The Morning after Pill or MAP Ethical consequences of a solution
The idea of a female contraceptive is nothing new. For decades, women and doctors have been trying to come up with the ideal solution to planned parenting from the introduction of "birth control pills" to female prophylactics to injections. With abortion being the most controversial of them all, and ultimately sparking, the debate of a woman's right to choose what goes on with her own body. The morning after pill or emergency contraceptive is yet another offered solution to women and men wishing not to become parents at every engagement of intercourse. The moral questions raised with this newest pharmaceutical contraceptive are some of the same questions that have been asked about all the rest of the present birth control methods available. Because of how quickly MAP works and its potential for reckless abuse, people are concerned about its dangers to women and the repercussions of the additional moral questions raised by it. (Bossom)
Before we can measure the moral and ethical implications of using this drug, we need to take a closer look to be sure we fully understand what it is we are holding in moral contempt. From a scientific perspective, this contraceptive is a high dosage of the conventional birth control pill used by thousands of women every day. However, unlike "the pill", which is used on a schedule of the calendar, a woman can take MAP right after sex and it performs its function over 72 hours to prevent or end a pregnancy. The Morning After Pill has three possible ways to prevent pregnancy. First, ovulation is inhibited. Second, the menstrual cycle is altered, delaying ovulation. Lastly, it irritates the lining of the uterus in case the first two ways do not work. The fertilized egg cannot attach to the lining of the uterus, where it needs to be in order to grow. (all)
The manufacturer Barr Pharmaceuticals, Inc. of this contraceptive explicitly confirms in a statement released to the public, "that Morning After Pills are not the same as Mifepristone (Mifeprex), the so-called abortion pill." (Barr Pharmaceuticals, Inc.) "The abortion pill terminates an established pregnancy, one in which the fertilized egg has attached to the uterine wall and has already begun to develop." (Pruthi) Some would say this argument of differences is of the same church, but a different pew, which leads us to the first moral measurement of this drug, the lightning rod for the views of all contraceptives by the highly structured religious sector, holding the Divine Command theory above all other moral measuring machines.
From a religious perspective, all life is precious and no one has the right to play God. Not even in the cases of rape, incest, or at the expense of a mother's life. The Catholic Church has not moved an inch on their position. Those religious supporters that believe in the Divine Command Theory (Krasemann) would justify their position by saying that the Morning After Pill is still murder at the initial step of life. Maybe not as dramatic as late term abortions, still it is the conscious prevention of life that a higher being has created. In addition, this higher being has his or her way of terminating a pregnancy when things do not go right. However, this point could be argued as nature's natural selection of survival of the fittest. Although this idea is, an entirely separate ethical debate unto itself. Once again, through the rules and teachings of some religions, women do not have presumed control of their own bodies. In which case, when a woman breaks one of the rules set forth by her church there are punishments to face. Such as eternal damnation, which awaits those accused of the sin of killing of Humanae Vitae (Latin, "Human Life"). (Bernadeane Carr) "Contraceptives are wrong because it is a deliberate violation of the design God built into the human race." (Bernadeane Carr) Of course, the church does have its own underlying motives for disapproving of the use of birth control, which is to insure the perpetuation of the religion.
In regards to prolife supporters, who have at times taken a more aggressive role in their efforts to have their point of view heard, sometimes with deadly consequences. The burning of abortion clinics and shooting abortion doctors are some of the ruthless tactics used by some pro-life supporters. (Press) The paradox of this situation is, if only referenced to the Kant Theory (Krasemann) that by doing these things they are in fact breaking the very ethical code they are trying to uphold. Killing and burning abortion clinics all of the time by some of the people, does not sound like a code for the betterment of society.
The less-extreme pro-life supporters would seem to be the most unlikely of allies in supporting the church's position, but for different reasons. Like football fans on opposite sides of the field supporting the same team. Pro-lifers, although there are many factions with a semi-religious moral base, others have taken a more Utilitarianview. To put contraceptives to the utilitarian test we have to ask, "Is it useful in bringing about a desirable end?" That would depend on your perspective of the action, from the point of view of the patient, yes; from the perspective of right to chose supporters, yes; from the view of the doctor's prescribing contraceptives, yes. However, the larger statement of Utilitarianism states, "Everyone should perform the act or follow the moral rule that will bring about the greatest good for everyone concerned." (Krasemann) Is the use of contraceptives bringing the greatest good for all? This question cannot be answered by one standing for all because in a situation-by-situation basis, what would seem morally wrong when measured by utilitarian ethical standards, however it may still be a necessity of fact. For example, we could say that the use of contraceptives would seriously reduce our population; on the other hand, we do not want more under age teenagers having babies.
Nevertheless, are women using contraceptives doing the morally right thing? This question can be addressed by applying the ethical theory of Ethical Egoism, which in its three forms states, "Individual ethical egoism, everyone ought to act in my own best interest. Moreover, Personnel ethical egoism, I ought to act in my own self-interest, but I do not say what others should do. Finally, universal ethical egoism, what says everyone should always act in his or her own best interest, regardless of the interests of others, unless their interests help me." (Krasemann) From a purely practical standpoint, it may be in a woman's own best interest not to get pregnant at the drop of a hat. For example, if a woman has other medical problems that would automatically put her or her baby's life at risk. Some could argue she needs to act in her own best interest. Not to mention by not putting her own best interest first she would be in moral conflict with another moral measurement machine. The Kant Duty Ethics machine (The Categorical Imperative) which says, "The statement cannot be contradicting of itself and must be able to be applied as a rule for all. By saying some women with serious conditions should put themselves at risk of death all the time by never using contraceptives." (Krasemann) is clearly an immoral statement. Therefore, cannot be used as the rule, which leads me to another question. Should women who have the intentions to use a baby as a means to an end be forced to use contraceptives? In the eyes of some courts, yes, as they have ordered some low-income women with a criminal background to seek preventions to becoming pregnant as a stipulation of conditions set by the court. (LibertySuger)
What about the moral standing of the doctors? Are physicians offering the drug along with pharmacists willing to fill the prescriptions doing the right thing? In regards to an ethical measurement of the acts of the doctors, the Virtue Ethics Theory (Krasemann) perhaps is the best machine for this question. There are opponents that argue that doctors are tools of the giant drug companies, pushing sales. Others argue doctors have no moral standard because they prescribe contraceptives. In fact, it would seem some doctors out there are not acting completely immoral. Although it is not completely clear where all doctors stand on the moral position on the issue. This is what one doctor had to say about it as reported on the Concerned Women for America website, "If scientific study should validate that a hormonal contraceptive agent is partly abortifacient in its action, we would oppose that agent just as we oppose elective medical and surgical abortions." (Bossom)
Two other doctors, who researched the post-fertilization effects of hormonal contraceptives who have published the findings in the American Medical Association's Archives of Family Medicine, said that the evidence suggested that there are post-fertilization effects at least some of the time. However, both doctors observed that very few patients were aware of the possibility. They firmly believe that women should be given enough information to make an informed decision about whether they wish to use the Morning After Pill. (Bossom) Although this is a position, it may not be a virtuous one. The Virtue Ethic Theory states, "moral excellence, righteousness, and responsibility, of good and virtuous character." (Krasemann) Are these doctors upholding to this standard of ethical code? No, dishing out chemical contraceptives to under-informed women and teenagers is not a demonstration of virtuous ethics. There is no moral high ground in condoning, at least in part, reckless behavior. Deep down both the doctors and women will either choose to listen to their own intuition about what is good and bad for them or not. However, as Intuition (Krasemann) is the most abstract of all the ethical disciplines. It becomes hard to measure the level of intuition used in the decision to use contraceptives. One thing is true, at any point after using the contraceptive a person can choose to listen to their institution and stop.
There are many views, opinions, and judgments on the subject of abortion and contraceptives. Some well meaning and some that are not. As with everything, people's passions about a subject or act can be carried too far, until they themselves become an immoral act. Betraying unconsciously by the same passions and wills having a moral compass is supposed to help direct. We have seen the religious point of view, the pro-life point of view, touched upon the views of a woman's right to choose, and the medical point of view. To address the last ethical theory in regards to the distribution and use of contraceptives, we turn to the Ross Prima Facie Duties, "That certain duties apply to all humans, obeying in a general way before other considerations which are Fidelity, Reparation, Gratitude, Justice, Beneficence, and Nonmaleficence." (Krasemann) Again, a great deal, if not all of these duties are abstract in the sense they cannot be concretely proven to be taking place or not. However, the silver bullet to this argument is that, each man must decide for himself with trust in his intuition if in fact he is abiding by these duties. Being abstract makes it hard to see their application to our subject. Once again, it is solely based on point of view. From the point of view of the doctor, Fidelity will only hold if he or she is perfectly clear with the patient about the risks associated with this drug and a moral discussion has taken place about all the choices a woman has available. However, in the same token the women must not only be truthful with her lover and doctor but with herself. One overlooked aspect of duty theories is how it would apply to one's self. Not just, how one uses duties to make moral judgments in regards to others. Reparation, once again, one can only make reparation if one feels they have done a wrong thing in the first place. The doctor may feel righteous in his cause to help women and a woman may feel she owes no reparation to anyone about her choices about her own body, unless of course she has feelings of guilt as her decision causes a moral religious conflict.
Gratitude maybe what a women may feel for the services of the doctors for their help, or perhaps a doctor may feel gratitude for women taking responsibility for themselves and for an unwanted pregnancy. Justice is certainly, what a liberal woman would feel if finally they have a say over themselves; Doctors in their support of a woman's right to choose. Only those whose cause is prevailing can have a sense of justice. Although, some would take morality and the law into their own hands, dishing out justice in their own way, which is undermining of the concept of justice for all. Vigilantism is not a duty of a society. Beneficence, the helping to improve the condition of others in intelligence and happiness. Certainly, some doctors supporting this drug must feel they are helping those wishing for this kind of help. The church must feel they are helping those in need of guidance, even if they don't know they need it. It is safe to say that everyone in support of their own cause believes they can help someone, even if it is only themselves. People do service to others for selfish reasons. This does not mean that anyone of these virtues are being upheld in the manner they were intended. Nonmaleficence; this concept or virtue rings home for many people on the firing lines of this debate. Because there are so many ways to inflict injury; with words, actions, non-action, rocks, and bullets. A doctor withholding information that would influence a woman's decision to use the drug is injury. One can say the demonstration of any of these virtues alone doesn't deem a person morally fit. The Theory of Ross is reduced to food for thought for the common person to reflect on. To do a moral inventory and work to apply wisdom in our judgment of others and ourselves. The discovery of this piece has been that there is a moral question at the heart of this debate and there are no easy answers. However, the beauty of all of the ethical theories is that they demand investigation and thought of who we are and how we look at the world.
Bibliography
11 march 2009 <http://www.barrlabs.com/>.
all. 5 oct 2005. 10 march 2009 <http://www.pro-life.net/article.php?id=10130>.
Bernadeane Carr, STL, Censor Librorum, August 10, 2004. 10 august 2004. 10 march 2009 <http://www.catholic.com/library/Birth_Control.asp>.
Bossom, Elizabeth. CWA. 8 march 2206. 11 march 2009 <http://www.cwfa.org/articledisplay.asp?id=1559&department=CWA&categoryid=life>.
Krasemann, Jacques P . Thiroux Keith W. Ethics Theory and Practice. Upper Saddle River: Pearson-Prentice Hall, 1995. 41.
Krupnick, Joseph C. Flakemagazine.com. 2007. 5 feb 2009 <http://www.flakmag.com/opinion/planb.html>.
LibertySuger. Citizen suger. 25 9 2008. 11 march 2009 <http://www.citizensugar.com/2079537>.
Press, Garry Mitchell Associated. Moseshand.com. 2009. 20 march 2009 <http://www.moseshand.com/studies/two_doctors.htm>.
Pruthi, Sandhya. MayoClinic.com. 24 may 2008. 5 feb 2009 <http://www.mayoclinic.com/health/morning-after-pill/AN00592>.
Wright, Wendy. Concerned Women for America . 25 aug 2206. 5 feb 2009 <http://www.cwfa.org/articles/5621/CWA/life/index.htm>.
Before we can measure the moral and ethical implications of using this drug, we need to take a closer look to be sure we fully understand what it is we are holding in moral contempt. From a scientific perspective, this contraceptive is a high dosage of the conventional birth control pill used by thousands of women every day. However, unlike "the pill", which is used on a schedule of the calendar, a woman can take MAP right after sex and it performs its function over 72 hours to prevent or end a pregnancy. The Morning After Pill has three possible ways to prevent pregnancy. First, ovulation is inhibited. Second, the menstrual cycle is altered, delaying ovulation. Lastly, it irritates the lining of the uterus in case the first two ways do not work. The fertilized egg cannot attach to the lining of the uterus, where it needs to be in order to grow. (all)
The manufacturer Barr Pharmaceuticals, Inc. of this contraceptive explicitly confirms in a statement released to the public, "that Morning After Pills are not the same as Mifepristone (Mifeprex), the so-called abortion pill." (Barr Pharmaceuticals, Inc.) "The abortion pill terminates an established pregnancy, one in which the fertilized egg has attached to the uterine wall and has already begun to develop." (Pruthi) Some would say this argument of differences is of the same church, but a different pew, which leads us to the first moral measurement of this drug, the lightning rod for the views of all contraceptives by the highly structured religious sector, holding the Divine Command theory above all other moral measuring machines.
From a religious perspective, all life is precious and no one has the right to play God. Not even in the cases of rape, incest, or at the expense of a mother's life. The Catholic Church has not moved an inch on their position. Those religious supporters that believe in the Divine Command Theory (Krasemann) would justify their position by saying that the Morning After Pill is still murder at the initial step of life. Maybe not as dramatic as late term abortions, still it is the conscious prevention of life that a higher being has created. In addition, this higher being has his or her way of terminating a pregnancy when things do not go right. However, this point could be argued as nature's natural selection of survival of the fittest. Although this idea is, an entirely separate ethical debate unto itself. Once again, through the rules and teachings of some religions, women do not have presumed control of their own bodies. In which case, when a woman breaks one of the rules set forth by her church there are punishments to face. Such as eternal damnation, which awaits those accused of the sin of killing of Humanae Vitae (Latin, "Human Life"). (Bernadeane Carr) "Contraceptives are wrong because it is a deliberate violation of the design God built into the human race." (Bernadeane Carr) Of course, the church does have its own underlying motives for disapproving of the use of birth control, which is to insure the perpetuation of the religion.
In regards to prolife supporters, who have at times taken a more aggressive role in their efforts to have their point of view heard, sometimes with deadly consequences. The burning of abortion clinics and shooting abortion doctors are some of the ruthless tactics used by some pro-life supporters. (Press) The paradox of this situation is, if only referenced to the Kant Theory (Krasemann) that by doing these things they are in fact breaking the very ethical code they are trying to uphold. Killing and burning abortion clinics all of the time by some of the people, does not sound like a code for the betterment of society.
The less-extreme pro-life supporters would seem to be the most unlikely of allies in supporting the church's position, but for different reasons. Like football fans on opposite sides of the field supporting the same team. Pro-lifers, although there are many factions with a semi-religious moral base, others have taken a more Utilitarianview. To put contraceptives to the utilitarian test we have to ask, "Is it useful in bringing about a desirable end?" That would depend on your perspective of the action, from the point of view of the patient, yes; from the perspective of right to chose supporters, yes; from the view of the doctor's prescribing contraceptives, yes. However, the larger statement of Utilitarianism states, "Everyone should perform the act or follow the moral rule that will bring about the greatest good for everyone concerned." (Krasemann) Is the use of contraceptives bringing the greatest good for all? This question cannot be answered by one standing for all because in a situation-by-situation basis, what would seem morally wrong when measured by utilitarian ethical standards, however it may still be a necessity of fact. For example, we could say that the use of contraceptives would seriously reduce our population; on the other hand, we do not want more under age teenagers having babies.
Nevertheless, are women using contraceptives doing the morally right thing? This question can be addressed by applying the ethical theory of Ethical Egoism, which in its three forms states, "Individual ethical egoism, everyone ought to act in my own best interest. Moreover, Personnel ethical egoism, I ought to act in my own self-interest, but I do not say what others should do. Finally, universal ethical egoism, what says everyone should always act in his or her own best interest, regardless of the interests of others, unless their interests help me." (Krasemann) From a purely practical standpoint, it may be in a woman's own best interest not to get pregnant at the drop of a hat. For example, if a woman has other medical problems that would automatically put her or her baby's life at risk. Some could argue she needs to act in her own best interest. Not to mention by not putting her own best interest first she would be in moral conflict with another moral measurement machine. The Kant Duty Ethics machine (The Categorical Imperative) which says, "The statement cannot be contradicting of itself and must be able to be applied as a rule for all. By saying some women with serious conditions should put themselves at risk of death all the time by never using contraceptives." (Krasemann) is clearly an immoral statement. Therefore, cannot be used as the rule, which leads me to another question. Should women who have the intentions to use a baby as a means to an end be forced to use contraceptives? In the eyes of some courts, yes, as they have ordered some low-income women with a criminal background to seek preventions to becoming pregnant as a stipulation of conditions set by the court. (LibertySuger)
What about the moral standing of the doctors? Are physicians offering the drug along with pharmacists willing to fill the prescriptions doing the right thing? In regards to an ethical measurement of the acts of the doctors, the Virtue Ethics Theory (Krasemann) perhaps is the best machine for this question. There are opponents that argue that doctors are tools of the giant drug companies, pushing sales. Others argue doctors have no moral standard because they prescribe contraceptives. In fact, it would seem some doctors out there are not acting completely immoral. Although it is not completely clear where all doctors stand on the moral position on the issue. This is what one doctor had to say about it as reported on the Concerned Women for America website, "If scientific study should validate that a hormonal contraceptive agent is partly abortifacient in its action, we would oppose that agent just as we oppose elective medical and surgical abortions." (Bossom)
Two other doctors, who researched the post-fertilization effects of hormonal contraceptives who have published the findings in the American Medical Association's Archives of Family Medicine, said that the evidence suggested that there are post-fertilization effects at least some of the time. However, both doctors observed that very few patients were aware of the possibility. They firmly believe that women should be given enough information to make an informed decision about whether they wish to use the Morning After Pill. (Bossom) Although this is a position, it may not be a virtuous one. The Virtue Ethic Theory states, "moral excellence, righteousness, and responsibility, of good and virtuous character." (Krasemann) Are these doctors upholding to this standard of ethical code? No, dishing out chemical contraceptives to under-informed women and teenagers is not a demonstration of virtuous ethics. There is no moral high ground in condoning, at least in part, reckless behavior. Deep down both the doctors and women will either choose to listen to their own intuition about what is good and bad for them or not. However, as Intuition (Krasemann) is the most abstract of all the ethical disciplines. It becomes hard to measure the level of intuition used in the decision to use contraceptives. One thing is true, at any point after using the contraceptive a person can choose to listen to their institution and stop.
There are many views, opinions, and judgments on the subject of abortion and contraceptives. Some well meaning and some that are not. As with everything, people's passions about a subject or act can be carried too far, until they themselves become an immoral act. Betraying unconsciously by the same passions and wills having a moral compass is supposed to help direct. We have seen the religious point of view, the pro-life point of view, touched upon the views of a woman's right to choose, and the medical point of view. To address the last ethical theory in regards to the distribution and use of contraceptives, we turn to the Ross Prima Facie Duties, "That certain duties apply to all humans, obeying in a general way before other considerations which are Fidelity, Reparation, Gratitude, Justice, Beneficence, and Nonmaleficence." (Krasemann) Again, a great deal, if not all of these duties are abstract in the sense they cannot be concretely proven to be taking place or not. However, the silver bullet to this argument is that, each man must decide for himself with trust in his intuition if in fact he is abiding by these duties. Being abstract makes it hard to see their application to our subject. Once again, it is solely based on point of view. From the point of view of the doctor, Fidelity will only hold if he or she is perfectly clear with the patient about the risks associated with this drug and a moral discussion has taken place about all the choices a woman has available. However, in the same token the women must not only be truthful with her lover and doctor but with herself. One overlooked aspect of duty theories is how it would apply to one's self. Not just, how one uses duties to make moral judgments in regards to others. Reparation, once again, one can only make reparation if one feels they have done a wrong thing in the first place. The doctor may feel righteous in his cause to help women and a woman may feel she owes no reparation to anyone about her choices about her own body, unless of course she has feelings of guilt as her decision causes a moral religious conflict.
Gratitude maybe what a women may feel for the services of the doctors for their help, or perhaps a doctor may feel gratitude for women taking responsibility for themselves and for an unwanted pregnancy. Justice is certainly, what a liberal woman would feel if finally they have a say over themselves; Doctors in their support of a woman's right to choose. Only those whose cause is prevailing can have a sense of justice. Although, some would take morality and the law into their own hands, dishing out justice in their own way, which is undermining of the concept of justice for all. Vigilantism is not a duty of a society. Beneficence, the helping to improve the condition of others in intelligence and happiness. Certainly, some doctors supporting this drug must feel they are helping those wishing for this kind of help. The church must feel they are helping those in need of guidance, even if they don't know they need it. It is safe to say that everyone in support of their own cause believes they can help someone, even if it is only themselves. People do service to others for selfish reasons. This does not mean that anyone of these virtues are being upheld in the manner they were intended. Nonmaleficence; this concept or virtue rings home for many people on the firing lines of this debate. Because there are so many ways to inflict injury; with words, actions, non-action, rocks, and bullets. A doctor withholding information that would influence a woman's decision to use the drug is injury. One can say the demonstration of any of these virtues alone doesn't deem a person morally fit. The Theory of Ross is reduced to food for thought for the common person to reflect on. To do a moral inventory and work to apply wisdom in our judgment of others and ourselves. The discovery of this piece has been that there is a moral question at the heart of this debate and there are no easy answers. However, the beauty of all of the ethical theories is that they demand investigation and thought of who we are and how we look at the world.
Bibliography
11 march 2009 <http://www.barrlabs.com/>.
all. 5 oct 2005. 10 march 2009 <http://www.pro-life.net/article.php?id=10130>.
Bernadeane Carr, STL, Censor Librorum, August 10, 2004. 10 august 2004. 10 march 2009 <http://www.catholic.com/library/Birth_Control.asp>.
Bossom, Elizabeth. CWA. 8 march 2206. 11 march 2009 <http://www.cwfa.org/articledisplay.asp?id=1559&department=CWA&categoryid=life>.
Krasemann, Jacques P . Thiroux Keith W. Ethics Theory and Practice. Upper Saddle River: Pearson-Prentice Hall, 1995. 41.
Krupnick, Joseph C. Flakemagazine.com. 2007. 5 feb 2009 <http://www.flakmag.com/opinion/planb.html>.
LibertySuger. Citizen suger. 25 9 2008. 11 march 2009 <http://www.citizensugar.com/2079537>.
Press, Garry Mitchell Associated. Moseshand.com. 2009. 20 march 2009 <http://www.moseshand.com/studies/two_doctors.htm>.
Pruthi, Sandhya. MayoClinic.com. 24 may 2008. 5 feb 2009 <http://www.mayoclinic.com/health/morning-after-pill/AN00592>.
Wright, Wendy. Concerned Women for America . 25 aug 2206. 5 feb 2009 <http://www.cwfa.org/articles/5621/CWA/life/index.htm>.
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