 to 39 years of age.
• 37.4% of the women had undergone at least one previous abortion.
• 52% of the women who used clinics had no previous delivery.
• 48.2% of the women who used the hospitals had no previous delivery.
• Perhaps the most startling statistic is that women who have had at least one delivery account for a growing proportion of abortions: 38% in 1985 and 48.9% in 1998.
• The number of repeat abortions continues to rise. Repeat abortions increased from 20% in 1985 to 37.4% in 1998.
• These combined figures are taken from detailed records in the database for abortions done in 1998 in Canadian clinics and hospitals. These figures represent only 61.1% of the total information required to profile 110,034 abortions and excludes any data for 297 U.S. abortions.

Table 2: Percentage of Therapeutic Abortions by Selected Characteristics for 1998.

*Note: Database includes abortions performed in Canada on Canadian residents only. Only Ontario & Alberta clinics reported.

Comments about the statistics.

In an effort to put a face on the percentages quoted in the table, consider the combined known figures for abortions performed in the hospitals and clinics at 9-12 weeks gestation. At 49.5% distribution this represents at least 33,270 babies destroyed in clinic and hospital abortions by these methods: suction D&C, (the primary initial procedure - 95.2% in 1998), surgical D&C, hysterotomy, hysterectomy, saline, prostaglandin, menstrual extraction and 'other' (not defined).

Complications: The average stay in hospitals (and clinics) for an abortion in 1998 was less than one day. Any complications incurred are now reported for the first and second complication (haemorrhage, infection, laceration, perforation, retained products of conception or 'other'). At least 538 women are reported to have sustained complications: 316 women had retained "products of conception."

The Provinces with the highest number of abortions are: Ontario (42,452), Quebec (31,673) British Columbia (15,482) and Alberta (10,355).

Historical notes: Before 1969 the law permitted abortion only when necessary to preserve the life of the mother. The law was amended on May 14, 1969 to allow abortion in cases where "the continuation of the pregnancy...would be likely to endanger the life or health of the mother". The word "health" was not defined. Abortions were to be performed in accredited hospitals with the approval of a therapeutic abortion committee of three doctors. On January 28, 1988 the Supreme Court of Canada struck down the 1969 law on the basis of "unequal access" to Therapeutic Abortion Committees across Canada.

There is no cut-off point in pregnancy after which abortions may not be performed. This means that the child in the womb can be aborted in hospitals and clinics at any time, by any means, for any reason, right up to and during birth with impunity.

Pregnancy is not a disease; however, Statistics Canada reports show that abortion is a frequently performed surgical procedure in Canada.

Abortion is elective surgery which does not cure any medical condition.

Statistics Canada estimates that 1 Canadian woman in 3 will have at least one abortion in her life time.

The leading cause of death in Canada is induced abortion...110,331 deaths in 1998.

Between 1970 and 1998 Canada has sanctioned the deaths of 2,165,050 babies awaiting birth.

For further information on induced abortion statistics please contact Action Life (Ottawa) Inc.

Action Life Online Article

 By Lyn Smith 

If you are an avid Solitaire player you may have opened a new deck of cards and after several game variations sensed that something was amiss: the game simply could not be won. You then discovered that the deck was short one ace.

In the game of abortion statistics which is being played out by the Canadian Institute for Health Information(CIHI) and the Health Care Statistics Division of Statistics Canada, it has become obvious with the release of their "annual" figures for therapeutic induced abortions that all four aces for Accuracy, Comprehensiveness, Full Disclosure and Frequency have been pulled, rendering the statistics almost meaningless.

On March 31, 2004, three years after the fact, Statistics Canada published on their website The Daily, their survey of the figures compiled and provided by CIHI for therapeutic induced abortions performed on Canadian women in 2001.

The numbers indicated that 106,418 induced abortions were performed in 2001 (175 of those were reported by American States). The Canadian hospitals reported 61,227 abortions and the clinics reported 45,016.

For the whole of Canada for every 100 live births there were 31.9 babies killed by induced abortion. British Columbia, however, had a ratio of 39.2 deaths by induced abortion per 100 live births, Quebec had a ratio of 42.2 deaths for every 100 live births and the Northwest Territories headed the pack with 46.7 deaths per 100 live births. It should be noted that in 2001 Statistics Canada predicted that there would be more deaths than births in Canada by 2025 due to the declining birth rate and an aging population. (In order to avoid a population collapse a replacement rate of 2.1 children is required. )

The number of reported induced abortions rose from 105,427 in the year 2000 to 106,418

in 2001; that was an overall increase in the national rate of abortions from 15.4 in 2000 to 15.6 in 2001. This rate was based on 1000 women between 15-44 years of age. The Northwest Territories rate was 28.3; Nunavat was 22.7; Quebec was 19.6; British Columbia was 17.7 and the Yukon rate was 16.7

Even using the incomplete information which Ontario provided for 2001, we see that Ontario continued to have the most abortions of any province (38,827 or 36.5%). You may recall that in 1999 Statistics Canada wrote that "due to incomplete reporting by Ontario, all therapeutic abortions performed in Ontario and therapeutic abortions performed in other provinces on Ontario residents have been excluded." As a result, for the first time since the abortion statistics had been published the Canadian Institute for Health Information (CIHI) failed to provide the figures for the total number of abortions performed on Canadian women in 1999. In 2001 we had an ‘aggregate' count for Ontario but we were also advised that the Ontario Ministry of Health and Long-term Care "no longer maintains a system for the collection of detailed information on abortions performed in Ontario clinics but, instead, uses the billing system of the Ontario Health Insurance Plan (OHIP) to provide counts of clinic abortions to the Therapeutic Abortion Survey". This means that information is no longer available for clinic abortions performed on non-residents of Ontario or on Ontario residents who do not submit a claim to OHIP. In fact only the province of Alberta provided detailed records for their 5,325 clinic abortions. Detailed breakdowns for clinic abortions are not available from any other provinces or territories. This is a disgraceful omission when you consider that the percentage of abortions done in clinic settings has risen to 42.4% of the total abortions listed in the Database.

For many years the detailed records in the Database provided an anonymous profile of the women seeking abortions: marital status, age of the mother, gestational period for the child at the time of the abortion, previous deliveries, previous abortions, initial procedure used to abort and immediate complications after the abortion. With regard to the issue of data accuracy Statistics Canada made thie point in their 2001 Therapeutic Abortion Survey that "for data years 1970 to 1987, the coverage of the survey was considered to be 100% of all induced abortions performed in Canada." In 2001 the detailed records in the data base plummeted to 46.2% of the known combined numbers for hospital and clinic abortions: the smallest amount of detailed information since the inception of the abortion reports in 1970.

From the sparse detailed records we can calculate that 19.5% of the abortions were done on an age group starting at 10-19 (9,615 females) while 51.5 % were done in the 20-29 age group (25,264) and 25.1% were done on women in the 30-39 age group (12,313). From the detailed records available we can determine that at least 36.9% of the women underwent more than one (repeat) abortion. The initial procedure listed for abortion was primarily Suction D & C (94.6%) but under the procedure category ‘Other' (0.1%), 49 abortions can be calculated - were those late term Dilatation and Extraction?

Under Selected Characteristics - Gestation Period we see that at least 1,619 babies were over 16 weeks of age when aborted; yet under the category Complications by Gestation Period, complications are listed for babies 13-16 weeks, 17-20 weeks and finally over 20 weeks. Complications occurred for 15% of the women whose babies were over 20 weeks when aborted. Also, under First Reported Complication a sub note indicates that 2 deaths were reported by hospitals although they are classed in the breakdown as an amount too small to be expressed as a percentage distribution.

Many people monitoring the abortion statistics have suspected since 1986 that there has been an agenda to suppress and to eventually eliminate the release of the abortion figures.

Within the 2002 Survey Report of the 1999 data Statistics Canada indicated that they "collect and compile the numbers and rates of abortions and selected demographics and medical information about women obtaining abortions in Canadian and U.S. hospitals and clinics". In the 2004 Survey Report for the 2001 abortions, however, the words were changed to read, "The purpose of the Therapeutic Abortion Survey is to provide some basic indicators (e.g. counts and rates) on induced abortions. Information from this database is also used in the calculation of pregnancy statistics, especially for teen pregnancies. Traditionally, teen pregnancy statistics provide information by the subgroups 15-17 and 18-19. These subgroups are not available or imputed on the Therapeutic Abortion Survey Database" (as obtained by CIHI since 1995).

They indicate that CIHI in its new responsibility for data collection sent out a one-page survey to private clinics in Canada who supply aggregate counts only. CIHI also obtained data from provincial/territorial/ state departments of health or directly from hospitals and clinics. Depending upon the source the format can also vary from a single sheet of paper providing only aggregate counts with most of the data element fields remaining blank to detailed electronic records submitted through CIHI's Discharge Abstract Database.

In 2000 the detailed records indicated that 13% of the women were married at the time of their abortion. In 2001 the Survey notes that "The Discharge Abstract Database, the major source for hospital abortion data, no longer collects marital status as of fiscal 2001-02.....Consequently only 13% of total records (hospital and clinic abortions) contain a known marital status." Even this limited information is not in the Therapeutic Abortion Survey breakdown.

Statistics Canada also points out that the word "therapeutic" in their survey is retained only in the interest of ‘historical continuity'. Before 1969 the law permitted induced abortion if the life of the mother was endangered. After 1969 they introduced the word "therapeutic" to cover abortion for "health" reasons, although health was never defined. To quote the 2004 Survey Report, "In 1988, with the removal of abortion from the Criminal Code, a reason for obtaining an abortion was no longer required." (italics mine).

So there we are. Despite all our arguments that detailed comprehensive and demographic statistics are imperative in determining the long term psychological and physical effects of abortion on women's health, our appeals have been ignored. The authorities are so determined to provide abortions on demand that Life Canada learned from the Ontario Ministry of Health in September 2004 that they sent 56 women for late term abortions (defined as after 20 weeks) to the United States in the fiscal year 2003-2004 at a cost of $397,514.00 (more than $7,000.00 per abortion). According to Life Canada's press release of September 23/04, "The government's proposed solution to this scandalous situation is to open and fund a private clinic in Quebec to specialize in late term abortions" because this approach would eliminate the need for women to travel to the U.S.

In this ongoing game of burying abortion statistics which is being manipulated by the Canadian Institute for Health Information, it is obvious that the fate of the unborn child is irrelevant. To put it bluntly, the unborn child is the sacrifice on the altar of personal convenience. There is only one certainty: Canadians in the 31 years from 1970 to 2001 impassively sanctioned and financed the deaths of at least 2,483,476 babies awaiting birth.

Lyn Smith is a member of Action Life Ottawa (Inc.).

Action Life News, 2004

By Lyn Smith

Once again we do not have accurate statistics for the 105,383 induced abortions in Canada in 2002.
The Therapeutic Abortion Statistics Survey as published for 2001 and in the The Daily on February 11, 2005 for the year 2002 is a recitation of mea culpa excuses for the obvious failure of both The Canadian Institute for Health Information and Statistics Canada to provide accurate and comprehensive data about the induced abortions being performed in our Canadian hospitals and clinics.

The Therapeutic Abortion Survey was designed originally in 1970 to account for all legally induced abortions performed in Canada hopefully those numbers would also include a count for Canadian women who went to the U.S. for terminations. More importantly, demographic and medical case details would accompany these counts. Statistics Canada was responsible for this survey of hospital and clinic abortions.

Perhaps you will recall that in the 2001 survey, Statistics Canada defended their former historical accuracy by saying that for "the data years 1970 to 1987, the coverage of the survey was considered to be 100% of all induced abortions performed in Canada."
In 1986 it became apparent that there was a determined effort afoot to eliminate the abortion statistics. Dr. Ivan Fellegi, the newly appointed Chief Statistician of Statistics Canada, advised the Minister of Supply and Services, Stewart McInnes to cease compiling figures for the induced abortions because "they did not give a precise and worthwhile picture of the therapeutic abortions done in Canada." The Director of Health Services, Statistics Canada, David Bray, was quoted in the Ottawa Citizen on October 8, 1986 as saying that he issued his August directive to hospital administrators requesting them to discontinue sending the annual Therapeutic Abortion form to Statistics Canada as a "cost cutting measure" and also that "the figures weren't relevant to most Canadians" (69,572 abortions in 1986). He also thanked them for their cooperation over the years.
There was such an outcry from all groups interested in the impact of abortion on Canadian society that the new minister responsible for Statistics Canada, the Honourable Monique Vezina reversed the decision with this promise, "the method of compiling the (abortion) figures will be changed to provide a more precise picture of therapeutic abortions performed in Canada." The Chief Statistician of Canada, Dr. Ivan Fellegi, was advised to continue the annual compilation of abortion statistics.
In the year 1994, however, The Canadian Institute for Health Information (CIHI) was formed. When CIHI was created their mandate was established jointly by federal and provincial/territorial ministers of health: to improve the health of Canadians and the health care system by providing quality, reliable and timely health information as well as by developing and managing databases and registries. (www.cihi.ca). CIHI assumed responsibility for data collection, compilation and processing. Statistics Canada remains involved in the approval of the final annual file and plays a major role in the dissemination of data from the survey. Dr. Ivan Fellegi has served on the Board of Directors since its inception. After CIHI took over the role of collecting the abortion statistics the decline in the quality of the data was very noticeable. Even the late Dr. Marion Powell, a strong abortion advocate who served on the Privy Council of Canada and worked on the federal committee reviewing the abortion law commented that "because of a lack of consistency in reporting abortion statistics, the actual number of abortions performed in clinics can only be estimated" (Canadian Med. Assoc. J. 1^st June 1997; 156 (11).
As of 2000 CIHI estimated that the CIHI Therapeutic Abortion Database represented approximately 90% of all abortions performed in Canada involving Canadian residents, although many of these abortions are now recorded as aggregate counts only.
Ontario continues to have the highest number of abortions of any province (38,109). Despite this fact, The Ontario Ministry of Health and Long-term care announced in 2000 that they no longer maintain a system for the collection of detailed information about the abortions performed in Ontario clinics. It is of interest that the Deputy Minister of Health for Ontario is a member of the Conference of Deputy Ministers of Health, which maintains "strong links" with the Board of CIHI. There were 18,483 clinic abortions in Ontario in 2002; this represents 48.5% of all the Ontario abortions. Ontario now uses the OHIP billing system only for an aggregate count of the clinic abortions. Information is no longer available for non-residents of Ontario or for Ontario residents who do not submit an OHIP claim for their abortion. Statistics Canada notes that caution should be taken in comparing Ontario clinic data after 1999 with that for 1998 and earlier. At present only the province of Alberta provides detailed information for their clinic abortions (5,567 in 2002).

The abortion law amended in 1969 to allow abortion in cases where "the continuation of the pregnancy...would be likely to endanger the life or health of the mother" (the word health was not defined). The number of abortions recorded in the 1970 survey was 11,152. In 1978 there were 79,315 induced abortions. In 2002 the number of reported abortions has risen to 105,383. This number does not include the 152 women who were reported to have obtained abortions in the U.S. Border States. It should be noted that in 2002 Nunavut sent a count for only 3 months so that Nunavut is not included in the current 2002 provincial and territorial count.
The national rate of abortions per 100 live births in 1970 was 3.0. In 2002 the national rate was 32.1. This means that for every 100 babies born alive, 32.1 were killed by abortion. Despite the swelling numbers of abortions during the ensuing 32 years, the detailed records available in the data base for hospital and clinic abortions combined have dwindled once again from 69% in 1995 to 54% in 2001 (some data elements were assigned values of ‘unknown' or ‘not available') to 47% of the available demographic and medical case items in 2002 (the age group of the mother, marital status at the time of the abortion, gestational age of the child, any immediate complications, nature of the procedure, previous deliveries and the number of previous abortions).|
In 2002 the records showed that only 13.3% of the abortions were carried out on married women. In 2001 the marital status category was eliminated from the detailed database tables of CIHI.
Statistics Canada stated in 2001 that "The title of the survey retains the word ‘therapeutic' for the sake of "historical continuity." When the survey began in late 1969 a woman could only obtain an abortion for health reasons. In 1988, with the removal of abortion from the Criminal Code, a reason for obtaining an abortion was no longer required." In other words, as we have always said, abortion on demand.
To compound the problem for anyone attempting to obtain an accurate profile of a woman seeking an abortion, Statistics Canada now says the Survey is no longer treated as mandatory. I quote: "Coverage of abortions performed in Canada was considered to be 100% prior to 1988. In January 1988 the Supreme Court of Canada struck down the 1969 abortion law and some hospital and provincial ministry respondents interpreted this action as the basis for no longer having to report to the Therapeutic Abortion Survey. The law had included a provision enabling provincial ministries of health to obtain abortion data from hospitals. At the federal level, however, Statistics Canada surveys (including the Therapeutic Abortion Survey) are mandatory unless otherwise specified, but Statistics Canada chose to treat the Therapeutic Abortion Survey as ‘voluntary' but encouraged respondents to continue to supply data for health-related purposes. [Data Quality in the Therapeutic Abortion Survey - Stats Canada 2000]

So what can we glean from the existing abortion statistics?

In 2002 there were 105,383 abortions in Canadian hospitals: 58,536 were in hospitals and 46,847 were in clinics. The clinic abortions now account for 44.5% of the total abortions.
Statistics Canada reports that 52% of the abortions were done on women in their twenties; however, 337 abortions were reported for girls under 15 and 19,007 were done on girls from 15-19 years of age (CANSIM table 106-9024).
Ontario leads the way with 38,109 abortions, followed by Quebec reporting 30,841 and British Columbia 16,076. The overall rate of abortion per 100 live births is 32.1 but the rate for Quebec is 42.6, British Columbia is 39.9 and the Yukon Territory is 36.9.
From the incomplete database we can determine that 35.2% of the women had one or more previous abortions and 48.7% aborted their first pregnancy.
We have detailed records for 71.7% of the hospital abortions, 16.2% of the clinic abortions and for the combined hospital and clinic abortions we have detailed records for only 47% of the 2002 abortions.

For 2001 and 2002 under the category "of initial procedure" there is a new entry:
Medical (pharmaceutical) abortions under antacid and antimetabolite (Methotrexate) both for hospital and clinical procedures.

 Published in Action Life News, 2005.

Statistics Canada reported that there were 96,815 induced abortions performed on Canadian women in 2005. Data on induced abortions performed on Canadian women in the United States is no longer collected as of 2004. Manitoba did not report numbers for induced abortions obtained in clinics in the province. The number of induced abortions recorded for every 100 live births was 28.3% . 

ANNUAL THERAPEUTIC ABORTIONS AND ABORTION RATES FOR CANADIAN WOMEN FROM 1970 - 2005 AS REPORTED BY STATISTICS CANADA AND THE CANADIAN INSTITUTE FOR HEALTH INFORMATION (CIHI)*

*Induced abortions were classified as therapeutic beginning in 1969 when the first survey, the collection of legally induced abortion data was taken.  Statistics Canada says “the term ‘therapeutic’ remains in the title of the survey for the sake of historical consistency”.  Since 1970 abortion figures have been compiled for hospital abortions.  In 1978 Quebec began to report some figures for clinic abortions.  In 1990 the clinic figures reported related to Quebec, Newfoundland, Nova Scotia, Ontario, Manitoba and British Columbia.  In 1991 published clinic data included figures reported from Alberta.  In 1994 clinic data included figures from New Brunswick.

Starting in 1995, therapeutic abortion data were collected from reporting areas within and outside the country by the Canadian Institute for Health Information (CIHI).  The data once collected is then transferred to Statistics Canada for analysis and publication.  The Induced Abortions Statistics 2005 publication is available as catalogue number82-223-XI. ** Since 2004, data for induced abortions performed on Canadian women in American states are no longer collected.

Note: As of 1999, the Ontario Ministry of Health and Long Term Care no longer maintains a system for the collection of detailed information on abortions performed in Ontario clinics but instead uses the billing system of the Ontario Health Insurance Plan (OHIP) to provide counts of clinic abortions to the Therapeutic Abortion Survey. This means that information is no longer available for clinic abortions performed on non-residents of Ontario or on Ontario residents who do not submit a claim to OHIP.

The total of 97,254 induced abortions reported in the Statistics Canada tables for 2005 on their website includes abortions performed on non-Canadian residents: the number 96,815  is for abortions performed on Canadian women only.  In 2005, Manitoba figures include only abortions performed in hospitals, no numbers were reported for clinics.

It is becoming increasingly difficult to formulate a complete profile of the women who undergo the abortion procedure because of incomplete and missing demographic and medical case data. 

Statistics Canada and the Canadian Institute for Health Information (CIHI) report a total of 97,254 abortions for 2005.  There are records in the database for 96,815 abortions and total detailed records for only 41,330 hospital and clinic abortions combined. Consequently, the percentage distribution of selected characteristics such as gestational age of the child, age of the mother, number of previous abortions, any immediate complications, etc. is based only on the total detailed records available. 

CLINICS:  The total number of clinic abortions reported in 2005 was 46,348 and these clinic abortions accounted for 47% of all abortions performed in 2005.  Only one province (Alberta) provided detailed records for 6,905 clinic abortions (14% of the 46,348 clinic abortions recorded in the database).  Ontario accounts for 36% of all abortions reported in Canada.

HOSPITALS: Canadian hospitals reported 50,562 induced abortions in 2005 and of the 50,467 listed in the database, detailed records are available for only 34,425.  Nineteen years ago in 1988, hospitals  reported 66,137 abortions and case items were missing for 5,484 of these cases (8%).  Hospitals  in Québec no longer fully report items such as: age of the mother,  previous deliveries, number of previous abortions, gestational age of the child at the time of abortion, nature of the abortion procedure, complications etc. 

Overall, using combined hospital and clinic figures, we learn that selected demographic and medical information is now available for only 42% of the 96,815 induced abortions performed on Canadian women in 2005.

From the incomplete data obtained by CIHI, Statistics Canada, Health Statistics Division reported that in 2005:

1. 54.3% of the women having clinic and hospital abortions were between 20 to 29 years of       age and 24.5% were 30-39 years of age at the time of their abortion. **Almost 8 of induced abortions were performed in clinics (46,348).
2. 52% of induced abortions were performed in hospitals (50,467).
3. 31.7 % of the women had undergone at least one previous abortion.**
4. 16.6 % of women having clinic and hospital abortions were between 10 and 19 years of age.**
5. Marital status at the time of the abortion procedure is no longer listed in the Selected Demographics and Medical Statistics tables of Statistics Canada.
6. 53.1% of women undergoing an abortion in Canada had no other children.**
7. Perhaps the most startling statistic is that women who have had previous deliveries account for a growing proportion of abortions: 42.0 % in 2005.**

**These combined figures are taken from detailed records in the database for abortions done in 2005 in Canadian clinics and hospitals. These figures represent only 42% of the total records in the database (96,815) falling short of the information necessary to provide an accurate profiling of the 96,815 women who had abortions in 2005. There is no data for abortions done in the U.S.

Percentage of abortions byselected characteristics

Database includes abortions performed in Canada on Canadian residents only. Only Alberta clinics responded. N.B.: Percentage distribution is based on detailed records only.

In an effort to put a human face on the percentages quoted in the table, consider the combined known figures for abortions performed in hospitals and clinics at 9-12 weeks gestation . At 41% distribution this represents at least 16,945 babies dead by clinic and hospital abortions.

COMPLICATIONS:  First, second and third immediate complications only are reported in the survey  (hemorrhage, infection, pelvic damage, retained products of conception, death or ‘other’). At least 372 women were reported to have sustained complications: of these, 372 women had “retained products of conception”.

The provinces with the highest number of abortions are: Ontario (33,546), Québec (29,259), British Columbia (14,444), Alberta (10,859).

HISTORICAL NOTES:

Before 1969 the law permitted abortion only when necessary to preserve the life of the mother.  The law was amended on May 14, 1969 to allow abortion in cases where “thecontinuation of the pregnancy...would be likely to endanger the life or health of the mother”.  The word “health” was never defined.  Abortions were to be performed in accredited hospitals with the approval of a therapeutic abortion committee of 3 doctors. On January 28, 1988 the Supreme Court of Canada struck down the 1969 law, (Section 251 of the Criminal Code) for procedural reasons related to Section 7 of the Charter of Rights and Freedoms. There is no cut-off point in pregnancy after which abortions may not be performed. This means that the child in the womb can be aborted in hospitals and clinics at any time, by any means, for any reason, right up to and during birth with impunity.

• Pregnancy is not a disease; however, abortion is a frequently performed surgical procedure in Canada. 
• Abortion is elective surgery, which does not cure any medical condition.
• The leading cause of death in Canada is induced abortion...96,815 babies dead by induced abortion in 2005.

  BETWEEN1970 AND 2005 CANADA HAS SANCTIONED THE DEATHS OF 2,880,167 BABIES AWAITING BIRTH.

For further information on induced abortion statistics, please contact Action Life (Ottawa) Inc at 309-376 Churchill Avenue North, Ottawa, ON K1Z3C5. Phone 1-613-798-494, Fax 1-613-798-4496

What can be said about the state of abortion statistics in Canada that has not been said before? The statistics are incomplete and therefore inaccurate. In the past, abortion statistics were the responsibility of Statistics Canada. This task has now been assigned to the Canadian Institute for Health Information (CIHI). Following the 1988 court decision in Morgentaler, abortion clinics began to appear and most submitted only abortion numbers to Statistics Canada. Other medical case data such as gestational age of the child, age of the mother, method of abortion, complications and any previous abortions were not reported except by clinics in Alberta. Since then the quality of abortion statistics has declined substantially.

Some clinics did not even submit their numbers to the Canadian Institute for Health Information for the statistical years 2006 and 2007.

Abortion clinics in Manitoba had not reported the number of abortions performed in their facilities at the time of release of the 2007 and 2008 abortion statistics. The designation Unknown appeared in the tables. CIHI acknowledged the deficiencies with abortion statistics but said that no legislative requirement exists for clinics to report their figures whereas hospitals are obliged by their provincial /territorial Ministry of Health to report all hospital activity.  A revised table now available on CIHI’s website shows a number of 1,134 for Manitoba clinics for 2007.

The revised official statistics for 2007 as reported by the Canadian Institute for Health Information give a total of 98,762 abortions performed in Canada.

47,281 abortions were performed in hospitals. 51,481 abortions were performed in clinics.

Figures below report gestational age for abortions performed in Canadian hospitals in 2007 (excluding Quebec).

30.2% of hospital abortions (9,976) were performed at 8 weeks and under.

40.6% of hospital abortions (13,399) were performed at 9 to 12 weeks.

7.4% of hospital abortions (2,442) were performed at 13 to 16 weeks.

3.1% of hospital abortions (1,015-1,023) were performed at 17 to 20 weeks.

1.7% of hospital abortions (549) were performed at over 21 weeks.

17.1% of hospital abortions (5,641) have an unknown gestational age.

Excluding the 14,251 abortions performed in Quebec hospitals, we have a total of 33,030 hospital abortions. Please note that the percentages and numbers listed above for gestational age are based only on data for 27,389 hospital abortions out of a total of 33,030 hospital abortions.

Number and percentage distribution of Induced Abortions performed in Canadian Hospitals (excluding Quebec) in 2007 by Number of Previous Induced Abortions

50% had no previous abortions

19.2% had had one previous abortion

10.7% had had two or more previous abortions which means that 29.9% of women undergoing an abortion had at least one previous abortion.

The previous abortion rate is unknown for 20.1% of abortions in hospitals.

CIHI tells us that “Information on the number of previous induced abortions is not available from clinic data or from Quebec data.”.

An analysis of an Ontario group’s study, Project for an Ontario Women’s Health Evidence-Based Report (POWER) found that abortion numbers in Ontario for 2007 are higher than reported in official statistics. While the POWER study does not provide the actual numbers of abortions, it provides the abortion to live birth ratio. Calculation of the data provided in the POWER report found that the actual number of abortions in 2007 in Ontario may be close to 51,000 abortions, almost twenty thousand more than the figure of 32,000 reported by the Canadian Institute for Health Information (CIHI). Statistics Canada gives the number of live births in Ontario as approximately 138,000. Using the POWER report ratio of 37:100 abortions to live births, this would suggest that were 51,060 abortions in Ontario in 2007

The Power study also revealed that 52% of women aged 25 to 29 years who had an abortion in a hospital in 2007 reported having at least one previous abortion. “Overall in Ontario, 40% of women having a hospital induced abortion reported having had a previous induced abortion.” The rate of repeat abortions for clinics was not included in this calculation.

The Power study used OHIP billing records and several databases making their data more reliable. They explain that the induced abortion rates they present “differ from the rates reported by Statistics Canada for a number of reasons. Among these is the following: “Unlike Statistics Canada, which receives Ontario data only on abortions performed by hospitals and clinics funded directly by the Ontario Ministry of Health and Long term Care, our data used province wide billing data and therefore also captured abortions billed to the provincial insurance plan, including those performed in other clinics or private offices.”

Overall, incomplete abortion statistics means that the actual numbers are higher than the official statistics. One can safely assume that there were more than 100,000 abortions in Canada in 2007.

The Canadian Institute for Health Information reported that there were 93,755 abortions in Canada in 2009. Note that abortion statistics for 2009 are incomplete as clinic data for British Columbia is incomplete. CIHI notes that there is no legislative requirement for clinics to report their activity while “hospitals are mandated by their provincial/territorial ministry of health to report all hospital activity (not limited to abortion).”

The actual number of abortions in Canada is higher than reported. Abortions performed in doctors’ offices or clinics that are not licensed are not included in the statistics. Richard Trudeau, director of health statistics at Statistics Canada said in 2008 that “there’s more and more literature to indicate that there might be abortions performed in physicians’ offices, and those we’re unable to monitor.” These could number in the thousands according to one abortion doctor. (1)

From the incomplete data obtained by CIHI, we know:

Clinics: The number of clinic abortions reported was 52,115 and these clinic abortions accounted for 55.6 % of abortions performed in 2009. Ontario reported 17,352 clinic abortions which accounts for 33.29% of clinic abortions in Canada. As of 1999, the Ontario Ministry of Health and Long Term Care no longer maintains a system for the collection of detailed information on abortions performed in Ontario clinics but instead uses the billing system of the Ontario Health Insurance Plan (OHIP) to provide counts of clinic abortions to CIHI. This means that information is no longer available for clinic abortions performed on non-residents of Ontario or on Ontario residents who do not submit a claim to OHIP. Therefore these abortions are not counted in the Ontario clinic numbers.

Quebec hospitals and clinics also report only induced abortions covered by their provincial insurance plan. All other provinces/territories (including Ontario hospital data) include in their data all induced abortions even if paid for by the patient or another health insurance plan.

Overall, clinic information is not available for the following demographic and medical case data: gestational age of the child, previous induced abortions, previous deliveries, method of abortion and complications. Some clinics did provide data for the age of the mother.

Hospitals: The number of hospital abortions reported was 41,640 and these hospital abortions accounted for 44.4% of abortions performed in 2009. Hospitals in Quebec no longer fully report items such as: age of the mother, previous deliveries if any, number of previous abortions, gestational age of the child at the time of abortion, nature of the abortion procedure and complications.

Detailed records are available for less than 24,000 hospital abortions out of 41, 640.

Previous induced abortion: Based on incomplete hospital data (excludes the 12,826 Quebec hospital abortions), 30.7% of hospital abortions were performed on women who had at least one previous abortion. CIHI says that “information on the number of previous induced abortions is not available from clinic data or from Quebec data.”

Age of the mother: 47% of hospital abortions were performed on women in their twenties. 25,210 abortions were performed on women aged 20 to 24 years old. 19, 053 were performed on women aged 25 to 29 years old.

Gestational age of the child: From incomplete hospital data (excludes the 12,826 Quebec hospital abortions), we find information concerning gestational age for 23,686 abortions. Of those 23,686 hospital abortions, 552 are listed after 21 weeks. 951 hospital abortions were performed from 17 to 20 weeks. The gestational age is unknown for another 5, 128 hospital abortions.

29.0% of hospital abortions were performed at 8weeks and under.

41.2% were performed at 9 to 12 weeks.

6.8% were performed at 13 to 16 weeks.

In summary, the gestational age is unknown for 70,069 abortions (52,115 clinic abortions and 17,954 hospital abortions).

It is becoming increasingly difficult to formulate a complete profile of the women who undergo the abortion procedure because of incomplete and missing demographic and medical case data.

There are no legal restrictions on abortion in Canada which means that abortions can be performed at any stage for any reason.

Between 1970 and 2009, Canada has sanctioned the deaths of nearly 3,300,000 babies awaiting birth.

[1]Mick, Hayley. Abortion rate keeps dropping. Globe and Mail, May 22, 2008.

It's time for the facts to be known...

Many people who are concerned about the short and long term effects of abortion on Canadian society have entertained the suspicion that there is a long term strategy to suppress abortion information. 

With little fanfare and even less media attention on December 18, 2000 Statistics Canada released their analysis of the 1998 abortion stats on their Daily web site on behalf of The Canadian Institute of Health Information. CIHI, which was incorporated in 1993 as a not-for- profit corporation, has taken over the responsibility of collecting the abortion data from all hospitals and clinics. CIHI’s Mission Statement includes the creation of public awareness of factors affecting good health, always respecting individual record confidentiality. In the meantime, the annual therapeutic abortion manual which had been published since the early 70’s has been withdrawn. To retrieve custom data for the figures once freely available, it is now necessary to pay a fee.

CIHI reported that 110,331 Canadian babies were aborted in 1998: however, their abortion data base provided details for only 69% of the 68,273 therapeutic abortions performed in Canadian hospitals and for only 49% of the 41,761 therapeutic abortions performed in clinics (about 1 in 3 abortions were done at clinic sites).

On January 18, 2002 unless you were regularly monitoring The Daily web site you most certainly would have missed the press release of the so-called “1999 statistics” which announced:

“Due to incomplete reporting by Ontario, all therapeutic abortions performed in Ontario and therapeutic abortions performed in other provinces on Ontario residents have been excluded.” (Therapeutic Abortion Survey 1999).

As a result, for the first time since the abortion statistics have been released The Canadian Institute for Health Information (CIHI) has failed to provide the figures for the total number of abortions done on Canadian women. The figures actually reported by the other provinces represent 65,662 induced abortions but only 44% (29,016 abortions) have detailed records.

The Daily web site states that, “As Ontario usually reports about 40% of all abortions, data for this province have a major impact on the national picture.” Using 40% as the estimate for Ontario’s share and adding in the 231 abortions done on Canadian women in the United States we can project that at least 109,609 abortions were performed in 1999. (It should be noted, however, that for the last three years after the original tables were calculated and released, the numbers usually increased because of revisions).

When we examine the history of the publication of abortion statistics since 1970, the agendum to suppress abortion statistics now appears obvious. In 1969 when abortion became legal John Turner as Minister of Justice ordered annual compilation and publication of the abortion data by Statistics Canada (then known as the Dominion Bureau of Statistics). Without the benefit of electronic information gathering the information was readily available, although no statistics were given for the Quebec abortion clinics.

In 1978-79 Ivan Fellegi of Statistics Canada was seconded to American President Jimmy Carter’s Committee on the Reorganisation of the United States Statistical System. The U.S. does not have a central agency for compiling abortion statistics and depends heavily on the Alan Guttmacher Institute (AGI), a special research affiliate of The Planned Parenthood Federation of America (PPFA), the nation’s largest promoter and provider of abortions.

In 1984 Dr.Fellegi assumed the position of Chief Statistician and retains this position today. In 1986 Dr. Ivan Fellegi advised the then Minister of Supply and Services, Mr. Stewart McInnes, to discontinue the abortion statistics program because it did not give a precise and worthwhile picture of the therapeutic abortions done in Canada. If such a situation did exist in 1986 why would Dr. Fellegi not strive to improve the situation? In his August 1986 directive to the hospital administrators Mr. David Bray, Director of Health Services at Statistics Canada, requested that they immediately “discontinue sending us the annual Therapeutic Abortion Report form” as a cost cutting measure and explained that “the figures weren’t relevant to most Canadians.” This was said despite the fact that the number of induced abortions reported in 1986 had escalated to 69,572 from the 11,000 reported in 1971. In his letter to Dr. A.D. Thompson Administrator of Health Care Institutions, Halifax, Nova Scotia, Mr. Bray also wrote, “Finally, on behalf of Statistics Canada I want to thank you and others involved in the data collection since 1969. The cooperation of your organisation in this program has been much appreciated.”

There was such an outcry of public protest about this decision to cease compiling statistics on induced abortion that the new Minister of Supply and Services, Hon. Monique Vézina, told the House of Commons on November 5, 1986 that the method of compiling figures would be changed to provide a more precise picture of therapeutic abortions performed in Canada.

In spite of this promise a pattern of less comprehensive data emerged in the late 1980’s. Fewer and fewer statistics were being provided about marital status at the time of the abortion, age grouping of the candidates, the number of previous deliveries, the number of previous abortions (repeat abortions), the type of abortion procedure and the frequency and nature of any complications. The figures identifying the gestational age of the child at the time of the abortion were decreasing and some were classed as age unknown, although it is usually based on the date of the (abortion) “event” as of the last menstrual period of the woman.

Then came the announcement that after 5 years of preparation (begun in 1989) the newly created agency, The Canadian Institute for Health Information (CIHI) would collect the abortion data leaving the analysis to Stats Canada. This represented a merger of two not-for-profit groups; Management Information Systems (MIS) and The Hospital Medical Records Institute (HMRI).

Dr. Fellegi, Chief Statistician of Canada, would also serve on the CIHI Board of Directors along with various provincial Deputy Ministers of Health and community health officials. In his October 22/96 correspondence Dr. Ivan Fellegi stated that the CIHI would“fill in data gaps found in the current system.” Since the mandate of CIHI is to provide comprehensive and integrated health information, this merger should have meant more rather than less information about the abortions done in both hospitals and clinics settings. As well, Janet Hagey (Statistics Canada-Health Division) had offered public assurance that “all pertinent information including that on abortion will continue to be collected and made available.” Remember, if Dr. Fellegi had the power to suggest in 1986 that abortion statistics no longer be compiled surely he enjoyed the same clout to request compliance with the surveys. In a February 1995 letter to Western Report, Mr. Bruce Petrie of Statistics Canada writing in reference to an article which suggested the possibility of misleading statistics concerning violence against women said, “In past years when formal approval of new data collections was requested from successive ministers, not once during the 15 year tenure of the current Chief Statistician (Fellegi) and his predecessor was any survey substantively discussed with any minister, let alone subject to any order, request or hint that it be modified.” Mr. Petrie also said that we (Statistics Canada) “go to great lengths to maintain our hard earned reputation for objectivity, impartiality and professionalism.”

The increasing paucity of abortion data renders interpretation impossible and is completely unacceptable, particularly to those in the medical health sciences and to educational resource centres such as Action Life. Every statistic listed under medical case items and demographics is important in assessing the impact of abortion on a woman’s health (post-abortion trauma, physical and psychological damage, suicide incidence, infertility, sterility and the increased risk for developing breast cancer after even one abortion). Compelling international research studies including some funded by the U.S. National Cancer Institute refute the idea of “safe” abortions.

Twenty-eight of 37 international epidemiological studies show that even one abortion increases the risk of developing breast cancer by 30% later in life. If it is a first pregnancy the overall risk is 50%. This risk increases for those under 18 or over 30 and is compounded for those with a family history. The limited detailed records available for 1999 indicate that 21% of abortions were done on girls 10 to 19 years of age. Also, the very limited detailed records for complications immediately after the hospital abortion indicates that 80% of the girls under 15 had at least one complication and 22.2% of those girls 15-19 had one immediate complication.

Despite repeated unsuccessful efforts to meet with the then Minister of Health, Hon. Allan Rock and the previous Minister Responsible for Statistics, Hon. John Manley, we continue to reiterate that this inadequate data is inexcusable. The new Minister currently responsible for Statistics is the Hon. Allan Rock. Dr. Fellegi is answerable to the Minister responsible for Statistics.

Accurate statistics are needed to examine the relationship between marital status and abortion incidence. The sparse data base for 44% of the Therapeutic hospital and clinic abortions performed (excluding Ontario) indicates that only 10.4% were married women with 60% classed as single, separated/divorced/widowed or common-law. Within this category 29.5% were listed as marital status unknown! Accurate abortion statistics are increasingly important for demographic and immigration decisions. The Montreal Gazette (March 11/00) reports that the number of women seeking abortions in Quebec has doubled in the last two decades (30,702 in 1999). The increase in abortion numbers has coincided with a sharp drop in the birth rate which has resulted in the population of that province falling below the replacement level.

In 1995 Nancy Miller Chenier, Political and Social Affairs Division, Research Branch, Library of Parliament released a study titled “Costs of Abortions done in Canada” which showed that in the fiscal period of 1992-1993 the cost for induced abortion in hospital and clinic sites was at least $51,646,926 payable from the public purse. Ms. Miller Chenier stated that she found the task of calculating the annual cost of abortion procedures to be a “complex and inexact process.” Why should this be? From a monetary standpoint alone this information would most certainly be ‘relevant’ to the Canadian public who are worried about hospital bed shortages and the rising costs for medical care.

Since abortion is classified as a “health” matter, then every anonymous statistical aspect of abortion should be a matter of public record. The Federal Task Force on Health released a one year report in 1996 which stated that, “One of the Forum’s concerns is that consumers are not getting the information they need to make decisions about their health.” Pregnancy is not a disease and induced abortion is an elective procedure. And no plausible excuse can be found for concealing exactly how many Canadian babies die each year by induced abortion.

Action Life Online Article

By Lyn Smith 

By Paul Ranalli, M.D.

It is hard to overestimate the importance of a published article reviewing the consequences of abortion that appeared in the January 2003 issue of the U.S. journal Obstetrics & Gynecology Survey.  The article, (reprints available from our office), by Professor Dr. John M. Thorpe and his colleagues at the University of North Carolina's School of Public Health, is presented as a continuing medical education (CME) review.

Among the highlights, Dr. Thorpe found that a woman who aborts a pregnancy increases her lifetime risks of breast cancer, depression, attempted suicide, and subsequent premature births. Properly publicized and given the kind of attention they deserve, these revelations could deal a staggering blow to defenders of allegedly "safe" legal abortion, and help influence public sentiment.  Not that it will easy.

What the public may not fully realize is that powerful positions in the American medical hierarchy are stocked with ardent "pro-choice" individuals. Their influence has meant that there has been a kind of tacit understanding over the past three decades: abortion must not be criticized. Thus the meticulous work of epidemiology professor Dr. Joel Brind, demonstrating that an induced abortion increases a woman's risk of breast cancer, is routinely dismissed. But reasonable medical scientists should be able to agree that, whatever one's personal views, real science only emerges when original medical data is properly gathered, carefully analyzed, published, debated about its merits, and finally attached to our existing body of knowledge. A scientist worthy of the name always betrays his or her own professional code whenever such knowledge is willfully suppressed. Yet, for the longest time this is exactly what has happened to studies which offer an attempt to analyze the complications and impact of abortion on women. That time may be ending.

Professor Thorpe and his fellow authors conclude that abortion significantly raises a woman's risk of: Breast Cancer. "A statistically significant positive association between induced abortion and breast cancer cannot easily be dismissed." The authors conclude that Dr. Brind's seminal 1996 study remains superior to the other three review articles cited, because only his meta-analysis is quantitative, while the other three (one of which confirmed a slight ABC link, while the other two did not), were merely opinion-based. Aside from the independent risk that abortion itself poses, the authors note that, simultaneously, a woman exposes herself to the well documented additional future risk of breast cancer when she "clearly sacrifices the protective effect of a term delivery should she decide to abort and delay childbearing." However, the authors do not do full justice to the magnitude of the ABC link in a number of ways. They do not outline the staggering preponderance of studies which confirm the link-to date, 29 of 38 published studies worldwide since 1957. Also, they make a curious error: they misstate Brind's meta-analysis conclusion regarding the ABC link as "1.2" in the article's Abstract. But in the text it's quoted correctly as "1.3."  While the numerical difference may seem small (1.3, or 30% increased risk vs. 1.2, or 20% increased risk), the error represents a 33% relative understatement of risk.

Depression and Suicide

The authors review one of medicine's greatest secrets: the long-observed higher rate of depression after induced abortion, yet not after spontaneous abortion (miscarriage). A strong link between suicide attempt and completed suicide is noted to be "an objective rather than a subjective outcome because the effects are seen after induced abortion rather than before." Subsequent pre-term birth, a total of 19 of 24 studies show a link between women who abort a pregnancy and premature delivery in later pregnancies due to an acquired "incompetence" of the woman's uterus. Induced abortion also raises the risk of placenta praevia, a dangerous pregnancy complication that causes both premature delivery and excessive maternal bleeding, which can be fatal. The overall increased risk of later premature delivery ranges from 30% to 100% higher. They note a "dose-response" effect as well-that is, the more abortions a woman has the greater the likelihood of a premature delivery of a subsequent wanted baby.

The authors also do not mention related work by researcher Judith Lumley. She found that a previous induced abortion leads in subsequent births to the delivery of the most extreme premature infants.  Left unsaid in Thorpe's review is the direct association of abortion on the later incidence of babies born with cerebral palsy.  Extremely premature newborns have a risk of cerebral palsy 38 times that of over al1 newborns. Heartbreak, hardship, and massive medical resources can thus be laid at the feet of the practice of abortion, just from this one category of complication alone.

Although the breast cancer link to abortion has been the most contentious, abortion defenders may be the most stunned by the powerful data linking induced abortion to depression and suicide. After all, one of the few claimed medical indications for abortion is its putative "mental health" benefits, to relieve the anxiety and depression of a woman in a crisis pregnancy. The party line among abortion adherents is that women experience immediate relief at having their crisis "terminated," and this may be true in the very short term. Yet it may be seen as a measure of the uncaring motives of the abortion industry that the extent of their concern for a woman's mental health extends no further than the clinic exit door. In truth, women carry the physical and mental scars with them forever. Rather than an alleged cure for depression, abortion has now been revealed to increase depression and attempted suicide. The risk is so striking that the authors recommend "careful screening and follow-up for depression and anticipatory guidance/precautions for women who choose elective abortion." In other words; for a depressed, suicidal woman in a crisis pregnancy, abortion is the last thing she needs (i.e. abortion doctors should screen out such troubled women). If an abortion is committed, she must be watched very carefully. Dr. Thorpe and his colleagues call for two measures. First, noting the limited quality and attention given to studies of abortion complications (itself a scandal), they call for a commitment to new, original research. Second, they urge a requirement that abortion consent forms include a realistic warning of the subsequent increased risk of premature birth, placenta praevia, and breast cancer. They conclude: "Failure to provide this information is a direct threat to maternal autonomy, diminishing a woman's ability to give informed consent."

Will "pro-choice" adherents in the medical profession rise to meet this challenge? One can only hope. Since the only true "choice" is a fully informed choice, how will abortion advocates justify any further patronizing efforts to cover up this evidence from women? Women contemplating abortion have the ability, and the right, to know the real risks. Their lives literal1y depend on it.

Dr. Ranalli is a Toronto neurologist, and an advisor to the deVeber Institute for Bioethics and Social Research.

Action Life Online Article

New Government Study In Finland Ignored by Abortion Providers.

A recent government funded study in Finland shows that women who abort are approximately four times more likely to die in the following year than women who carry their pregnancies to term. In addition, women who carry to term are only half as likely to die as women who were not pregnant.

"This is an impeccable, record-based study," said David C. Reardon, Ph.D., who authored a review of the Finland study and other related studies in the latest issue of The Post-Abortion Review. "It proves beyond a shadow of a doubt that abortion is not safer than childbirth."

Researchers from the statistical analysis unit of Finland's National Research and Development Center for Welfare and Health (STAKES) examined death certificate records for all women of reproductive age (15-49) who died between 1987 and 1994, a total of 9,129 women. They then examined the national health care database to identify any pregnancy-related events for the women in the 12 months prior to their deaths.

The researchers found that compared to women who carried to term, women who aborted in the year prior to their deaths were 60 percent more likely to die of natural causes, seven times more likely to die of suicide, four times more likely to die of injuries related to accidents, and 14 times more likely to die from homicide. Researchers believe the higher rate of deaths related to accidents and homicide may be linked to higher rates of suicidal or risk-taking behavior.

"Even though this important study was published in the top Scandinavian obstetrics journal, it has been completely ignored by the American press," Reardon said. "Even worse, abortion counselors continue to lie to American women. They are telling women that abortion is safer than childbirth, when this and other irrefutable studies prove exactly the opposite. The entire body of medical literature clearly shows that abortion contributes to a decline in women's physical and mental health. Women aren't hearing this. Nor are they being told that giving birth actually contributes to women's overall health, not only in comparison to those who abort but also in comparison to women who have not been pregnant."

A link to a full text copy of The Post-Abortion Review article can be found at http://www.afterabortion.org/PAR/V8/n2/finland.html

Action Life Online Article

By Angela Dickieson 

February 5th was the date that changed my life forever. I was in the day surgery waiting room with my boyfriend at the time, waiting to have the simple, quick, (so the nurses had explained) termination of my pregnancy--abortion. I felt an unusual calm, convincing myself that this was the only way to go and the right thing to do. After all, that's what Kirk (not his real name) wanted and I didn't want to lose him.

I grew up in a "buffet style" Catholic home. We practised what suited us, and things that didn't suit our life styles or decisions, we threw out of the window. One thing my parents did oppose was abortion. When I first dated in my late teens, my father sat me down and sternly said that if ever the situation arose that I would become pregnant, I was to know that abortion was not a choice in this house and that my parents would help me raise the child. Through the years, this was a reassuring thought even though I wasn't planning on getting pregnant.

A good friend of mine got pregnant one day and decided that she did not want a future with the father of the child, and therefore had an abortion. I was so furious with her, furious that she could ever get to that point, I clearly remember saying to her: I WOULD NEVER HAVE AN ABORTION, NO MATTER WHAT THE SITUATION. IT IS WRONG!!! Well, lo! and behold! a couple of years later I found myself in her shoes.

Kirk and I had only been dating for three months when I became pregnant. When we first met we discussed issues and values that were important to us and both he and I agreed that abortion was not a solution, but murder. When the home pregnancy test turned out to be positive, my first reaction was shock, and then denial. I was a nurse now but also completing my third year B.Sc.N. at the University of Ottawa. How would this change my future? Then my father's powerful words put things into perspective. I told Kirk that I would put university on hold until after the baby was born. Kirk had other ideas. He explained that because we had known each other for only three months, he didn't want to bring a child into this world: "If you do have the baby, we will get married and later we will divorce. I will then hire the best lawyer in town and make sure this child comes with me." His response was a complete shock. Now looking back, I know he panicked, felt cornered and saw no way out but to "get rid of the problem." For seven weeks, Kirk mentally abused me with threats of what might happen if I didn't have an abortion: "There is no other choice! You must have the abortion!!" Everyday I cried, asking God what I was supposed to do. Kirk broke down my strong line of defence, day by day, bit by bit, until one day I said to myself, "he is right".

After the procedure, I felt numb and emotionless, as if nothing had ever happened. I thought, let's move on from where we left off. I finished my remaining semester and returned to my R.N. position in the Emergency Department.

My first day back to work was bizarre. I wasn't able to talk to my patients or colleagues without breaking down, crying hysterically. If you knew my personality, you would know this was an odd behaviour for me. I was a happy, positive, outgoing, emotionally stable person. This behaviour was completely out of character for me. Even I was confused by these puzzling outbursts. My employer gave me two weeks sick leave and I was obliged to seek psychological counselling during that time.  The psychologist and I came to a quick conclusion after two sessions--I had begun to grieve the loss of my baby!! So often I had to point out the signs to my patients and family, yet I never recognized them in my own situation.

My first response was SHOCK: I didn't allow myself to feel anything because I had to finish school. That part of my life was blocked out completely and buried somewhere in my subconscious. Then came SEVERE ANGUISH: crying, crying, uncontrollable crying. I also began to feel enormous anger, towards Kirk but mostly towards myself for having made the worst decision of my life--taking the life of my baby because it interfered with our goals. After a few months, MOURNING followed: I knew I had offended God in the worst way. I kept asking my baby, who now was in heaven, to forgive me for having made the selfish choice of not giving her the opportunity of life here on earth. For RESOLUTION, I needed forgiveness from God as well.

I had asked God to show me my baby in a dream. A little girl appeared over a flower covered meadow, with a big smile on her face. She had Kirk's straight chestnut hair and my big blue eyes. She was skipping along singing a song. When I woke up, I decided to name my daughter Maria.

It has been eight years since I had the abortion. She is often on my mind and I miss her dearly. I wish I could have held her, cuddled her, brushed her hair, bought her first dress and shoes, seen her take her first steps, done all the beautiful things I have enjoyed doing with my three sons. I am crying as I am writing this part because the pain will always remain in my heart that she is not here with us. 

ACCEPTANCE is the last stage: I have taken full responsibility for my actions. Something good has to come out of this tragedy... A change of heart from the Moms and Dads who feel abortion is the only option.

Many people may think that the public is well educated on the topic of abortion, and health
professionals even more so. This is a great fallacy!!!! During my seven years of nursing education, the only thing "touched on" regarding abortions were the different types one can have at different gestational ages. The procedures were played down and no mention was ever made of the details of the procedures, such as the counting of all body parts to make sure no parts of the body of the baby are left in the uterus, or the use of a strong saline solution in abortions of babies at more advanced gestational age, which tortures the babies by eating away at their delicate skin--the baby is delivered only when it is presumed dead. One of the main reasons I like to talk about this subject to young and old students is that WE ARE BEING LIED TO. I believe that we have a right to know the whole truth about all the procedures as well as all the short and long term consequences.

When a person goes for any kind of surgery or procedure, it is the legal responsibility of the physician to fully explain the procedure and list ALL possible consequences and side effects so that an INFORMED consent can be made by the patient. Before the person goes to the operating room, a registered nurse normally asks the patient to explain back what they understood of the procedure and if they are aware of the possible side effects. By signing the consent form, the patient is giving permission for the procedure. Occasionally some patients are not properly informed and sometimes change their mind before the surgery when they come to fully comprehend the whole picture.

In my case, I think, had more complete information been provided, it would have shaken me up and made me realize that abortion was not the way to go. I think if we all knew the whole truth we might reconsider our decision in wanting one. There are other choices such as adoption or keeping the baby. Women and men, young and old, who are faced with an unwanted pregnancy, panic. When we panic, wrong decisions are often made because we act out of desperation.

For those of you who demonstrate in front of the abortion clinics, my advice to you if you want to reach someone's heart in hopes that they will change their mind is talk to them with love and kindness. Hold them in your arms. Pray for them and the baby. If you've had an abortion, share your story with them and let God change their hearts. I strongly believe that deep down in our hearts and souls, we KNOW that abortion is wrong. That's why a majority of women and men never talk about it , perhaps out of guilt or because they are still at the denial stage, which could last a life time.

My husband (not Kirk) was also involved in an abortion decision with a past girlfriend. We have had an opportunity to share our story with some friends of ours who were considering aborting their third child. After sharing, we asked God to do the rest of the work which was to change their hearts. In the next few days, they came to realise that their financial situation was not a reason to abort their baby. Today they have the most beautiful baby boy. They can't imagine being without him.

Maria is in my heart everyday. I wish I could change history, but I can't. I have made some crazy and stupid decisions in my life but there is only one I will regret for the rest of my life and that was the visit to the outpatient surgery clinic eight years ago.

Content

•      Questionnaires: cause for concern
•      The damage being done
•      Guilt 
•      Anxiety
•      Depression
•      Loss
•      Anger
•      Suicide
•      Post-abortion psychosis
•      Other victims of abortion
•      Conclusion
•      References

We are told by abortion advocates that there are no adverse psychological effects from abortion. In contrast, the women who are suffering from the emotional after-effects of abortion are telling us that the psychological consequences are devastating and long-lasting.

Questionnaires : Cause for Concern

Abortion promoters are quick to partially quote questionnaires. The general finding of over 1000 questionnaire-based papers is that the main, immediate reaction to abortion is relief.[1]

The same questionnaires also find abortion to be traumatic, accompanied by distress, anxiety, and numbness; but abortion adherents ignore these findings.

Questionnaires, no matter how skillfully designed, do not get to the core of one's true feelings. In-depth research has found that when women are in trusting, sharing relationships, they report deep-seated feelings of guilt, anxiety, depression, loss, anger and exploitation over their abortion experiences.

A point in fact is the research by Drs. Ian Kent, R. C. Greenwood, Janice Loeken, and W. Nicholls at the University of British Columbia.[2] They found that a group of women asked by questionnaire about their abortions concluded that their abortions were mildly traumatic, but their main reaction was relief. Also, a feeling of emotional numbness after the abortion was reported, especially by teenagers.

Compare this to another group of women in therapy for reasons not directly associated with their abortions. After some time in therapy, the women's deep feelings began to surface - feelings of intense pain, bereavement and identification with their aborted babies. These feelings appeared even when a woman rationally tried to maintain that abortion was the only possible course of action. In group sessions or alone with the therapist, women expressed their pain and regret.

A totally different reaction appears when a woman communicates her deep feelings to people she has come to know and trust instead of ticking off a superficial response on a questionnaire. On questionnaires women report "socially approved" responses; in a trusting relationship they report their genuine emotions.

The Damage Being Done

The immediate reaction after an abortion may be relief - no more fear of the unknown. But what about later - one month, one year, ten years later? In-depth studies are reporting consistent findings. The psychological damage is taking the following forms: guilt, anxiety, depression, a sense of loss, hostility, suicide, and psychosis.[3, 4] And women suffer from not one but a combination of these difficulties. This trauma is recognized as a psychological stress disorder by the American Psychiatric Association and is listed in their Diagnostic and Statistical Manual of Mental Disorders (DSM III-R:309.89, Washington, D.C., American Psychiatric Press, 1987, page 250).

Guilt

Guilt over an abortion is a frequent reaction - a reaction that may smoulder for years. [5, 6, 7, 8, 9, 10] Women confronting their guilt make such statements as "I murdered a baby." Many symptoms can result from unresolved guilt. Some are depression, complexes, or fears of infertility and of sex.

Anxiety

Anxiety often is felt very keenly and expressed by women in the post-abortion period. [11, 12] Women cry, "I'm going crazy," or "I'm always fearful."

Many women are anxious about physical complications. Often they are worried that they may never have another child. In some cases there are no symptoms of physical problems, in other cases there are, such as miscarriages or tubal pregnancies.

Depression

Women often describe symptoms of depression when telling of their feelings about their abortion experiences. Many feel completely immobilized. They haven't been interested in anyone or anything since their abortion. They don't talk to anyone, they don't go to work, they don't function adequately in any area of life. In short, they are alienated from those around them and feel they have no one to confide in.

In their depression, many women find they have been crying since their abortions. They state, "I cry all the time." Others have insomnia and nightmares about little boys or girls the age their children would have been. Some have constant, distressing flashbacks of the abortion procedure.

During depressions occurring in the mid-decades of a patient's life, therapists frequently hear expressions of remorse and guilt concerning abortions that occurred twenty or more years earlier. [13] And the patient's psychological pain from the abortion surfaces as she discusses another problem, the one that brought her to the therapist.

A family who has experienced prenatal detection of an abnormality and has chosen abortion is also at risk of emotional trauma.[14,15] Studies indicate that the incidence of depression following such selective abortion may be as high as 92 percent among women and 82 percent among men and is greater than that associated with the delivery of a stillborn child. The cause of the preborn's death makes the difference. A stillbirth usually is
regarded as an unfortunate accident; in selective abortion, the baby's death is the result of a premeditated choice.

Loss

When a post-abortive woman is allowed to grieve, she articulates a sense of loss. Women describe a number of reactions. "I cannot look at babies, little children or pregnant women," or "I'm jealous of mothers," or "I want to get pregnant again to replace my lost baby."

Often women are simultaneously experiencing other losses that serve to increase their pain. Their relationship with their sexual partner has deteriorated or even been destroyed since the abortion. There is much distress and confusion over husbands or boyfriends abandoning them after their abortions or lacking concern about their emotional pain.

Another loss is that of self-esteem and of values that the women cherished before their abortions but found obliterated by their abortions. They are disappointed in themselves for going against their previously held values. They describe themselves now as "violent" or "not worthy of love or of children" or "copping out." [16, 17]

Anger

Anger is strongly felt and expressed toward people involved in the abortion: themselves, counselors, physicians, boyfriends and spouses, for example.

Anger is directed toward doctors and counselors who "don't present the other side of the picture" or "don't warn of the possible physical and emotional problems." One woman states, "After the abortion, when I was in pain emotionally, no one at the clinic wanted to see me again."

Husbands and boyfriends cause anger when they don't support their partner who desperately needs help and understanding or when they have encouraged or forced the woman to have an abortion.

Women are not only disappointed in themselves but angry with themselves when they feel they went against their previously held values.

Along with the anger are feelings of being misled and exploited by the so called professionals they went to for help before and after their abortions. Many women state they were given misinformation such as "your pregnancy is only tissue," or "don't think of it as killing, only getting your period going again." Women are angry, hostile, and resentful because they are not informed about prenatal development, abortion methods
and their risks - physical and psychological - and alternatives to abortion. Women say they were made to feel like helpless, powerless "victims" and still feel that way in their interactions.[18]

Women who regret having abortions, and feel they were exploited by counselors, doctors, husbands or boyfriends who pushed abortion as a solution to problems, are founding post-abortion counseling groups. The founding women and those who continue to join the groups discover they all have problems, especially with guilt and depression, and feel what they did is wrong. These counseling groups help women for whom pregnancy poses a problem by providing the needed assistance to bring a baby safely to term and to care for him or her adequately after delivery.

Suicide

A growing problem is suicide after an abortion. An increasing number of attempted and successful suicides by women on the approximate date their babies would have been born had they not aborted them is being reported by physicians, researchers, and counsellors.[19] The highest rate is for 15- to 24-year-olds.

To illustrate, a 17-year-old attempted to kill herself by crashing her car beyond repair while driving under the influence of alcohol and 29 Bufferin tablets. She walked away from the accident and was found sitting in a cemetery. During her abortion, she had calculated her baby's birth date, the exact date the accident occurred.[20]

Post-abortion Psychosis

In 1979 alone, Drs. Sim and Neisser reported 95 post-abortive psychoses from Israel and from Birmingham, England, indicating that this problem is not as rare as some would suggest.[4] Compared to post-delivery disturbances, post-abortion psychoses are more serious, last longer, and are more likely to recur.

In the following examples, abortion produced severe psychoses 6-12 weeks post-abortion in women who functioned well before their abortions.

"A 17-year-old honor student attended a summer program in an area in which she excelled. This was the first time she had been away from home for an extended period. She met her first boyfriend, fell in love and became pregnant. She visted a sister in a northern city and obtained an abortion without her parents' knowledge.

 "Later, she developed lethargy, malaise, nausea with occasional vomiting. Thorough physical evaluation failed to reveal any organic cause for the symptoms. A short time later she complained of feeling bloated, excessive weight gain, breast engorgement and tenderness.

"On the eve of the first anniversary of her abortion, she experienced an overt psychosis. The mental status examination revealed marked regression, visual hallucinations, and psychotic thought processes...The regression was so severe that she had fecal incontinence and smeared the feces on herself and around the room...

"Psychological testing revealed a marked amount of guilt...Treatment with an antipsychotic drug was begun...She was able to attend school...However, each time her menstrual period began, she rapidly regressed to psychotic behavior with fecal smearing and visual hallucination."[21]

Two other examples illustrate further. After three years one woman believed her baby to be alive. Another woman continued to see everyone as the devil.[4]

Other victims of abortion

The same psychological reactions to abortion may occur in others close to a woman who has aborted, such as her partner, relatives, nurses and doctors. As examples, one mother became immobilized with depression after letting her daughter have an abortion. A husband was tormented by guilt over his wife's abortion and recent miscarriage.

Doctors and nurses who have participated in many abortions report nightmares, and researchers documenting this conclude, "Regardless of one's religious or philosophic orientation, the view of abortion remains the same. . . that unconsciously the act of abortion was experienced as an act of murder."[11]

Conclusion

Those who have aborted are telling us they pay a psychological price. Their views of themselves, their relationships, their emotional stability, and their ability to effectively cope with life are damaged, sometimes beyond repair. The emotional reactions are both immediate and long-term. Psychologically, women are in states of crisis. And the psychological aftermath of abortion extends beyond the one who has aborted to affect significant others in her life.

Denial of the psychological complications of abortion by abortion advocates demonstrates a lack of concern for women and further exploitation of them. Women are not well-informed or prepared for the psychological problems created by abortion, and then when they are suffering from these difficulties, they are told their pain does not exist. This denial prevents the offering of assistance, and the lack of needed help denies recovery, thereby maintaining the existence of psychologically incapacitated women.

References:

   1.Doan, B.K., and Quigley, B.G., "A Review," Canadian Medical Association Journal, Sept. 1, 1981, vol. 125.

  2. Kent, I., et. al., "Emotional Sequelae of Therapeutic Abortion: A Comparative Study." Presented to annual meeting of Canadian Psychiatric Assoc., Saskatoon, Saskatchewan, Sept. 1977. 

 3. Parthun, M.L., "Post-Abortion Mourning: The Hidden Grief," Care for the Dying and the Bereaved,  I. Gentles, ed. Anglican Book Centre, Toronto, 1982. 

4. Mall, D.,and Watts, W.F., The Psychological Aspects of Abortion, University Publications of America, Washington, D.C., 1979. 

5. Kent, I., et al. BC Med J 20 (4). April 1978. 

6. Bulfin, M.J., "Deaths and Near Deaths with Legal Abortions." Presented at ACOG Convention, Oct. 1975. 

7. Simon, N.M., and Sentuvia, A.G., "Psychiatric Sequelae of Abortion," Arch Gen Psych 15, Oct. 1966. 

8. Peterson, P., Hannover Medical School, in deutsches Arzteblatt. 

9.  Francke, L.B., The Ambivalence of Abortion, Random House, 1978. 

10. Wren, B.G., "Cervical Incompetence: Aetiscogy and Management," Med J Aust 1146, Dec. 29,1973. 

11. Kibel, H.D., "Staff Reactions to Abortion, A Psychiatrist's View," Ob Gyn 39 (1), Jan. 1972. 

12. Quay, E.A., "Doctors Note Serious Side Effects on Women Following Abortion," The Wanderer, Nov. 16, 1978.

13. Sands, W.L., "Psychiatric History and Mental Status," Diagnosing Mental Illness: Evaluation in Psychiatry and Psychology, Freedman and Kaplan, eds. Atheneum, 1973. 

14. Niswander, K.R., and Patterson, R.N., "Psychologic Reaction to Therapeutic Abortion," Ob Gyn 29, May 1967. 

15. Blumberg, B.D., et al., "The Psychological Sequelae of Abortion Performed for a Genetic Indication," Am J Ob Gyn 122 (7), Aug. 1975. 

16. Ekblad, M., "Induced Abortion on Psychiatric Grounds, A Follow-up Study of 479 Women," Acta Psychiat Neurol Scand suppl 99:238, 1955

17. Kotasek, A., "Artificial Termination of Pregnancy in Czechoslovakia," Int J Gynaec Obstet 9, May 1971.

18. Cowell, C.A., "Problems of Adolescent Abortion," Orthopanel 14, Ortho Pharmaceutical Corp Publication. 

19. "Abortion and Suicide," NRL News, March 11, 1982.

20. Tishler, C.I., "Abortion and Suicide," Pediatrics, Nov. 1981.

21. Spaulding, G., and Cavenar, I., "Psychoses Following Therapeutic Abortion," Amer J Psychiatry,  135(3), March 1978. 

1.  Action Life Online Article

For some women who have an abortion the hardest thing is finding anyone to sympathize with their pain, says Felicity Dargan.

"I grieve and see no end to the grief because what I did, rightly or wrongly, was irreversibly and irrevocably permanent. Do you see? I cannot, for all the riches in the world, get my child back."

Melinda Tankard Reist knows abortion is a taboo subject, but she wanted women who had had abortions to tell their stories. "In all the polemic of the abortion debate, we never hear women's lived experiences of abortion," the Canberra-based writer and researcher said.

"Giving sorrow words" tells stories of post-abortion grief. It is powerful reading. Ms. Tankard Reist, 36, a married mother of three, said: "The women share so much of themselves, their grief and suffering. So it's very personal. You feel you have been let inside their lives. There was one woman who just wept and wept on the phone. She kept repeating 'I just want to hold my baby, I just want to hold my baby'. That was harrowing. I didn't want to play the role of counsellor, but a lot of these women had never talked about their abortions and never grieved. There were times I felt I could not cope with another phone call. But I couldn't rest until the book had been born. I felt it had to happen."

Giving sorrow words is not about the politics of abortion. The author blames the politics for drowning out the voices of women harmed by it. "Abortion is seen as such a hard won right that to criticise it, or talk about the damaging repercussions, is betraying the cause," she said. "Some women felt they were selling out."

The book features the personal accounts of 18 women -- teenagers to 70 year-olds -- and draws on the experience of 200 others. Some women spoke of one abortion, others about two to five, one wrote of twelve.

"The idea for the book came four years ago," said Ms. Tankard Reist. "I write about women's health issues and have always been broadly interested in the subject of abortion. I heard two women's stories in one week and the journalist in me recognised there was a lot more to be told."

About 300 women responded to advertisements Ms. Tankard Reist placed in women's magazines and newspapers. Common to all the stories is the tremendous pressure the women felt to have their abortion. Few felt they had a choice.

"Many women said it was others, usually partners or parents, who wanted them to have the abortion," Ms Tankard Reist writes in the introduction."The experience of too many women was that the people they normally relied on for support withdrew it."

Zelda's husband gave her an ultimatum: "It's me or the baby." Zelda wrote: "I felt I had no choice....inside I was thinking 'oh please don't let this happen; I want to keep this child.'"

"Each night when my husband came home, I begged him 'please don't make me have an abortion.'"

Beatrice, 38, also had an unsympathetic husband. "I don't use the word 'choice' because...when you are cornered, there does not seem to be a choice," she wrote. "I look on my husband as the "judge" and myself as the 'executioner'."

Eighteen year old Melanie was pressured by her boyfriend and her parents to abort. "I didn't have one person to support me having the baby," she wrote.

Lena, who became pregnant at 25, wanted her child, but she did not feel strong enough to have it without her partner's support. After they broke up, Lena felt tricked. "At the end of it all, I am left alone without the love of either the father or the child...I feel I have lost something I can never regain," she wrote.

All the women felt a depth of grief for which they were not prepared. "A woman's abortion pain is discounted and minimised due to the prevailing view that a termination is really no big deal, 'just a curette', an easy fix," Ms. Tankard Reist writes. "Abortion is promoted by many who dominate the discourse on the subject as a procedure without repercussions."

Many women tried to commit suicide, while others felt they had to punish themselves. Self-mutilation and eating disorders were common."I had a strong need to punish myself, to punish the woman who had killed my child," Catherine wrote.

Many women recalled how coldly they had been treated at the abortion clinic, how they received inadequate counselling and were hurried out after the procedure. Serena wrote: "I felt ripped off...as about 20 other women were 'done' in the same session. I felt so cheap, so utterly foul."

A nurse yelled "congratulations" to Genevieve after her abortion. "I felt like a rape victim being raped over and over again by the system. All I wanted was to get out of the hell hole."

Some women noted the irony of how they nurtured their baby leading up to their abortion. "I refused to take pain relief tablets because it could harm the baby, even though the days were slowly ticking by and his chance at life was fleeing anyway," Justine wrote.

Catherine felt "strangely protective towards the baby." "Such contradictions," she wrote. "Even as I was planning to kill it, I was also nurturing it. I stopped smoking and drinking, was careful about what I ate and what I lifted."

The women struggled to find ways to cope with their loss. Justine visited a cemetery and "adopted" the grave of a baby boy who had lived only three days.

After her abortion, Zelda bought a blue teddy bear and pretended it was her baby. "She would push it in a pram," Ms. Tankard Reist said.

Three women said they felt like snatching babies. Their sense of loss was so strong, they were looking for anything to replace it.

Because conventional wisdom is that abortion is mostly trouble-free, Ms. Tankard Reist said women who were troubled were forced to be "invisible." "Their stories have been disqualified," she writes. "Their experience is trivialised. Grief for an aborted baby is forbidden grief: it remains taboo."

Ms. Tankard Reist said she wanted people to understand what abortion meant for many women.

"It isn't the quick fix it is presented as," she said.

"Abortion can devastate some women for the rest of their lives. It touches women at an extremely deep and emotional level. If the potential ramifications aren't told to women, they can not make a free and informed decision. The book is for the women who contributed to it. For the first time in their lives, when everyone else has been denying their children, they have been validated."

I felt I had to do it for everyone.

Jane had an abortion two days before Christmas in 1997. She was 19. Now 22, Jane is pregnant and this time she is determined to have her child. "I would never survive another abortion," Jane said. "When I first fell pregnant, I had been with my boyfriend two years. I was working and living at home. My boyfriend didn't want the baby. Neither did my parents. They didn't think I could cope financially and said I was too young. My boyfriend once said: 'if you have it, I couldn't love it' and that really affected me. I didn't want the abortion. I was absolutely terrified. But I felt I had to do it for everyone else."

Jane said the counselling at the abortion clinic was "pathetic." "The woman was hopeless," she said. "She just said 'we have a problem here; let's get rid of it'." After the abortion, Jane felt hatred towards her boyfriend and her family. She also felt tremendous guilt and deep grief.

"I became depressed and suicidal, my family wondered why I was hysterical when it was all over," Jane said. "I felt I was dealing with it on my own."

Jane sought counselling at Open Doors Counselling Centre in Ringwood and later saw a psychiatrist for three months. "I had been told that, at 12 weeks, my baby was just a bunch of cells," she said. "Then the counsellor explained how much the baby was formed and that made me feel worse."

Jane fell pregnant four months ago, to the same man. "I told him after my abortion that if I ever got pregnant again, I would never have an abortion; that I would rather bring it up on my own," she said. "He's a lot better about it. We're living together, both working and planning to get engaged."

Jane said she believed little attention was paid to the psychological effects of abortions. "If I had read the book Giving sorrow words (to which she contributed) before I had the abortion, there's no way I would have gone ahead with it," she said. "There's got to be much more counselling before and after."

One of the hardest things for Jane was having nowhere to grieve for her baby. "My niece died soon after (the abortion) when she was 18 days old, and we got to grieve at her grave," Jane said.

"I've got nothing. There is absolutely no recognition of my child. Teenagers need to be told of the consequences of abortion. The message is: 'Don't worry, you can get an abortion and you'll be fine the next day.' But you won't be."

Reprinted with permission from the Sunday Herald Sun, April 30, 2000, Melbourne, Australia.

The book "Giving sorrow words" may be borrowed from the Action Life resource centre.

French Study Finds Strong Evidence 

By Randall K. O'Bannon, Ph.D.,
NRL-ETF Director of Education & Research

In 2003, when pro-life Ob-Gyn Byron Calhoun and researcher Brent Rooney published their summary of 49 studies that showed having an abortion increased the risk of subsequent prematurity in the Journal of American Physicians and Surgeons [1] the world didn't give the subject much attention. Now, with the publication of a major study coming out of France in the British Journal of Obstetrics and Gynecology[2] solidly confirming the link between abortion and subsequent premature births, the evidence and the implications will be harder to ignore.

The study, titled "Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study," covered about one-third of all premature births occurring in France in 1997. Dr. Caroline Moreau of INSERM, France's National Institute of Health and Medical Research, and colleagues examined the records for 1,943 very preterm births (born between 22 and 32 weeks), 276 moderately preterm births (born at 33-34 weeks), and a comparison group of 618 full-term births.

The conclusion the French research team reached is that women with a history of induced abortion had a 50% higher risk of having a very preterm delivery than women who had not aborted. The risk was 70% higher for delivering a baby at 22 to 27 weeks gestation, a category which researchers call "extremely preterm deliveries." (This can be confusing unless you understand that the "extremely preterm birth" category is a subset of the larger "very preterm birth" category: 22-32 weeks.)

The idea that abortion might have an impact on future pregnancies is logical enough. Abortion involves not simply the destruction of the unborn child, but an aggressive assault on the woman's reproductive organs.

Any injury, even if undetectable at the time of the abortion, might have consequences when that woman becomes pregnant in the future. In other words, more than one child may die from the original abortion.

Results were even more striking when researchers looked at the association between abortion and specific causes of subsequent very preterm delivery (22-32 weeks).

There was no observable connection between having an abortion and having a subsequent very preterm delivery that is due to high blood pressure, a common cause of prematurity. However, there was a substantial increased risk of premature birth causes that could conceivably be tied to infections or injuries brought on by what the authors refer to as the "mechanical processes" of abortion.

For example, the study showed a 40% increased risk of a very premature birth (22-32 weeks) caused by placental abruption (separation of the placenta from the uterine wall, accompanied by hemorrhage) and 140% increased risk of very premature birth tied to placenta previa (in which the pregnancy implants low in the uterus, partially or completely covering the cervical opening, which can involve bleeding in the third trimester).

The increased risk of subsequent extremely preterm births (22 to 27 weeks) for women who have had an abortion was even greater. Risk of placental abruption in these cases was 50% greater, while the risk of placenta previa was 310% higher!

There were also significant increases in risk (70%-120%) associated with other common causes of preterm birth, such as fetal growth restriction, prematurely ruptured membranes, and the early onset of labor.

The significance of these findings cannot be overstated. Babies have survived and thrived even when born as early as 22 or 23 weeks old, but generally speaking, the earlier the baby is born, the greater the risk to the life and health of both mother and child.

The researchers say that their findings, along with those of similar studies, "all suggest that induced abortion could produce cervical and uterine abnormalities, responsible for an increased risk of subsequent preterm delivery."

It has been speculated elsewhere that damage to the endometrium during aggressive curettage may prevent the embryo from implanting in its normal place in the upper uterine wall, leading to placenta previa or placental abruption.

Researchers speculate that forced or mechanical dilation of the cervix in abortion may lead to cervical incompetence (so that the uterus fails to hold the child in place), which may increase the risk of upper genital tract infections. Generally, the authors say, abortion may bring about the "revival of local infections processes caused by surgery," itself believed to be a risk factor for premature rupture of the membranes.

Pro-lifers have long made the point that every abortion has at least two victims - - the innocent child, who loses his or her life, and the mother, who is often emotionally scarred and possibly physically damaged. This new evidence demonstrates that abortion may not only claim those immediate victims, but may reach into the future to strike a woman's later offspring.

Turns out that Calhoun and Rooney were really onto something after all.

NOTES:
1. See our report "Abortion Linked to Subsequent Premature Births" on Calhoun and Rooney's article in the July 2003 NRL News.
2. Caroline Moreau, et al., "Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study," British Journal of Obstetrics and Gynecology, 112 (April 2005): 430-37.

First published in National Right to Life News. Reprinted in Action Life News summer 2005, with permission

By Amy R. Sobie and David C. Reardon, Ph.D.

In both Canada and the United States, about 20 percent of all abortions taking place in are performed on teens.(1) Teenage abortion has been linked to a number of physical and psychological problems, including drug and alcohol abuse,(2) suicide attempts and suicidal ideation,(3) and other self-destructive behaviors.

Compared to women who abort at an older age, women who abort as teens are significantly more likely to report more severe emotional injuries related to their abortions.(4) This finding is supported by the fact that women who aborted as teens participate in disproportionately large numbers in post-abortion counseling programs.(5) In the WEBA study of post-abortive women, for example, more than 40 percent of the women had been teenagers at the time of their abortions.(6)

The Psychological Risks

Compared to women who have abortions in adulthood, teens who abort:

• Are two to four times more likely to commit suicide.(7)

• Are more likely to develop psychological problems.(8)

• Are more likely to have troubled relationships.(9)

• Are generally in need of more counseling and guidance regarding abortion.(10)

• Are nearly three times more likely to be admitted to mental health hospitals than women in general.(11)

Studies have shown that the major factors in pregnancy decision making among teens are the attitude of the teen's parents, the baby's father, and her peers; the personality of the teen herself; and the cultural and public policy attitudes toward abortion by which she is surrounded.(12) Compared to older women, teens are more likely to abort because of pressure from their parents or sexual partners,(13) putting them at higher risk for adverse psychological effects after abortion.

Teens are also more likely to report having wanted to keep the baby, higher levels of feeling misinformed in pre-abortion counseling, less satisfaction with abortion services and greater post-abortion stress.(14) They consider the abortion procedure itself to be stressful and associated with feelings of guilt, depression and a sense of isolation.(15) Researchers have also found that reports of more severe pain during abortion among younger women are linked to greater levels of anxiety and fear prior to the abortion.(16)

Younger women have a more difficult time adjusting to their abortions. One study found that teenage aborters were more likely to report severe nightmares following abortion and to score higher on scales measuring antisocial traits, paranoia, drug abuse and psychotic delusions than older aborters. Teens were also more likely to use immature coping strategies such as projection of their problems onto others, denial or "acting out" than older women--strategies researchers speculate might become permanent.(17)

Replacement Pregnancies

Another study found that less than one fourth of teens were able to achieve a healthy psychological adaptive process after their abortions, and many continued to reenact their trauma through a cycle of repeat pregnancies and abortions.(18) One study found that on average, 59 percent of teens who had experienced a pregnancy loss--generally due to induced abortion--become pregnant again within 15 months.(19) In another study, 18 percent of teenage abortion patients had become pregnant again within two years.(20)

Repeat pregnancies are a symptom of young women "acting out" unresolved abortion issues and the desire to "replace" the lost pregnancy with another child. Unfortunately, "replacement babies" are often aborted because the woman faces the same pressures as she did the first time, and sometimes even more. For example, a New York City study found that teens who had one previous abortion were four times more likely to abort their current pregnancy than girls experiencing their first pregnancy.(21) Another study of teen abortion in Los Angeles found that 38 percent of the teens had undergone an earlier abortion and 18 percent had undergone two abortions in the same year.(22)

Sometimes a teen who has been especially traumatized will choose abortion as a form of self-punishment or as an unconscious attempt to resolve her trauma by continually repeating it. In other cases, she may be hoping to continue her pregnancy but will feel pressured by her parents or partner to submit to an abortion as "what is best for everyone." In one heart-wrenching example, a teenage girl reported that she was forced by her mother to abort four times before she was finally able to insist on keeping her fifth baby.(23)

The Physical Risks

Teenage abortion patients are up to twice as likely to experience cervical lacerations during abortion compared to older women.(24) This increased risk is thought to be due to the fact that teens have smaller cervixes which are more difficult to dilate or grasp with instruments.

Teens are also at higher risk for post-abortion infections such as pelvic inflammatory disease (PID) and endometritis (inflamation of the uterus), which may be caused either by the spread of an unrecognized sexually transmitted disease into the uterus during the abortion, or by micro-organisms on the surgical instruments which are inserted into the uterus.(25) Researchers believe that teens may be more susceptible to infections because their bodies are not yet fully developed and do not produce pathogens that are found in the cervical mucus of older women and which can protect them from infection.(26)

Other studies have shown that young women who have had PID previously or who have not had a previous full-term birth are more vulnerable to post-abortion infections.(27) In addition, because teens are less likely than adults to take prescribed antibiotics or follow other regimens for the treatment of medical problems such as infection, they are at greater risk for infertility, hysterectomy, ectopic pregnancy and other serious complications.(28)

Because teens are more likely to abort their first pregnancy, they face other risks as well.(29) For instance, research has shown that an early full term birth can reduce a woman's risk of breast cancer, but that induced abortion of a first pregnancy carries a 30 to 50 percent increased risk of breast cancer.(30) In addition, aborting teens lose the protective effect of having a full-term pregnancy at a younger age, which reduces breast cancer risk.

Complications of Late-Term Abortions

The Centers for Disease Control has reported that 30 percent of teenage abortions occur at or after 13 weeks gestation, compared to only 12 percent of abortions overall.(31) The high rate of late-term abortions among teens is a symptom of how they feel trapped into abortions that they cannot evade.

Women who undergo late-term abortions often delay having the abortion precisely because (1) they have mixed feelings about the decision or feel less satisfied with it, (2) they have religious or moral objections to abortion, or (3) they have a more favorable attitude toward the unborn baby than women who have abortions in the first trimester.(32) Greater ambivalence about abortion increases the likelihood that women will resist advice and pressure from others to abort for a longer period of time, hoping with each passing week that more support for keeping the baby will materialize.

In this regard, polls have consistently found that more teens have pro-life or anti-abortion attitudes than do older women, which may help to explain the much higher late-term abortion rate among teens. No doubt another factor is that teens are more likely to conceal their pregnancies, either out of shame or in an effort to avoid being pressured into an unwanted abortion. After all, many teens know well in advance that their parents or boyfriends will support only one choice: abortion. But teens who conceal their pregnancies are never truly safe from the pressure to abort. Since abortion is legal during all nine months of pregnancy, it's never too late for parents or others to begin pressuring a girl into an abortion once her pregnancy is discovered or revealed.

Late-term abortions, and all of the factors related to ambivalence--such as delay, concealment of the pregnancy, and feeling pressured to abort--are significantly associated with more severe emotional and psychological problems after abortion.(33) Teens who abort in the second and third trimester also face a greater risk of physical complications, including higher rates of endometritis,(34) intrauterine adhesions, PID, cervical incompetence, subsequent miscarriages and ectopic pregnancies, rupture of the uterus and death.(35) In addition, dilation and extraction abortions, frequently used in the second trimester, are associated with low birth weight in later pregnancies,(36) which can cause various health and developmental problems for the baby, including cerebral palsy.(37)

Conclusion

The pro-abortion Alan Guttmacher Institute estimates that approximately 40 percent of teenage abortions take place without parental involvement.(38) As a result, these teens' parents have no advance warning about the physical or emotional complications their children may experience. When the abortion causes subsequent emotional reactions that are not understood--such as depression, anger, and substance abuse--parents may react with anger and confusion, exacerbating the problems of the teen and her family.

The cost of such concealment can be dreadfully high. Both 16-year-old Erica Richardson of Maryland and 13-year-old Dawn Ravanell of New York died from complications after they had abortions without telling their parents.(39) Sandra Kaiser, a 14-year-old St. Louis girl with a history of psychiatric problems, committed suicide three weeks after her half-sister took her for an abortion without telling Sandra's mother.(40)

As shown in this brief literature review, numerous studies have found that, compared to older women, younger women--especially adolescents--are at significantly higher risk of physical and psychological complications following abortion. But this information is not generally known by the public, and certainly not by the parents who pressure their daughters into abortions.

In many of these cases, the parents truly believe they are helping to protect their daughter's future. They have no idea that they are subjecting her to a physical and psychological trauma that will forever scar her life. 

Abortion is fraught with dangers and risks, especially for younger women who are at greater risk of suffering both physical and psychological complications. 

Notes:

1. L.M. Koonin et. al., "Abortion Surveillance United States, 1996, Centers for Disease Control," MMWR, 48(SS4):1, July 30, 1999.

1. Statistics Canada., "Induced Abortion Statistics," 2005 (rate is 16.88% for 2005) 

2. H. Amaro, et al., "Drug use among adolescent mothers: profile of risk," Pediatrics, 84:144-150, 1989.

3. B. Garfinkel, et al., "Stress, Depression and Suicide: A Study of Adolescents in Minnesota," Responding to High Risk Youth (University of Minnesota: Minnesota Extension Service, 1986)

4. W. Franz and D. Reardon, "Differential Impact of Abortion on Adolescents and Adults," Adolescence, 27(105):172, 1992.

5. T. Strahan, "Differential Adverse Impact of Abortion on Teenagers Who Undergo Induced Abortion," Assoc. for Interdisciplinary Research Bulletin, 15(1):3, March/April 2000.

6. D. Reardon, "Psychological Reactions Reported After Abortion," The Post-Abortion Review, 2(3):4-8, Fall 1994.

7. M. Gissler, et. al., "Suicides after pregnancy in Finland: 1987-94: register linkage study," British Medical Journal, 313:1431-1434, 1996; and N. Campbell, et al., "Abortion in Adolescence," Adolescence, 23:813-823, 1988.

8. W. Franz and D. Reardon, op. cit..

9. J. Marecek, "Consequences of Adolescent Childbearing and Abortion," in G. Melton (ed.), Adolescent Abortion: Psychological & Legal Issues (Lincoln, NE: University of Nebraska Press 1986) 96-115.

10. J. Gold, "Adolescents and Abortion," in N. Stotland (ed.), Psychiatric Aspects of Abortion (Washington, DC: American Psychiatric Press, 1989) 187-195.

11. R. Somers, "Risk of Admission to Psychiatric Institutions Among Danish Women who Experienced Induced Abortion: An Analysis Based on National Report Linkage," (Ph.D. Dissertation, Los Angeles: University of California, 1979. Dissertation Abstracts International, Public Health 2621-B, Order No. 7926066)

12. T. Strahan, "Factors in Pregnancy Decision Making by Teenagers," Assoc. for Interdisciplinary Research Newsletter, 7(4):1, Jan./Feb. 1995.

13. P. Barglow and S. Weinstein, "Therapeutic Abortion During Adolescence: Psychiatric Observations," J. of Youth and Adolescence, 2(4):33,1973.

14. W. Franz and D. Reardon, op. cit.

15. F. Biro, et al., "Acute and Long-Term Consequences of Adolescents Who Choose Abortions," Pediatric Annals, 15(10):667-672, 1986.

16. E. Belanger, et. al., "Pain of First Trimester Abortion: A Study of Psychosocial and Medical Predictors," Pain, 36:339; and G.M. Smith, et. al., "Pain of first-trimester abortion: Its quantification and relationships with other variables," American Journal Obstetrics & Gynecology, 133:489, 1979.

17. N. Campbell, op. cit.

18. Horowitz, "Adolescent Mourning Reactions to Infant and Fetal Loss," Soc. Casework, 59:551, 558-559, 1978.

19. S.R. Wheeler, "Adolescent Pregnancy Loss," in J.R. Woods, Jr. and J.L. Woods (eds.), Loss During Pregnancy or the Newborn Period (Publisher, 1997).

20. H. Cvejic et. al., "Follow-up of 50 adolescent girls 2 years after abortion," Canadian Medical Assoc. Journal, 116:44, 1997.

21. T. Joyce, "The Social and Economic Correlates of Pregnancy Resolution Among Adolescents in New York by Race and Ethnicity: A Mulitvariate Analysis," American J. of Public Health, 78(6):626, 1988.

22. R. Bobrowsky, "Incidence of Repeat Abortion, Second Trimester Abortion, Contraceptive Use and Illness Within a Teenage Population," Unpublished Doctoral Thesis, 1996.

23. C. Nykiel, "Nobody Told Me I Could Cry," The Post-Abortion Review, 7(1):1-2, Jan-March 1999.

24. R.T. Burkman, et. al., "Morbidity Risk Among Young Adolescents Undergoing Elective Abortion," Contraception, 30(2):99, 1984; and K.F. Schulz, et. al., "Measures to Prevent Cervical Injury During Suction Curettage Abortion," The Lancet, 1182-1184, May 28, 1993 .

25. R.T. Burkman, et. al., "Culture and treatment results in endometritis following elective abortion," American J. Obstet. & Gynecol., 128:556, 1997; and D. Avonts and P. Piot, "Genital infections in women undergoing induced abortion," European J. Obstet. & Gynecol. & Reproductive Biology, 20:53, 1985.

26. W. Cates, Jr., "Teenagers and Sexual Risk-Taking: The Best of Times and the Worst of Times," Journal of Adolescent Health, 12:84, 1991.

27. J.L. Sorenson and I. Thronov, "A double blind randomized study of the effect of erythromycin in preventing pelvic inflammatory disease after first trimester abortion," British J. Obstet. & Gynecol., 99:434, 1992.

28. "Teenage Pregnancy: Overall Trends and State-by-State Information," Report by the Alan Guttmacher Institute.

29. K.D. Kochanck, "Induced Terminations of Pregnancy, Reporting States 1988," Monthly Vital Statistics Report, 39(12): Suppl. 1-32, April 30, 1991.

30. J. Brind, et. al., "Induced abortion as an independent risk factor for breast cancer: a comprehensive review and analysis," J. Epidemiology & Community Health, 50:481, 1996.

31. Strahan, "Differential Adverse Impact on Teenagers Who Undergo Induced Abortion," op. cit..

32. T. Strahan, "Psycho-Social Aspects of Late-Term Abortions," Assoc. For Interdisciplinary Research Bulletin, 14(4):1, 2000.

33. D. Reardon, Making Abortion Rare (Springfield, IL: Acorn Books, 1996) 162.

34. R. T. Burkman, et. al, "Culture and treatment results in endometritis following elective abortion," op cit..

35. S. Lurie and Z. Shoham, "Induced Midtrimester Abortion and Future Fertility: Where Are We Today?" International J. of Fertility, 40(6):311, 1995.

36. H.K. Atrash and C.J. Hogue, "The effect of pregnancy termination on future reproduction," Baillieres Clinic Obstet. & Gynecol., 4(2):391, 1990.

37. B. Rooney, "Is Cerebral Palsy Ever a Choice?" The Post-Abortion Review, 8(4):4-5, Oct.-Dec. 2000.

38. "Teenage Pregnancy: Overall Trends and State-by-State Information," op. cit.

39. K. Sherlock, Victims of Choice (Akron: Brennyman Books, 1996) 31-32, 40-41.

40. R. Kerrison, "Horror Tale of Abortion," New York Post, Jan. 7, 1991.

Originally printed in The Post-Abortion Review, Vol. 9(1), Jan.-March 2001.

Copyright 2001, Elliot Institute, PO Box 7348, Springfield, IL 62791-7348.

Additional material is posted at www.afterabortion.org. If you, or someone you know, is suffereing from an abortion experience call 1-800-665-0570 for a referral or to receive confidential, compassionate help to healing and recovery. 

By Ian Gentles

Earlier this year a great deal of anxiety was provoked in the media by the publication of a medical report on the long-term consequences of hormone replacement therapy for women. Among the several negative effects of HRT, the one that caused the greatest distress was the increased risk-about 25 per cent-of breast cancer.

The incidence of breast cancer among women has certainly risen alarmingly in the past three decades. Many explanations for this rise have been suggested: a more polluted environment, changes in diet, smoking, the postponement of childbearing, the contraceptive pill, and other drug therapies.

But the media have paid almost no attention to the many studies that have documented a significantly higher incidence of breast cancer among women who have abortions, in particular those who abort their first pregnancy before the age of 20. At least 27 studies in ten countries have discovered an increased risk of 30 per cent-significantly higher than the increased risk of 25 per cent reported in the single study of the effects of HRT.

Strange to say, the authors and sponsors of several of these studies have shied away from the implications of their findings. The National Cancer Institute in the U.S., for example, sponsored a major study which showed a 36 per cent increased risk (rising to a disturbing 50 per cent among women under 20 who abort their first pregnancy) of breast cancer among women who undergo abortions. In fact, given that young women who carry their first pregnancy to term reduce their chances of breast cancer by 30 per cent, the consequences are even more dramatic. The lifetime chances of a woman in North America being diagnosed with breast cancer are currently about ten per cent. A woman who has a child before age 20 has a seven per cent chance. On the other hand, if she aborts that first early pregnancy, she more than doubles her lifetime chances to fifteen per cent. Yet the National Cancer Institute, and other establishment voices such as the prestigious New England Journal of Medicine stoutly continue to deny that there is any link between abortion and breast cancer.

Curiously, the establishment on the other side of the ocean is much less reluctant to recognize the link. In April 2000, Britain's Royal College of Obstetricians and Gynecologists acknowledged that studies demonstrating the abortion-breast cancer link "could not be disregarded."1 Writing in the London Times a year later, Dr. Thomas Stuttaford declared that "an unusually high proportion" of the women diagnosed with breast cancer in the U.K. each year "had an abortion before eventually starting a family. Such women are up to four times more likely to develop breast cancer."2

There are solid physiological reasons for the association between induced abortion and the later development of breast cancer which have to do with the hormonal effects of pregnancy on a woman's breast tissue. A surge of the hormone oestradiol at conception reaches twentyfold in the first trimester, triggering an explosive growth of breast tissue-a period when breast cells are most likely to be affected by carcinogens. When a woman completes her first full pregnancy, further hormonal changes propel these newly produced breast cells through a state of differentiation, a natural maturing process that greatly reduces the risk of future breast cancer.3 An early, abrupt termination of pregnancy by abortion arrests this process before the cancer-reducing evolution of hormone release can occur, leaving a large population of dangerously-stimulated breast tissue cells in place, enormously raising future cancer risk. On the other hand, ". . . an early first, full-term pregnancy would provide the greatest protection against breast cancer by drastically reducing, early on, the presence of undifferentiated and hence vulnerable breast cells, thereby decreasing the risk of subsequent transformation."4 A fascinating animal study supports this line of reasoning. Two groups of rats were exposed to a chemical carcinogen before mating. The group that carried a first pregnancy to term developed mammary tumours at a rate of six per cent. The group whose pregnancies were aborted, however, developed mammary tumours at an astounding rate of 78 per cent.5
These are among several dramatic findings dredged up from the obscurity of scientific journals and presented in Women's Health After Abortion: The Medical and Scientific Evidence, a new book I co-authored with Elizabeth Ring-Cassidy.6 In it, we review and summarize over 500 studies which have appeared in medical and professional journals, most of them over the past twenty years. What follows here is a brief overview of our work.

Cancers of the cervix, ovaries and rectum
Research in this area is in its early stages, but a few studies from the past decade point to a link between abortion and subsequent cancers of the reproductive system, as well as colorectal cancer. Cervical cancer in particular seems to be directly associated with induced abortion. Studies of cancer of the ovary have presented conflicting evidence. A strong association has been discovered between abortion and cancer of the rectum. What is remarkable is that with the increase in cancers of the breast and reproductive system in women over the past thirty years, there has as yet been so little interest in investigating the link with induced abortion. Despite the overwhelming weight of the studies pointing to such a link, their conclusions have been generally ignored by the research establishments in North America. The rationale for this may be that for some it is more important for abortion to remain accessible than for women to be informed about a clear threat to their health. Thus, the politicized and controversial nature of the subject, and the desire of some powerful groups to keep abortion "safe, simple, and easily available," have militated against the objective consideration of data pointing strongly to a link between abortion and various cancers.

Maternal mortality
In both Canada and the U.S. there is a general and systematic underreporting of maternal deaths, whether from abortion, pregnancy, or during delivery. Not least among the reasons for this is the fact that more and more abortions are now performed in free-standing clinics. A woman whose post-abortion condition is life threatening generally goes to a hospital, not back to the clinic. The attending emergency room doctor may not record a subsequent death as resulting from an abortion. The practice of coding the immediate rather than the underlying cause of death also causes underreporting: an induced abortion may result in bleeding, embolism, cardiac arrest or infection, or it may lead to a subsequent ectopic pregnancy. But the death certificate of a woman who dies from these conditions may make no reference to abortion.
A recent, large-scale Scandinavian study found that within one year of the end of a pregnancy, women who had induced abortions suffered a mortality rate that was almost four times greater than that for women who delivered their babies. And their rate of suicide was six times greater.7 A recent study in Wales found that women who had induced abortions were 2.25 times more likely to commit suicide than women admitted for normal delivery.8 A large-scale California study just recently published reported similar findings. These studies, using record linkage and involving many hundreds of thousands of cases, authoritatively refute the oft-repeated fiction that induced abortion is safer for women than giving birth.

Ectopic pregnancy
While overall health has generally improved in the past century, there has been a disturbing rise in ectopic pregnancies. Between 1970 and 1990 they doubled, trebled or quadrupled in frequency, depending on the country, so that they now account for two per cent of all pregnancies in the areas studied. The rise of ectopic pregnancy coincides almost exactly with the steep rise in the frequency of induced abortion during the same period. Studies from Italy, Japan, Yugoslavia and the U.S. have documented a much higher risk of ectopic pregnancy among women who have had one or more abortions. Yet the authors of an American study that uncovered a 160 per cent increased risk arrived at the strange conclusion that abortion "does not carry a large excess risk" of ectopic pregnancy.9 This is one of many examples in the literature of abortion researchers making statements in the abstracts or conclusions of their articles that flatly contradict their findings.
Uterine perforations, pelvic inflammatory disease, and infertility
Among the other risks involved in surgical abortion are uterine perforation, uterine adhesions, retained fetal fragments and infections that lead to pelvic inflammatory disease (PID). PID is now epidemic in Canada and much of the rest of the world. Nearly 100,000 women contract it each year in Canada alone. The disease is difficult and expensive to treat, and causes infertility in women. The link between PID and abortion is well established in the sense that women who undergo surgical abortions suffer a much higher incidence of PID afterwards. The link is even stronger among women who have had two or more abortions.10

Pain and abortion
Some abortion clinics attempt to reassure their patients that the pain they are about to suffer will resemble nothing greater than heavy menstrual cramps. A large study conducted in Montreal paints a different picture. Pain is the most subjective of experiences, yet when the pain scores of these abortion patients were checked against other acute and chronic pain syndromes, "they were found to be higher than fractures, sprains, neuralgia or arthritis, and equal to those of amputees experiencing phantom limb pain and patients with cancer." When it comes to mental pain, abortion is often touted as bringing relief from the depression caused by pregnancy. Not necessarily so. The Montreal study found that 50 per cent of the women who had high depression scores "remained clinically depressed and anxious two weeks after the procedure."11 

Chemical Abortions

Chemical or drug-induced abortions have been hailed in some quarters as a less traumatic solution to an unwanted pregnancy than surgical abortion. Yet these are not without their own difficulties. A variety of studies have found failure rates ranging from 6 to 45 per cent, necessitating a second, surgical abortion. There are unpleasant side effects, including prolonged bleeding, diarrhea, fevers and nausea, as well as the inconvenience of several visits to the doctor and the lack of immediate confirmation of the success of the procedure. Typically, the abortion is not triggered until twenty-four days after the drug has been administered. Furthermore, the pain is reported to be even greater than surgical abortion.12

Risks to future children
The most recent studies point to an approximately 85 per cent increase in premature (or "very preterm," meaning less than 33 weeks' gestation) births to women who have had a previous induced abortion. This risk increases sharply with every additional abortion that a woman undergoes.13 Premature infants suffer a very high incidence of disability. Their rate of cerebral palsy for example, is thirty-eight times greater than that of the general population. Induced abortion, therefore, has appalling implications for women who subsequently wish to bear a child. It is the direct cause of many thousands more cases of cerebral palsy in North America than otherwise would have occurred.

Depression, guilt and low self-esteem
Abortion is frequently touted as the obvious answer to a woman's emotional distress at the discovery that she is pregnant. Research suggests that this is a glib answer. Far from being a "quick fix," abortion exacerbates problems such as depression, grief or low self-esteem. In general, women who are suffering from psychological or psychiatric disorders before they undergo an abortion will continue to experience these difficulties afterwards, sometimes in greater measure.14 A very large-scale study in California, using record linkage, found that over a four-year period women who aborted had a 72 per cent higher rate of psychiatric admission to hospital than women who delivered their babies.15

Repeat abortions are a growing phenomenon in both Canada and the U.S., where they constitute forty and fifty per cent respectively of all abortions. Women who undergo the experience of two or more abortions also experience lowered self-esteem coupled with a lack of self-respect. In the words of one researcher, "rather than being a relief, an abortion may be additional proof of their worthlessness."16
Many women have mixed feelings about their decision to abort. It has been shown that ambivalence about having an abortion entails a greater likelihood of suffering negative emotional consequences such as depression and guilt. Ambivalent women more often state that it was their partner who decided on the abortion. Only a minority initially wanted it. The discovery that many women are pressured into abortion by men is not surprising if we bear in mind that opinion surveys have consistently found more women opposing abortion than men. This is because abortion often suits men's convenience much better than it does women's.

Adolescents

Teenagers who abort are at greater risk than older women for later psychological and physical problems. They suffer lower self-esteem, absence of affect and greater symptoms of depression than those who are either not pregnant or carry their pregnancies to term. The most striking evidence of this is a major American study which found a six to tenfold increase in suicide attempts among adolescent girls who had had an abortion at any time in their lives.17
The higher suicide rate also applies, though less dramatically, to older women. The high rate of post-abortion suicide has never been taken into account by those who claim that abortion is a safer procedure than childbirth.

Religion and healing
Women who are religious are very likely to experience regret or guilt after abortion. The simplistic solution sometimes offered is that women should abandon their religion or switch to one that doesn't induce guilt. Either that, or the major religions that frown on abortion-Judaism, Islam, Christianity-should change their positions. In contrast to this advice, it has been found that some of the most interesting efforts to promote women's emotional healing after abortion involve the harnessing of their religious spirituality. Initiatives such as Project Rachel put forgiveness at the heart of their therapy: forgiveness of everyone involved in the woman's abortion, forgiveness of herself, and finally, discernment of how to move on and make a positive impact on her world.18
Grief therapy and abortion for genetic reasons
An increasing number of pregnancies are aborted because prenatal tests have shown the fetus to be defective in some way. Interestingly, there is no attempt to deny or minimize the distress and grief that often accompany these types of abortion. The loss of a defective fetus is recognized as being equivalent to the loss of a child. This legitimizes the use of humanizing terms. It is permissible to grieve. Researchers drop the word "fetus" and write instead about "the baby's abnormality," the "death of the baby," "guilt over having killed the baby," "saw the child," "lost baby," and so on. Why this starkly different approach? Apparently it is because a pregnancy aborted for genetic reasons is assumed to be, in the beginning at least, a wanted pregnancy. Yet it is known that depressive symptoms following pregnancy loss are unrelated to the woman's attitude towards the pregnancy. In other words, the woman who rejects her pregnancy is just as likely to grieve her loss as the woman who wanted to be pregnant.19

The effect on siblings
Almost never considered in the abortion decision is its impact on other children in a family. Children do not understand the socially-constructed distinction between fetus and baby. If they find out about their parents' decision to abort a pregnancy, they undergo marked and disturbing reactions. "Abortion can produce a deep, subtle (and often permanent) fracture of the trusting relationship that once existed between a child and parent."20 Furthermore, the knowledge that a potential sibling has been aborted can lead to behavioral disturbances, emotional insecurity, fears of abandonment, and delayed grief that surfaces years later.
The effect on men
Men are generally more favorable to abortion than women. Yet the stark fact is that men have no rights whatever when it comes to abortion. Their only options are to support the woman emotionally if she aborts, or support her financially if she chooses to bear the child. Thus for men abortion can be "a private exercise in powerlessness." Many experience grief at the loss of the child they have fathered, and may have a psychological need for recognition of their mourning. This could also be a reason why so many men abandon the relationship after an abortion.

Interpersonal relationships

There is no doubt that abortion results in worsening relationships between women and those who are close to them. The rate of marital breakup and relationship dissolution is anywhere from 40 to 75 per cent after abortion. Couples commonly experience reduced libido. A previous abortion leads to more post-partum depression following a subsequent delivery. There is less bonding, less touching and less breast-feeding of the new baby. More than one study has found that women who abort are also likelier to abuse their other children. Conversely, people who have been abused are more likely to have an abortion. Far from ending the problem of child abuse, abortion appears to have made it worse.22

* * * * *
Much post-abortion research is conducted by those committed to preserving unrestricted access to induced abortion. Their tendency is to cite only the work of those who share their political outlook on the question. Most post-abortion research is short-term, with the result that long-term consequences tend to be ignored. Many women, especially those who abort late in pregnancy, are unwilling to participate in follow-up studies. Finally, in North America, unlike in European and other countries, there is a pronounced bias against reporting bad news about induced abortion.
In a surprising number of North American studies data on abortion are downplayed or omitted from the discussion or conclusion sections of the paper. Here are a few examples from the highly contentious field of breast cancer and abortion. In 1995 Lipworth and colleagues found that there was a 100 per cent increased risk of breast cancer for women whose first pregnancy ended in abortion. In the discussion section the author downplayed this increase as "at most statistically marginal."23 In another study Ewertz and Duffy found that induced abortions were associated with an almost fourfold increased risk of breast cancer. In the discussion section this finding was not commented upon, the authors confining themselves to the observation that "pregnancies must go to term to exert a protective effect against breast cancer."24 A study by Daling and colleagues found a 2.5 risk-in other words a 150 per cent increase in the risk of breast cancer for women whose first pregnancy was aborted before age eighteen-but in their Discussion Section said that their findings "give only slight support to the hypothesis that there is an increase in breast cancer incidence among women of reproductive age."25

The investigation of abortion's after-effects is also bedeviled by coding and diagnostic problems. International Disease Classification codes prevent cross-referencing between ectopic pregnancy and induced abortion, even though a clear link has been demonstrated. Pelvic inflammatory disease or Asherman's Syndrome (intra-uterine adhesions, a complication of surgical curettage) may arise from an abortion but not be identified in that way either.
All the adverse effects of abortion put together affect perhaps twenty per cent of the women who undergo the procedure. Though a minority, they are a substantial one. The question that Women's Health After Abortion raises is: Are women entitled to know about the risks? Or are those who draw attention to them merely sowing unnecessary despondency and alarm, as some would claim? Fortunately the courts have already established that informed consent must be an essential ingredient of good patient care. Elective procedures-and induced abortion is an elective procedure-require from the physician a greater degree of disclosure than emergency procedures. Common but minor risks must be disclosed. Extremely rare risks must also be disclosed if they have serious or fatal consequences.
I co-authored this study because of a conviction that the increased risks associated with induced abortion-breast cancer, death, sterility, ectopic pregnancy, pelvic inflammatory disease, emotional distress, harm to subsequent children, the impact on partners and other children-are serious enough to merit dissemination beyond the pages of professional journals. If women have the right to choose, surely they also have the right to make their choice an informed one.

NOTES
1. Royal College of Obstetricians and Gynaecologists. Evidence-based Guideline no. 7: The Care of Women Requesting Induced Abortion. (London, Apr. 2000).
2. The Times (17 May 2001), p. 8.
3. J.L. Kelsey, "A review of the epidemiology of human breast cancer." Epidemiologic Reviews. 1979; 1:74-109.
4. N. Krieger. "Exposure, susceptibility, and breast cancer risk." Breast Cancer Research and Treatment 1989 July (13:3), 205-223.
5. J. and I.H. Russo. "Susceptibility of the mammary gland to carcinogenisis. II. Pregnancy interruption as a risk factor in tumor incidence." American Journal of Pathology 1980; 100 (2): 497-512.
6. Elizabeth Ring-Cassidy and Ian Gentles. Women's Health after Abortion: The Medical and Psychological Evidence. Toronto: de Veber Institute for Bioethics and Social Research, 2002.
7. M. Gissler et al. "Suicides after Pregnancy in Finland, 1987-94: Register Linkage Study." British Medical Journal 1996 Dec. 7; 313(7070): 1431-4; M. Gissler et al. "Pregnancy-Associated Deaths in Finland, 1987-94-Definition Problems and Benefits of Record Linkage." Acta Obstetricia et Gynecologica Scandanavica 1997 August; 76(7): 651-7.
8. C.L. Morgan et al. "Suicides after pregnancy. Mental health may deteriorate as a direct effect of induced abortion." British Medical Journal 1997 March 22; 314 (7084); 902-3.9. J.R. Daling et al. "Ectopic pregnancy in relation to previous induced abortion." Journal of the American Medical Association 1985 February; 253 (7) 1005-8.
10. J.L. Sorenson et al. "A double-blind randomized study of the effect of erythromycin in preventing pelvic inflammatory disease after first-trimester abortion." British Journal of Obstetrics and Gynaecology 1992 May; 99(5): 436.
11. E. Belanger et al. "Pain of the first trimester abortion: a study of psychosocial and medical predictors." Pain 1989 March; 36(3): 339-50.
12. M.D. Crenin. "Methotrexate for abortion at 
13. P.V. Ancel. "Very and moderate preterm births: are the risk factors different?" British Journal of Obstetrics and Gynaecology 1999 Nov.; 106(11):1162-70.
14. J.A. Rosenfeld. "Emotional responses to therapeutic abortion." American Family Physician 1992 January; 45(1): 137.15. J.R. Cougle et al. "Psychiatric admissions following abortion and childbirth: A record-based study of low-income women." Archives of Women's Mental Health 2001; 3(4) Supp. 2:47.
16. M. Gissler et al. "Suicides after pregnancy-authors' reply." British Medical Journal 1997 March 22; 314(7084):902-3.
17. B. Garfinkel et al. "Stress, depression and suicide: a study of adolescents in Minnesota." In Responding to High Risk Youth. Minnesota Extension Service, University of Minnesota (1986). 43-55.
18. V. Thorn. "Project Rachel: Faith in action, a ministry of compassion and caring." In Post-Abortion Aftermath, ed. M. Mannion. Kansas City, MO: Sheed and Ward, 1994: 144-63.
19. D.C. Reardon et al. "Depression and unintended pregnancy in the National Longitudinal Survey of Youth: a cohort study." British Medical Journal 2002 January 19; 324(7330): 151-2.
20. J. Carton, J. "The cultural impact of abortion and its implications for a future society." In M. Mannion, ed. Post-Abortion Aftermath. Kansas City: Sheed and Ward, 1994: 91.
21. Rue, V. "The psychological realities of induced abortion." In M. Mannion, ed. Post-Abortion Aftermath. Kansas City: Sheed and Ward, 1994, p. 24.
22. P. Ney, P. "Relationship between abortion and child abuse." Canadian Journal of Psychiatry 1993 October; 24(7): 610-20; M.I. Benedict et al. "Maternal perinatal risk factors and child abuse." Child Abuse and Neglect 1985; 9(2): 217-24.
23. L. Lipworth et al. "Abortion and the risk of breast cancer: a case-control study in Greece." International Journal of Cancer 1995 April; 61(2): 184.
24. M. Ewertz et al. "Risk of breast cancer in relation to reproductive factors in Denmark." British Journal of Cancer 1988 July; 58(1): 102.
25. J.R. Dating et al. "Risk of breast cancer among white women following induced abortion." American Journal of Epidemiology 1996 August; 144(4): 379.
Ian Gentles is research director of the deVeber Institute, and Professor of History at York University, where he teaches a seminar on human population and the family.

First published, research sponsored by the deVeber Institute for Bioethics. Reprinted with permission.

Pro-Choice Researcher Says Some Journals Rejected Politically Volatile Findings

Springfield, IL (Feb. 9, 2005) -- A study in New Zealand that tracked approximately 500 women from birth to 25 years of age has confirmed that young women who have abortions subsequently experience elevated rates of suicidal behaviors, depression, substance abuse, anxiety, and other mental problems.

Most significantly, the researchers - led by Professor David M. Fergusson, who is the director of the longitudinal Christchurch Health and Development Study -  found that the higher rate of subsequent mental problems could not be explained by any pre-pregnancy differences in mental health, which had been regularly evaluated over the course of the 25-year study.

Findings Surprise Pro-Choice Researchers

According to Fergusson, the researchers had undertaken the study anticipating that they would be able to confirm the view that any problems found after abortion would be traceable to mental health problems that had existed before the abortion.  At first glance, it appeared that their data would confirm this hypothesis.  The data showed that women who became pregnant before age 25 were more likely to have experienced family dysfunction and adjustment problems, were more likely to have left home at a young age, and were more likely to have entered a cohabiting relationship.

However, when these and many other factors were taken into account, the findings showed that women who had abortions were still significantly more likely to experience mental health problems.  Thus, the data contradicted the hypothesis that prior mental illness or other "pre-disposing" factors could explain the differences.

"We know what people were like before they became pregnant," Fergusson told The New Zealand Herald.  "We take into account their social background, education, ethnicity, previous mental health, exposure to sexual abuse, and a whole mass of factors."

The data  persistently pointed toward the politically unwelcome conclusion that abortion may itself be the cause of subsequent mental health problems.  So Fergusson presented his results to New Zealand's Abortion Supervisory Committee, which is charged with ensuring that abortions in that country are conducted in accordance with all the legal requirements.  According to The New Zealand Herald, the committee told Fergusson that it would be "undesirable to publish the results in their ‘unclarified' state."

Despite his own pro-choice political beliefs, Fergusson responded to the committee with a letter stating that it would be "scientifically irresponsible" to suppress the findings simply because they touched on an explosive political issue.

In an interview about the findings with an Australian radio host, Fergusson stated: "I remain pro-choice. I am not religious. I am an atheist and a rationalist. The findings did surprise me, but the results appear to be very robust because they persist across a series of disorders and a series of ages. . . . Abortion is a traumatic life event; that is, it involves loss, it involves grief, it involves difficulties. And the trauma may, in fact, predispose people to having mental illness."

Journals Reject the Politically Incorrect Results

The research team of the Christchurch Health and Development Study is used to having its studies on health and human development accepted by the top medical journals on first submission.  After all, the collection of data from birth to adulthood of 1,265 children born in Christchurch is one of the most long-running and valuable longitudinal studies in the world.  But this study was the first from the experienced research team that touched on the contentious issue of abortion.

Ferguson said the team "went to four journals, which is very unusual for us - we normally get accepted the first time."  Finally, the fourth journal accepted the study for publication.

Although he still holds a pro-choice view, Fergusson believes women and doctors should not blindly accept the unsupported claim that abortion is generally harmless or beneficial to women.  He appears particularly upset by the false assurances of abortion's safety given by the American Psychological Association (APA). 

In a 2005 statement, the APA claimed that "well-designed studies" have found that "the risk of  psychological harm is low."  In the discussion of their results, Fergusson and his team note that the APA's position paper ignored many key studies showing evidence of abortion's harm and looked only at a selective sample of studies that have serious methodological flaws.

Fergusson told reporters that "it verges on scandalous that a surgical procedure that is performed on over one in 10 women has been so poorly researched and evaluated, given the debates about the psychological consequences of abortion." 

Following Fergusson's complaints about the selective and misleading nature of the 2005 APA statement, the APA removed the page from their Internet site.  The statement can still be found through a web archive service, however.

Study May Have Profound Influence on Medicine, Law, and Politics

The reaction to the publication of the Christchurch study is heating up the political debate in the United States.  The study was introduced into the official record at the senate confirmation hearings for Supreme Court Justice Samuel Alito.  Also, a U.S. congressional subcommittee chaired by Representative Mark Souder (R-IN) has asked the National Institutes of Health (NIH) to report on what efforts the NIH is undertaking to confirm or refute Fergusson's findings. 

The impact of the study in other countries may be even more profound. According to The New Zealand Herald, the Christchurch study may require doctors in New Zealand to certify far fewer abortions.  Approximately 98 percent of abortions in New Zealand are done under a provision in the law that only allows abortion when "the continuance of the pregnancy would result in serious danger (not being danger normally attendant upon childbirth) to the life, or to the physical or mental health, of the woman or girl."

Doctors performing abortions in Great Britain face a similar legal problem.  Indeed, the requirement to justify an abortion is even higher in British law.  Doctors there are only supposed to perform abortions when the risks of physical or psychological injury from allowing the pregnancy to continue are "greater than if the pregnancy was terminated."  

According to researcher Dr. David Reardon, who has published more than a dozen studies investigating abortion's impact on women, Fergusson's study reinforces a growing body of literature showing that doctors in New Zealand, Britain and elsewhere face legal and ethical obligations to discourage or refuse contraindicated abortions.

"Fergusson's study underscores that fact that evidence-based medicine does not support the conjecture that abortion will protect women from ‘serious danger' to their mental health," said Reardon.  "Instead, the best evidence indicates that abortion is more likely to increase the risk of mental health problems.  Physicians who ignore this study may no longer be able to argue that they are acting in good faith and may therefore be in violation of the law."

"Record-based studies in Finland and the United States have conclusively proven that the risk of women dying in the year following an abortion is significantly higher than the risk of death if the pregnancy is allowed to continue to term," said Reardon, who directs the Elliot Institute, a research organization based in Springfield, Illinois.  "So the hypothesis that the physical risks of childbirth surpass the risks associated with abortion is no longer tenable.  That means most abortion providers have had to look to mental health advantages to justify abortion over childbirth."

But Reardon now believes that alternative for recommending abortion no longer passes scientific muster, either. 

"This New Zealand study, with its unsurpassed controls for possible alternative explanations, confirms the findings of several recent studies linking abortion to higher rates of psychiatric hospitalization. depression, generalized anxiety disorder, substance abuse, suicidal tendencies, poor bonding with and parenting of later children, and sleep disorders," he said.  "It should inevitably lead to a change in the standard of care offered to women facing problem pregnancies."

Some Women May Be At Greater Risk

Reardon, a biomedical ethicist, is an advocate of "evidence-based medicine"-a movement in medical training that encourages the questioning of "routine, accepted practices" which have not been proven to be helpful in scientific trials.  If one uses the standards applied in evidence-based medicine, Reardon says, one can only conclude that there is insufficient evidence to support the view that abortion is generally beneficial to women.  Instead, the opposite appears to be more likely. 

"It is true that the practice of medicine is both an art and a science," Reardon said. "But given the current research, doctors who do an abortion in the hope that it will produce more good than harm for an individual woman can only justify their decisions by reference to the art of medicine, not the science."

According to Reardon, the best available medical evidence shows that it is easier for a woman to adjust to the birth of an unintended child than it is to adjust to the emotional turmoil caused by an abortion.

"We are social beings, so it is easier for people to adjust to having a new relationship in one's life than to adjust to the loss of a relationship," he said.  "In the context of abortion, adjusting to the loss is especially difficult if there any unresolved feelings of attachment, grief, or guilt."

By using known risk factors, the women who are at greatest risk of severe reactions to abortion could be easily identified, according to Reardon.  If this were done, some women who are at highest risk of negative reactions might opt for childbirth instead of abortion.

In a recent article published in The Journal of Contemporary Health Law and Policy, Reardon identified approximately 35 studies that had identified statistically validated risk factors that most reliably predict which women are most likely to report negative reactions.

"Risk factors for maladjustment were first identified in a 1973 study published by Planned Parenthood," Reardon said.  "Since that time, numerous other researchers have further advanced our knowledge of the risk factors which should be used to screen women at highest risk.  These researchers have routinely recommended that the risk factors should be used by doctors to identify women who would benefit from more counseling, either so they can avoid contraindicated abortions or so they can receive better follow up care to help treat negative reactions."

Feeling pressured by others to consent to the abortion, having moral beliefs that abortion is wrong, or having already developed a strong maternal attachment to the baby are three of the most common risk factors, Reardon says.

While screening makes sense, Reardon says that in practice, screening for risk factors is rare for two reasons. 

"First, there are aberrations in the law that shield abortion providers from any liability for emotional complications following an abortion," he said.  "This loophole means that abortion clinics can save time and money by substituting one-size-fits-all counseling for individualized screening.

"The second obstacle in the way of screening is ideological. Many abortion providers insist that it is not their job to try to figure out whether  an abortion is more likely to hurt than help a particular woman. They see their role as to ensure that any woman who wants an abortion is provided one."

"This ‘buyer beware' mentality is actually inconsistent with medical ethics," Reardon said. "Actually, the ethic governing most abortion providers' services is no different than that of the abortionists: ‘If you have the money, we'll do the abortion.'  Women deserve better.  They deserve to have doctors who act like doctors. That means doctors who will give good medical advice based on the best available evidence as applied to each patient's individual risk profile."

Fergusson also believes that the same rules that apply to other medical treatments should apply to abortion. "If we were talking about an antibiotic or an asthma risk, and someone reported adverse reactions, people would be advocating further research to evaluate risk," he said in the New Zealand Herald. "I can see no good reason why the same rules don't apply to abortion."

# # #

Sources:

David M. Fergusson, L. John Horwood, and Elizabeth M. Ridder, "Abortion in young women and subsequent mental health," Journal of Child Psychology and Psychiatry 47(1): 16-24, 2006.

Tom Iggulden, "Abortion increases mental health risk: study"  AM transcript. http://www.abc.net.au/am/content/2006/s1540914.htm
Nick Grimm "Higher risk of mental health problems after abortion: report" Australian Broadcasting Corporation. 03/01/2006 http://www.abc.net.au/7.30/content/2006/s1541543.htm

Ruth Hill, "Abortion Researcher Confounded by Study" New Zealand Herald 1/5/06, http://www.nzherald.co.nz

APA Briefing Paper on The Impact of Abortion on Women, http://web.archive.org  of http://www.apa.org/ppo/issues/womenabortfacts.html

Reardon DC. "The Duty to Screen: Clinical, Legal and Ethical Implications of Predictive Risk Factors of Post-Abortion Maladjustment." The Journal of Contemporary Health Law & Policy. 2003 Winter;20(1):33-114.

First published on www.afterabortion.org by the Elliot Institute, PO Box 7348, Springfield, IL 62791-7348

Additional material is posted at www.afterabortion.org.

Is abortion safer than childbirth?

Studies reveal Maternal Death Rate after Abortion Three to Four Times Higher than from childbirth

A 2004 study of pregnancy-associated deaths published in the prestigious American Journal of Obstetrics and Gynecology found that the mortality rate associated with abortion is 2.95 times higher than that associated with pregnancies carried to term. The study included the entire population of women 15 to 49 years of age in Finland between 1987 and 2000. The researchers linked birth and abortion records to death certificates. Non-pregnant women had 57.0 deaths per 100,000, compared to 28.2 for women who carried to term, 51.9 for women who miscarried, and 83.1 for women who had abortions. 1

A record-based, government-funded study of 9,192 Finnish women published in 1997 in a Scandinavian obstetrics journal revealed that women who have an abortion are four times more likely to die from its psychological impact than those who have given birth. The causes of death listed for the women who died within a year of their last pregnancy were suicide, injuries attributed to accident, homicide, traumatic physical injuries which were listed as "unclear violent deaths", and natural causes. The data from this study seems to suggest that induced abortion produces an unnatural physical and psychological stress on women that can result in a negative impact on their general health. 2

A study by New Zealand's Dr. David Fergusson, published in the January 2006 Journal of Child Psychology and Psychiatry, found that women who had abortions were at higher risk for suicide, major depression, anxiety disorder and drug dependence. 3

More Evidence that Abortion Harms Women

Psychiatric care more likely after abortion

A study published in the May 2003 Canadian Medical Association Journal discovered that women who have an abortion are more likely to be hospitalized afterward for psychiatric care, compared to women who carry their baby to term. The study is based on a review of the medical records of 56,741 California women. It revealed that those who had abortions were 2.6 times more likely than women carrying a child to term to be hospitalized for psychiatric treatment in the first 90 days following the abortion or the birth. All of the women in the study were free of any psychiatric hospital admissions or pregnancies in the year before the study. 4

Abortion Complications are seriously under-reported, leaving women who undergo abortion largely unaware of the range of physical and psychological risks they face.

Canadian Study

A study of 41,039 women sponsored by the College of Physicians and Surgeons of Ontario found that, in the three month period following an induced abortion, hospital patients had a more than four-times higher rate of hospitalizations for infections, a five-times higher rate of "surgical events", and a nearly five times higher rate of hospitalization for psychiatric problems than the matching group of women who did not have abortions. 5

Abortion and Breast Cancer Risk

It is a well established fact that abortion can increase a woman's risk of developing breast cancer by denying her the protective effect of a full-term pregnancy. Approximately 70 epidemiological studies dating back to 1957 have reported data on induced abortion and breast cancer, and 80% of them show increased risk of breast cancer among women who chose abortion. 6  A 1996 meta-analysis, Brind et al, found a significant independent risk of breast cancer associated with induced abortion. The findings concluded that an abortion elevates a woman's overall risk of developing breast cancer by 30%. 7

"Breast cancer, pelvic infection, infertility, life threatening ectopic pregnancy, and subsequent premature births - with much higher rates of children born with cerebral palsy - were found to be associated with abortion in a comprehensive review of the world medical literature. Abortion complications were not limited to physical health. While abortion is often regarded as a cure for the depression and stress of a crisis pregnancy, the study found that women are more likely to commit suicide after abortion than after giving birth to a child."

            The deVeber Institute for Bioethics and Social Research

Impact on Subsequent Pregnancies

The book Women's Health After Abortion The Medical and Psychological Evidence, published in 2003 by the deVeber Institute for Bioethics and Social Research, reveals that the most recent studies point to an approximately 85 per cent increase in premature (or "very preterm", meaning less than 33 weeks' gestation) births to women who have had a previous induced abortion. The risk increases sharply with every additional abortion that a woman undergoes. Premature infants suffer a very high rate of disability. Their rate of cerebral palsy for example, is thirty-eight times greater than among the general population. Induced abortion, therefore, has appalling implications for women who subsequently wish to bear a child. 8

Now it is true that all the medical and psychological complications put together affect only a minority of the women who have abortions. Yet the complications are serious and extensive enough to justify a woman being told about them. If she is not told, how can she possibly give her informed consent to the operation?

Ian Gentles, Research Director, deVeber Institute for Bioethics and Social Research

Produced by New Brunswick Right to Life Association and LifeCanada with the support of the Friends of Alliance Foundation.

1) Gissler M, Berg C, Bouvier-Colle MH, Buekens P. Pregnancy-associated mortality after birth, spontaneous abortion or induced abortion in Finland, 1987-2000. Am J Ob Gyn (2004) 190:422-427.

2) Gissler M, et al. Pregnancy-associated deaths in Finland 1987-1994-definition problems and benefits of record linkage. Acta Obsetricia et Gynecologica Scnadinavica (1997) 79:651-657.

3) Fergusson DM, Horwood LJ Ridder EM. Abortion in young women and subsequent mental health. Journal of Child Psychology & Psyciatry (January 2006) 9:16-24.

4) Reardon DC, Cougle JR, Rue VM, Shuping MW, Coleman PK, Ney PG. Psychiatric admissions of low income women following abortion and childbirth. Can Med Assoc J. (2003) 168 (10):1253-7.

5) Ostbye T, Wenghoffer Ef, Woodward CA, Gold G, Craighead J. Health services utilization after induced aboritons in Ontario: A comparison between community clinics and hospitals. American Journal of Medica Quality (2001) 6 (3):99-106.

6) See LifeCanada's website:

 www.abortionbreastcancer.ca

7) Brind J, Chinchilli VM, Severs WB, Summy-Long J. Induced abortion as an independent risk factor for breast cancer: a comprehensive review and metanalysis. Journal of Epidemiology and Community Health (1996) 50:481-496.

8) Ring-Cassidy E, Gentles I. Women's Health after Abortion: The Medical and Psychological Evidence. Toronto: The deVeber Institute for Bioethics and Social Research, 2003. To order this book contact: www.deveber.org

For more information:

 www.afterabortion.org

 www.abortionbreastcancer.com

Does Abortion Access Protect Women's Health? 

by Head, Jeanne E. and Hussey, Laura, from World and I, No. 6, Vol. 19; Pg. NA; ISSN: 0887-9346, June 1, 2004

Jeanne E. Head, a retired labour and delivery nurse, is vice president for international affairs and UN representative for the National Right to Life Committee. Laura Hussey is a Ph.D. student and research assistant for the National Right to Life Committee.

Just as abortion continues to stir a storm of acrimony in the United States, controversy rages around the world over the procedure's legalization in the many countries that still prohibit or sharply limit it. The chief justification for making abortion legal is reducing maternal mortality. Yet what's often overlooked in the debate is that the main factor that has dramatically diminished abortion-related fatalities since the 1930s and '40s until today is not legalizing the procedure so much as improving the overall quality of national health- care systems.

Organizations such as the UN's World Health Organization (WHO) report 40-50 million annual abortions worldwide with 70,000 abortion-related maternal deaths. Scanty data, however, make an accurate assessment of the status of abortion and abortion laws throughout the world a daunting, virtually impossible task. WHO's estimates are largely constructed by statistical estimation, based on meager data and poorly supported assumptions.

The group nonetheless frequently repeats these figures in the interest of expanding the legality of abortion, as do the United Nations Fund for Population Activities (UNFPA) and other UN bodies. So do their nongovernmental partners, whose ranks include such abortion advocates as the International Planned Parenthood Federation (IPPF), the International Women's Health Coalition (IWHC, which has published a manual for increasing access to abortion), and the Center for Reproductive Rights (CRR, formerly known as the Center for Reproductive Law and Policy).

Unfortunately, untrustworthy statistics lead to misidentifying the real causes of maternal mortality in the developing world. They also result in channeling valuable resources away from improving general and maternal health care and the overall health status of women, which, according to WHO's 1991 Maternal Mortality: A Global Fact Book, sharply decreased maternal mortality in the developed world from 1941 to 1951, long before legalization of abortion.

Although it was not a new idea, the move to make abortion a global, fundamental human right began in earnest with the 1994 International Conference on Population and Development (ICPD) in Cairo. After much controversy and compromise, participating countries ultimately stopped short of any outright call for a worldwide legal right to abortion but agreed on language involving calls to advance reproductive rights and reproductive health services, decrease the "need" for abortion, and eliminate "unsafe abortion." While these goals sound apolitical, abortion advocates in fact view them as synonyms for the broad legalization of abortion. IWHC, for example, recently challenged fellow abortion proponents to state their mission more boldly, "to move beyond the rhetoric of 'prevention and management of unsafe abortion' to argue that access to safe abortion is the most direct way to eliminate unsafe abortion."

STATUS OF WORLD ABORTION LAWS

In preparation for the Cairo ICPD, the UN Population Division in 1994 published Abortion Policies: A Global Review to catalog the world's abortion laws. It updated this in 1999, before the five-year review of the Cairo conference. In these volumes, the Population Division shared some of its difficulties in gathering this information. For starters, several countries had not codified their abortion laws, leaving decisions about its legality to common law or religious law. Researchers struggled to obtain legal documents from many developing countries.

Even where abortion law was codified, researchers found it difficult to know where in a country's code to look for the law. They found that abortion policies were not always uniform throughout a nation, especially if the state had a federal structure. Information on the law was not always widely disseminated. Even in the case of actual, written law, the problem remained that abortion laws are often subject to a wide range of interpretation and enforcement.

Further, as we observed in our own research, even reports on the world's abortion laws diverge, sometimes substantially. For example, in its 1999 report, the Population Division reported that 120 countries permitted abortion to preserve the mother's mental health, while in a 2003 report, CRR listed only 88 countries with a mental health exception. One should therefore hesitate to accept any single report as entirely factually correct.

That said, according to the Population Division, approximately three- quarters of UN member states (140 of 192) provide some restriction on abortion as of 1999. All countries studied permit abortion to save the life of the mother, with the exception of 3 in which a defense of "necessity" may nevertheless allow the abortion. Including these 3, 65 countries allow abortion only to save the mother's life. Fifty-two permit abortion on request, for any reason. Among the remaining 75 nations, in addition to allowing abortion to save the mother's life, 1 allows the procedure for the mother's physical health, and 3 add an exception in cases of rape or incest. Thirty-seven countries permit abortion to preserve the mother's life, physical health, or mental health only, and 7 expand the list with rape or incest. Twelve add fetal impairment to all the latter, and 6 add economic and social reasons to the physical or mental health and rape or incest exceptions. Nine countries combine these exceptions differently.

Within these categories, there is much variation in interpretation, implementation, and limitations pertaining to such elements as spousal or parental consent and the period of gestation. For example, CRR reports that most countries, including those that allow abortion on demand, provide some gestational limits (8--24 weeks) on abortion. They do not include the United States here, for the Supreme Court's application of its broadly defined health exception to the third trimester of pregnancy effectively allows abortion on request throughout pregnancy.

In its draft release of World Population Monitoring 2002, the Population Division remarks, "The past decade witnessed significant developments in abortion trends and laws." However, when one compares the Population Division's 1994 report and its accompanying summary chart to its 1999 edition, a detailed reading reveals that very few countries have actually changed their abortion laws.

The Population Division's summaries indicate that from 1994 to 1999, 53 countries expanded the conditions under which abortion was legal, 11 restricted those conditions, and 1 both added and subtracted conditions. The report's text, however, identifies a legal or regulatory change to abortion's status in only a small fraction of these countries. The policy chart's footnotes explained more. For many countries that appeared to have changed their laws, researchers had merely recoded as the country's 1999 policy those same policy interpretations that had been footnoted in 1994. For example, while 25 countries appeared to have added a mental health exception between 1994 and 1999, most of the changes could be accounted for by a decision to begin interpreting a "health" exception to include mental health, as is done in the United States. This, too, could explain the disparity between the Population Division and CRR reports.

The mental health exception is a special concern because it has become a legal wedge that essentially allows abortion on demand. Much of the Population Division's misinterpretation involved Central American, South American, and Muslim countries that have persistently resisted calls to broadly legalize abortion. After obtaining and examining the abortion laws of several Latin American countries and interviewing knowledgeable individuals from these countries, we learned that, indeed, none of the laws we studied have exceptions for mental health. Argentina reiterated its legal protection of fetal life from conception as recently as 1997; like many other Latin American countries, it strictly enforces its health exception.

HOW DO ABORTION LAWS CHANGE?

Some countries actually changed their laws after 1994, particularly when America's so-called Mexico City policy was not in effect (1993--2000). (Under this policy, only family planning organizations that do not perform or promote abortion or work to change foreign countries' abortion laws can receive U.S. "population assistance" funds for their activities.) In many of these countries, U.S.-based and other foreign nongovernmental organizations, such as the U.S. Agency for International Development (USAID) and family-planning funds recipients IPPF and PPFA, played a major role. This is one reason abortion advocates so vigorously protested President George W. Bush's reinstatement of the Mexico City policy in January 2001.

The U.S.-based CRR filed a lawsuit in 2001 against Bush, challenging the Mexico City policy. In its complaint, CRR details its strategy of working through foreign NGOs and using UN conferences and treaties to bypass national legislatures and establish "a right to abortion in the United States and every country on earth." As a consequence, CRR lists Guyana, Albania, Burkina Faso, South Africa, and Cambodia among the several countries that liberalized their abortion laws in the wake of the two major UN conferences at which the abortion issue loomed large: the 1994 Cairo ICPD and the 1995 Beijing Fourth World Conference on Women. As of 2001, CRR reported that it had ongoing specific projects in 23 countries. Several nations in this group have recently liberalized their abortions laws.

CRR boasts that many of these changes took place with the help of foreign NGOs receiving USAID funds. South Africa's law, which was changed in 1996 over the objections of a majority of the population and in the absence of almost one-quarter of the legislature, is described in Abortion Policies: A Global Review as "the most liberal in Africa, and, indeed, the world." More recently, CRR applauds its part in the government of Nepal's 2002 decision to legalize abortion on request through 12 weeks of pregnancy--and beyond when certain conditions are present. On its Web site, PPFA International similarly credits several of its partners in Nepal.

NUMBERS OF ABORTIONS

Earlier we mentioned the most prevalent argument made by abortion advocates to convince countries to liberalize their abortion laws--that vast numbers of women are undergoing and dying from "unsafe" abortions in countries where abortion is not broadly legal.

We put the word unsafe in quotes because WHO actually defines unsafe as "illegal." In its 1998 report Unsafe Abortion, the organization says, "For the purpose of these tabulations, unsafe abortion has been defined as an 'abortion not provided through approved facilities and/or persons.' " WHO continues: "What constitutes 'approved facilities and/or persons' will vary according to the legal and medical standards of each country," but at the same time it admits that "the legality or illegality of the services may not be the defining factor of their safety."

Even if we were able to identify those types abortions that are dangerous, we simply do not have the data to count them. Many developing countries lack even basic birth and death registration systems. We do, however, have "estimates," in the roughest sense of the word. In Unsafe Abortion, WHO estimates that 20 million "unsafe" abortions are performed every year. Planned Parenthood's research affiliate, the Alan Guttmacher Institute (AGI), estimates 26 million legal abortions worldwide and thus tags the annual total at 46 million in its 1999 report, Sharing Responsibility. Both reports admit the roughness of these figures.

In World Population Monitoring 2002, the UN Population Division calls these estimates "quite speculative since hard data are missing for the large majority of countries." Further, even in those countries in which some abortions are legal, statistics were available for just 45 countries and in only half of them were the data believed to be "reasonably complete." This means that worldwide abortion estimates are largely constructed by statistical estimation, based on a very meager amount of actual data. WHO's report shows that most data on developing countries come from the following sources:

• Counts of women admitted to hospitals for abortion complications.
• Surveys asking women about their abortion history.
• Papers written by NGOs and public agencies.
• Estimates by "experts," based on their perceptions of abortion's prevalence in a given area.

The frequency with which WHO lists "experts' estimates" as data sources is especially disturbing. Even when researchers have some hard data, these statistics are adjusted and extrapolated multiple times based on such things as assumptions about the frequency of miscarriage and abortion complications and the degree of the always-presumed underreporting. WHO cites very little supporting data for these assumptions. This is a concern because the particular multiplier that researchers choose for adjusting their data could affect their estimates of worldwide abortions by many millions. (See "From the Groundless to the Ridiculous," p.xxx.)

ABORTION POLICIES AND MATERNAL MORTALITY

A second problem with the argument that broadly legal abortion will cure high levels of "unsafe" abortion and maternal mortality is that the legalization of abortion does nothing to solve the underlying problem of poor health care in the developing world. In the United States, the world's leader in modern medicine, the Centers for Disease Control and Prevention reports that over 300 women have died from legal abortions since the procedure was legalized nationwide in 1973. Even under the best medical conditions, an experienced abortionist may puncture a uterus, bowel, or bladder, leading to hemorrhage, infection, and possibly death. Under the sort of circumstances prevailing in the developing world, where conditions may not always be fully sanitary, where emergency facilities and supplies are absent or inadequate, where doctors may not be trained or equipped to handle trauma, and where even basic medical and surgical supplies such as antibiotics and sterile gloves may be scarce or unavailable, mortality rates would be expected to be substantially higher, whether abortion is legal or not.

Legalization would very likely increase women's exposure to these health risks. Evidence indicates that the liberalization of abortion laws increases the number of abortions. Stanley Henshaw, lead researcher for AGI, has admitted, "In most countries, it is common after abortion is legalized for abortion rates to rise sharply for several years, then stabilize, just as we have seen in the United States." The Population Division's report notes several countries in which abortions rose rapidly after the law's liberalization.

Women generally at risk because they lack access to a doctor, hospital, or antibiotics before abortion's legalization will face those same circumstances after legalization. And if legalization triggers a higher demand for abortion, as it has in most countries, more injured women will compete for those scarce medical resources.

UN publications provide several examples in which legal abortion and lower maternal mortality rates do not coincide. Consider Britain, where abortion has been broadly legal for decades, and the nearby Republic of Ireland, which has long banned the practice. According to the 1990 UN Demographic Handbook, Ireland's maternal mortality rate for 1988 was some three and a half times lower than Britain's. Abortion Policies: A Global Review notes that, despite the recent expansion of India's laws to allow abortion for social and economic reasons, the procedure is still practiced under dangerous conditions and the maternal mortality rate remains high. In Paraguay, in contrast, the Population Division comments that maternal mortality rates have been declining, even though abortion is generally prohibited and "clandestine abortion is common."

Despite these facts, arguments about high levels of "unsafe" abortions and the need to legalize abortion to decrease maternal mortality still dominate the international abortion debate. Yet the facts suggest that maternal mortality can be reduced in the developing world the same way it has been done in the developed world since 1941--by improving basic and maternal health care and the general health status of women, not by legalizing abortion.

An excellent resource  on abortion and women's health by the National Right to Life Committee and MCCLGO! Global Outreach (Minnesota Citizens Concerned for Life Global Outreach)

Why Legalized Abortion is Not Good for Women's Health

Why Legalized Abortion is Not Good for Women's Health - French

The cardiologist walked into the room, glanced at my chart and asked, "So you didn't get an abortion?" As I was 34 weeks pregnant, it seemed an unnecessary question.

 For one agonizing night we had actually considered it. Twenty-two weeks into my second pregnancy we learned that the boy I was carrying had Down syndrome and a serious heart defect. Though my husband and I detested the idea of abortion, we wondered if we were cruel to let him live. On April 17, 1996, we sat in our living room, numb with shock. "What if sparing him suffering is the only thing we can do for him?" Keith asked our rector, Duke Vipperman, who had come by to talk to us.

Tax-funded abortions: The facts

Why are Canadians paying for abortion-on-demand?

• Abortion should be de-insured because most abortions are done for socio-economic reasons. 
• Polls consistently show that the majority of Ontarians (and Canadians) support de-insuring abortions.
• An Ontario study of 41,039 women during the three month period after abortion revealed that hospital patients had a more than four times higher rate of hospitalizations for infections, a five times higher rate of “surgical events” and a nearly five times higher rate of hospitalization for psychiatric problems than the matching group of women who had not had abortions. (College of Physicians and Surgeons 2001.)

MYTH: The Canada Health Act requires provinces to pay for abortions.

FACT: The Canada Health Act says that provinces must fund medically necessary services. The act does not mention abortion or any other services as being medically necessary.On March 8, 2001, Health Canada stated in a letter, “This is further to your request under the Access to Information Act, dated August 1, 2000, for: Documents, reports & correspondence in the department that provide evidence that abortions are medically necessary." I regret to inform you that after a thorough search of all likely record holdings, departmental officials have confirmed that they have no records relevant to your request." (M. Snider, Assistant Coordinator.) For more information on the Canada Health Act:www.canada.gc.ca.

MYTH: The federal government provides the provinces with a list of medically necessary services that they must fund.

FACT: Provinces decide what services are medically necessary and will therefore be funded through the health care system.The Senate Standing Committee on Social Affairs, headed by Liberal Senator Michael Kirby, states in its interim report, dated March 2001, that “the determination of what services meet the requirement of medical necessity is made in each province by the provincial government in conjunction with the medical profession.” Does the College of Physicians and Surgeons decide? CBK Radio Noon Edition, July 28, 1991, hosted by Barry Burgess, interview with Dr. Doug Geekie, Director of Communications Canadian Medical Association: “It is the responsibility and the authority of the province, exclusively to determine what services will be insured.”

MYTH: The Supreme Court has said abortions must be paid for by taxpayers.

FACT: There has not been a court ruling on who should pay for abortions. Edmonton lawyer Mark McCourt has compiled a summary of case law on abortion:

•  R. v. Morgentaler {1988, SCC}
•  B.C. Civil Liberties Association v. B.C. (A.G.) {1988, BCSC}
•  Borowski v. Canada (A.G.) {1989, SCC}
•  Tremblay v. Daigle {1989, SCC}
•  Lexogest Inc. v. Manitoba (A.G.) {1993, Man.CA}
•  R. v. Morgentaler {1993, SCC}
•  Morgentaler v. New Brunswick (A.G.) {1995, NBCA}
•  PEl (Minister of Health) v. Morgentaler {1996, PEICA}

“To conclude, the applicable case law divulges no legal impediments whatsoever to a decision by provincial governments to de-insure abortions that are elective and medically unnecessary (done for socio-economic reasons or as a means of birth control), or indeed, to de-insure all induced abortion services. In short, the jurisprudence appears clear that the courts cannot force provincial governments to tax-fund abortion services.” McCourt Law Offices, Edmonton, Alberta.

MYTH: Most abortions are done for medical reasons.

FACT: Almost all abortions are done because women ask for them, not because a doctor recommends them. The Canadian Abortion Rights Action League (CARAL) president, Marilyn Wilson, told a Commons Finance Committee on October 31, 2001, that women seek abortions,“...for socio-economic reasons. Sometimes it is a desire to complete their education and become financially independent. In many cases, couples with children wish to restrict their family size in order to provide adequate financial support.”  Abortion is almost never done for medical reasons. It’s a personal choice.  So just how many abortions are we paying for?

• In 2010, 44,091 abortions were reported in Ontario. (1)
• 28% of all abortions in Canada (excluding Québec) in 2010 were performed on women who had one previous abortion.
• Abortions are most common among women  20 to 29 years old.

MYTH: Abortion is a procedure without complications.

FACT: Abortion has a number of complications and side effects both physical and psychological. As early as the late 70s, the Badgley Commission, appointed by the federal government, conducted two background papers that found women who had abortions were more likely to experience physical and mental health problems than women who carried their babies to term. Studies conducted around the world have found that induced abortion may increase a woman's risk for breast cancer. In addition, there are complications such as excessive bleeding and perforated uterus. Abortion also increases the risk of subsequent premature and/or low birth weight births.

The information in this brochure was compiled by Alliance for Life Ontario. Updated by Action Life 2012.

(1) OHIP billing records- Freedom of Information request to Ontario Ministry of Health and long-term Care by Patricia maloney - Run with Life blog

Action Life Online Article

The abortion drug RU486 was approved on September 30, 2000 for use in the United States by the Food and Drug Administration. In  Vancouver in July 2000  a doctor began the first clinical trials of RU486 in Canada.  In September 2001, following the death of a Canadian woman participating in RU486 tests, the trial program in Canada was cancelled.  At least 30 women worldwide have died after RU486 abortions. Some articles concerning RU486 include misinformation which could lure the public into falsely concluding that the dangerous drug provides a simple, easy abortion. Commonly called the "abortion pill", RU486 aborts an unborn child in a lengthy, painful and psychologically difficult process. The RU486 technique actually uses two powerful synthetic hormones with the generic names of MIFEPRISTONE and MISOPROSTOL to chemically induce abortions in women. Confusion remains about how the drug works. It is important that the myths surrounding RU486 be dispelled.

The morning-after pill is a multiple dose of an oral contraceptive. The MAP may prevent ovulation or, if fertilization has occurred, it may ruin the implantation of a newly conceived human being. It is important that the potential for post-fertilization effects be communicated to patients and health-care providers, as many consider human life to be present and valuable from the moment of fertilization.

The common description of the MAP as emergency contraception fails to accurately describe its possible abortifacient action and is misleading the public. The confusion is aggravated by the current attempt to re-define pregnancy as occurring after implantation. It is a basic fact of human embryology that life begins at conception.

 By Paul Ranalli, M.D.

The ominous influence of the abortion establishment has reached down into medical training, with news that a Canadian medical school plans to deny a medical degree to a young student who has refused to perform or refer for any abortive procedure.

By Gudrun Schultz 

Another woman has died in the U.S. after taking the chemical abortion drug mifepristone, commonly known as Mifeprex or RU-486. Six women have now died from the drug in the U.S. alone, and over 800 cases of side effects, many of them life-threatening, have been reported.

By Lyn Smith 

Abortion advocates frequently use the criterion, when discussing abortion, that they be "safe and legal". The question should be, "safe for whom"?  For the 100,000 Canadian babies aborted annually in Canada, there wasn't any safety factor, only certain death. So, the question now becomes does the word "safe" truly apply for the mothers whose pregnancies were ended by abortion?

- that, in the absence of Canadian Law, abortion is permitted during all nine months of pregnancy. This includes surgical and suction dilation and curettage, saline, prostaglandin and ‘other' methods.

Canadian Criminal Code

 British prohibitions against abortion were the law in Canada until the Canadian Parliament created its own Criminal Code. Under the British 1861 Offenses Against the Person Act, a uniform maximum penalty of life imprisonment for abortion was established, which also provided that the pregnant woman herself, as well as the abortionist, could be held guilty of the offence. Those prohibitions and penalties against abortion were incorporated into the Canadian Code. The law was steadfast in its protection of unborn children.

In 1929 Britain passed the Infant Life Preservation Act which allowed that abortion could be lawful if done in good faith to preserve the life of the mother.  The Canadian Criminal Code reflected this change in Section 237, and allowed abortion to preserve the life of the mother.