The reaction to my last blog, in which I discussed reports of doctors refusing pap smears to women in Canada, has been strong. Comments swirled, other sites and liserves picked it up, and I have wondered, why this one? I have written on many controversial subjects, from marital rape to seniors having sex, and yet a blog on pap smears has garnered attention from all over Canada and the US. In fact, even Peggy Cooke, whose wonderful essay on being pro-choice in Canada was the inspiration for my blog, professed not to understand why people have chosen to focus on this particular part of her essay given that it was not her main argument.

I chose to focus on this issue, because I myself was shocked that a doctor would refuse to perform what I believe is a routine medical procedure, certainly part of my yearly physical, on religious grounds. Frankly, there are no religious arguments that in my mind can excuse a doctor who is charged with the overall well-being of their patient from refusing to perform a pap smear. Cancer happens, whether you have sex or not, so to tell a young woman that she is too young, or doesn't need to worry about it, puts her life at risk. Pap smears save lives and no amount of moral policing is going to change my mind.

Did my piece blow the problem out of proportion? That all depends on who you ask. I don’t think the cases Peggy Cooke reported are isolated; I think that this is happening all of the time and women are just accepting it. Why did I choose to write about pap smear refusal? Because I think that it is really just an affirmation of what we all know to be true: that women’s access to unbiased, medically-sound reproductive health care in Canada is being compromised by doctors hiding behind conscience clauses to refuse services and referrals because those services and referrals "go against their beliefs.” Referrals, even when they are given, are often not enough. Canada struggles with doctor shortages; this means that some women simply cannot pick up and find another physician if one denies her critical services.

The very fact that women have to rely on gatekeepers for their physical well-being is astonishing. Men don’t have the same problems: their form of contraception, condoms, can be bought without a prescription and without a physical check-up.

Finally, I think that discussing issues such as this one shows us that we can no longer sit back complacently and tell ourselves that our system is working. Yes, it does work, but there are cracks, and the longer we let them develop, the harder it will be to repair them. From not getting pap smears, to being told you are too young (or too old) to have sex, an array of warning signs suggest that we need to demand comprehensive medical treatment that is unbiased and without judgement.