In Canada, Some Doctors Refuse to Do Paps


While attending a recent event honoring the twentieth anniversary of the all-important Morgentaler decision here in Canada, I came upon some disturbing news: doctors in Canada are denying pap smears to women citing religious objections. You read it right: doctors are using their personal morality to further restrict a women’s right to equal health care. I came across this fact in an essay written by Peggy Cooke, the recent winner of Canadians for Choice’s essay submission contest that answered the question “Why is a pro-choice Canada so important?”

In her essay detailing her experience as an abortion clinic patient escort, she writes, “I have two close friends whose doctors will not even give them pap tests because it goes against the doctor’s religious beliefs.” Peggy lives in New Brunswick, one of the most repressive provinces in terms of reproductive policy. The provincial government continues to violate the Canada Health Act, by requiring women to seek approval from a doctor and a gynecologist in order to access publicly funded abortions. Abortions done at the private Morgentaler clinic are not funded.

I contacted Peggy to learn more about what was going on with the doctors refusing to perform pap smears and she responded by saying that in one case it is actually the doctor's receptionist who won't allow her young unmarried friend to make an appointment for a pap smear saying that she is too young and doesn't need one (she was 19 at the time of the incident). The second instance deals with a couple who are doctors, who run a practice together. Known for their religious and anti-choice beliefs, these doctors will not prescribe contraception. The doctor who refused to perform the pap smear works in the same practice.

So when did a test that is used to screen for disease and cancer suddenly become a procedure which doctors can “object” to do? Am I naïve in thinking that pap smears are a medically necessary part of a women’s yearly physical? I wonder if the same doctors refuse men prostate exams on religious grounds, or does morality only apply to women?

To look for answers, I turned to Patricia LaRue, Executive Director at Canadians for Choice, to see what she could tell me if doctors have the right to refuse ANY procedure that they see as going against their religion. She reminded me that doctors have a "conscience clause," allowing them to refuse prescriptions for birth control, abortion, and now pap smears. The conscience clause is put in place by the Canadian Medical Association so that physicians are not forced to act in any way that goes against their personal beliefs.

However, doctors are also bound by a Code of Ethics to "inform your patient when your personal values would influence the recommendation or practice of any medical procedure that the patient needs or wants." In New Brunswick, the doctor shortage means that young unmarried women simply cannot find a doctor who would give them the services that they request, because there are no other doctors to choose from.

Legally, doctors who use the conscience clause are required to give a referral to a doctor that will perform the procedure that they themselves refuse to do. In real life, however, this seldom transpires. Many doctors feel a "conscientious objection" not only to the procedure but to the referral, and do not refer, claiming they can not in good conscience refer a patient for a procedure that they object to. Many women never report these doctors because they are already in a vulnerable position and fear the stigma attached to reporting doctors for refusing sexual and reproductive health procedures.

So it seems that religious objections and morality policing have moved beyond the realm of abortion and contraception, and have moved into regulating the kind of tests that women can access that may in fact save her from cancer. In Canada we pride ourselves on "universal healthcare," but to access that health care, it seems that you must fit into your doctor's classification of the "normal."

For more information on pap smears visit this page.

Postscript

In my last post, I wrote about the website www.AbortionInCanada.ca, an anti-choice site "marking the twentieth anniversary of legal abortion in Canada" and asking whether abortion provision in Canada has "gone too far." It seems that this group has been targeting youth by creating an “event” on facebook to discuss the twentieth anniversary of the legalization of abortion in Canada. It came to my attention when my youngest sister, who is 16, virtually attended this event. When I went on the page dedicated to the event I found a very slick anti-choice group dedicated to spreading the myths surrounding abortion. The sad part of this group is that they do not allow for postings on their “wall,” or else I would have posted some information to dispel the myths. This is the same group that claims that “In Canada women can have 9-month abortions.” When I asked my sister about it she answered that she didn’t read in-depth the invitation that was sent to her about the group, but that because it talked about the anniversary of the legalization of abortion, and there was no blatant anti-choice propaganda on the invitation, she joined. It makes me wonder how many other youth joined the group not knowing the truth, and read the lies on this posted on this site.

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  • invalid-0

    WHY? WHY? WHY refuse something like a pap smear? What’s next, refusing general check-ups for women?

  • invalid-0

    One of the great myths sold to women is that they need Pap smears done annually. The American Cancer Society recommends every 3 years for most women.

  • invalid-0

    idyllicmollusk,

    This post was linked to by Lawyers, Guns & Money
    http://lefarkins.blogspot.com/2008/02/expansion-of-religious-exemptions-to.html

    commenters janet and micheyd provide the explanation:

    In this crazy-fundie world, treating an STD (though cervical cancer can, however rarely, develop without sexual contact) provides an “out” for sin – so the doctor believes that he is encouraging/promoting the behavior.

  • invalid-0

    That’s what a Pap smear is designed to detect – either a pre-cancerous stage or the disease.

    I’ll say this – only MEN are damn fool enough to equate a diagnostic procedure with some addled ideas about prudery.

    I’m a man and the son of a physician. My mother – Tulane, Class of 1950. One of two women to graduate from that medical school 58 years ago.

    Idiots and demagogs who hate women are behind this gross attack on women’s health. I’d have the physicians licenses for this abomination, were it in my power.

  • invalid-0

    And I can’t find anything for pap smear that matches any post at her site.

    Can you provide any corroboration for your claim? It would certainly be outrageous if true, but so far, all we seem to have is your foaf claim.

  • http://jemima-aslana.livejournal.com/ invalid-0

    Be it that they need a pap smear once every year or once every three years it won’t really make a difference if there is no doctor to perform it.

  • invalid-0

    I refer you to the above article, in particular this quote:

    “it is actually the doctor’s receptionist who won’t allow her young unmarried friend to make an appointment for a pap smear saying that she is too young and doesn’t need one (she was 19 at the time of the incident).”

    I’ve personally witnessed faith-motivated stupidity with regard to healthcare and sexuality from both sides of the gender divide. I agree that the concept is borne of a fundamental fear and hatred of female sexuality, but that doesn’t mean that only men enforce it.

    As someone who has suffered through cancer myself, if I had been refused a diagnostic procedure on the basis of a doctor’s religious beliefs, I wouldn’t rest until his or her laughable medical career was nothing but a distant memory.

  • http://antichoiceantiawesome.blogspot.com/ invalid-0

    I actually haven’t posted about this on my blog, and that’s why you can’t find it there. It is from the essay that I read at the 20th anniversary celebrations in Ottawa.

  • http://www.vomitcomit.wordpress.com invalid-0

    I live in NB, and I’ve never had any issues, aside from the asinine need for a referal to a gyno and the abortion problem. They have a pap clinic-you just call, and make the appointment. No questions.

    I’m really curious what part of the province she’s in. This place is ass backwards, but it’s been awhile since I’ve had any major issues. (Being denied BC at the Sexual Health Clinc since I was “too old” was my favorite)

  • http://antichoiceantiawesome.blogspot.com/ invalid-0

    Fredericton. Both of the friends of mine that were refused pap smears go to Fredericton doctors.

  • http://www.vomitcomit.wordpress.com invalid-0

    I know I’m not the only woman who would LOVE to know their names.

    I thought it was bad enough here in Moncton…..

  • invalid-0

    These “conscience clauses” are utterly bogus and now the chickens are coming home to roost for the proponants of these wastes of legislative time. When certain doctors try to use their relgious beliefs to deny women a basic cancer diagnostic test,it’s the top of a slippery slope. The next probably step is doctors refusing to treat women belonging to a different Christian denomination, a different religion, or even atheists.

  • invalid-0

    So a doctor should be forced to perform a procedure which he or she genuinely objects to on moral grounds?

    Are we talking about a democracy of free men and women here, or a totalitarian dictatorship?

  • invalid-0

    That’s not the issue here. The issue is with doctors who discriminate against individual patients and refuse care based on personal facts that are entirely irrelevant to the procedure.

  • harry834

    based on "moral" grounds, we essentially have doctors deciding who is and isn't "worthy" of medical treatment,

    doctors turning away patients whom they deem "unworthy"? This is the "free society" your talking about?

    And yes, I agree with Katie. Doctors decisions about treatment should be based on the medical needs of the patent, not the doctor's personal religious or "moral" views.

  • invalid-0

    I’m not from another era, and I remember a day when family doctors and ObGyn’s in Canada performed paps. If a doctor has a moral objection to this, he should find a different specialization. If a vegetarian gets a job at MacDonald’s and decides he doesn’t want to touch meat, he should get a different job.

    Having said that, no doctor other than an abortion doctor should be obligated to perform abortions, but I do believe a referral would be in order.

  • invalid-0

    Have you ever wondered WHY New Brunswick gets away with not covering private clinic abortions with health care dollars? The Canada Health Act stipulates that only services deemed medically necessary are to be covered under our health care. Abortion, hailed as a choice, is just that; a choice. It is not a medically necessary procedure in most cases. While most provinces don’t want to bother with the “fight,” New Brunswick has decided not to back down. They don’t want to fund elective abortion with their tax dollars. And no one says they have to. Remember? There is no abortion law in Canada.

  • invalid-0

    But some day along will come a lawsuit filed because a doctor refused to treat a particular male patient for “moral reasons” (example: a pro life doctor turns away an unmarried man who had a vasectomy, then refuses to refer him to another doctor. Resulting in the patient’s death of cancer not diagnosed in time).
    Just try to imagine the s***storm of media coverage.

  • invalid-0

    You should include the actual text of the conscience clause instead of just vaguely referring to it. The CMA does not govern how doctors practice, in any provice. They are a professional association more akin to a Union. Thus they can’t impose any legal requirement on doctors to make referrals.

    If there exists such a requirement, even if it is not practiced, it would come from the province’s respective self-regulating body, like the Ontario College of Physicians or from a provincial statute.

    Your overarching point is well taken, but I think you need to dig a little deeper.

  • invalid-0

    I’ve often thought that my perfect job is to become a pharmacist and then convert to Christian Science.

    Then I could tell all my customers that I wouldn’t give them any mediceine, but I would pray for them.

    Or maybe a muslim ligour distributor.

    This religious exception thing is nonsense – if your religion prevents you from performing your job, you are morally obligated to get another job, not to refuse to do it.

  • invalid-0

    Simple solution – Object to pap smears? Don’t become a gyno/OB. It’s deranged to go into a profession knowing that your beliefs are antithetical to practices in the spectrum of services, intending to deny care to certain individuals.

  • invalid-0

    We have had this issue crop up out here on the “High Plains” of Saskatchewan where Medicare was first brought into Canada by a frightful bunch of humanist/socialists (And yes we are snobs and are proud about both facts)

    There is a simple response to denial of a right to ones health services [Abortion is such a right]

    Sue the persons who deny you that right be they private citizens, medical practicioners or politiciansSue them … and then have someone else sue them again just for good measure!

  • invalid-0

    Photobucket

  • invalid-0

    My wife missed her yearly pap smear by one year.
    The two year period between tests was enough for her to develop endometrial cancer of the uterus, and for it to take hold.
    The cancer eventually killed her.

    You don’t know what you’re talking about.

  • invalid-0

    Hello thordora,

    I live in NB, and I want to have a pap done for the first time. Where is that pap clinic you mentioned? ot their phone number.
    Thanks!

    Adriana

  • invalid-0

    If you could post the text of that essay somewhere, I’d be interested in reading it. As it is, the Reality Check blog is listed as the “source”, and it isn’t.