of the CMA in publishing Humane Medicine. There was certainly no intention to encourage a "hard-soft" myth. In terms of content CMAJ and Humane Medicine are to be viewed as complementary rather than competitive. Although doubtless there are readers of Humane Medicine of Watters' persuasion, there are many for whom faith and healing are not exclusive categories. Before we accept the findings of the Batson-Ventis study the sample size, the questionnaires and the behaviour measures need to be scrutinized. Thomas 'a Kempis may not be a prime candidate for a Christian role model nowadays, but a text quoted out of context does not offer the strongest link in an argument. Like their patients, many practitioners are devoutly or nominally religious. If quoting scripture helps a patient become more accepting of care, why not quote scripture, provided the caregiver is comfortable doing this? Since religious commitments are a fact of existence, there are sound pragmatic reasons for accepting patients and caregivers where they are rather than where some think they ought to be. Humane Medicine takes that as a defensible
point of departure. It is surprising that Watters finds so much to object to in Humane Medicine. It was never intended as a missionary flier but, rather, as a forum for exchanges on the practice of medicine where science, humanism and religion meet. In these exchanges one would expect the religious (of whatever persuasion) to identify elements in their thinking held in common with humanists, and those of a strictly scientific bent might appreciate humility in the face of the unknown. Athol Roberts, MD, CM, FCFP, LLD 199 Grafton St. Charlottetown, PEI
Medical procedures prohibited outside hospital in Nova Scotia I wish to bring to the attention of Canadian physicians legislation passed by the Nova Scotia government that is a direct, heavy-handed and unwarranted attack against the right of doctors to practise good medicine. The Medical' Services Act, as it is called, gives the minister of health the power to decide which medical procedures may only be performed within hospital walls, with a fine of not less than $10 000 and not more than $50 000 for each infraction. Instead of using normal medical criteria based on current knowledge and practice the minister decides which acts warrant prosecution and a fine. The bill was originally directed against me personally because of my stated intention of opening a freestanding abortion clinic in Halifax in order to help women from the Atlantic region, who still have to travel enormous distances to obtain abortion services. In fact, although I am now the only doctor being accused under this provincial statute the danger is that other doctors might find themselves in the same situation. The regulations under this bill prohibit the following procedures: arthroscopy, colonoscopy (which does not include flexible sigmoidoscopy), upper gastrointestinal endoscopy, abortion (including therapeutic abortion but not including emergency services related to a spontaneous abortion or to complications arising from a
previously performed abortion), lithotripsy, liposuction, nuclear medicine, installation or removal of intraocular lenses and electromyography (including nerve conduction studies). The minister of health did not consult the provincial medical board in drafting this bill. After passage of the legislation the mmn-
ister did meet with representatives of the Nova Scotia Medical Society, who persuaded him to remove some procedures, such as ultrasonography, mammography and fluoroscopy, from the prohibited list. In spite of the approval of clinics as adequate and safe facilities for the performance of abortions by such professional associations as the CMA, the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists, the Nova Scotia bill still insists on an in-hospital only requirement. I hope that doctors across the country and their associations will vigorously oppose this unwarranted intrusion into medical practice and the freedom of doctors to practise good medicine without arbitrary government interference. Henry Morgentaler, MD 85 Harbord St. Toronto, Ont.
[A copy of this letter
was sent to
Nova Scotia Minister of Health David Nantes with an invitation to respond. Mr. Nantes declined to do so. - Ed.]
Has Ontario's health care system gone to the dogs? J am extremely frustrated over the erosion of the quality of the health care services offered to our patients due to underfunding by our government. Last week the dog of a friend died and the professional bills amounted to $600. The public is willing to pay a veterinarian $55 for an electrocardiogram, whereas the local general practitioner would receive approximately $18. Chest radiography of the dog cost $120; the technical and professional reimbursement from the Ontario Health Insurance Plan for CAN MED ASSOC J 1990; 142 (3)
203
point of departure. It is surprising that Watters finds so much to object to in Humane Medicine. It was never intended as a missionary flier but, rather, as a forum for exchanges on the practice of medicine where science, humanism and religion meet. In these exchanges one would expect the religious (of whatever persuasion) to identify elements in their thinking held in common with humanists, and those of a strictly scientific bent might appreciate humility in the face of the unknown. Athol Roberts, MD, CM, FCFP, LLD 199 Grafton St. Charlottetown, PEI
Medical procedures prohibited outside hospital in Nova Scotia I wish to bring to the attention of Canadian physicians legislation passed by the Nova Scotia government that is a direct, heavy-handed and unwarranted attack against the right of doctors to practise good medicine. The Medical' Services Act, as it is called, gives the minister of health the power to decide which medical procedures may only be performed within hospital walls, with a fine of not less than $10 000 and not more than $50 000 for each infraction. Instead of using normal medical criteria based on current knowledge and practice the minister decides which acts warrant prosecution and a fine. The bill was originally directed against me personally because of my stated intention of opening a freestanding abortion clinic in Halifax in order to help women from the Atlantic region, who still have to travel enormous distances to obtain abortion services. In fact, although I am now the only doctor being accused under this provincial statute the danger is that other doctors might find themselves in the same situation. The regulations under this bill prohibit the following procedures: arthroscopy, colonoscopy (which does not include flexible sigmoidoscopy), upper gastrointestinal endoscopy, abortion (including therapeutic abortion but not including emergency services related to a spontaneous abortion or to complications arising from a
previously performed abortion), lithotripsy, liposuction, nuclear medicine, installation or removal of intraocular lenses and electromyography (including nerve conduction studies). The minister of health did not consult the provincial medical board in drafting this bill. After passage of the legislation the mmn-
ister did meet with representatives of the Nova Scotia Medical Society, who persuaded him to remove some procedures, such as ultrasonography, mammography and fluoroscopy, from the prohibited list. In spite of the approval of clinics as adequate and safe facilities for the performance of abortions by such professional associations as the CMA, the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists, the Nova Scotia bill still insists on an in-hospital only requirement. I hope that doctors across the country and their associations will vigorously oppose this unwarranted intrusion into medical practice and the freedom of doctors to practise good medicine without arbitrary government interference. Henry Morgentaler, MD 85 Harbord St. Toronto, Ont.
[A copy of this letter
was sent to
Nova Scotia Minister of Health David Nantes with an invitation to respond. Mr. Nantes declined to do so. - Ed.]
Has Ontario's health care system gone to the dogs? J am extremely frustrated over the erosion of the quality of the health care services offered to our patients due to underfunding by our government. Last week the dog of a friend died and the professional bills amounted to $600. The public is willing to pay a veterinarian $55 for an electrocardiogram, whereas the local general practitioner would receive approximately $18. Chest radiography of the dog cost $120; the technical and professional reimbursement from the Ontario Health Insurance Plan for CAN MED ASSOC J 1990; 142 (3)
203
