Figure 1 shows the disadvantages and advantages of the main methods of contraception.
Figure 1:
In the midst of all the moral and ethical issues surrounding the morning-after pill, many people fail to grasp the biology underlying this ‘emergency contraception.’
Firstly, conception immediately after sexual intercourse is rare. Instead, it occurs a few days after the egg(s) has/have been discharged from the ovary. This process is called ovulation. During the time between intercourse and conception itself, the sperm continue to travel through the fallopian tube until the egg appears. Therefore, taking emergency contraception, the ‘morning after’ intercourse will prevent a pregnancy. 3, 5, 8 .The meaning of the words morning-after should not be taken literally as it is effective within seventy two hours of unprotected sexual intercourse. 11
The pharmacology of the morning-after pill is a combination of hormones. The types of hormones and the proportion in which they are used vary in different morning-after pills. Some morning-after pills contain only one hormone called progestin (Plan B) and some contain small doses of two hormones, progestin and estrogen (mifepristone).4 Progestin prevents the sperm from reaching the egg and also prohibits a fertilised egg from attaching to the endometrial lining of the uterus (implantation). 3
The moral and ethical controversies surrounding the morning-after pill stem from the fact that GPs can now prescribe it to girls who are classed as minors; younger than sixteen years of age. Those opposed to this bold endeavour, propose that prescription to minors will only serve to fuel an already risky attitude of having unprotected sex first and asking questions later.
Many also argue that rampant ill health will become a force to contend with, as exposure to the risk of infections such as Chlamydia, Gonorrhoea, HIV-AIDS and other sexually transmitted diseases7 will only increase with frequent unprotected sex. Furthermore, such sexual behaviour will more than likely become a channel for irresponsibility that is cycled through future generations, leading to the unnecessary misuse of young bodies.
Confidentiality between child and parent is another ethical issue that surrounds the morning-after pill. This is an ethical concern for all parties involved: the doctor, the minor and her parents.
Parents feel that it is wrong that GPs have the authority to not consult them when prescribing their daughter with the morning-after pill. For instance, Manchester mother Sue Axon, went to the High Court in November 2005 to challenge the law passed by the Department of Health, which allows doctors to provide abortion or contraception advice to minors without parental consent 12. Incidentally, she lost her battle to have the law changed. Many parents, like Sue Axon, are of the same opinion on this issue.6
Recent figures suggest that across England about 2,400 girls aged 13 received the morning-after pill in 2004. Many parents were alarmed by these figures, particularly because the medical staff did not inform the parents of the girl about the treatment their child was undergoing, without gaining the child’s consent. 9
These figures show that many young girls are, in a less explicit manner, abusing their bodies with contraceptive chemicals. This will not bode well for their more mature years as an adult when they are trying to conceive. The contraceptive chemicals they swallowed during their years of throwing caution to the wind, will impinge on their fertility because of the disruption these chemicals cause to their menstrual cycle 9. The ultimate outcome being that their chances of concieving are reduced. It is this bilogical truth that explains one of the main reasons as to why the morning-after pill stirs up a host of concerns regarding minors. 13
Furthermore, one is forced ponder the worrying statistics that show that the government is losing the battle for instilling responsible sexual behaviour in young people. 9
The morning-after pill is condoned by people who state it is no different from the so called abortion pill and anything enmeshed with the ‘A’ word, is of paramount moral and ethical disputation. However, morning-after pills, which prevent pregnancies, are entirely different from the abortion pill, which aborts a zygote. 3
Taking into account the cumalative effect of, the confidentiality issues, the risk of catching STDs and of course the statistics, it is obvious that the controversies surrounding the morning-after pill cannot be justified in one statement that says “It is morally right/wrong that to sell the morning-after pill to minors”. Each user differs in their situation and where it may seem irresponsible and reckless for one girl it may be the only responsible decision for another. For example, someone who uses the morning-after pill after a reckless night fueled by alcohol and promiscuity could be deemed as careless. However, in a situation where a young girl has been raped and instead of having abortion, takes the morning-after pill, reason suggests that it is not an issue where the girl should be condoned.
To say that there is a defined right and wrong concerning the moral and ethical issues surrounding the ‘morning after pill’, would be unjustified. The heart of the matter is deeper than government legislation or parent confidentiality; it lies in the concernment of a girl.
In order to find a plausible solution, biology, age, culture and social well being of the situation must be considered. Moral and ethical perfection is an insignificant subjective. Striving to choose and get the best option for any girl, whether it is to take the morning after pill or not, must remain the objective.
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References
1) Interview with morning-after pill user [Interview]
2) http://www.bbc.co.uk/relationships/sex_and_sexual_health/contr_combpill.shtml [Website].
3) http://www.mayoclinic.com/health/morning-after-pill/AN00592 [Website].
4) http://www.uspharmacist.com/index.asp?show=article&page=8_1567.htm [Website]
5) Mishell’s Textbook of Infertility, Contraception and Reproductive Criminology.
Fourth Edition [Book].
6) http://www.famyouth.org.uk/bulletin.php?number=122#confid [Website]
7) Science by The American Association for the Advancement of Science- July 2nd 2004, vol 305: page 17 [Magazine].
8) New Scientist- September 2nd 2006, issue 2567: pages 4-5 [Magazine].
9) The Sunday Times- January 8th 2006. [Newspaper].
10) The Guardian- November 24th 2006 [Newspaper].
11) British Medical Journal- 7th October 2006 [Journal].
12) http://www.fpa.org.uk/attachments/published/117/PDF%20Under%2016s% 20consent%20and%20confidentiality%20August%202004.pdf [Website].
13) Best Practice & Research. Clinical Obstetrics & Gynaecology. 2006 Jun;20 (3):311-22. Epub 2006 Feb 9 [Journal].