The ethics of state-sponsored and clinical promotion of long-acting reversible contraception
Authors: Wale, J. and Rowlands, S.
Journal: BMJ Sexual and Reproductive Health
Volume: 47
Issue: 3
Pages: E11
eISSN: 2515-2009
ISSN: 2515-1991
DOI: 10.1136/bmjsrh-2020-200630
Abstract:Objectives To review ethical aspects of the promotion and provision of long-acting reversible contraception (LARC). Specifically, to examine (1) the tension between informational exchange and the active promotion of LARC methods to new and existing contraceptive users by healthcare professionals; and (2) the distinct ethical issues arising from the promotion of LARC methods by state-sponsored actors and healthcare professionals. Methods Narrative review and ethical analysis. Findings There is an ethical difference between raising awareness/informational provision and actively promoting or prioritising specific contraceptive methods. It matters whether the policy choice is made, or the promotional activity about contraception is undertaken, by individual healthcare professionals at a local level or by more remote state-sponsored actors, because the relationship between the promoter and the (potential) contraceptive user is of a different kind. Imposing a dual responsibility upon healthcare professionals for raising awareness/informational exchange and the active promotion of LARC creates an unnecessary tension and barrier for the delivery of patient-centred care. Conclusions This review highlights the need for ethical reflection on the central role of the promoting agent and the distinction between facilitating informational awareness and active promotion of LARC. LARC methods should not be prioritised in isolation and without regard to the wider implications of public promotion. A balanced narrative and information-sharing programme that respects the individual interests of each contraceptive user is called for, especially in direct professional/service user relationships. No assumption should be made that user decision-making will necessarily be determined and influenced solely by the relative effectiveness of the contraceptive method..
https://eprints.bournemouth.ac.uk/34004/
Source: Scopus
The ethics of state-sponsored and clinical promotion of long-acting reversible contraception.
Authors: Wale, J. and Rowlands, S.
Journal: BMJ Sex Reprod Health
Volume: 47
Issue: 3
Pages: e11
eISSN: 2515-2009
DOI: 10.1136/bmjsrh-2020-200630
Abstract:OBJECTIVES: To review ethical aspects of the promotion and provision of long-acting reversible contraception (LARC). Specifically, to examine (1) the tension between informational exchange and the active promotion of LARC methods to new and existing contraceptive users by healthcare professionals; and (2) the distinct ethical issues arising from the promotion of LARC methods by state-sponsored actors and healthcare professionals. METHODS: Narrative review and ethical analysis. FINDINGS: There is an ethical difference between raising awareness/informational provision and actively promoting or prioritising specific contraceptive methods. It matters whether the policy choice is made, or the promotional activity about contraception is undertaken, by individual healthcare professionals at a local level or by more remote state-sponsored actors, because the relationship between the promoter and the (potential) contraceptive user is of a different kind. Imposing a dual responsibility upon healthcare professionals for raising awareness/informational exchange and the active promotion of LARC creates an unnecessary tension and barrier for the delivery of patient-centred care. CONCLUSIONS: This review highlights the need for ethical reflection on the central role of the promoting agent and the distinction between facilitating informational awareness and active promotion of LARC. LARC methods should not be prioritised in isolation and without regard to the wider implications of public promotion. A balanced narrative and information-sharing programme that respects the individual interests of each contraceptive user is called for, especially in direct professional/service user relationships. No assumption should be made that user decision-making will necessarily be determined and influenced solely by the relative effectiveness of the contraceptive method.
https://eprints.bournemouth.ac.uk/34004/
Source: PubMed
The ethics of state-sponsored and clinical promotion of long-acting reversible contraception
Authors: Wale, J. and Rowlands, S.
Journal: BMJ SEXUAL & REPRODUCTIVE HEALTH
Volume: 47
Issue: 3
eISSN: 2515-2009
ISSN: 2515-1991
DOI: 10.1136/bmjsrh-2020-200630
https://eprints.bournemouth.ac.uk/34004/
Source: Web of Science (Lite)
The Ethics of State-Sponsored and Clinical Promotion of Long-Acting Reversible Contraception
Authors: Wale, J. and Rowlands, S.
Conference: Contemporary Issues in Fertility Control
Dates: 13 November 2019
Place of Publication: Bournemouth, UK
Abstract:Long-Acting Reversible Contraception (LARC) methods offer highly effective fertility control options for many women. Many State-sponsored actors and healthcare professionals have been active in promoting these forms of contraception to the public and to individual patients. Whilst the clinical, safety and economic benefits have been investigated at length, not enough attention has been devoted to the ethical issues arising from the promotion and use of these contraceptive methods. In this paper, we argue that the delivery of LARC can be ethically neutral if confined to information provision and supporting potential users in the context of a full range of contraceptive methods. However, we argue that there is an ethical difference between raising awareness and actively promoting or prioritising specific contraceptive methods. Further, it matters whether the policy choice or promotional activity is undertaken at a local level by healthcare professionals or by more remote State-sponsored actors, because the patient relationship generates special professional obligations in the context of fertility control.
https://eprints.bournemouth.ac.uk/34004/
https://www.bournemouth.ac.uk/events/contemporary-issues-fertility-control
Source: Manual
Preferred by: Sam Rowlands
The ethics of state-sponsored and clinical promotion of long-acting reversible contraception.
Authors: Wale, J. and Rowlands, S.
Journal: BMJ sexual & reproductive health
Volume: 47
Issue: 3
Pages: e11
eISSN: 2515-2009
ISSN: 2515-1991
DOI: 10.1136/bmjsrh-2020-200630
Abstract:Objectives
To review ethical aspects of the promotion and provision of long-acting reversible contraception (LARC). Specifically, to examine (1) the tension between informational exchange and the active promotion of LARC methods to new and existing contraceptive users by healthcare professionals; and (2) the distinct ethical issues arising from the promotion of LARC methods by state-sponsored actors and healthcare professionals.Methods
Narrative review and ethical analysis.Findings
There is an ethical difference between raising awareness/informational provision and actively promoting or prioritising specific contraceptive methods. It matters whether the policy choice is made, or the promotional activity about contraception is undertaken, by individual healthcare professionals at a local level or by more remote state-sponsored actors, because the relationship between the promoter and the (potential) contraceptive user is of a different kind. Imposing a dual responsibility upon healthcare professionals for raising awareness/informational exchange and the active promotion of LARC creates an unnecessary tension and barrier for the delivery of patient-centred care.Conclusions
This review highlights the need for ethical reflection on the central role of the promoting agent and the distinction between facilitating informational awareness and active promotion of LARC. LARC methods should not be prioritised in isolation and without regard to the wider implications of public promotion. A balanced narrative and information-sharing programme that respects the individual interests of each contraceptive user is called for, especially in direct professional/service user relationships. No assumption should be made that user decision-making will necessarily be determined and influenced solely by the relative effectiveness of the contraceptive method.https://eprints.bournemouth.ac.uk/34004/
Source: Europe PubMed Central
The ethics of State-sponsored and clinical promotion of long-acting reversible contraception
Authors: Wale, J. and Rowlands, S.
Journal: BMJ Sexual & Reproductive Health
Volume: 47
Issue: 3
ISSN: 2515-1991
Abstract:Objectives To review ethical aspects of the promotion and provision of long-acting reversible contraception (LARC). Specifically, to examine (1) the tension between informational exchange and the active promotion of LARC methods to new and existing contraceptive users by healthcare professionals; (2) the distinct ethical issues arising from the promotion of LARC methods by State-sponsored actors and healthcare professionals. Methods Narrative review and ethical analysis. Findings There is an ethical difference between raising awareness/ informational provision and actively promoting or prioritising specific contraceptive methods. It matters whether the policy choice is made, or the promotional activity about contraception is undertaken, by individual healthcare professionals at a local level or by more remote State-sponsored actors, because the relationship between the promoter and the (potential) contraceptive user is of a different kind. Imposing a dual responsibility upon healthcare professionals for raising awareness/ informational exchange and the active promotion of LARC, creates an unnecessary tension and barrier for the delivery of patient-centred care. Conclusions This review has highlighted the need for ethical reflection on: the central role of the promoting agent and the distinction between facilitating informational awareness and active promotion of LARC. LARC methods should not be prioritised in isolation and without regard to the wider implications of public promotion. A balanced narrative and information sharing programme that respects the individual interests of each contraceptive user is called for, especially in direct professional/ service user relationships. No assumption should be made that user decision-making will necessarily be determined and influenced solely by the relative effectiveness of the contraceptive method.
https://eprints.bournemouth.ac.uk/34004/
Source: BURO EPrints