Tag: reproductive health services

Bioethics Blogs

Global Health Policy: Trump and the Reinstatement of the Global Gag Rule

By: Jorge Luis Rivera-Agosto

On January 23, 2017, President Trump signed a Presidential Memorandum reinstating the so-called Mexico City Policy. The Memorandum conditions U.S. global health and family planning assistance to a strict rule that precludes foreign non-governmental organizations (also known as “NGOs”) from promoting or performing abortion as a method of family planning. Also known as the “global gag rule,” this policy represents a blow specifically to women’s health worldwide. Thanks to this new action, it will become harder, like in past years when it was in effect, to have resources to support family planning and reproductive health services, such as “family counseling, contraceptive commodities, condoms, and reproductive cancer screenings.” Even though the U.S. government won’t retract from the Memoranda until this Administration ceases, global efforts should be made to ameliorate the negative effects the new policy will cause.

The Mexico City Policy was first enacted by President Reagan in 1984 – and at the time, it represented an expansion of existing legislative restrictions of the use of U.S. funds for abortions internationally. It was then rescinded by President Clinton in 1991; reinstated by President Bush in 2001; rescinded by President Obama in 2009; and reinstated and expanded by President Trump in 2017. The policy requires foreign NGOs “to certify that they will not perform or actively promote abortion as a method of family planning, using funds from any source (including non-U.S. funds), as a condition for receiving U.S. government global family planning assistance and any other U.S. global health assistance.” The reason given to enact such policy was that the U.S.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Latest global abortion figures suggest measures to prevent them and make known their true meaning

Latest global abortion figures suggest the necessity to spread the meaning of an abortion, which is nothing other than ending the life of a human being

Knowing the incidence of abortion in different parts of the world is important in order to promote measures to prevent it. In a recent article by our Observatory (see HERE), we discussed an extensive study in The Lancet that addressed this issue.

In 2010-2014, the annual incidence of abortions was 35 per 1000 women aged between 15 and 44 years, 5 points less than in 1990-1994. As a result of population growth, however, the total number of abortions worldwide increased by 5.9 million in this period of time, from 50.4 million in 1990-1994 to 56.3 million in 2010-2014.

While the number of abortions fell by 19 points in developed countries, from 46 to 27 per 1000 women, there was a decline of only 2 points in developing countries, from 39 to 37.

vector nasciturus 1ª semanasAround 25% of pregnancies ended in abortion in 2010-2014; of these abortions, 73% were performed in married women and 27% in unmarried women.

These data show that abortion rates have declined significantly since 1990 in developed but not developing countries.

Analysis of the latest global abortion figures discussed here suggests a need to implement measures to prevent them that should not only include facilitating access to reproductive health services — as in the article cited and accompanying editorial (The Lancet 16 July 2016) — but should also be aimed at spreading the meaning of an abortion, which is nothing other than ending the life of a human being.

The figure of 56.3 million abortions annually in 2010-2014 should be a wake-up call for the moral conscience of those of us who presently have the chance to live.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Latest global abortion figures suggest measures to prevent them and make known their true meaning

Latest global abortion figures suggest the necessity to spread the meaning of an abortion, which is nothing other than ending the life of a human being

Knowing the incidence of abortion in different parts of the world is important in order to promote measures to prevent it. In a recent article by our Observatory (see HERE), we discussed an extensive study in The Lancet that addressed this issue.

In 2010-2014, the annual incidence of abortions was 35 per 1000 women aged between 15 and 44 years, 5 points less than in 1990-1994. As a result of population growth, however, the total number of abortions worldwide increased by 5.9 million in this period of time, from 50.4 million in 1990-1994 to 56.3 million in 2010-2014.

While the number of abortions fell by 19 points in developed countries, from 46 to 27 per 1000 women, there was a decline of only 2 points in developing countries, from 39 to 37.

vector nasciturus 1ª semanasAround 25% of pregnancies ended in abortion in 2010-2014; of these abortions, 73% were performed in married women and 27% in unmarried women.

These data show that abortion rates have declined significantly since 1990 in developed but not developing countries.

Analysis of the latest global abortion figures discussed here suggests a need to implement measures to prevent them that should not only include facilitating access to reproductive health services — as in the article cited and accompanying editorial (The Lancet 16 July 2016) — but should also be aimed at spreading the meaning of an abortion, which is nothing other than ending the life of a human being.

The figure of 56.3 million abortions annually in 2010-2014 should be a wake-up call for the moral conscience of those of us who presently have the chance to live.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Why We Need a Male Pill: Enhancing Men’s Reproductive Autonomy and Unburdening Women’s Contraceptive Responsibility


One of the key tenets of
reproductive autonomy is being able to control if, when, and with whom one
reproduces. Men’s reproductive autonomy is inhibited by the lack of good
contraceptive options available to them. Whereas women have 11 types of contraceptives—including
barrier, hormonal, permanent, and long-acting reversible—men only have two
types—the male condom, a barrier method, and vasectomy, a permanent method. It
is not just the number of methods that is problematic; it is also the lack of long-acting
reversible contraceptives (LARCs). Many men want to maintain their future
fertility, thus ruling out vasectomy, but do not want to rely on condoms,
especially if they are in a long-term monogamous relationship. While part of
the reason some men do not like condoms is because they can decrease sexual
sensation, another reason is that the failure rate for actual use is so high:
17%. Female LARCs, in contrast, have much lower failure rates for actual use,
which enhances their reproductive autonomy because they are equipped with effective
methods to enact their reproductive desires (i.e. avoiding pregnancy).


The lack of male LARCS causes some
men to rely upon their female partner to contraceptive since she has more and
better contraceptive options. Yet this dependence on his partner may also
comprise his reproductive autonomy because he has to trust that she is
consistently and correctly using female methods. If she does become pregnant,
he has no recourse and, in many settings, is legally responsible for any
offspring, including financial and even social obligations to the child.


Placing the majority of
contraceptive responsibility on women due to the lack of male methods is not just
bad for men; it is also bad for women.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Men’s reproductive health: Neglected in policy and practice

In recognizing the health-related and financial benefits of preventive reproductive health services, the Affordable Care Act (ACA) has included them (namely contraception and preconception care) as part of standard care and without co-payment. While the inclusion of women’s reproductive health care in the ACA is a milestone for women’s health, children’s health, and reproductive health overall, it is troubling that the ACA does not seem to make any mention of men’s reproductive health
Men’s reproductive health is not only missing from policy, also from everyday practice. Whereas women know to see a gynecologist for their reproductive health and can easily do, men are often unsure of where to turn for the reproductive health needs. Most men have never heard of the field of andrology, which is devoted to men’s reproductive health, and this field is so small and fragmented that it may be difficult for a man to find a nearby andrologist. Some men seek out urologists for their reproductive health, but many urologists are not trained in all areas of men’s reproductive health. Men may also talk to their primary care physician about their reproductive health needs, but many of these physicians are not very familiar with men’s reproductive health since it is barely covered in medical school. Family planning centers tend to focus on treating women and some family planning providers have even been known to be hostile toward men. The lack of healthcare providers trained to treat in men’s sexual and reproductive health contributed to American Board of Obstetrics and Gynecology recent statement that condoned OBGYNs treating certain areas of men’s sexual and reproductive health.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The New Brunswick Abortion Law Repeal: Only Half the Story

Joanna Erdman celebrates the New Brunswick decision to eliminate barriers to abortion access.

__________________________________________

The New Brunswick government has just announced that it will repeal two controversial requirements in Regulation 84-20 – the requirements limiting public funding for abortion services to those performed by a specialist and certified as medically required. As these requirements are barriers to abortion access, their repeal should be celebrated.

Both of these requirements are relics of another era. Clinical safety has not justified the first requirement (that abortion services be performed by a specialist) for some time. And, the Canadian Supreme Court long ago showed the second requirement (that an abortion be certified as medically required) to be a cover for gross injustice. The term “medically required” provides no meaningful standard on the basis of which to decide that, as a matter of law, an abortion should be funded. Reliance on this term allows individual practitioners to reach individual decisions about access to abortion, creating the potential for inequity in access. This was precisely the reasoning of the Canadian Supreme Court in R v. Morgentaler (1988) to defeat the criminal abortion law. The Court said it was grossly unjust to decide a legal entitlement to health care on the basis of such a vague and uncertain standard.

new-brunswick-flag

Photo by Corbin Fraser

The Court further reasoned that the criminal abortion law unjustifiably restricted abortion services to hospital settings. While the in-hospital requirement may have been medically justified in the past, the Court held that it was now an “exorbitant” requirement. Given this precedent, it is most regrettable that in taking down barriers to abortion access, the New Brunswick government decided not to repeal the requirements in Regulation 84-20 and s.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Privileging Infertility over Abortion in New Brunswick

Rachael Johnstone questions New Brunswick’s infertility Special Assistance Fund in light of its abortion policy.

_________________________________________________

Following in the footsteps of Ontario and Quebec, New Brunswick Health Minister Ted Flemming recently announced the government’s $1 million commitment to establish a fund to offset the cost of in vitro fertilization (IVF) or intrauterine insemination procedures for infertile couples. New Brunswickers who qualify are eligible for a one-time grant of $5,000, or 50% of the cost associated with their treatment, whichever is less. No policy outlining the nature of acceptable treatments (for instance, the number of embryos that can be implanted) has accompanied this announcement.

This move could be seen as expanding the reproductive choice of individuals struggling with infertility. However, when evaluated in the context of the provincial government’s failure to repeal a highly controversial regulation that creates significant barriers to abortion access, it suggests a troubling view of women and their reproductive rights.

Legislative Assembly, Fredericton, New Brunswick

Legislative Assembly, Fredericton, New Brunswick

In many respects, New Brunswick’s policy is similar to Ontario’s. Ontario announced plans to launch a program in 2015 to cover some of the costs of one single-embryo IVF cycle, excluding drugs. In contrast, Quebec’s provisions are much more substantial. The first province to provide coverage for IVF in 2010, Quebec now provides coverage for 3 to 6 IVF attempts, including drugs. One of Quebec’s rationales offered was to help boost the population, while Ontario cited a desire to lower the healthcare costs associated with multiple births. The motivations of the New Brunswick government have not been made explicit, beyond a desire to “alleviate the financial burden of those dealing with infertility,” a burden which can be prohibitively expensive.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.