IS CONTRACEPTION NATURAL?

Caroline Smith
1992 Woodrow Wilson Biology Institute


Rationale:

New reproductive technologies have raised many ethical issues that must be addressed by modern society. For some people a still more basic ethical issue is yet to be decided - do humans have a duty to reproduce? If they do not, what is the ethical framework in which reproduction and reproductive rights may be considered? This paper is designed to give the classroom teacher a brief background in the ethical history of contraception, and one major argument that supports contraception even if people have a 'duty to reproduce.' The material is not meant to be used directly with students.

Introduction:

Contraception (birth control) is a topic that is often addressed quickly and with some trepidation by most high school teachers because the subject is fraught with emotional, psychological, and religious overtones. However, it is a topic that must be addressed because many students are sexually active (or have plans to be), the AIDS crisis has once again brought reproductive activity into the limelight, and overpopulation is often given as a major cause of numerous ecological and geopolitical problems.

Contraception will be defined as those techniques that prevent fertilization from occurring. Any device or technology that prevents implantation or allows for early termination of pregnancy will be considered abortion. In the minds of some United States citizens the line between contraception and abortion is somewhat vague - both are somewhat morally neutral. For many others a definite distinction exists and the issue is an ethical one.

Historically, the use of contraception has depended as much on the religious, political, moral, or ethical context of the time as much as it has on the existence or knowledge of a particular technique (Spicker, 1987). No religion or ethical system has ever been indifferent to the issues involved in reproduction: (WHO, 1990)

  1. Social or governmental pressures have often existed to encourage or discourage births related to the dominance of a particular ethnic or political group

  2. Birth control has been used to increase the quality of life. (Many 19th century European women did not want children because of the high mortality rates of women and children.)

  3. Religious views, such as the desiring of one male child, have increased or decreased birth control

  4. The theology of the Roman Catholic Church has influenced the contraceptive use of the Western World

  5. The historical definition of personhood has changed to include or exclude women, ethnic groups, children, etc.

  6. In modern United States society many people have planned fewer children so they want them to be healthy and normal

Recent History

Until the mid-20th century techniques for contraception were primitive and unreliable. That is not to say that there were no methods. Cleopatra is known to have used ergot, a medicinal herb causing uterine contractions. The population of France after the French Revolution decreased considerably due to a high use of simple contraception and abortion.

Contraception was quite controversial in the United States until the 1960's when a series of judicial decisions and governmental policies, along with the advent of the "Pill," marked the conversion of a private vice into a public virtue (Reed, 1987). In 1967 Congress amended the Social Security Acts to include budgets for family planning in domestic maternal health programs and removed contraception from the list of items that could not be purchased with foreign aid funds (Reed, 1987). (In 1984 Title X regulations denied United States foreign aid to any organization that performs abortions, advises women on abortion, or lobbies on behalf of abortion rights (Scientific American, 1991). That policy denies U.S. funding to many international organizations that offer contraceptive services in Third World Countries.) In 1965 the Supreme Court expanded the right to privacy to protect the ability of married persons to use contraception. This protection was extended to unmarried persons in 1972. In Roe vs. Wade, 1973, the right was further extended to include certain practices of abortion. Since the advent of the 'Pill' in the 1960's, a host of fundamental ethical questions have arisen or been highlighted.

Moral Analysis:

Three types of questions may be asked about various aspects of human reproduction: (Bayless, 1984)

  1. What desires and values are rational?

  2. Given rational desires and values, what ethical norms can be accepted?

  3. Given rational desires and values, what policy norms are acceptable?

Moral analysis aims to consider issues through rational argument. To use moral analysis one basic assumption is implicit: "freedom is a basic value of rational persons. Those who want to limit freedom by ethical or policy norms carry the burden of persuasion" (Bayless, 1984). It is particularly difficult to make these assumptions when the topic is considered to be private, or rational reasoning is limited due to the emotion or fear of the topic.

The basic general question of reproductive ethics is whether people have a 'duty to reproduce.' "Even if they do not, is reproduction a good thing or is it morally neutral?" (Bayless, 1984.)

The most persuasive argument that people have a 'duty to reproduce' stems from natural law theory (Bayless, 1984.) People should do good and avoid evil. Those things that people are naturally inclined to do are most likely good. Humans act to continue or preserve their existence; therefore, life is a fundamental good or value. The natural law argument against contraception follows these rational steps: (Bayless, 1984)

  1. Good ought to be pursued and evil avoided.

  2. Good ends are those towards which people are naturally inclined.

  3. People are naturally inclined to sexual intercourse.

  4. A natural purpose of sexual intercourse is reproduction.

  5. Therefore, reproduction ought to be pursued in sexual acts (i.e. duty to procreate).

  6. To act intentionally against the good of reproduction is evil and ought to be avoided.

Look at step five - does every individual have the duty to reproduce? The purpose of reproduction is continuation of the species. Not everyone must have children to do this so it may not follow that reproduction ought to be pursued in all sexual acts.

A more basic argument to refute natural law theory addresses step two: "Are the ends to which humans are naturally inclined basically good" (Bayless, 1984)? Many philosophers think not. (The modern allegory Lord of the Flies pictures a society in which the natural inclinations of humans are anything but good.) Some religious philosophers reason that if God made the universe He would not make creatures with bad inclinations. But evolutionary process excludes only traits and inclinations that do not support survival. A trait may not be morally good just because it assures survival.

Further, if people's lives contain intrinsic good then it is good that people live and existence is good. So bringing about a valuable life by reproduction is then a good thing to do provided greater harm is not also produced (Bayless, 1984). But is it not entirely possible that reproduction may produce greater harm? Many people do not want children and the duty to reproduce would impose much unhappiness. If people have children out of duty they may not be good parents and their children would be less happy.

If both steps two and five in the natural law theory are not necessarily logical then it very well may be that people are doing nothing wrong by not having children and contraception is then not morally wrong. (The Roman Catholic church sanctions the rhythm method because persons involved are not purposely preventing conception. The act is open to reproduction even though they hope it won't occur.)

Further Considerations:

Conflict occurs or may occur between the rights and responsibilities of individuals and those of society in connection with decisions about reproduction and the effects of this conflict on women, children, the family, and society as a whole (WHO, 1990).

"Sexuality is a private matter. Patterns of sexual conduct may be of legitimate public concern" (Dubler, 1987). Questions that may arise in this context are: 1. Who has the right to decide what constitutes sexual behavior? 2. Who may be responsible for the consequences of sexual behavior? 3. Who has the right to control sexual behavior?

Public policies arise as a result of such questions. Since the invention of agriculture no important culture has left decisions about reproduction entirely up to individuals. In the United States both legislative and court decisions have addressed such questions. One major policy that affects sexual behavior is the 'right to privacy' established by the 14th Amendment to the Constitution. A state can restrict that privacy only by a clear showing of harm or by demonstration of a compelling state interest.

World population growth places contraception in another category of ethical questions. Major ethical questions concerning population issues include:

  1. Is there a right to control reproduction in the light of population development?

  2. Do we have a moral responsibility to control reproduction in this context? (Reed, 1987)

  3. How do the issues of distributive justice (the proper or just distribution of social benefits and burdens under conditions of scarcity) and coercion affect those ethical concerns?

Abortion:

Since any discussion of contraception will likely lead to some interest in or discussion of abortion, a brief overview of the ethical basis of abortion viewpoints is appropriate. Generally there are three broad groups of views - conservative, liberal, and moderate.

The conservative view says that fetuses have the same rights as other human beings, including the right not to be killed. Abortion is ethically wrong except to save the life of a pregnant woman and abortion should be illegal except in such cases.

The liberal view says that fetuses do not have rights. Abortion is ethically permissible because there are no rights to be violated; abortion should be legal.

The moderate view may be anything in between the liberal and conservative. The fetus usually has some moral status; discussion is about when the moral status occurs and how much. Abortions are ethical under certain conditions (life of mother, rape, severe fetal malformation, etc.) Some legal restrictions on abortion should occur.

A good discussion of these viewpoints may be found in the book Reproductive Ethics by Michael Bayless.


THOUGHT PROVOKERS FOR TEACHER OR STUDENTS:

  1. "Sexuality is a private matter. Patterns of sexual conduct may be of legitimate public concern" (Dubler, 1987).

  2. Use of words: 'Family Planning' vs. 'Birth Control Devices and Drugs' 'Promiscuous vs. Sexually Active'

  3. "Morally or ethically the use of contraception is not different from the use of seat belts; it represents a reasonable precaution against a known risk" (Nathanson, 1987).

  4. "By making a contraceptive available we neither condone vice nor impose virtue" (Nathanson, 1987).

  5. The IUD prevents implantation not fertilization. Why is it considered a contraceptive not an abortifacient?


References:

Bayless, Michael D. Reproductive Ethics. Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 1984.

Bondeson, Will, Tristram Engelhardt, Jr., and Stuart F. Spicker, (eds.). The Contraceptive Ethos, Reproductive Rights and Responsibilities . Boston: D. Reidel Pblg., 1987.

Dubler, Nancy N. "The Right to Fornication; The Right to Reproduce. " The Contraceptive Ethos, Reproductive Rights and Responsibilities. Boston: D. Reidel Pblg, 1987.

Luigi, Mastrioianni, Jr., Peter J. Donaldson, Thomas T. Kane, (eds.). Developing New Contraceptives. Washington, D.C.: National Academy Press, 1990.

Noonan, John T., Jr. "The History of Contraception: Seven Choices. " The Contraceptive Ethos, Reproductive Rights and Responsibilities. Boston: D. Reidel Pblg., 1987.

Reed, James. "The History of Contraceptive Practices." The Contraceptive Ethos, Reproductive Rights and Responsibilities. Boston: D. Reidel Pblg., 1987.

World Health Organization. Research in Human Reproduction, Biennial Report, 1988-1989. Geneva: World Health Organization, 1990.


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