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Conservatives in crossfire from Canadian, British doctors

The federal government came under criticism Thursday from both British and Canadian doctors. The British objected to the Conservatives' position on funding abortion in international maternal-health programs. The Canadians complained about the defunding of the only Canadian agency to oversee issues of medical ethics.

The Lancet, Britain's leading medical journal, published an editorial on Canada's G8 health leadership. In part, it said:

Canada should be praised for making maternal and child health a priority issue for the G8. As an Article by Margaret Hogan and colleagues in today's issue shows, around 350 000 women die during childbirth every year. 9 million children younger than 5 years also die every year. Most of these deaths are preventable.

Canada's health plan to address this situation is still thin on details but it promises to include training and support for frontline health workers; better nutrition and provision of micronutrients; treatment and prevention of diseases such as pneumonia, diarrhoea, malaria, and sepsis; screening and treatment for sexually transmitted diseases, including HIV/AIDS; family planning; immunisation; and clean water and sanitation.

However, a few key elements are missing from the framework. For example, there is no talk of emergency obstetric care. This omission is likely to be an oversight and should be rectified. Improving access to safe abortion services is also absent from the plan. Sadly, this omission is no accident, but a conscious decision by Canada's Conservative Government not to support groups that undertake abortions in developing countries.

This stance must change. 70 000 women die from unsafe abortions worldwide every year. The Canadian Government does not deprive women living in Canada from access to safe abortions; it is therefore hypocritical and unjust that it tries to do so abroad. Although the country's decision only affects a small number of developing countries where abortion is legal, bans on the procedure, which are detrimental to public health, should be challenged by the G8, not tacitly supported.

Canada and the other G8 nations could show real leadership with a final maternal health plan that is based on sound scientific evidence and not prejudice.

Meanwhile, the Canadian Medical Association Journal reported on the sudden cut in funding to the National Council on Ethics in Human Research:

Canada has long been viewed as somewhat of a desert with regard to oversight of research ethics boards, largely because it lacks any manner of accrediting or auditing watchdog.

It may have just become a wasteland as the one body involved in any manner of review of boards, the National Council on Ethics in Human Research (NCEHR), which largely operated in an educational mode, has had its funding yanked by Health Canada and the Canadian Institutes of Health Research.

It had once been hoped that NCEHR could be transformed into a national accrediting and oversight body for research ethics boards. But with the funding cut, some research ethicists fear that efforts to establish such an agency have been scuttled.

...“I was kind of thunderstruck,” says Michael McDonald, a chair of applied ethics at the University of British Columbia. It was “a large loss to Canada in terms of how we do human subjects research,” concurs Dr. Ray Saginur, a research ethics expert at the University of Ottawa in Ontario.

Although NCEHR panels did not report their findings to government and had no authority to mandate quality assurance reviews in cases where a research ethics board had problems, it was still the “principal organization to promote participant safety in Canada,” says Heather Sampson, an ethicist at Toronto East General Hospital in Ontario and an NCEHR board member.

The effect of the defunding has been to privatize the council; the article concludes by noting that "the council has incorporated as a nonprofit organization and will be seeking donations to remain operational."

Crawford Kilian is a contributing editor of The Tyee.

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