On sex selective abortion - again

Unless you live under a rock some place in Canada you cannot have missed this year's instalment of the annual procession of anti-choice campaigners on Ottawa's Parliament Hill. Of course, Canadians overwhelmingly are happy with the country's liberal take on abortion. So, much like Christian conservatives fudge the euthanasia issue by pretending that it is about protecting the 'vulnerable', the same people are at it when it comes to re-opening the abortion issue. They claim concern for what they describe as 'female gendercide'. Of course, there is nothing in Canada approaching a female gendercide, but like the vulnerability rhetoric in the euthanasia debate, they hope to garner at least some support when they make it look like they are protecting women. The real question is whether or not you believe that women should have the right to choose an abortion. The Canadian answer has been for a long time that they do. Once that answer is given, there are no 'right' or 'wrong' motives in that context, because a woman could even have an abortion for no reason at all. It is completely up to her. End of story. The nonsense about female gendercide defies belief, but it fits into a change of religiously motivated anti-choice activists' agitprop. Like in the euthanasia debates they no longer wave just their religious books, they do present actually public reason based arguments. It turns out these reasons are flawed, but they serve the agitprop purpose they have been invented for.

I repost below a commentary I wrote in January 2012 on this issue. Nothing really needs to be added, but it's well worth keeping it in mind in the context of the current anti-choice activities in Ottawa.

Odd CMAJ Editorial

There is a big of an outcry in Canada over an Editorial by the current Interim Editor-in-Chief of the Canadian Medical Association Journal, Dr Rajendra Kale. Kale argues that pregnant women in Canada should not be provided with information about the sex of the fetus to avoid female feticide among Indo-Canadians. Kale proposes that women should only be told 30 weeks after conception to make it more difficult for them to have an abortion based on an arbitrary marker such as the sex of the fetus. Indeed, The Toronto Star newspaper reports that there is some empirical evidence suggesting a not insignificant gender balance in parts of the country: 'Though Canada does not collect statistics based on ethnicity at birth, population statistics show the country, now home to more than a million Indo-Canadians, has a skewed gender ratio. According to the 2006 census figures, nationally there are 932 girls to 1,000 boys under age 15 in the South Asian community, compared to 953 girls to 1,000 boys in the general population. The numbers in the South Asian community in the Toronto area are further skewed with 917 girls to 1,000 boys in the Toronto Central Metropolitan Area. Broken down further, it shows 904 girls to 1,000 boys in Mississauga, and 864 girls to 1,000 boys in Brampton.'

The gender imbalance itself is not really a great deal of concern in the country as a whole, the differential between the South Asian community and the general populations is a mere 20. Not exactly a dramatic figure. That doesn't mean that this differential is not higher in certain parts of eg Toronto, but in the big swing of things this isn't a dramatic situation. Baldev Mutta, a staff member in a Punjabi Community Health Centre notes in the Star that there is a preference among recent immigrants in favour of male off-spring. Women are reportedly threatened with divorce if they don't agree to to abort female fetuses.

It goes without saying that putting women under such pressures is unacceptable. It also seems, for most circumstances, bizarre to me that - recent migrant or not - anyone would have strong preferences for the sex of his or her off-spring. However, there can be at least some ethically unproblematic reasons, too. For instance, a family might have a preference for a 50:50 ratio among their off-spring and so decide to abort a male or female fetus in favour of a future child of the desired sex. Having knowledge of their off-springs sex sooner rather than later arguably is better overall, because the aborted fetus would be less advanced in its development. There could also be good health reasons for wanting to know, for instance in the case of sex linked genetic diseases.

My point is that it is unacceptable to view certain reasons for wanting an abortion acceptable and other reasons sufficiently dodgy that one chooses ('doctor knows best', it goes without saying!) which women will be told of the sex of their off-spring and which women must not be told. It is clear from the statistics quoted by Kale in his Editorial that the overwhelming majority of Indo-Canadians do not actually choose abortions based on the sex of their off-spring. Preventing them -and anyone else -for that matter from knowing the sex of their off-spring is plain offensive. No wonder that a woman from such a cultural background is quoted along these lines in the Toronto Star, “It’s upsetting, to be honest with you,” says Hussain, who worries Kale’s editorial will further push this kind of discrimination. “It’s a stereotype that brown people will abort a child who is not a boy.” 

I might be mistaken, but I suspect that Kale's real agenda is anti-choice to begin with. He confuses fetuses and 'girls' as well as fetuses and 'women' in his Editorial as this quote shows quite nicely, 'Postponing the transmission of such information is a small price to pay to save thousands of girls in Canada. Compared with the situation in India and China, the problem of female feticide in Canada is small, circumscribed and manageable. If Canada cannot control this repugnant practice, what hope do India and China have of saving millions of women?'

Of course, the lives of neither women nor girls are at stake here. The issue is whether or not pregnant women have a right to know the sex of their off-spring. In Canada they do. It's a good thing. Cultural biases need to be confronted where they occur, there mustn't be technical pseudo-solutions to them that infringe on hard-won individual liberties that women can rightly take for granted today in Canada. If the argument really is about the morality of abortion, Kale should have argued that case and should not have chosen to engage in skirmishing activities to do with Indo-Canadians.

Bad news for anti-euthanasia campaigners

One can understand why anti-euthanasia campaigners get ever more desperate in their campaign strategies. After all, they can't be entirely honest with us any longer about their true motives, namely their religious convictions that just are not shared by most of us. So they have resorted to go on and on and on about the dangers of sliding down a slippery slope from voluntary to non-voluntary euthanasia, endless warnings about abuses of all kinds, stuff like that. They even publish agitprop papers in scientific outlets. An example as good as any is an article by Ottawa palliative care specialist Jose Pereira in Current Oncology that consist to a large extent of empirically false claims 'supported' by references that do not sustain his claims. As far as stooping low is concerned, anti-euthanasia campaigners do not seem to know what shame is all about, they certainly seem to have none. Remarkably the online outlet that chose to publish Mr Pereira's agitprop piece has so far refused to publish what would be a very long list of corrections to Pereira's error ridden article. The interested public, coming across Pereira's piece in medical databases, is still downloading his stuff without being notified about the long list of errors the article contains, even though the editors of the online publication are very much aware of these mistakes. I do wonder why basic principles of editorial professionalism seem to be of no concern to them. For what it's worth, in my considered view as an experienced editor of a large international bioethics journal, Pereira's piece should have been retracted a long long time ago. I encourage you to read his article as well as the second piece I link to above (by Jocelyn Downie and colleagues - they're showing how error-ridden this article really is).

One of the biggest current claims by anti-choice campaigners is that vulnerable elderly are at grave risk of being abused, should voluntary euthanasia ever come about. The thing is, of course, there is exactly zero evidence that  the decriminalisation of assisted dying has resulted in abuse of anyone, including vulnerable elderly. Today the New York Times has a remarkable line on this particular matter. It writes about a medical doctor, 67 year old Dr Wesley, a patient suffering from ALS, a disease that in effect lays waste to our muscles while leaving our mind intact, as the New York Times so aptly describes. The article notes, 'Dr. Wesley is emblematic of those who have taken advantage of the law. They are overwhelmingly white, well educated and financially comfortable. And they are making the choice not because they are in pain but because they want to have the same control over their deaths that they have had over their lives.' None of this is any news to pro-choice campaigners, but this kind of information doesn't suits the anti-choice crowd's scare campaigns, so you will undoubtedly hear more about vulnerable elderly and abuse and horror etc etc. All this in the service of subjugating secular societies' citizens to religious dictates as to how our lives must end. 

Anti-choice AgitProp

I have just penned an editorial for BIOETHICS on the fall-out resulting from the Report on End-of-Life Decision-Making in Canada that I had a hand in producing. The gist of it is that I wondered whether there's much point debating this issue with anti-choice activists (you know, for hire 'anti euthanasia', 'pro-life' agitprop types). I gave two examples, in said editorial, of encounters I had in the aftermath of the release of said Report where I confronted anti-choicers with incontrovertible evidence that their arguments are flawed. They were, in fact, unable to counter the arguments I put forward, yet that did not stop them, within 24 hours, from repeating arguments they knew at that stage to be faulty. So, why pretend that you have a genuine counter-part in a public debate, when arguably the real motives of your opponents are not out in the open to begin with and when their arguments, peppered with heart wrenching abuse stories, serve their propaganda objectives only. 


I began, half tongue-in-cheek, about a week ago a competition, encouraging readers of this blog to send me mistake they found in two such newspaper pieces of agitprop. To my delight, people actually took the time to dissect these two pieces. So, trying to be a good sport here, I am reproducing some of the mistakes people have identified in said agitprop. For reference, the Report is here or here. The agitprop articles  were published in a National Post blog entry penned by Barbara Kay, as well as in a piece published by Licia Corbella in the Calgary Herald.


Here we go: Both articles (the incriminating 'evidence' was self-reportedly 'googled' by Ms Corbella, it seems) report at great length and to much fanfare incidences of non-voluntary euthanasia in jurisdictions that have decriminalized assisted dying in some form or shape. Both authors take this as evidence that a slippery slope exists, whereby people's lives are being terminated in these jurisdictions variously against their wishes or without having requested this as a result of decriminalization. Ms Corbella bitterly complains that we have missed this evidence that is so very easily available to anyone with access to google (Ms Corbella's favourite research tool, presumably right next to wikipedia and the Anti-Euthanasia Coalition's website). Well, it turns out that we have mentioned non-voluntary euthanasia cases in our Report. Was Ms Corbella too busy copy-pasting her evidence from fellow anti-choice activists websites to actually read the Report we produced?  Be that as it may, we also pointed out that non-voluntary euthanasia takes place in societies that have not decriminalized assisted dying, hence the existence of non-voluntary euthanasia in societies that have decriminalized demonstrates nothing at all. This point has been made very eloquently in this article in the Ottawa Citizen. In fact, we provided empirical evidence in our Report that following decriminalization non-voluntary euthanasia has actually decreased in some jurisdictions (not as sexy as Ms Corbella's anecdotes, I know).  Ms Corbella was called on her obvious mistake by commentators on the Calgary Herald's on-line site, but has chosen not to reply, which brings me back to my theme: These agitprop type activists are not seriously engaged in debate, and we should not pretend otherwise. 


Barbara Kay makes a similarly obvious mistake, uncritically citing Margaret Somerville, a conservative Christian activist employed at McGill University who campaigns traditionally on any topic the Catholic Church has a strong view on (among her favourites are: gay marriage, and end-of-life issues). Kay quickly declares Somerville a bio-ethicist even though Somerville doesn't seem to have any formal degree type education at all in ethics. Be that as it may, Somerville is cited in Ms Kay's commentary, claiming that a survey shows that Canadians are in favor of improving palliative care rather than decriminalizing assisted dying. Our Report is duly blamed for not having taken this survey into account in our report. Not quite, and here we have another example of misleading use of empirical evidence. The poll in question was actually published after we completed our empirical survey chapter. More than that, the poll in question is not actually at variance with the findings of the polls we cite. The poll cited in the newspaper blog was commissioned by Life Canada (an anti-choice organization). [p 3 of on-line poll] Most of the questions in this poll are, given the nature of its partisan funder, suitably leading. However, on the evidence cited in this report 57% of respondents were in favor of the decriminalization of assisted dying. Surveys commissioned by organisations less in agitprop mode than Life Canada found significantly higher percentages of Canadians in support of a more permissive regime when it comes to assisted dying. We have cited some of those in our Report. Reportedly Life Canada has since dropped the decriminalization question altogether. Ms Somerville, in fact, used one bit of the Life Canada poll that suited her anti-choice agenda, and happily ignored what the actual evidence shows. She created the misleading impression that the survey results demonstrate preferences when they highlight priorities. The question posed was basically (pretending misleadingly that a society could have only one or the other) whether respondents were in favor of improving palliative care or in favor of decriminalizing assisted dying. [p 4 of on-line poll] I strongly encourage the interested reader to both read the newspaper blog as well as the actual survey in order to evaluate the evidence for the claims I am making in this paragraph. Kay and Somerville's misleading use of the data in Life Canada's poll brings us back to me theme for this entry: What's the point of having a serious debate with activists who are clearly not seriously interested in a genuine exchange of arguments? 


Ms Kay also mistakenly claims that access to euthanasia in the  Netherlands initially required evidence of a terminal illness. The fact is that terminal illness was never a necessary condition for access to euthanasia in that country, rather the relevant criteria were autonomous choice and individual suffering. Unlike in Ms Kay's reality, the Netherlands actually decriminalized euthanasia in 2002 and not in 1984 as she claims in her National Post piece. The problem with getting her facts right also bedevils Ms Corbella's commentary/article. She excitedly waves her hands about a 1995 report indicating that some 950 people's lives were terminated in the Netherlands without their request. Euthanasia, as already mentioned, was only decriminalized in the Netherlands in 2002.  Ms Kay must be equally desperate, why else would she have chosen to also resort to a 1995 piece to comment on the reality of euthanasia in the Netherlands today? I suspect that our two campaigners both used the same journal article, happily ignoring empirical evidence that has since 1995 been published in peer reviewed international medical journals - as referenced and discussed in our Report -  simply because it suited their ideological agenda. The author of the 1995 paper has not responded to the more recent evidence as it has accumulated.  It is worth mentioning that the incidence of non-voluntary euthanasia is higher in some countries with prohibitive regimes than in the Netherlands and Belgium.  There is no evidence that legalization of voluntary euthanasia results in non-voluntary euthanasia.  Rather, if anything, it reduces non-voluntary euthanasia.


What bothers me about agitprop such as that served up by Corbella, Kay and Somerville is that they must know that their arguments are not sustainable. They're not sustainable in the sense that it should be obvious to these authors that they are misleading the public with their intellectual content.  It seems pointless then to pretend that there is a serious intellectual debate taking place here. All that can reasonably be achieved is to debunk flawed and misleading arguments when they pop up. Because, trust me, you will see the same arguments popping up again in up-coming anti-euthanasia agitprop, probably within less than 24 hours after I post this blog entry. Such is life on the anti-choice campaign trail. 


Thanks to everyone who participated in the impromptu competition. The book price goes to a Canadian entrant, Mr. A. M. He found no less than 18 false or misleading statements across the articles/comments by Kay and Corbella. Well done Sir!