For a time he was able to refer the women to two other doctors who did abortions, but they became unavailable. There was no one to whom he could send them, and some of them were ending up in the emergency department after amateur abortions. He has said that he felt like a coward for sending them away and that he was shirking his responsibility. Eventually, in spite of the risks to himself—loss of career, prison for years or for life—he decided to perform abortions and, at the same time, challenge the law. He knew from other doctors and from newspaper reports that women in Montreal had died from incompetent abortion. He knew that the women were determined to get abortions in spite of the danger to their health and lives. He knew that he could prevent those unnecessary deaths. And so he determined to use civil disobedience to change the law.