Contraception Ethics

What is ethics ?

The Oxford definition : "the moral principles governing or influence conduct".
Everyone has a subjective point of view of objective reality and a personal opinion. These are the values of an individual. These values are sometimes completely personal, but are often influenced by social norms, political ideals, religion, etc. Ethics determines how we conduct ourselves, depending on these values. Ethics determines our definition of what is right and what is wrong.

Medical ethics is the way morals influence our use of scientific discoveries.

What are the ethical issues with contraception ?

Contraception is a contraversal topic, because it concerns reproduction, which is a fundamental aspect of human life. It is also closely linked to sexuality, wich is another delicate topic. Opinions concerning this topic are divergent, of course, and we shall attempt to analyse the different viewpoints.

In which circumstances is contraception acceptable?

Some people will never have problems to use any kind of contraceptive method because they just consider it as useful and don't think much further. Others, at the contrary, think that any kind of contraception is to ban, because it destructs life. And they don't want to accept that it can be very useful... These two archetypes are good examples of what are the extreme opinions about the subject. There are many arguments to support the two sides, and also more nuanced points of view. We will try to analyze the different situations that require the use of contraceptives and there multiple facets. The arguments of the different parties basically depend on these three factors :

• Why is contraception used?
• Who chooses to use it?
• When? With which method?

Why is contraception used?

Even though religion tends to condemn the very concept of contraception, there are different kind of people with their own motives, who cannot be judged the same way. There is different reasons for using contraception depending on the situation :

• A couple : either to choose the moment to have a child (if the couple finds itself too young and want to have children later or too old and already have children), either to to not have any child at all.

Comment: contraception may help couple to choose the best moment to have a child, which can be considered a good thing if it is in the child's best interest. In the second situation (not to have child at all), contraception is used as a personal choice, to prevent having a child when the couple is capable of having children. It can be for several reasons (economic, lack of maternal instinct, etc).

• A single adult: a single woman may choose not to have a child, not having a serious partner (or a single man may ask his occasional partner to use contraception.)

Comment: Single adults may choose not have a child outside of a serious relationship (a child could suffer from the absence of solid, stable couple). Single adults may also take advantage of the freedom contraception gives them, and do not wish to found a family.

• A teenager: teenagers who are single or in a couple

Comment: Teenagers generally choose not to have children because they consider themselves to young to found a family, and wish to pursue other activities, such as their studies. A good aspect of this is that it prevents young teenagers of having children they surely wouldn't be able to raise properly, but some may think contraception promotes extra-marital sex. For teenagers who are not in a stable relationship, the situation isn't really similar to that of an adult single: a teenager is still gathering experience. Changing partners every three months isn't the same when you're sixteen and when you're thirty-one.

• Unwanted close encounters: In certain cases, the sexual relationship was unwanted by the woman; for example, in the case of a rape or in the case of a prostitute, who doesn't have a choice but to do that particular job.

Comment : in these cases, the eventual child is clearly unwanted, and for reasons that have nothing to do with the fact of creating life. Contraception permits to stop the birth of a baby conceived in violence, in shame or at least without any love. For these particular cases, the invention of contraception is a really good thing. Of course, ones may think such a job is to banish and thus that there is no need for contraception.

LITTLE CONCLUSION : contraception is used for three main reasons

• To have a sexual life and pleasure without decisive consequences
• To choose the best moment to have a baby
• To avoid having a baby because the parent(s) don't want one in their life
• To avoid having a baby because the child would certainly suffer in the life the parent(s) can offer to him

Who chooses to use it ?

The birth of a human being ALWAYS involved TWO persons. Thus avoiding this birth should also be a commun decision. That is not and can not be always the case in the reality.

• When the man does not care...

It is the woman who carries the baby until it can see the world. Already at the begining the man is less involved : if he decides to leave, to shirk, nothing can hold him (except love or a minimal sense of responsability ...). If the woman wants to walk away, the baby stays in herself and follows her. As we know, contraception acting before fertilization and independant of sexual act (pill, patch and introterine device) is nearly always taken by the women : she knows her life could radically change if she is not careful. It is possible that his partner does not know if she takes or not something. This ignorance is often due to the disinterest of the man for this "detail". The physical possibilities of easily walking away can not be an excuse for the man. Neither can be the physical location of the foetus. When he makes love with a woman, the man should ALWAYS be aware of the situation. Maybe the girl uses no contraceptive methods and if she get pregant his life too would radicaly change and without he even thought about it.
Of course now we should normally never make love without condom, because of STD. But one girl over eight get pregnant using only this method...

• When the girl decides alone

For a woman, it is very easy to take the pill without her partner knows it (if he wants to have a baby and she doesn't want). This happened much at the beginning of the pill, when the woman saw the possibility to work if she had only two or three children (while their husband wanted more).
The contrary is also easy : to say she is taking the pill, but in fact she is not (for example a pretty old couple, and the woman feels it is the last moment for her to have a baby in her life). This happens and this is manipulation.

• When the family decides for the couple

In certain cases (particularly when a woman get pregnant without being married) the family decides for the couple that the woman must abort. Often it is for a question of honor. This experience is horrible even if the woman would certainly be rejected from her community if she gives birth.
This familial decision can also be motivated by economical and religious reasons.

• When an external decision doesn't let any choices to the persons concerned

Their is two representative examples. First China : the government forbids to any couple to have more than one child for the country not to be overpopulated. This causes many problems (girls killed at birth to permit that the family has a boy instead - less expensive - or also the formation of a society consituted of spoiled child...) The second concerns handicapped persons. Depending on the cause, the laws allow doctors to sterelise them - which is another form of contraception.

LITTLE CONCLUSION : contraception let sometimes unappropriate person(s) decide for life, as well as it leads to unequal responsabilities in the process. A couple should, as far it is possible, take a decision together.

When it is used ? With which method ?

Contraception is used to prevent or avoid having a baby. The difference between prevention and avoidance is the moment when contraception is used. When contraception is used to prevent the sperm cells from reaching the oocyte, with a condom for example, fertilization is avoided. However, when contraception involves destroying the fertilized ovum (day after pill), it is preventing the future foetus from developing. Some think using contraception is destroying life. But when exactly does life begin ? In the fertilized egg (the first seven days), in the embryon (until three months), or in the foetus (from three to nine months) ?

• Sexual abstinence

Some people (particularly religious believers) think sexual contacts should always have the aim of procreate and never to provide pleasure. Using condom (or any kind of contraception acting before the meeting of the ovum and the sperm cell) is already avoiding life's fromation. Thus the only solution for them not to have a baby is sexual abstinence.

• Contraception acting before fertilization

There are many : condom (for man or woman), pill, patch, soft methods... Because they prevent fertilization, life doesn't even have the possibility to begin. Thus certain persons think these methods are the only acceptable ones. However, several religions believe that contraception preventing fertilization is acceptable, as it doesn't destroy an already existing embryo.

• Pill ang patch

Some think these methods change the natural cycle of the woman and so are artificial and not ethically acceptable...

• Introterine device

Can act before but also after fertilization (by creating a hostile environment for the impregnated ovum). Thus it can destroy the start of a life.

• The day after pill

Contraception method acting after fertilization.

• Abortion

It kills the embryon. In Switzerland abortion is legal during the 12 first weeks, if the mother is in a distress situation. Thus we can deduce that ethically, life begins with the foetus for the swiss government (otherwise abortion would mean to kill somebody, and that is forbidden by the laws...)

LITTLE CONLUSION : There is no unique definition of what life is. Scientifics and religious organisations mostly disagree about whether or not contraception is morally acceptable.

General conlusion

Ethic (dictated by many different criterions) influences our choice of contraceptive methods. However the final decision depends also on other factors, such as medical reasons, diponibilities or costs of the methods and the social and religious environment.

References

• Islam and contraception [1]
• BBC website: http://www.bbc.co.uk/religion/ethics/contraception/

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