Ethical issues on Family Planning

Sofie Krisnadi

Reproduction: health objectives and ethical issues

Today, reproductive health and sexual health are major, world-wide, health objectives and human rights concerns. An example: family planning has made considerable, world-wide progress in the last decades.

The moral argument about contraception

People have found it necessary to limit family size for various reasons Folk methods and avoidance of intercourse Margaret Sanger instrumental in causing changes in the availability of birth control and contraceptive devices to women Zero population growth.

The moral argument about contraception

Philosophical arguments such as the "natural law" Arguments based on different ideas of marriage, sex and the family Human rights arguments such as

'procreative liberty' a woman's right to control her own body human rights arguments about mass birth control programmes

Arguments based on the good or bad consequences of birth control Arguments about the environmental and resource problems caused by over-population Religious arguments

A bit of history

In every historical period and everywhere, sex and reproduction have been an important topic of ethical reflection. In turn, ethical views on this topic reflect prevailing beliefs about: -the link between sexuality and reproduction, -the place of women and children in society, -the facts of prenatal life as seen by different cultures in different times.

Various moral traditions

Antiquity in Europe: Various objectives of contraception/abortion were already debated: -to limit family size, -to control demographic growth, -to dissociate sex from reproduction. Middle Ages: -Christian hostility to sexual pleasure without reproduction,

Two ethical perspectives on birth control

1-The individual point of view, grounded in the human rights tradition. The emphasis tends to be on personal rights and welfare, and the extent to which actions and policies promote them. Ethical reasoning is mostly based on deontological arguments invoking rights and obligations.
2-The collective point of view, concerned mostly with population issues and the aggregate results of individual behaviours on health and demography. The emphasis tends to be on utilitarian ethical arguments, that approve of actions and policies to the extent that they promote the greatest good for the greatest number. Communitarian views, that promote the collective values of specific communities can also be influential.

Two ethical perspectives on birth control

Reproductive rights entail:
Freedom to decide whether, when and how many children to have. Right to:

-modern family planning information, -modern family planning methods.

Right to control one's own sexuality.

Reproductive rights are human rights (2)

Reproductive rights can clash with: 1-National claims and policies 2-Community claims and policies. Physicians must reflect on their ethical commitment to personal vs. community values. Physicians must be clear on their ethical commitment to the health and welfare of individuals, families and communities, over and above any other commitments.

FP - Human rights benefits

It's essential for "procreative liberty

If people are not allowed a choice over whether or not to have children their autonomy and freedom to control their lives is seriously restricted.

FP - Health Benefits

It prevents the conception of unwanted children

and so reduces the number of possible abortions

It enables women whose health would be at risk if they conceived, to continue to have sex The use of condoms helps prevent sexually transmitted diseases and HIV

FP - Family Benefits

Prevents the conception of children that a family cannot support

Enables people to avoid having more children than they want Improves marriage because

enables couples to enjoy sexual activity without being anxious about conceiving a child enables couples to have fewer children and thus spend more time together reduces the cost of marriage (children are expensive)

FP - Benefits for women

Promotes gender equality and the autonomy of women:

pregnancy and child-bearing affect women much more than men women should have the right to choose or avoid these activities any restriction of birth control is therefore sexual discrimination enables women to enjoy sexual activity on the same basis as men any restriction of birth control is therefore a denial of women's right to sexual autonomy without contraception a woman may find herself having regular pregnancies

Enables women whose health would be at risk if they conceived, to continue to have sex

FP - Demographic benefits

Enables world population to be controlled and thus protects the environment and reduces poverty

many people think this is a dubious benefit, and point out that fairer use of the world's resources would be a better way of reducing poverty. Also more environmentally friendly behaviour would be a better way of protecting the environment

Contraception is inherently wrong

Contraception is unnatural Contraception is anti-life Contraception is a form of abortion Contraception separates sex from -

reproduction

Contraception brings bad consequences

Contraception carries health risks The "contraceptive culture" is dangerous Contraception prevents potential human beings being conceived Contraception is often misused in mass population control programmes in a racist way Mass population control programmes can be a form of cultural imperialism or a misuse of power Contraception may lead to depopulation

This sounds odd to an age concerned about over population but for substantial parts of the last 150 years this was a real fear.

Contraception leads to immoral behaviour

Contraception makes it easier for people to have sex outside marriage Contraception leads to widespread sexual immorality Contraception allows people (even married people) to have sex purely for enjoyment

The ethical problems of mass birth-control programmes (1)

Many people think that God's command to "be fruitful and multiply" can be taken too far. It's generally accepted that over-population will seriously damage the earth and the lives of most people on it. Large increases in population have already damage the environment and condemned many people in Africa, Asia and Latin America to poverty. In the last few decades, the effect of population control upon the environment has emerged as a justification for regulation of fertility in dependent of economic concerns.

The ethical problems of mass birth-control programmes (2)

However many people believe that there serious moral objections to plans to use contraception in order to control population. One objection that isn't covered here is that the real cause of poverty and damage is over consumption by a few, and that if rich nations stopped consuming far more than their fair share of resources there would be no need for population control to be applied unfairly to poor nations