Contraception Ethics 08

Definition of contraception

Contraception means avoiding or dicreasing the probability of pregnancy, using some medications, devices, or any other method that is temporary and/or reversible (WHO's definition). It concerns both males and females. The condom, the contraceptive diaphragm, the emergency pill and even abstinence are examples of contraceptive methods. Any form of sterilization such as castration or tubal ligation does not belong to contraceptive methods as it is permanent and irreversible. The contraception ethics is a big debate that started about 30 years ago, and has never concluded yet: still today, people discuss whether contraception is morally "good" or "bad", from various points of view.

Abortion will not be included. Please note that preventive and emergency contraception will be distinguished in some cases on this page: while preventive contraception just prevents any fertilization to happen, emergency contraception is performed by destroying a fertilized ovum (a zygote) which is believed to contain life by some people.

What is contraception on an ethical and a scientific point of view?

Scientific point of view:

• It is a voluntary prevention of pregnancy that can be used by both men and women.
• Through many methods, it gives us the possibility to choose between creating a family or not.
• Certains methods give the population a possibility to prevent ourselves from sexual diseases.
• It is an easy way to control population but is against procreative liberty. (ex: China, one child policy)

Ethical point of view:

• Contraception gave the women more rights over their body.
• Contraception gave women the choice not to have an unwanted child wich is linked to the fact that women have more rights.
• However, it might be considered as an inhibition of life. Do we kill somebody before he even has a chance to live? It leads us into the question of when does Life begin.
• It's a dilemna between reproductive rights : first for a woman to have the right to control her body and secondly the right for everyone to live (as seen in the articles of human rights).

Websites : http://www.bbc.co.uk/ethics/contraception/ http://en.wikipedia.org/wiki/Reproductive_rights -

When does Life begin?

This is the big question of our chapter. How to define life? How does it begin ? At which step? Is it the shape of an embryo that allows us to call it a human being? Is it its capacity of thinking ? Or does Life begin at fertilization, the meeting of two living cells?

This question really begun in the 90's with the discover of the in vitro fertilization, the scientists asked themselves if the embryo was already a human being or not. Scientists realized that there are many different point of views. Here are ar few:

• On the metabolic view, there is no real beginnig because the sperm cell and the egg are already alive. They are units of Life.
• On genetic view, Life begins at fertilization. At this moment a unique organism is created by the combination of the genes of the father and the mother. It has it own properties.
• On neurological view: In our Society, death is defined by the loss of the EEG (electroencephalogram) pattern this induces the idea that life begins at the acquisition of the EEG (around the 27th week).The EEG mesures the electrical activity in the brain.
• The physiological view sees Life beginning at the moment when the baby has become independent of its mother. It has its own respiratory, circulatory and alimentary system. This is when the umbilical cord is cut, so at birthday.

There are many other scientific views , but in the end we have to say that the beginning of Life cannot be defined by science only.

For the Catholic Chuch it is a question of soul. They changed their mind many times in history. First thay said that an immediate ensoulment is impossible and fixed the animation of the male fetus at 40 and for the women's fetus at 80 days after conception. For a long time, the penalty for contraception or abortion was excomunication. Nowadeays, the Church considers the act of conception as the beginning of Life.

This tough question induces a wide field of different possibilities and there isn't one precise answer. As scientifically every cell lives, we switch from the question "When does Life begin?" to "When can it be considered as a human- being?". Knowing that human-beings can only produce human-beings, we come to a point where we realize that the question is in fact about the value of (human-)Life. Yet, this question can only be seen on a moral and ethical level. Has a fertilized egg the same value as an embryo or a baby? - This question might never be answered as everybody has its own point of view. Everyone should use the method of contraception for which he has the least (or no) moral issues.

Legislative Point of view of Contraception

In a majority of countries, like in Europe or in North America, Contraception is allowed because they consider in the law that babies become a human being twelve weeks after fertilization. For Islamic Countries a baby is already a human beeing six weeks after fertilization.

In the other hand, some countries like China limited at one the number of children per family ( one child policy) because the state can't assure a good condition of life (hygiene, school etc) if they are too numerous.

In africa, some politics are thinking also about this one child policy to prevent difficulties which are important in africa ( lack of food, lack of medication and hygiene).

Ethical issues concerning each method of contraception.

In scientific middle, contraception is also a subject of problems, because physicians and other biologists do not agree about the real question of this debate which is "when does life really begin".

There are several methods of contraception interfering with the fertilization cycle at very different steps. Obviously, these steps are linked with the problematic of the contraception in an ethical point of view. Each method can be in contradiction with one way of thinking and throws into question the real beginning of Life.

When we talk about a contraceptive method such as the combination pill for women, we're dealing with inhibiting life at it's primary origin by acting on the sperm cell. The pill stops the ovulation and prevent the ova to be released, thus fertilization does not occur. The failure rate is usually less than 1 percent, however, in certain cases the ova can be still released and killed by the amount of hormones contained in the pill. (more informations about the pill : [1])

Using the pill could thereby be seen as a murder; we kill a fertilized egg that is considered to be the beginning of Life for many people and we stop the normal cycle of life by preventing the ovulation. The IUD, or intra uterine device, has almost the same effects. It is placed in the uterus and weakened the sperm and affect its movement, change the ligning of the fallopian tube and prevent implantation.(informations: [2]).

Working on the same step but with male sperm cells, vasectomy is one of the most efficient contraceptive method. It consist in blocking the production of viable sperm cells by tubal ligation. It is a complete sterilization but does not avoid the production of sperm cells.

These two methods (pill and vasectomy) raise another question : can we consider a sperm cell (or an ova) by itself as alive ? It can be the case on a metabolic point of view and on a religious one (even if they are still contentious).

Another method is the abstinence, although not seen as the religious concept. This method is called “the natural method” and consist of not having sexual intercourse during a chosen period of time, which takes place few day before and after the ovulation. Whereas others methods like the pill, it is 100% natural and is the more ethical method, according to all the different points of view, even though it is not very efficient (10% to 20% of failure rate).

Working on the same biological step as the abstinence, we find the use of the condom. The condom keep the semen out of the woman's body (if it is a male condom, the contrary also exists with the female one, for more precise information : [3]) and does not allow the ova to be fertilized. Again, this method is going against the religious beliefs and the idea that the sexual cells are living cells.

Finally, the last method is the emergency contraception as the “morning-after-pill”. It is the most discussed contraceptive method, especially if it is taken as a regular contraceptive. The “morning-after-pill” can act on the fertilized cell, when the nucleus from both ova and sperm cell have fused, by preventing the implantation of the embryo in the endometrium, but it can also avoid fertilization by preventing the sperm to reach the ova (more informations on emergency contraception: [4]).

Since we're talking about an embryo, some people consider it to be the murder of a human being. Almost all the controversy stops here: if the ova is fertilized, it is no longer a cell but a human being, having the right to live.

Philosophical-Ethical Movements : Ideas about Contraception

Pro - Feminists

Generally the feminist movement is favourable at the idea of contraception, they consider it as a choice that women have the right to have, because for them choice's liberty is essential.

Against - Religion

Emergency contraception induces the destruction of a zygote, an ovum that has been fertilized by a sperm cell, and it is believed that fertilization is the "instigator" of life (see "When does life begin"). Thus, using an emergency contraception method means that a life has been killed. Most religious groups considerate Life as a gift from God and the most precious property, and therefore strictly condemn the use of emergency contraception.

Additionally, some other religions including Christianism are opposed to all preventive contraception methods, except abstinence because in that case no living body is destroyed, unlike emergency contraception. The goal of contraception obviously is to have a sexual relationship without fearing an unwanted pregnancy. This is much blamed by Christianism (for example) as from their point of view, the natural role of procreation is replaced by the pleasure of sex and the gift of God is refused- it is for that reason that only "abstinence" as contraceptive method would be tolerated.

Interestingly, since nothing in the Bible explicitely defines at what point a child should be considered alive in its early development (from conception to birth), the opinions about it (and thus, about the morale of contraception too) come from philosophical interpretations of the biblical texts and vary a lot. While most believe that Life occurs at the moment of conception, and then reject contraception, some think that it occurs when blood is first developped (about 20 days after conception) and some others at childbirth. In these last two cases, contraception would be mostly accepted.

References

• Movie on stem cell: [5]

Bibliography

• http://www.pagetronic.com/jeux/culture/la-chine-populaire.xhtml
• http://8e.devbio.com/article.php?id=162 This webpage explains much about the religious pov concerning sexual abuse and other povs that changed through history.
• http://www.prolifephysicians.org/lifebegins.htm
• http://www.nrlc.org/abortion/wdlb/wdlb.html
• http://8e.devbio.com/article.php?ch=21&id=7
• http://www.religioustolerance.org/abo_when.htm

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