Katrina Ackerman, PhD Candidate, University of Waterloo
Recent media coverage of an Alberta doctor’s refusal to prescribe birth control to walk-in clinic patients indicates the medical profession’s ongoing struggle to balance personal morality and professional ethics. Whether a doctor should be able to deny birth control prescriptions or abortion referrals based on moral or religious grounds is a murky issue and has been prevalent since the formation of Canadian medical societies in the 1800s. The Canadian medical profession’s struggle to maintain control over abortion and contraception can be traced back to the mid-nineteenth century when, in their efforts to regulate the profession, medical societies used aspects of science and religion to argue that life begins at conception and condemned alternative medical practitioners for offering methods to terminate pregnancies. In 1892, physicians were instrumental in the criminalization of abortion. Nearly a century later, doctors held an equally prominent role in the liberalization of the procedure. After decades of witnessing women attempt to control their own fertility—and many times die in the process—the Canadian Medical Association advised the federal government to amend the abortion law. In 1969, the federal government liberalized the abortion law to allow the procedure when a mother’s life or health was endangered. While doctors were prominently involved in the liberalization of the abortion law in 1969, divisions immediately heightened within the profession over the justifiability of the procedure.
The reality was that Canadian and international medical societies did not have straightforward scientific reasoning for determining when life began and could not ascertain if or when abortions were acceptable. Scientific beliefs, as well as ethical, legal, and social considerations influenced individuals’ and medical societies’ reasoning on the abortion issue. Advancements in neonatal medicine in the 1970s complicated the issue for abortion rights doctors as innovative medical technologies enabled physicians to highlight embryological development and subsequently convinced many scientifically trained professionals to question the rationality for abortions. In the decade following the revised abortion law, debates over whether abortion could be considered a medically necessary act, without consideration of the fetus, polarized doctors.
When some medical professionals called for greater liberalization of abortion access in 1970, after witnessing the ineptitude of therapeutic abortion committees, doctors opposed to the procedure quickly came to the defense of the fetus. In a letter to the Canadian Medical Association Journal, Dr. P.G. Coffrey from Kemptville, Ontario argued that the medical profession was lowering its moral standards because “to perform an abortion on an embryo, fetus or unborn child (call it what you like), which is alive, is immoral for the reason that this is taking a human life.” Coffrey believed that with additional research on the subject, doctors would find that “[l]ife is a continuum from conception to death, and one cannot arbitrarily say that at some moment between conception and birth ‘life’ begins.” Coffrey was not alone in his fear that the medical profession was denigrating the sacredness of the fetus—from British Columbia to Newfoundland, Canadian doctors expressed their outrage and concern that the profession was permitting the destruction of human life.
Anti-abortion sentiments intensified within the profession when the Canadian Medical Association passed a policy that supported abortions for socioeconomic or mental health reasons. In 1971 the association put forward a new abortion policy, which argued that abortion should be a “matter to be decided upon by the patient and physician concerned” and approved on “non-medical social grounds.” The policy passed with a vote count of 78 to 74. The “marathon” abortion debate was “perhaps the most heated and emotional debate ever witnessed by observers of General Council.” The Canadian Medical Association continued to debate the abortion policy at the annual meetings throughout the 1970s and increased internal divisions within the medical society. The association tried to alleviate concerns by opposing “abortion on demand” and emphasizing that no practitioner or hospital should be forced to perform any abortions. However, the medical society’s attempt to clarify the policy by defining abortion as the “termination of pregnancy before 20 weeks of gestation” dissatisfied members and they called for a special federal commission on the procedure so that the Canadian Medical Association could “build a scientific base for decisions on abortion.”
The federal government established a Committee on the Operation of the Abortion Law in 1975, chaired by sociologist Robin F. Badley, to explore the aftermath of the abortion law amendments and discovered that doctors were partly responsible for inequitable access to abortion. The Committee argued that 47.7 per cent of Canadian doctors believed abortion “lowered the value of human life” and these doctors undeniably influenced a hospital’s stance on the issue. The report proved that the Canadian Medical Association’s 1971 abortion policy was a prescription that many doctors ignored.
Abortion debates continued to intensify in the 1980s as advances in prenatal technologies and surgeries increasingly challenged physicians to determine if the rights of the pregnant woman superseded the rights of the fetus. The increasing use of ultrasound imaging during pregnancy and its ability to create images of the fetus convinced many doctors that abortion was reprehensible. The association’s attempts to specify when abortions were medically and socially acceptable merely intensified polarization within the Canadian medical profession. The internal divisions created by the Canadian Medical Association’s liberal abortion policy would become a motivating force for pro-life groups. Doctors and scientists opposed to abortion became key figures in the transnational pro-life movement and provided scientific reasoning for activists’ opposition to abortion.
Katrina Ackerman is a doctoral candidate in history at the University of Waterloo. Her research explores the effectiveness and longevity of pro-life activism in the Maritime Provinces. Her forthcoming article, “In Defense of Reason: Religion, Science, and the Prince Edward Island Anti-Abortion Movement, 1969-1988,” explores pro-life lobbying campaigns in Prince Edward Island and will appear in a special issue on reproductive health history in the Canadian Bulletin of Medical History.
Constance Backhouse, “The Celebrated Abortion Trial of Dr. Emily Stowe, Toronto, 1879,” Canadian Bulletin of Medical History, 8 (1991): 159-87; Tracy Penny Light, Shifting Interests: The Medical Discourse on Abortion in English Canada, 1850-1969, PhD Dissertation, University of Waterloo, 2003; Wendy Mitchinson, The Nature of their Bodies: Women and their Doctors in Victorian Canada (Toronto: University of Toronto Press, 1991), 132-59.
 Daniel Callahan, “How Technology is Reframing the Abortion Debate,” The Hastings Center Report 16, 1(February 1986): 33-42.
 P. G. Coffey, “Correspondence: Therapeutic Abortion,” CMAJ 102 (January 17 1970): 91.
 For a similar argument, see P.B. Walsh, “Correspondence: Abortion,” CMAJ 102 (28 March 1970): 644.
 P.G. Coffrey “Correspondence: Therapeutic Abortion,” CMAJ 103 (21November 1970): 1196; L. L. de Veber, “Correspondence: Therapeutic Abortion,” CMAJ 103 (26 September 1970): 645; Z. Gorecki, “Correspondence: Therapeutic Abortion,” CMAJ 103 (26 September 1970): 645; Eduard Upenieks, “Correspondence: Therapeutic Abortion,” CMAJ 103 (26 September 1970): 645; Cesar Heine, “Correspondence: Therapeutic Abortion,” CMAJ 103 (7 November 1970): 1088; Cesar Heine, “Correspondence: Therapeutic Abortion,” CMAJ 102 (30 May 1970): 1211.
 D.A. Geekie, “Abortion: A Review of CMA Policy and Positions,” CMAJ 111, 5 (7 September 1974): 475.
 Dr. W.D.S. Thomas, President of the Canadian Medical Association, “Address,” 1980 Annual Meeting of the Medical Society of Nova Scotia, Nova Scotia Medical Bulletin (December 1980): ix-x.
 D.A. Geekie, “CMA Policy Review on Abortion,” CMAJ 119, 7 (7 October 1978): 807-808.
 “Association News,” CMAJ 105, 5 (4 September 1971): 522-523;Geekie, “Abortion,” 476, 477; “Association News,” CMAJ 113, 1 (12 July 1975): 59.
 The Report of the Committee on the Operation of the Abortion Law (Ottawa: Ministry of Supply and Services Canada, 1977): 127.
 Brian Frazer, “The CMA Abortion Survey,” CMAJ 129 (15 December 1983): 1259; Paul de Bellefeuille, “The CMA Abortion Survey,” CMAJ 129 (15 December 1983): 1259-1260; Donovan Brown, “The CMA Abortion Survey,” CMAJ 129 (15 December 1983): 1260; P. G. Coffrey,“The CMA Abortion Survey,” CMAJ 129 (15 December 1983): 1260.