The recent anti-contraceptive editorial and letter in the Dispatch sidestep some important medical and ethical realities.
First, contraceptives are frequently used for disabling ovarian and uterine conditions that preserve fertility, which surgery would not. The medical option is deemed ethical. Second, most pregnancies are either wanted or unwanted. An estimated one in four children in the U.S. is now living in poverty, it costs to have and raise children, and for many people the desire and decisions regarding pregnancies are largely economic. To help people medically make these decisions is considered ethical. The potential societal costs of more children in poverty should not be ignored.
In my view there are two conservative ethical views sparring with these realities. The first is that all contraception is morally wrong and therefore should be discouraged at every turn. This concept postulates the greatest good for the greatest number — at the risk of some harm to a minority. At another level, the ethical argument is “We have different values, but don’t force your values on me.” Both of these stances are different from medical ethics, which is foremost to determine what is best for the individual patient, understanding that there is risk in any decision. But if all contraceptives are so morally wrong, why not simply outlaw them? A cost-only focus smacks of availability to the rich vs. unavailability to the poor.
Another ethical reality is that most recent arguments usually place all conception responsibility and restrictions on women, even though it usually takes a man to cause a pregnancy. If all men used condoms responsibly, women would not need contraceptives. But then all men would obviously be violating the above conservative ethics. Therefore it still seems preferable to scapegoat women, just as Adam did to Eve in the garden.
Charles R. “Dick” Peterson, M.D.