LL Wynn, Joanna N Erdman, Angel M Foster, James Trussell
Abstract This article compares the ethical pivot points in debates over nonprescription access to emergency contraceptive pills in Canada and the United States. These include women’s right to be informed about the contraceptive method and its mechanism of action, pharmacists’ conscientious objection concerning the dispensing of emergency contraceptive pills, and rights and equality of access to the method, especially for poor women and minorities. In both countries, arguments in support of expanding access to the pills were shaped by two competing orientations toward health and sexuality. The first, “harm reduction,” promotes emergency contraception as attenuating the public health risks entailed in sex. The second orientation regards access to pills as a question of women’s right to engage in nonprocreative sex and to choose from among all reproductive health-care options. The authors contend that arguments for expanding access to emergency contraceptive pills that frame issues in terms of health and science are insufficient bases for drug regulation; ultimately, women’s health is also a matter of women’s rights.
Abstract The fear of many is that some physicians have been co-opted by the penal authorities and state legislatures in this country to believe that physician participation is a civic duty and one that is in the prisoner’s best interest. In reality, these physicians are being used as a means to an end. They are being used by certain states to medicalize executions in order to make them more palatable to the American public and to prevent capital punishment from being declared unconstitutional because it is “cruel and unusual punishment.” A basic tenet of the principle of respect for persons is that one may never use another person as a means to an end. Legislating that physicians must be present at executions uses these physicians as pawns, or means, in order to legitimize capital punishment. This not only violates the rights of these physicians but violates the basic ethical principles of the medical profession and distorts the physicians’ role in society.
Extract The children of women who have been denied an abortion are at risk of certain disadvantages, but such problems could be alleviated by better adoption and social programs. Since well educated women have the most “liberal” attitudes towards abortion’4 and are the least likely to have economic reasons for wanting an abortion, programs to prevent abortion should be directed towards changing their attitudes. Also, women who have been denied abortion should be followed up, both for the child’s sake and to prevent further requests for abortion.
Extract . . . risks are relative. A woman exposed to childbirth is at greater risk than a woman having an induced abortion . . . Blame for cervical lacerations sustained in the course of an induced abortion should be laid on the surgeon, not on the procedure. . . . .We are impressed by improvements in maternal and infant health reported in areas where safe legal abortions are relatively easy to obtain: mortality and morbidity from septic illegal abortion all but disappear and neonatal mortality plummets. . . While the state did not force her to have heterosexual intercourse, it is clearly intending her to remain pregnant against her will by making it impossible to interrupt a pregnancy she has tried to avoid. It is our view that abortion should be at the bottom of a list of options available to an unwillingly pregnant woman. . . . there needs to be a consensus among gynecologists as to the point during gestation when abortion is no longer an option. . . abortion is a nasty business. The answer to its elimination surely lies in . . . adequate sex education in our schools, and training programs in human sexuality and reproductive regulation in the curricula of our health care educational institutions.