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Emergency Contraception: Ethical Issues

Is Emergency Contraceptive Abortion?

How does ella contraceptive work? The main ethical objection to Emergency Contraception (EC) is that it is a form of abortion. These objections hinge on the definition of when pregnancy begins. The most common scientific view is that pregnancy begins when the embryo becomes embedded in the uterus, while, for most objectors, it is at the point of conception. The latter view leads to the possibility that any method that potentially destroys the embryo can be seen as a form of abortion. ella emergency contraceptive pill debates still continue over this fact.

Many researches and health professionals dispute this view, claiming that EC prevents unwanted pregnancy, leading to fewer abortions.

http://ec.princeton.edu/questions/ecabt.html

Emergency Contraception and the Catholic Church

The ethical issues around EC are particularly prominent in the Catholic Church. In general because of the anti-abortion position of the Church and in particular the right of catholic health professionals and institutions to refuse to prescribe or administer EC, even in the case of rape victims.

When a woman decides to take part in ella contraceptive use, neither she nor the doctor can know whether the technique works as a contraceptive to prevent fertilisation, or terminates the development of the fertilised egg. This lack of certainty has led some catholic commentators to argue that where there can be no scientific certainty, moral certainty should prevail. In this case, the moral good of preventing an unwanted pregnancy for a rape victim can trump the ethical objections to abortion.

Within the Catholic Church, Bishops are opposed to EC while the majority of Catholics are not.

In the USA, 78% of catholic women are in favour of EC for rape victims and 57% for it in broader circumstances.

In Mexico, 85% of catholics are in favour of EC for rape victims and 73% for it in broader circumstances.

These statistics are broadly similar throughout catholic Latin America. http://www.abortionreview.org/index.php/site/article/868/

The Ethics of Access

From the beginning, a moral debate has taken place around the availability and access of EC.

As can be seen from the above statistics, a moral distinction is often drawn between EC after a sexual assault and after consensual unprotected sex. Only the most diehard of anti-abortionist would object to EC being prescribed or sold to rape victims.

In the early days, concerns about side effects and the safety of EC, particularly multiple use were prominent. As it has become increasing clear that EC is a safe procedure, more so than either abortion or pregnancy, these objections have been significantly eroded.

However, moral objections remain to EC being available as an over the counter drug, particularly in the case of girls below the age of consent. These concerns primarily relate to fears that EC will lead to immoral or sexually irresponsible behaviour. There are also fears that EC will increase unprotected sex leading to an increase in sexually transmitted diseases.

In the USA and UK EC is widely available without prescription to any woman above the age of seventeen and sixteen respectively. In practice only a small number of women use EC. In a Survey by the Office for National Statistics, only 6% of participating women had used EC, despite the fact that 93% were aware of it.

http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Sexualhealthgeneralinformation/DH_4001998

One reason for this could be morally biased advice given by health professionals.

Professional Moral Bias

Some studies have found morally biased attitudes by health professionals when prescribing, administering or selling EC. These include both favouring clients considered to be more responsible or worthy, and a punitive attitude to those considered feckless or undeserving. Such attitudes can be barriers to the take up of EC particularly among the poor and poorly educated, a group that might struggle the most with caring for an unwanted child. The conclusion that one study reached was that:

Recognizing these attitudes and striving to thwart them in favour of the virtue of compassion is essential to providing appropriate and ethical patient care.

http://virtualmentor.ama-assn.org/2012/02/jdsc1-1202.html

In surveys of the moral attitudes of pharmacists to EC, most had no moral qualms about selling EC over the counter. Pharmacists who had religious or moral objections to EC could also limit the wider use of EC, by either refusing to supply EC, or by giving confusing and biased advice.

http://eprints.whiterose.ac.uk/10208

Reducing Unwanted Pregnancy

The moral good most often cited for free access to EC is the reduction of unwanted pregnancy. A large study published in The Lancet concludes that:

Unintended pregnancy is common, although many choose to continue the pregnancy. However, EC use is low even among women with no intention of conceiving, and is thus unlikely to reduce unintended pregnancy rates. Rather, we need to find ways to improve the use of regular contraception.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69737-7/fulltext

As this survey indicates EC may not reduce the overall number of unwanted pregnancies, but this does not lessen its moral value. At the personal level, EC provides a morally preferable alternative to the possibility of abortion or unwanted pregnancy.

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