Anniversary of Choice (Canadian Edition)

So right at about the same time as the American anniversary of the Roe v. Wade decision, yesterday, we hit the 20th anniversary of the Morgentaler decision, which stands as the precedent for defining the right to acccess an abortion here in Canada.

So I will take this opportunity to note a couple of things about the reality and the discussion of reproductive justice in Canada.

One: I’m really grateful that the legal case setting out the terms of the issue rests on the principle that not granting it is a threat to a woman’s “life, liberty and security of person”, not on the nebulous and tangential concept of “privacy”. It’s nice that if we’re going to be talking about the legality or lack thereof, at least we’ll be talking about the actual point, and frankly, at least it’s easy to understand, whereas I can get very lost very quickly in discussions around the finer points of the Roe v. Wade distinction.

Two: I used to find it disconcerting that we in Canada had no actual law with respect to abortion, but the more I looked at it, the more I appreciated that not defining restrictions or terms is the only way that this:

An abortion is now treated like any other medical procedure and is governed by provincial and medical regulations.

…can be true (quoted from the linked CBC article). And is the way it should be. And while I have absolutely no faith whatsoever in our current Conservative federal government with respect to…well, anything, I tend to trust the courts in Canada, and while I think the Tories are perfectly willing to play rhetoric games with abortion issues, they’re not going to make any steps toward legislating against it, because they’d lose when it hit the bench.

Three: The problems with access to abortion in Canada are just that–access. Unsurprisingly, pretty much the same problems that plague every other aspect of our health care system, though the time sensitive nature of the need for this particular procedure would seem to emphasize the need to improve provision. Some notes:

  • medical schools are barely teaching the procedure these days. Several of the major schools in the country teach it only at a very high level of specialization.
  • women outside of major urban centres, especially in the North, essentially have no access at all. This is also the case in the US, but the kinds of geographical barriers we’re talking about here really need to be understood. Morgentaler has been talking about open “a” clinic in the territories to help meet this need (and good on him, because not having said it yet, it’s worth noting that this man is awesome). Look at a map and talk to me about the size of those territories. When I was living in Edmonton, we had a number of our research consultants come in from small towns/reserves in the NWT, and they considered it par for the course that there were literally no roads into town (have to fly out), especially in the winter, and that it would cost at least $1500 round trip per person just to get to Edmonton.
  • The other thing that has to be stated is that when we in Canada are talking about “Northern” issues, we are also inevitably talking about issues that are wrapped up with First Nations/Inuit issues. And I don’t think I could possibly do justice to the extent to which medical care on reserves/in the North is, to say the least, limited, and to which the debate around it is entwined with heavy post-colonial racism

Making the link between those three points, it seems to me that the most important thing the Canadian medical establishment could do right now with respect to choice issues would be to start teaching abortion procedures to GPs in medical school and encouraging more remote placement. The latter part needs to be focused on for the purposes of all kinds of medical care, but given the geographical reality that a GP may be the only kind of doctor any individual is able to see on any kind of a time-appropriate basis, that doctor needs the skills to meet a patient’s needs. Well, that doesn’t really link in the last point I made about the racism, but suffice it to say that I think it would be awesome if we could stop withholding medical care by using racist justifications.

(posting with no time to preview, forgive any typos, spelling errors or lack of brilliance accordingly)

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8 thoughts on “Anniversary of Choice (Canadian Edition)

  1. Jay says:

    As usual, no offense intended, and this may sound like a dumb questions, but…

    Why do you think a woman’s right to have an abortion is essential to her right to “life, liberty, and security of person”? I’m seeing the obvious situation of rape (for which I generally accept the necessity of abortion, situation determining). But other than that, I’m not seeing the necessity…and for me (opinion only, granted, and I’m not about to try legislating on it) the potential for harm to another’s right to life (aka the fetus) makes it a pretty dicey situation.

    I’m not a clinic bomber, or even a constitution-amender, when it comes to abortion. But I do generally think abortions should be as rare as possible…and any legal decision based on abortion as a right (in my parlance, something that cannot be trumped) is bound to make them much more common than I think they need to be.

  2. purtek says:

    To me, it’s important to leave the question of how the pregnancy occurred (ie. rape vs. consensual sex) out of this equation. If a woman was raped, then the *rape*, not any ensuing pregnancy (or lack thereof) was the violation of her “security of person” (and potentially her life). If a pregnancy occurs, it’s a separate issue.

    The threat to the woman’s life, liberty and security of person comes because a fetus has to gestate inside her body, and that will have a major impact on the way she is able to live her life for a minimum of nine months, seriously restricting her liberty and possibly threatening her health or life. The “security of her person” is compromised by having stuff happening inside that person that makes her body suddenly not entirely hers.

    In a philosophical debate about the fetus’ status as a “life” or not a life, there may be a number of arguments to be made. The existence of the fetus’ “right to life”, however, is much more difficult to argue for, since that would be a legal construct that requires a lot more support. Part of why I ultimately come down strongly in favour of reproductive rights is that in no other circumstances is one human being required to provide the use of his/her body in the service of another human being, even if that human being is unquestionably a “life”.

    The right of an individual to decide whether and under what circumstances to allow her body to be used for that purpose, to my mind, cannot be trumped. The merits of rarity aside, note that you’re factually incorrect in saying that defining abortion as a “right” is bound to make them much more common–they are more rare in Canada than in the US, where the legal precedent is based on other conditions (well, maybe both countries are more than they “need to be” in your opinion, but I don’t know how many abortions are going to fall into the “need” category, so take that argument for what it’s worth).

  3. Jay says:

    Okay…to start, I’m going to admit the obvious: I’m a man, I’ve never been (and never will be) pregnant, and my privelege in this situation is pretty darn heavy. So I’m going to do my best to work around that, but may not be able to. But I’m not going to just back out and say that since I can’t get pregnant, it’s none of my business…unless the pregnancy in question is due to parthenogenesis.

    Re: the rape issue. I agree that the rape itself is a violation of liberty and self, and I’ll withdraw my comment. That said, it leaves me in only this position: how can a pregnancy, a situation entered into voluntarily, be a loss of liberty or security?

    A woman who becomes pregnant in the modern day presumably does so because she wished to. Examples to the contrary are rape, accident, and ignorance.

    I firmly believe in fighting ignorance…I’m not an anti-sex-ed lunatic.
    I likewise believe accident should be rare in this day and age…contraception is readily available, and barring ignorance (see above) a woman understands that when she voluntarily has sex, the possibility of pregnancy is there. While contraception is not 100%, abstinence and sterilization are.

    (keep in mind, these are not just options for women I’m discussing…men likewise need to be responsible, and contraception/sterilization are options for them as well…I’ve considered vasectomy myself).

    So if you discount rape…a woman has myriad other options than abortion to prevent unwanted pregnancy. I see abortion as an unnecessarily drastic answer to a problem that already has multiple solutions.

    Yes, I’m aware pregnancy limits a woman’s options…but that’s after she’s already (presumably) made a choice to enter that state. So is pregnancy only a threat to the woman’s rights when she enters it involuntarily?

    As to the answer of whether a fetus is a life or has a right to life…

    I’ll admit it’s a murky question, and one for which I have no concrete answer. To me, it all hinges on the soul, and that is an intangible which cannot be readily identified.

    That said, I take the stance of “better safe than sorry”. If a fetus might be a life (as it might), we are better off not terminating any of them we don’t have to, especially if there are other options. Since there are, I don’t support abortion except in cases where those options are not feasible (mostly involuntary pregnancies).

    Discounting the involuntary, a woman is not “forced” to turn over her body to the fetus…she chose to do so when she conceived. Hence, I see a woman’s rights being threatened only in involuntary cases. Do you disagree?

    “The right of an individual to decide whether and under what circumstances to allow her body to be used for that purpose, to my mind, cannot be trumped.”

    Agreed, with a caveat…a person’s decision whether to allow her body to be used for any purpose must be made before another life enters the equation. If a woman does not want her body to be used to support a fetus, I feel she should make that decision before the fetus is created. If the decision is taken from her (re: involuntary again), we have entered a different area (in my way of thinking).

    Re: too many abortions
    When I said “a right to abortion will make abortions more common”, I meant that all other circumstances being equal, I believe the number will be greater if it is a right than if it is not. Canada v. USA is not a fair comparison, because all other things are not equal. USA pre-Roe v. USA post-Roe is (IMO) a more fair comparison…and the number of abortions did go up. Now is the part where I admit that since illegal abortions pre-Roe cannot be accurately counted, I can’t guarantee the accuracy of those facts…so in fact, I’m shooting in the dark. But I feel my assumption is logical…if an act is protected by law (by the highest law in the land, the Constitution, in the US), that act is more likely to be carried out by nominally law-abiding people. Is there a reason that runs contrary to this stream of thought?

    I absolutely wish to continue, but if you wish to drop it, I shall at once (I don’t think you originally intended to get in an abortion wrangle, and don’t wish to force you into one on your own blog). I hope I’m not being too confrontational or offensive, and I’m definitely interested in your thoughts and insights (especially as you have a perspective I have no direct access to).

  4. purtek says:

    You’re not being confrontational or offensive, and I’m absolutely willing to continue this discussion because, while you’re right that it wasn’t my intention, it is very rare to see even the remote possibility for respectful conversation on this issue. I’ll let you know if I become no longer comfortable with it, and I hope you’re okay with continuing to have it even knowing that it’s next to impossible that anything you say will change my mind. This is something I’ve had to think about and I’ve likely considered most of the points you can raise in some form or another. I welcome the opportunity to articulate my thoughts here, though, and I’m not doing so with the overall intention to change your mind, either. If I have a goal at all, let’s call it an increase in understanding between our divergent positions. Deal?

    Now then, appreciating that you’re not an anti-sex ed lunatic, your main point seems to be that a woman (and her partner/s), having been informed of the pregnancy risks/probabilities and determined her options accordingly (including birth control etc), makes the choice to accept pregnancy at the point that she has sex. And I disagree. I think that’s not a fair choice for a woman to have to make. You refer repeatedly to accidental pregnancies (let’s assume in some cases that this means birth control has failed), but I’m not entirely sure how you would address them.

    My question becomes then, at what point is it accidental enough to warrant abortion? If a woman has been on the pill, taking it properly and falls into the very small percentage of people who nonetheless get pregnant, does that make it okay to have an abortion? How about if she missed a few days and forgot? Does it matter what were her reasons for forgetting–she’s been too stressed, she’s depressed, she’s sick–or are we not to take those aspects of her “choices” into account? What if hormonal birth control fucks with her moods so badly that she feels her options are better served with another, less reliable, barrier method?

    When she makes any of these choices, at what point is she signing on for the nine-month deal (let’s address the length of the pregnancy only, trying to leave the adoption question out of the equation) on whatever date nature decided to that was the way it was going to be? Basically, I’m saying that yes, we (as women) should understand the risks of pregnancy going in to a situation and weigh our options accordingly. But there’s something quite troubling to me about refusing to give a woman the choice at a later date if exercising those options doesn’t work out as she expected or planned, or if, in the case of a wanted pregnancy, circumstances change following that initial choice (eg. her partner leaves, she loses her job, she discovers a previously undiagnosed illness etc.).

    In my mind, if abortion is wrong, it is always wrong, regardless of how the pregnancy occurred. But since we can’t know, my position is that erring on the side of caution means erring on the side of the life and liberty (including employment issues, health issues, relationship issues) of the entity that we factually know to be a living, soul-having human being (ie. the pregnant woman). I will never be in the circumstances of another individual as she makes her birth control choices, as she looks at the specifics of her mental, emotional and physical health, the state of her relationship and her financial situation and decides what to do about both birth control and about any pregnancy that occurs. I absolutely cannot codify what the proper decision-making process is for another individual with respect to birth control and sexuality (abstinence is just not a good choice for a lot of people, nor is sterilization) and I definitely cannot spell out specific terms that make one abortion okay but not another…like some numerical scale for how the decision should be processed.

    For me, the thought process in coming to this belief included the realization that under certain circumstances, I would agree with a woman’s decision to have an abortion. As soon as I’ve gotten that far, I have to accept that I will never know the full extent of the circumstances leading *any* woman to make her reproductive choices (before and after pregnancy) and therefore, I can’t establish a set of rules that make one okay and not another. And then it becomes up to each individual person in each individual situation.

    This whole line of reasoning comes down to: there are a hell of a lot of things going into that decision, and it’s damn well not my place to make them on behalf of anybody else, because that would, imo, be putting restrictions on their freedoms that I wouldn’t want anybody placing on mine.

    I hope this doesn’t sound too strident–my intent remains as stated above, but I know that when I get going, the passion tends to take charge.

  5. Jay says:

    1.) I’m cool with your goals for this conversation. Dennis Prager has a saying I approve of: “I prefer clarity to agreement”. Mutual understanding of divergent positions is a worthwhile goal.

    2.) Our major divergence is addressed early in your post: you don’t consider it fair for women to have to declare, basically, whenever they have sex “I’m willing to accept the possibility–however remote–that I might get pregnant and, if so, to bear, deliver, and care for that child”. I do, because there are options that can render it 100% impossible, and if you’re not willing to take those options, I feel one should accept the possible consequences. I’ll admit sterilization and abstinence are not attractive options in many cases, but they ARE options (and again…they are not options to be born only by women). I consider either a better option than abortion.

    3.) I’ll admit I don’t consider any accident an acceptable reason for having an abortion…only situations totally beyond a woman’s control. If the woman is in a long-term relationship and doesn’t wish to have children, I favor sterilization (vasectomy is usually the simplest option). If it’s merely to delay pregnancy, I favor the same method recommended for short-term relationships: chemical + barrier (which is as close to foolproof as things get).

    4.) If abortion is wrong (as I believe it is), it is always wrong (as I believe it is). I never believe it’s a good option, but I’m a realist enough to know that sometimes you go with the lesser evil. That said, I feel there has to be a middle ground between complete ban (abortion = greater evil always) and complete right, no questions asked (abortion = not evil).

    5.) Pursuant to 4, if we take my tack that abortion is sometimes okay and sometimes not, the question becomes in what circumstances is it okay. Your view (absolute right) is that the answer to that question is always in the woman’s hands, because it’s her body. My contrasting view is that while we can never really know what a woman is thinking/experiencing, that does not mean we cannot attempt to and–this will sound callous, I know–make the choice for her.

    A (perhaps flawed) analogy. I believe that killing is not always wrong…I believe that in self-defense or defense of others, and sometimes even in other cases, it is permissable to kill. Many people, and even the law, share this view. But despite the fact that we cannot know what each person who pulls the trigger is feeling/experiencing or what their situation is, we don’t leave it up to each person to decide for themselves whether killing is justified. We make them justify it to society.

    I understand the danger of this method, since I’ve seen it in the self-defense situation…you run the risk of disallowing the behavior because the law doesn’t accept your justification, even if it is valid. And that’s a legitimate concern. But while I feel we should be fairly broad in accepting reasons and rationales (for self-defense and abortion), I don’t feel we can say the law (through it, society) has no right to be involved.

    6.) The above argument hinges on the key fact which is always in debate…whether or not the fetus is a human life. If it’s not, the whole thing becomes moot, and you are 100% correct. If it is, I’m not forced (as some pro-choice people assert) to say it’s never okay…I believe killing is sometimes okay. But if it is, I believe the decision involves more than the woman alone, and thus, it should not be wholly her decision.

    I’ve never actually written all that out before, and it’s made me realize my views are nowhere near as solid as I thought they were (and for that matter, as I think they ought to be). Abortion is one of those issues where I am genuinely torn, and I can only justify my wishy-washyness by saying I feel it’s too important for me to go off half-cocked.

    No apologies necessary for your zeal on this subject…it is clearly a more immediate issue for you.

  6. purtek says:

    It’s taken me a few days to get to this, sorry. But, back now (a little).

    One of the points of raising the idea that if it’s okay sometimes, the anti-abortion position hits shaky ground, is that the fact that some (possibly including yourself) are willing to include a rape exception doesn’t seem to be a philosophically consistent position with the “fetus as human life” issue.

    A (perhaps flawed) analogy. I believe that killing is not always wrong…I believe that in self-defense or defense of others, and sometimes even in other cases, it is permissable to kill.

    So this analogy would cover the case where a woman’s health is threatened by her pregnancy. Self-defense allows us to kill another person who threatens to harm or kill us, and in this case, this fetus is doing just that. It’s the “person” at fault, so the analogy works.

    In the case of a woman who’s pregnant as a result of rape, this doesn’t apply. If that fetus is a human life, then “killing” it, however it was created, seems unfair. To use your analogy, it would be like if someone were trying to murder you, and you decided to kill a witness because the witness’ existence reminded you too much that someone was trying to murder you.

    Obviously, I’m not trying to say that rape exceptions are a bad thing. It’s just the kind of thing that makes me think this discussion really isn’t about the “rights” of that fetus–because somehow, if it’s not the woman’s fault that she got pregnant, on any level, then it’s just different, even if, to that theoretically alive fetus, I can’t imagine it’s all that different at all.

    Frankly, I’m just never going to be cool with this:

    My contrasting view is that while we can never really know what a woman is thinking/experiencing, that does not mean we cannot attempt to and–this will sound callous, I know–make the choice for her.

    I can’t really think of many other situations where it becomes okay to make a choice for another rational, adult human being. Where I get frustrated is that the choice being made for women here isn’t just about whether or not to carry through a specific pregnancy that’s already occurred, accidentally or otherwise. It’s kind of a choice to define how and when it’s okay to have sex and what kind of attitude a woman is supposed to take toward her sexuality. Which…would be one of the principle means of patriarchal control, because men are never going to have to face quite the same “consequences” of sexual choices. I know you’ve said a man should own up to his actions, but the point is he doesn’t have to, and (to go back to the “opt out” issue) even if he does, partially, at some point, a little, maybe…he can back out at any time. And he can make his sexual choices and develop his sexual attitude in a context that includes that knowledge, whether he wants it or not.

    I appreciate that you’re recognizing your privilege in this conversation, and respecting that this is an inherently more immediate issue for me. Because that’s pretty much what that above paragraph entails–this conversation has a hell of a lot to do with the different contexts/value systems/issues that are imposed onto sex for men vs. for women, and the fact that I can’t live a full adult life without negotiating those differences in a way that you’ll likely never have to (you can if you so choose, but that’s the point of privilege).

    I’m glad you’re good with the terms of this discussion, because although I many times use the second person above, I hope I’m never coming off as though I’m calling you an asshole. Maybe that should become my standard disclaimer. 🙂

  7. Jay says:

    “I can’t really think of many other situations where it becomes okay to make a choice for another rational, adult human being.”

    My society–and yours–does this all the time. 18 year olds (considered adult enough to drive, marry, vote, and die in war) do not have the choice to drink alcohol. Rational adults, who may be entirely capable of driving safely at high speeds, do not have the choice to drive over the speed limit. In Chicago, IL, rational adults do not have the choice to buy or carry weapons in their own defense…despite the Constitution specifically giving them that right!
    I could go on forever on the choices that are denied to us.

    If I feel my life is threatened, I have the choice as to whether or not to use lethal force to defend myself…but I am later forced to justify that choice to a court of law, and if the judge/jury disagree with my choice, I can be legally punished.

    Society removes choice from adults, or renders their choices illegal or unjustified, all the time. Heck, that’s mostly what laws ARE…the majority making choices for everyone. I see this as a similar situation. You do not?

    (and no worries on the asshole thing…I’m good)

  8. Jay says:

    (a bit more, which I probably should have put in the other post, but which needed a couple minutes to solidify)

    “In the case of a woman who’s pregnant as a result of rape, this doesn’t apply. If that fetus is a human life, then “killing” it, however it was created, seems unfair.”

    Certainly it’s unfair…but it might also be the best state of affairs, the most “net good”. Sometimes there are no good choices, and I acknowledge that; I’m a realist.
    But I don’t feel that, because I think it’s permissable to terminate a fetus to avoid severe mental/emotional harm to the mother, it’s okay to do it whenever the heck we want. I would prefer a justification of the action, some reason why it’s necessary.

    “To use your analogy, it would be like if someone were trying to murder you, and you decided to kill a witness because the witness’ existence reminded you too much that someone was trying to murder you.”

    I’d say it’s more like someone tried to murder you, and instead only hurt you very very badly, and then a witness to the assault was going to hang around with you for the next 18-20 years and talk to you about it constantly, maybe sleeping in your bed with you sometimes, and you’d have to support that witness financially.
    If somebody killed the witness in that case, I might let it slide.

    “It’s just the kind of thing that makes me think this discussion really isn’t about the “rights” of that fetus–because somehow, if it’s not the woman’s fault that she got pregnant, on any level, then it’s just different, even if, to that theoretically alive fetus, I can’t imagine it’s all that different at all.”

    I can’t imagine what the fetus feels…whereas I can try to imagine what the woman feels. To me, since the fetus’s continued existence puts burdens on the woman (on several levels…physical, emotional, financial), she and the fetus both have a stake in the decision. It’s not a case of “fetus trumps mother” or “mother trumps fetus”. I try to look for a case of least harm.

    Just because I consider the fetus to have some rights does not mean I think the fetus’s “right to life” automatically means any harm to the mother short of death doesn’t matter.

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