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Abortion returns to Canadian Parliament this week

2012 September 19

A Conservative MP in Canada has tabled a motion to re-examine the legal definition of personhood, emphasizing that we ought to reconsider whether unborn fetuses should be granted human rights. You can read the text of the motion here (see M-312). Of course, the pro-choice camp (which includes me) has widely decried the motion. But I admit that “I disagree with you” isn’t a good reason to say “let’s not even discuss it”. Seems a little undemocratic, no? Indeed, this argument from democracy is the major argument that has been advanced by the MP who tabled the motion. However, if you actually read the motion, you find that there are other reasons to reject it. So, I wrote a letter to my MP about it, which I figured was worth publishing here too. My letter refers to the motion’s proposal for a committee to address the following questions:

… (i) what medical evidence exists to demonstrate that a child is or is not a human being before the moment of complete birth, (ii) is the preponderance of medical evidence consistent with the declaration in Subsection 223(1) that a child is only a human being at the moment of complete birth …

Honestly, I don’t expect this motion to pass anyway, but I saw an opportunity to argue a point, and I couldn’t resist. With that in mind, here’s my letter (which recycles a few lines from the form letter at

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Grow up, Canada

2012 August 27

(Second in a multi-part series on Aboriginal issues in Canada. See Part I: Growing up Canadian.)

Last month, I wrote about what I learned about Canada’s native* peoples over the course of my first two dozen years, as I grew up in a white English-speaking Canadian family, consumed English-language mostly-Canadian media, and attended Canadian public schools and a Canadian university. I knew poverty and social problems were deeply entrenched in many Native communities; I figured that since losing traditional lands and livelihoods in the distant past, these problems became entrenched, and, well, poverty anywhere is just a tough nut to crack. We’re all doing our best, though.

I’ve since learned a little more.

In the interest of brevity, I’ll only highlight a few of the key pieces of history that I think we non-indigenous Canadians need to be a lot more aware of. I won’t try to provide a great deal of historical context explaining how settler-indigenous relationships, including treaties and trade, evolved since first contact; I won’t try to deconstruct the racist attitudes and the historical and cultural misunderstandings that underlie these policy decisions; I won’t try to describe in detail their effects and the reactions they’ve provoked from Canada’s indigenous peoples. My goal here is just to make it clear that Canada has treated its indigenous peoples very badly, and it still does. Like I said before, this is likely to be upsetting. (And once again, I must credit âpihtawikosisân for much of this knowledge, as well as the format/tone I’m adopting.)

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Growing up Canadian

2012 July 12

(First in a multi-part series on Aboriginal issues in Canada. See Part II: Grow up, Canada.)

This month finds me in the Aboriginal community of Chisasibi, the most populous Iyyu settlement in Eeyou Istchee. (In English they are called the James Bay Cree; these are the Cree terms.) I want to thank my Cree hosts for having me here, and for taking care of this land for so many generations. Chisasibi is about 1500km north of Montreal; it is the northernmost community in Quebec that is accessible by road, though I took a plane.

Lots of friends and family have asked for stories, but I am hesitant to jump into detail without first saying something about the historical context of my presence here, and how I have come to understand it. I’ll start by explaining what I learned about Native people, growing up as a non-Native child in urban Canada. I will include my perspectives from that time. A warning to people who already know the history of indigenous peoples in Canada: you may be upset by this post, since I suspect it reflects a pretty typical upbringing for a non-Native Canadian child. (Conversely, people who don’t know the history will find the next post upsetting.) Read more…

CPHA 2012 conference

2012 June 15

The Canadian Public Health Association’s 2012 conference just wrapped up in Edmonton. I attended this conference last year for the first time (in Montreal), and both times now, I’ve come away inspired, fired up, chock full of ideas and motivation and useful new knowledge. One long-returning attendee said of the conference that “it feels like coming home”, and I can’t agree more. Here are the highlights, mostly for my own records.

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Smoke screen

2012 May 19

I apologize for the dreadful and pejorative pun in the title, but it’s either this or something dry and academic. Deal with it.

I spent some time at a private breast cancer screening clinic recently. I worked with a doctor who was clearly dedicated to unearthing every last breast cancer in his patients. A noble cause. Immediately after their digital mammograms, women sat down with this doctor to examine the images together. Most women—some more than others—have some areas where their breasts are naturally more dense. The images of these areas are not so clear; in all the women that morning, he proceeded to do an ultrasound.

I was there as an observer, and the main thing I observed was this: the quest for health was, for this doctor and these patients, a quest for certainty. Patients come in with one question: “could I have breast cancer?” But mammograms often cannot provide certainty. So he pressed on, refusing to definitively say “no” until all the tests had been done: the women that morning variously underwent ultrasound, MRI, and/or needle aspiration in addition to their mammogram. During one ultrasound, I saw a woman’s eyes go wide as this doctor casually mentioned that he could see a small cyst. His gaze was on the screen. “A cyst is normal”, I ventured. “Yes, it’s usually normal”, he half-agreed. The anxiety was, well, palpable. In the end, nothing was found. “Come back in six months.” Was this screening really helping this woman? Pull up a chair: the answer is going to take a while.

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“Gendercide” in Canada?

2012 May 19

Last month, the Canadian (G&M, CBC) and even international media (Economist, al-Jazeera) were all aflutter about a study which found that Indian-born women giving birth in Ontario were giving birth to more boys than girls, provoking concerns about sex-selective abortion, which one notorious Canadian columnist called “the worst form of gender discrimination”. This on the heels of an American clinic advertising preconception sex selection services to Indians in Canada, and of a CMAJ editorial calling for the withholding of sex information from parents until 30 weeks of pregnancy to prevent this “evil”, “repugnant” practice. The topic is also adding fuel to the abortion debate at large, so kindly reopened for us recently by a Conservative MP.

For me, this story has raised two important questions.
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Statement of intent (version 1)

2012 April 11

Hey, I finally thought of a new name for this blog! I’ve also got some new ideas about the point of this blog, whose audience is basically my friends and family.

Who am I? I come from a middle-to-upper-class urban Canadian family; I’m white, male, heterosexual, cis-gendered, English-speaking, and able-bodied. I’m also a doctor. I am the most powerful kind of person in Canadian society. People like me don’t get everything we want, but compared to less privileged people, we basically call the shots around here.

This doesn’t necessarily mean that we’re selfish or malicious. Some of us are, but most of us mean well. When we do try to help others, we usually figure we know what’s best for them, and we have a relatively easy time putting our ideas into practice.

So that’s where I come from. However, I’m also a relentless iconoclast (thanks to my cousin Chris for teaching me this very apt word). This means that the more I learn about the world, the more my worldview radicalizes, and the more I’m at risk of alienating myself from “mainstream” Canadian society—the very people I need to be able to reach if I want to make the world a better place.

So I’m thinking that what I want to do with this blog is to practice writing about epidemiology and social justice, for people who have not really studied these things, in hopes of overturning some of the things you thought you knew—because I used to think I knew them too. Stay tuned.

(Hmm… is it just another sign of my privileged position in society that I imagine—as so many members of ruling classes have done before me—that I know best and it’s my responsibility to go around educating people? Maybe, but hey, you are an autonomous and active consumer of what I will write here. I will write about ideas that I have found surprising and compelling and worth passing on, because I think they have the power to improve the world, and I want you to be an ally in this effort. Read and consider these ideas for yourself, and engage me in a discussion—especially if you disagree with me or are simply not convinced. I might be wrong! If so, I’d like to know about it.)