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Maternity care at Mount Sinai hospital, Toronto / Screenshot

Mount Sinai hospital in Toronto, Canada, was taken to a human rights tribunal hearing by a woman, 45, who demanded that one of the twins she was carrying be aborted, using, as the procedure is described euphemistically, “selective reduction,” the National Post reported this week. The doctors involved refused to abort the healthy fetus, and the hospital told the patient in an email that they only reduce triplets or larger groupings, unless one of the twins in question exhibits an anomaly.

An article on the website of the American College of Obstetricians and Gynecologists, titled, “Fetal Reduction From Twins to a Singleton: A Reasonable Consideration?” concludes: “…physicians know that spontaneous twin pregnancy losses average 8–10%. Also, with experience, multi-fetal pregnancy reduction has become very safe in our hands. Our data suggest that the likelihood of taking home a baby is higher after reduction than remaining with twins. We propose that twin-to-singleton reductions might be considered with appropriate constraints and safeguards.”

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The Mount Sinai email informed the patient that the procedure was available in the US, but did not recommend a specific facility. The hospital later cited the “conscience of the clinicians” as the reason they could not go about eliminating one of the two healthy twin fetuses.

The patient, identified in the complaint as C.V., said in an interview: “It was very much a judgmental and ill-thought and essentially disrespectful reaction … I was literally in disbelief.”

The patient retained the services of Amir Attaran, an Iranian-American Associate Professor of Law and Population Health and the holder of the Canada Research Chair in Law, Population Health and Global Development Policy at the University of Ottawa, who filed a complaint on her behalf with the Ontario Human Rights Tribunal, for discrimination on the basis of sex and family status.

According to the Toronto Sun, in 2007 Prof. Attaran alleged he had proof of Canada’s military abusing Afghan detainees. But he never produced any of the promised proof, nor was such proof found by an all-party parliamentary committee. In 2013, when Attorney General of Canada and Minister of Justice Peter MacKay criticized Liberal leader Justin Trudeau for his admitted marijuana use, Attaran filed a complaint with the Nova Scotia Bar Association, accusing MacKay of professional misconduct. The complaint was dismissed. Also in 2013, Attaran filed a complaint alleging professional misconduct against lawyers who worked in the Prime Minister’s Office for violating legal ethics. According to the Toronto Star, those allegations “were fully investigated” and the inquiry was closed.

Needless to say, after Prof. Attaran had filed his complaint, Mount Sinai quickly referred C.V. to Toronto’s Sunnybrook Health Sciences Center, where they performed the “reduction.”

Last July, the tribunal exonerated the hospital, ruling that “the facts as alleged by the applicant do not establish a case of discrimination under the Code. In particular, the applicant cannot show that she was denied equal treatment to the medical service she wanted because of family status or because of pregnancy. The Application is dismissed on that basis.”

But according to the National Post, Mount Sinai has now amended its policy to say that elective fetal abortion is “ethically complex and divides many people,” and doctors unwilling to abort a healthy twin pregnancy for reasons of conscience or religion should have a plan in place to refer patients to other physicians.


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