When the Ontario Human Rights Tribunal ruled on July 18th that Mount Sinai Hospital was not discriminating when it refused to abort one of a patient’s two healthy preborn twins, the patient decided to appeal the ruling.

The patient, a 45-year-old woman who is referred to in the case as C.V, had filed a human rights complaint to the OHRT on May 2015 claiming that she had been discriminated against on the basis of sex and family status.

C.V. had underwent in-vitro fertilization, and as is often the case with in-vitro fertilization, it resulted in her getting impregnated twice. It was recommended to C.V. by her obstetrician that she abort one of the twins, claiming that her age gave her a higher risk of losing the whole pregnancy, and she was referred to Mount Sinai Hospital.

Mount Sinai Hospital, a Jewish hospital in Toronto, claimed that though it does practice “selective reduction” abortion on triplets due to the medical risk of triplets, it does not practice it on twin pregnancies unless one of the twins has an abnormality, and suggested she go to the United States for the abortion. The hospital later indicated it would consider aborting both of the twins, but refused to abort only one of them due to the conscience of the clinicians, as well as due to an unwritten “multidisciplinary consensus policy.”

After C.V., with the help of University of Ottawa health-law professor Amir Attaran, who took on the case pro-bono, filed her complaint to the OHRT, Mount Sinai Hospital referred her to Sunnybrook Health Science Centre, where she had one of her twins aborted. She later went on to give birth to the other child.

OHRT adjudicator Brian Cook ruled that Mount Sinai had not been acting discriminant towards C.V. due to the hospital’s refusal being based on the fact that the procedure was not deemed “medically appropriate” and thus the clinicians had no requirement to perform it.

Mount Sinai has since produced an official written policy on the outlines of a selective reduction abortion, which it claims does not represent a change in the procedures that were in place in May 2015, except that a conscientiously objecting physician is required to provide an effective referral. The hospital refuses to post their policy online though. Attaran claims that the hospital’s lawyers said to him that “we don’t want to be known as a hospital that does abortions.”

Selective reduction abortions have been on the rise over the last few years. Currently, about 20 per cent of people who go through in-vitro fertilization end up with multiple pregnancies.

Selective reduction abortions are still highly controversial, especially in a twin pregnancy where the chances of losing the entire pregnancy is not very high compared to when a mother has triplets or pregnancies of a higher order. For this reason, many abortionists who practice selective reduction abortions refuse to practice on twins. Additionally, there has been concerns about the psychological effect that selective reduction abortion has on parents who must raise the surviving sibling, as well as on the child itself if they are ever told about the sibling or siblings with whom they once shared a womb.