Stripping the “A-words” of their taboo

by Thomas Bouchard

Abortion and abstinence are so taboo in our medical jargon that even mentioning the words out loud in class invites nervous looks from classmates.  Since these topics are not emphasized in our medical education, if they are mentioned at all, we were grateful that these were the bookends of the 2007 Medical Students Forum in Toronto, hosted by the Canadian Physicians for Life. Especially useful was the evidence-based approach that the presenters took to the issues, with lengthy bibliographies that we could refer to when defending a pro-life position. We were so inspired by the physician-mentors at the forum that a group of us from the University of Calgary decided to debrief the rest of our class with the evidence, letting loose the A-words.

We divided our debriefing session into four topics that were presented at the conference: informed consent for abortion, fetal pain, the right not to refer, and addressing healthy sexual choices.  We sent out an email inviting classmates to this session, and heard that many of the most vocal pro-choice advocates in our class would be there.  Despite our nervousness, we maintained a very collegial discussion and were able to put a positive light on the pro-life perspective.

Our discussion with the students on informed consent (presented by Dr. Deborah Zeni at the conference) was the most challenging. One pro-choice student commented that as pro-life doctors, we would not be in a position to “inform” a woman seeking an abortion because of our bias. We explained that no matter what side of the issue we’re on, we should insist on adequate informed consent, rather than seeing abortion as an “easy solution” to an unintended pregnancy where serious consequences are left out of the picture.

The topic of fetal pain (presented by Dr. Paul Ranalli) was well-received by pro-choice students, who felt it was reasonable to give anesthetics to the fetus during an abortion due to the pain the fetus feels during the procedure.  A few students followed the logic through, remarking that if abortion advocates recognized fetal pain, it might be one step closer to recognizing the life of the fetus, which they don’t want to do.  Another vocal pro-choice advocate mentioned that the issue of fetal pain “humanized” the fetus. Although this topic doesn’t solve the problem of abortion, it was very helpful in giving students food for thought on the status of the fetus.

The right not to refer for abortions (clarified by Dr. Will Johnston and lawyer, Ruth Ross at the conference) was not well known by the students, and most agreed that because this is not a referred service, there is no need for a physician to refer. However, the discussion quickly turned into one of access to abortion services, and the pro-choice advocates insisted that while a doctor need not refer, he or she must not stand in the way of a woman accessing an abortion.

We finished our discussion by highlighting the need for a healthy approach to sexual choices (which was described by Dr. Stephen Genuis), explaining that if we ended abortions entirely we would not solve other significant social issues, notably teen pregnancy.  We mentioned the Uganda ABC program (Abstinence, Be Faithful, Condom use in discordant partners), which was of interest to the students, but some argued that the study had a political bias and current trends in Uganda are not reflective of the ABC program’s success.  Our rebuttal was simply that the message of abstinence and faithfulness are not bandaid-solutions, but are proven, population-based methods to reduce STDs and unintended pregnancies.

There was so much interest in our debriefing session that we held a second one the next day.  The students appreciated the evidence-based approach, which can be useful in a clinical setting, rather than a moral or faith-based approach to the arguments where common ground is not always found. This approach was also helpful for us as facilitators of the discussion – our critics could wrestle with the literature rather than with us.  In fact, students on both sides of the fence wanted more discussions like this, where students could speak about controversial life issues without the arguments becoming emotional attacks.  Our discussion empowered pro-life students to stand up for life and stand behind the evidence in the literature, and challenged pro-choice students to admit the reasonableness of a pro-life position.

We left our discussions encouraged, confident that we have Canadian physicians and other professionals helping us to form reasonable, evidence-based arguments in support of life.  We are indebted to the physician-mentors at the conference who are preparing us, the physicians of the next generation, to carry the torch for the unborn. Moreover, my fellow students and I would not have been able to attend this conference without the generous contribution of donors who sponsored us to go. We are very grateful for this gift!  As we start our journey in the medical profession, it is good to know that we have your support as we defend life in the public square.

Thomas Bouchard is a medical student at the University of Calgary, Class of 2010, and one of 57 students/residents sponsored by Canadian Physicians for Life to attend the 2007 Medical Students Forum in Toronto. This article is published in the Fall 2007/Winter 2008 issue of CPL's newsletter, Vital Signs.