HUM 003: Ethics USI Vincentian Learning Module

LESSON 11: REPRODUCTIVE ISSUES AND

CONTRACEPTION

Overview

After our discussion on the major ethical theories, we are now ready to
examine some concrete moral issues and to offer our ethical evaluations on them.
The application of the ethical principles and theories on some concrete moral issues
is aptly called as applied ethics. In this module we shall examine some of the
common moral issues in ethics and biomedical ethics. These issues namely:
abortion, and an example of reproductive technology, which is, contraception, are
deemed to be under reproductive issues. At this, we shall determine their morality
or ethicality.

Learning Outcomes

At the end of this module, you will be able to:

1. Examine the different reproductive issues;
2. Determine the different perspectives on the issues; and
3. Evaluate the morality of these reproductive issues.

Learning Content and Self-Assessment Question

In this module, we shall be learning about moral issues that need moral
deliberation. This branch of ethics is called applied ethics insofar as it uses ethical
principles to tackle or address some important ethical issues. Moral principles and
theories are deemed absurd if they are not used to examine issues and to determine
what is ethically right using moral reasoning. As we know Applied ethics refers to
the branch of ethics that focusses on particular situations in life where the principles
in ethics can be applied (Glenn 1968, xiii). Particularly, this tackles reproductive
issues like abortion, reproductive technology and the issue of contraception.

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A. ABORTION

Technically speaking, abortion is known as the termination or the ending of a

pregnancy. This moral issue has raised a number of moral debates which is primarily
rooted on the issue of the sanctity of human life. Some pro-life advocates believe that
abortion is intrinsically evil, thus morally reprehensible, due to deliberate ending of
human life which starts at conception. Some pro-choice advocates on the other hand
staunchly declare that it is the woman’s prerogative to decide on what to do with her
body. But before dealing with some moral judgments on the issue, let us first be
clarified with the different kinds of abortion. There are basically three (3) kinds of
abortion (Vaughn, 2017).

1. Spontaneous Abortion: This kind of abortion is caused by the natural course of

things. It is also called as miscarriage. Usually, this kind of abortion happens when the
woman or mother meets an unfortunate accident that leads to the ending of her
pregnancy. This kind of abortion is never intentional hence not deliberate. Therefore,
the moral agent, in this case, the mother, is not accountable for the said abortion
because she lacks freedom and will. Considering the criteria for human accountability,
this particular act does not qualify as a human act, but rather as an act of man. This
kind of abortion is then judged as not morally wrong.
2. Induced Abortion: This kind of abortion is also called as deliberate abortion. In this
kind of abortion there is an intention to abort the fetus or the intention to end one’s
pregnancy. Usually, this kind of abortion raises a number of moral objections. Moral
objections mainly come from the sanctity of human life argument.
3. Therapeutic abortion: This kind of abortion is performed in medical emergency
situations. An example of this situation is ectopic pregnancy. An ectopic pregnancy
occurs when the fertilized ovum is stuck in the fallopian tube rather than sliding down
to the uterus. In this case, the life of the mother is danger. Hence, the only reasonable
thing to do is to end the woman’s pregnancy. Some ethicists do not consider such an
abortion as malicious or objectionable. Rather, it is considered as therapeutic because
it aims to save the mother’s life. Consequently, the fertilized ovum has to be removed.
Applying the principle of double effect, therapeutic abortion is morally permissible
because the primary intention is to save the woman’s life (which is considered good),
the elimination of the ovum is just the consequent effect.

There are three main positions on the moral permissibility of abortion:

1. Conservative View: Abortion is never morally justifiable (unless the intention is to

save the mother's life), according to conservatives, because the unborn is a full human
being. Conservatives argue that because there is no clear cutoff point between zygote
and adult human, the unborn should be treated as an innocent person from the
moment of conception. Christian morality shares with this moral point of view. Induced
abortion is not morally acceptable and is considered as mortal sin from the Catholic
Christian perspective.

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2. Liberal View: The liberal viewpoint maintains that abortion is permissible whenever
a woman desires it, because the unborn child is not a human being in the full sense of
the term. Liberals argue that simply being biologically human is insufficient to establish
personhood, and that a fetus lacks the characteristics that define a person. The liberal
view argues that the woman who bears the fetus or ovum inside her body the absolute
right over her body and whatever inside it.
3. Moderate View: The moderate position is in the middle, rejecting both the
conservative position of no tolerance for abortion and the liberal position of abortion
on demand. All sides agree that murder is abhorrent, that people have a right to life,
and that personal liberty should not be restricted until absolutely necessary. Judith
Jarvis Thomson, a moderate, says that even if the conservative opinion that the fetus
is a person from the time of conception is valid, abortion may still be morally
permissible in some circumstances. The right to life of the unborn is not absolute; it
indicates that killing a fetus is always unlawful, but only when it is done unfairly. This
view argues that in some cases abortion is permissible on justifiable grounds.

Self-Assessment Question

Are you in favor of abortion? Briefly explain your answer.

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B. CONTRACEPTION

Contraception which is loosely translated as birth control method is defined

medically as the “use of any practices, methods, or devices that prevent pregnancy.”
Similarly, an article from Medical News Today defines contraception as “the use of
various devices, drugs, agents, sexual practices, or surgical procedures to prevent
conception or pregnancy.” In other words, contraception is a term which used to refer
to any method and practice which may use tools, devices and instruments which can
prevent conception or pregnancy. John Noonan (1996) in the same way defines
contraception in a similar vein, hence, “contraception is a term which can be applied
to any behavior, method or action which prevents conception.” The most popular and

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influential understanding of conception, however, is the view that conception starts

when the sperm cell and egg cell meet. Fundamentally, contraception refers to any act
which prevents conception though there is a possibility or impossibility of creating one.
A distinction should also be made between contraception and family planning method.
Contraception is simply the act or method of preventing conception. Hence,
contraception can be present within the context of family planning. This is why
contraception is sometimes identified as family planning method. However, it could
also be the case that contraception is done outside marriage and hence not having in
mind the thought about family planning. In this case contraception is not used for
family planning or birth spacing but solely to prevent conception and pregnancy.

Methods of Contraception (Hatcher 1990, 155-420)

Abstinence
Abstinence is defined as an absolute refrain from penis-in-vagina contact, which
is considered as a “natural” means of contraception. It is a common practice in almost
all parts of the world. It is also believed that there are two types of persons who
practice abstinence. First, is the type of person whose abstinence is freely and happily
chosen. In this case, he or she deserves respect, encouragement and support. Second,
is the type of person whose abstinence or chastity is dysfunctional or forced upon him
or her. This person needs help. Abstinence is deemed to be a natural family planning
method strongly advocated and endorsed by the Roman Catholic Church. This
contraceptive method requires great discipline and will on the part of the couple.

Condoms
Condoms are considered as artificial barriers covering the penis. For many
centuries, its use and function ranges from protection against pregnancy, infection, for
decoration and occasionally for penile and vaginal stimulation. When it comes to the
purpose of using condom at preventing unintended pregnancy, the effectiveness is
moderate. The only pitfall in using condom is its breakage and slippage.

Vaginal Spermicides
Spermicides are essentially contraceptive devices that kill sperm once they have
entered the vaginal canal. “Spermicidal preparations consist of two components: an
inert base or carrier (foam, cream, jelly, suppository, or tablet) that ensures dispersion
and keeps the spermicidal agent in the vagina near the cervix, and a spermicidal
chemical that kills the sperm,” according to the manufacturer.

Diaphragm
It is commonly made of rubber. Rubber made diaphragm was “popularized in
the early 1880s when they were dramatically described in Germany by K. Hasse writing
under the pseudonym W.P.J. Mensigna.” The diaphragm is “dome-shaped rubber cup.
Its rim is flexible and is inserted into the vagina before intercourse so that the posterior
rim rests in the posterior fornix and the anterior rim fits snugly behind the pubic bone.”

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Cervical Cap
It is a cup-shaped device (a miniature diaphragm with a tall dome) that fits over
the cervix and is held in place by a seal formed between its firm, flexible rom and the
surface of the cervix.” The effect of the cervical cup vis-à-vis its contraceptive effect is
the same with the diaphragm.

The Pill
It is called as an oral contraceptive. Medically speaking, oral contraceptives have
a number of effects during a woman’s menstrual cycle. Combined oral contraceptives
thwart pregnancy largely by suppressing ovulation through the combined effects of
estrogen and progestin.

Implant
Using a simple trocar, implants are normally put beneath the skin on the inside
of a woman's upper arm in a fan-shaped pattern. Each of the 6 match-sized capsules
is 34 mm length and 2.4 mm in diameter. During the first few weeks, the 36 mg of
levonorgestrel is released at a low, steady rate of around 80 mcg per day, gradually
falling to about 34 mcg per day by 2 to 6 months. At 60 months, the hormone output
steadily decreases to about 25 mcg per day. Implants should be replaced every 5
years.

Charting Menstrual Cycles/Calendar Method and Fertility Awareness

Method
Charting menstrual cycles and fertility awareness methods are considered to be
natural family planning methods along with abstinence, which are endorsed by the
Roman Catholic Church. This method then should be used along with abstinence, that
is to say, to have coitus only during infertile periods. The medical realm considers it
“natural” in so far as the methods used are “natural” signs and symptoms associated
with the woman’s natural dynamics.

Coitus Interruptus
The act of removing the penis from the vagina prior to ejaculation is known as
coitus interruptus. In that way ejaculation will not happen inside the vagina and thus
prevents pregnancy. Withdrawal of the penis from the vagina must totally and duly
done. Otherwise, withdrawal as a contraceptive method fails.

Intrauterine Devices
IUD is inserted inside the woman’s uterus during her menstrual cycle. This performed
during the woman’s menstrual cycle to avoid inserting it when the woman is already
pregnant.

The Catholic Church only proposes the use of the natural method of birth
control. In the discussion of John T. Noonan Jr., he cites three main reasons proposed

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by the Catholic Church for prohibiting the use of artificial forms of contraception,
tracing the dominant texts in the medieval period trying to condemn the use of these
methods. The reasons are: (1) Using artificial contraceptives is a form of homicide; (2)
Using artificial contraceptives is unnatural; (3) Using artificial contraceptives destroys
marital relations (Noonan 1986, 231). Noonan points out the reason why there is not
much philosophical discussion on the issue of contraception. Noonan observes that:
Contraception was not likely to be a topic of dramatic interest where society found no
moral issue in the act from the poems, novels, and drama of the United States in the
twentieth century, it could be difficult to derive any notion of the widespread practice
of contraception. Except in a dramatic presentation of a Catholic family, such as Gabriel
Marcel’s play Craissez et multiplies, birth control is not likely to present grounds for
struggle or comment. The lack of mention of the subject in Roman ancient literature
can perhaps be explained as a general acceptance of contraceptive methods.
During the ancient time however, considering the availability of the rudimentary
means of contraceptives yet deemed relatively effective, the ancient philosophers
might have approved the use of contraceptives. Aristotle probably approves the use of
contraceptives as Noonan points out that: “Aristotle, describing the contraceptive use
of cedar oil in a biological work, might have found moral comment inappropriate; but
he does approve of abortion as a way of preventing population, so that presumably he
did not object to less drastic techniques.” Socrates on the other hand, sketching a kind
of pastoral paradise notes in passing that the inhabitants would not beget too many
offspring “lest they fall into poverty or war.” In this light, it can be assumed that for
Socrates and Plato, the use of contraceptives might be held permissible if not
praiseworthy. Looking at the issue of contraception from a philosophical perspective
apart from the theory of natural law, one can use the two main ethical theories, namely
utilitarian ethics and deontological ethics, considering contraception’s merits and
ethical status.

Self-Assessment Question

As a youth, are you for or against the use of artificial contraceptives? Briefly explain
your answer.

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Key Points
l Abortion is defined as the ending of pregnancy.

l Contraception is a term which used to refer to any method and practice which may
use tools, devices and instruments which can prevent conception or pregnancy.

References

Books:
Noonan, J. (1986). Contraception: A History of Its Treatment by the Catholic Theologians and
Canonists. Cambridge: Harvard University Press.

Sambajon, Jr, Marvin Julian L. (2007). Health Care Ethics. Quezon City: C & E Publishing, Inc.

Vaughn, L (2017). Bioethics: Principles, Issues, and Cases. New York: Oxford University Press.
Hatcher, MD, Robert A., and et. al. (1990). Contraceptive Technology, 15th Revised Edition. New York:
Irvington Publishers Inc.
Internet Source:
Templeton, S. (2007). “Babies Aborted for Minor Disabilities.” Times Online.
http://www.timesonline.co.uk/tol/news/uk/health/article2689787.ece. Accessed 24
August 2020.

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