Carson Holloway

The costs of contraception

Carson Holloway
By Carson Holloway
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Coauthored with John Safranek

April 20, 2012 (thePublicDiscourse.com) - A great deal of public discussion has been sparked by the recent determination of the Department of Health and Human Services that it would, under the legal authority of the new health care law, require health insurance plans to cover the costs of hormonal contraception. Much of that discussion has focused on the nature and importance of religious freedom, since the directives would require some institutions, such as Catholic hospitals and universities, to provide health insurance coverage for things that are contrary to Catholic moral teaching. To a lesser extent, the HHS regulations have provoked some renewed discussion—at least among Catholics, but perhaps more generally among religious conservatives—about the morality of contraception itself, a topic that had seemed closed as a topic of genuine inquiry for the last generation.

The HHS directives should also give rise to another discussion, one that so far has not been undertaken: a discussion not of the legality of the mandates, nor of the morality of contraception, but of the physical costs of contraception, of the negative consequences it may have for the health and well-being of the women who use it. This aspect of the question has been all but totally ignored. For their part, the liberal partisans of the HHS mandates speak as if hormonal contraception is simply an unmitigated good, a clean gain, for women. Indeed, their argument suggests that such contraception is so unequivocally good that there can be no reasonable argument about the propriety of mandating its coverage as a health care benefit.

This assumption deserves to be challenged because it is untrue. That is, hormonal contraception carries certain physical costs in addition to the benefits touted by its proponents. Unless these costs are frankly acknowledged, American women will be in no position to make an informed choice about whether or not to use contraception. Yet presumably Americans of all ideological persuasions could agree that women should be in a position to choose or reject contraception based upon full knowledge of its potential physical consequences.

The popular view of contraception as an unmitigated good is based upon a naïve understanding of science’s ability to intervene in natural processes. Modern people are understandably impressed by science’s ability to manipulate nature, to divert it to courses more acceptable (or apparently more acceptable) to human well-being than it would take if left to itself. We are often more impressed, however, than would be justified on closer examination. It is, after all, impossible to interject technological control into any natural system without incurring some undesirable consequences. Liberals understand this very well when the issue is non-human natural systems—the “environment.” They can easily tell you the problems that are caused by cutting down trees, mining coal, or burning oil.

But a woman’s body is a natural system like any other. It is devised by nature—for a portion of the woman’s lifespan—to be capable of becoming pregnant, to be fertile. Medical science cannot simply turn that fertility on and off like a light switch. It is rather to be expected that suppression of fertility through the use of birth control pills will carry certain physical costs for the woman who does it. The evidence bears out this expectation. In discussing these consequences we divide them into two categories: health risks and costs to physical well-being.

The existing scientific literature suggests that the long-term use of birth control pills is associated with increased risk for certain serious, and potentially deadly, health problems. A 2009 Mayo Clinic study noted a doubling of the risk of breast cancer in women who had used birth control pills for more than eleven years. Similarly, another recent study, funded by the National Institutes of Health, found that longer duration of use of hormonal contraception, as well as earlier first age of use, increased risk of breast cancer. Specifically, the study found that women who started using birth control pills before age 18 were at 1.9 times the normal risk level for all forms of breast cancer, and that women 40 and younger were at a 4.2-fold increased risk of triple negative breast cancer, one of the worst forms, which accounts for between 10 and 17 percent of all breast cancer cases.

Some forms of hormonal birth control have also been associated with increased risk for blood clots. Yaz, which was for several years the top-selling birth control pill, was discovered to almost double the risk for blood clotting, which can be lethal. There were about ten deaths per year among Yaz users during the period from 2004 to 2008, although the actual number of fatalities may be higher. Finally, birth control pills are harmful for the cardiac health of women who suffer from atherosclerotic disease. Those who use birth control pills usually cannot know whether they are assuming this additional risk, since it is generally financially impractical to screen for atherosclerosis prior to the use of birth control.

While these problems are admittedly only risks and not certainties attending the use of birth control, it is also worth noting that they do not necessarily represent all of the risks involved. That is, birth control pills may in some cases be more perilous than we know. The aforementioned Yaz had been approved by the FDA and was in use for several years before its connection to blood clotting came to light. Similarly, the author of the aforementioned NIH study on birth control and breast cancer noted the “scarcity” of studies of this link, and hence the need for “further research” on it.

Birth control pills also tend to carry costs to physical well-being. Use of birth control pills is associated with an increased incidence of unpleasant things such as depression, mood swings, weight gain, impeded weight loss, headache, upper respiratory infection, sinusitis, nausea, menstrual cramps, acne, breast tenderness, vaginal candidiasis (commonly known as “yeast infection”), bacterial vaginitis, and urinary tract infection. Although normally not life-threatening, such physical ailments are certainly not insignificant to those who suffer them.

Moreover, they are especially noteworthy to the extent that they bear negatively upon the supposed benefit of contraception: sexual freedom. Sometimes the proponents of contraception present it as preventing pregnancy, but anyone with elementary knowledge of biology knows that pregnancy can be prevented even more reliably by refraining from sexual intercourse. Contraception’s real benefit, then, at least as its advocates see it, is sexual freedom, the ability to enjoy sex without unwanted consequences. The side effects mentioned above, however, put a serious dent in the argument for this benefit. Obviously, a woman suffering from some or even one of the physically unpleasant consequences of birth control will not be able to enjoy sexual activity as much as she otherwise might. This is especially evident in the case of several of the ailments noted above, the ones (such as vaginitis, urinary tract infection, and vaginal candidiasis) that involve vaginal discomfort.

Indeed, one commonly found side-effect of hormonal birth control is a decrease in libido or sexual desire. Whether this arises independently or is itself caused by some of the other disorders and discomforts noted above is immaterial to the basic fact that contraception, which is promoted as a means to sexual happiness, can in fact diminish a woman’s sexual happiness. The promise of contraception is that women will be able to have sex whenever they want to, but a closer look reveals that it might well make you not want to very much. Put another way, its claim to be a pure benefit is compromised to the extent that it diminishes the enjoyment of that which it puts within such easy reach. Access to more apples is not a pure gain if a larger percentage of the apples are spoiled and taste bad.

We do not claim that these risky and unpleasant side-effects render contraception immoral. The morality of contraception depends on philosophic arguments we are not making here. Nor do we claim that the bad side-effects are so severe as to justify a ban on contraception on public health grounds. We merely hold that these side-effects are often ignored in our public discourse, but that a truly free decision of women to use or not use them—as well as a truly free decision of voters whether to use government to promote them—depends on a frank acknowledgement of their costs along with their alleged benefits.

Carson Holloway is a political scientist and the author of The Way of Life: John Paul II and the Challenge of Liberal Modernity (Baylor University Press). John Safranek, MD, is a medical doctor practicing in Nebraska. He also holds a PhD in philosophy from the Catholic University of America, and his writings have appeared in the Hastings Center Report, the Texas Review of Law and Politics, and the University of Colorado Law Review. This article first appeared at thePublicDiscourse.com and is reprinted with permission.


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Although it is widely believed that people with Down syndrome are doomed to a life of suffering, in one large survey 99% of respondents with Down syndrome described themselves as "happy." Shutterstock
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‘Sick and twisted’: Down’s advocates, pro-life leaders slam Richard Dawkins’ abortion remarks

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By Dustin Siggins

Advocates on behalf of individuals with Down syndrome, as well as pro-life leaders, are slamming famed atheist Richard Dawkins’ statements made on Twitter earlier today that parents have a moral responsibility to abort babies diagnosed in utero with Down’s.

During a shocking Twitter rant, Dawkins responded to questioners saying that it was "civilised" to abort Down Syndrome babies, and that it would be "immoral" to choose not to abort babies diagnosed with the condition.

He said that his goal is to "reduce suffering wherever you can," indicating that unborn children cannot suffer, and that unborn children don't "have human feelings."

In addition to being scientifically challenged - unborn children can feel both pain and emotions - Dawkins' comments drew criticism for his callousness towards children with disabilities.  

"A true civilization – a civilization of love – does not engage in such cold and ultimately suicidal calculus"

"It's sick and twisted for anyone to advocate for the killing of children with disabilities," Live Action President Lila Rose told LifeSiteNews. "Dawkins's ignorant comments serve only to further stigmatize people with Down syndrome.

"While many people with Down syndrome, their families, and advocacy groups are fighting discrimination on a daily basis, Dawkins calls for their murder before they are even born," she said. "Those with Down syndrome are human beings, with innate human dignity, and they, along with the whole human family, deserve our respect and protection."

Carol Boys, chief executive of the Down's Syndrome Association, told MailOnline that, contrary to Dawkins’ assertion, "People with Down’s syndrome can and do live full and rewarding lives, they also make a valuable contribution to our society."

A spokesperson for the UK disabilities charity Scope lamented that during the "difficult and confusing time" when parents find out they are expecting a child with disabilities, they often experience "negative attitudes."

"What parents really need at this time is sensitive and thorough advice and information," the spokesperson said.

Charlotte Lozier Institute president Chuck Donovan agreed with Rose’s assessment. "Advocates of abortion for those 'weaker' than others, or of less physical or intellectual dexterity, should remember that each of us is 'lesser' in some or most respects," he said.

According to Donovan, "we deliver a death sentence on all of humanity by such cruel logic."

"A true civilization – a civilization of love – does not engage in such cold and ultimately suicidal calculus" he said.

One family who has a child with Down syndrome said Dawkins was far from the mark when he suggested that aborting babies with Down syndrome is a good way to eliminate suffering.

Jan Lucas, whose son Kevin has Down syndrome, said that far from suffering, Kevin has brought enormous joy to the family, and "is so loving. He just has a million hugs."

She described how Kevin was asked to be an honorary deacon at the church they attend in New Jersey, "because he is so encouraging to everyone. At church, he asks people how their families are, says he'll pray for them, and follows up to let them know that he has been praying for them."

It's not just strangers for whom Kevin prays. "My husband and I were separated for a time, and Kevin kept asking people to pray for his dad," said Jan. "They didn't believe that Kevin's prayers would be answered. Kevin didn't lose hope, and asking people, and our marriage now is better than ever before. We attribute it to Kevin's prayers, and how he drew on the prayers of everyone."

"I don't know what we'd do without him," said Jan.

Speaking with LifeSiteNews, Kevin said that his favorite things to do are "spending time with my family, and keeping God in prayer." He said that he "always knows God," which helps him to "always keep praying for my friends."

"I love my church," said Kevin.

Although it is widely believed that people with Down syndrome are doomed to a life of suffering, in one large survey , 99% of respondents with Down syndrome described themselves as "happy." At the same time, 99% percent of parents said they loved their child with Down syndrome, and 97 percent said they were proud of them.

Only 4 percent of parents who responded said they regretted having their child.

Despite this, it is estimated that in many Western countries the abortion rate of children diagnosed in utero with Down syndrome is 90%, or even higher. The development of new and more accurate tests for the condition has raised concerns among Down syndrome advocates that that number could rise even higher. 


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President George Bush takes the ice bucket challenge in a video released this week.
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What’s wrong with the viral ‘ice bucket challenge’? A lot, say pro-life leaders

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By Dustin Siggins

Pro-life leaders in the U.S. are warning about ethical problems with the viral "Ice Bucket Challenge" that has raised over $15 million for research into Lou Gehrig’s Disease since late July, making its way to the top of American politics, and the entertainment and business worlds in the process.

In recent days, former president George W. Bush, New Jersey Governor Chris Christie, Facebook founder Mark Zuckerberg, TV hosts Oprah Winfrey and Jimmy Fallon, and Microsoft founder Bill Gates have all had ice-cold water dumped on their heads in support of the effort.

They have been joined by many thousands of everyday Americans eager to do their part to raise funds to find a cure for the fatal neurodegenerative disease.

However, pro-life leaders from Patheos blogger Father Michael Duffy to the American Life League (ALL) are all pointing out that the ALS Association, which is behind the wildly popular fundraising effort, funds and otherwise supports embryonic stem cell research.

Instead, they are urging that pro-life people who want to participate in the ice bucket challenge send their donations to other charities that don't have similar ethical issues.

Embryonic stem cell research requires the destruction of an unborn child. This is unlike adult and umbilical cord stem cell research, which are considered ethical.

A spokesperson from the ALS Association admitted to American Life League in an e-mail that while the organization "primarily funds adult stem cell research," they are "funding one study using embryonic stem cells (ESC)..."

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"It is noble to combat a deadly disease,” Live Action president Lila Rose said in a statement provided to LifeSiteNews, but added that “it's such a shame that the ALS Association...chooses to support research that thrives from experimenting on and killing tiny, innocent human beings."

"Embryonic stem cell research, which requires the destruction of pre-born people, is inherently unethical and a violation of fundamental human rights, and even materialists must admit that promises of its benefits have failed to deliver," continued Rose. "There is no good reason to condone this practice; in fact, all it does is taint the ALS Association, whom I'd otherwise be happy to support."

In the e-mail to American Life League, ALS Assocation Spokesperson Carrie Munk defended the organization, saying that the embryonic stem cell research is being funded by an outside donor, and "the stem cell line was established many years ago."

She added that "under very strict guidelines, The Association may fund embryonic stem cell research in the future," and that currently "donors may stipulate that their funds not be invested in this study or any stem cell project."

At least one Catholic archdiocese has spoken up about the problematic relationship between ALS Assocation and unethical research.

"We appreciate the compassion that has caused so many people to engage in” the ice bucket challenge,” said a spokesperson for the Archdiocese of Cincinnati. “But it's a well established moral principle that a good end is not enough. The means to that ends must be morally licit."

Both Fr. Duffy and the archdiocese have recommended money be sent to the John Paul II Medical Research Institute in Iowa City, Iowa. It is an organization that exclusively researches with adult stem cells. 

One D.C.-area Catholic, Robert Vega, wrote on Facebook that "in light of the absolute dignity of human life and necessity to defend it...I have taken down my Ice Bucket video, untagged myself from my nomination video, and encourage anyone to whom I may have spread the Challenge to do the same."

Embryonic stem cell research, which was a major controversy throughout the presidency of George W. Bush, has quietly, although decidedly, become less popular after many of the exalted promises of its proponents failed to materialize. As LifeSiteNews reported, in 2012 California and Maryland funded a fraction of the embryonic stem cell research projects that they did in 2007. Likewise, Maryland funded nearly twice as many stem cell research projects in 2012 as it had in the prior year -- but only one of the grants was done for an embryonic research project.


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Catholic couple fined $13,000 for refusing to host same-sex ‘wedding’ at their farm

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Robert and Cynthia Gifford

The New York State Division of Human Rights (DHR) has ruled that the Roman Catholic owners of an Albany-area farm violated the civil rights of a lesbian couple when they declined to host the couple’s same-sex “marriage” ceremony in 2012.

Robert and Cynthia Gifford, who own and operate Liberty Ridge Farm in Schaghticoke, were ordered by DHR Judge Migdalia Pares and Commissioner Helen Diane Foster to pay $10,000 in fines to the state and an additional $3,000 in damages to the lesbian couple, Jennie McCarthy and Melissa Erwin for “mental pain and suffering.” 

Additionally, the Giffords must provide sensitivity training to their staff, and prominently display a poster highlighting state anti-discrimination laws.

The Giffords’ attorney, Jim Trainor, told LifeSiteNews that the two-year-legal drama and resulting fines all stemmed from a single brief phone call in 2012 that caught his clients off guard.

“The entire interaction between the Complainants and the Giffords transpired during a two to three minute telephone conversation which, unknown to Mrs. Gifford, was being tape recorded,” Trainor said.

“After communicating the fact that they chose not to hold same-sex marriage ceremonies at the farm because to do so would violate the Giffords’ sincerely held beliefs (that God intended marriage to be between a man a woman only), Mrs. Gifford invited the couple to visit the farm to discuss handling their wedding reception, which the couple refused.” 

The Giffords draw a line, Trainor explained, between a ceremony that solemnizes a homosexual relationship and a reception that celebrates the union after the fact.  To participate in the former, they argue, would be a violation of their own religious beliefs, especially because marriage ceremonies on the farm typically take place in and around the couple’s home, where they live full-time and are raising their two children. 

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But the Giffords are willing to serve gay couples in other ways – for example, they allowed another lesbian couple to throw a birthday party for their adopted child on the farm.

Trainor said he believes the decision by DHR goes too far in that it seeks to regulate what the Giffords can or cannot do in their own private home, even though state law only requires “places of public accommodation” to adhere to anti-discrimination laws.

“They consider the farm their home,” Trainor said. “They live there, they work there, they raise their kids there.”

Trainor also said that the Judge and Commissioner should have taken into account the Supreme Court’s recent Hobby Lobby ruling, which came down weeks before the DHR notified the Giffords of their decision.

“We're disappointed that neither the Administrative Law Judge nor the Commissioner considered the Gifford's Constitutional (1st Amendment) rights, including the right not to be compelled to participate in a ‘marriage’ ceremony which violates their own religious beliefs,” Trainor said. 

Trainor said he and the Giffords are evaluating their options for further legal action.

The Giffords could simply ask the DHR to reconsider their decision, but Trainor said he doubts that approach would be successful. In order to formally appeal the ruling the couple would have to go to the New York State Supreme Court. 

But there is another option: The Giffords could file a fresh lawsuit in either state or federal court challenging the constitutionality of the DHR ruling.

While religious liberty has been a hot topic in federal court lately, Trainor said New York’s state constitution “actually offers a lot” of protection when it comes to religious freedom. “Many people view it as more expansive than the U.S. Constitution in terms of religious freedoms.”

However, Trainor emphasized that the Giffords have not yet decided which avenue, if any, they are planning to take in terms of pursuing further legal action.

In the meantime, the Giffords will continue hosting wedding ceremonies and receptions at the farm, Trainor said. However, they are considering hiring a dedicated employee to handle the ceremonies in order to avoid having to directly participate in any future same-sex “weddings.”


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