Shared risk and shared responsibility: the ethics of male contraceptives.
autonomy
male contraception
reproductive ethics
reproductive rights
risk
unintended pregnancy
Journal
Andrology
ISSN: 2047-2927
Titre abrégé: Andrology
Pays: England
ID NLM: 101585129
Informations de publication
Date de publication:
19 Apr 2024
19 Apr 2024
Historique:
revised:
27
03
2024
received:
13
02
2024
accepted:
04
04
2024
medline:
19
4
2024
pubmed:
19
4
2024
entrez:
19
4
2024
Statut:
aheadofprint
Résumé
Efforts to develop reversible male contraceptives analogous to female oral contraceptives are underway and may be introduced in the next decade. The advent of novel male contraceptives provides an opportunity for an ethical reformulation of the contraceptive paradigm given the relational, rather than individual, nature of sexual relationships, and family planning. For individuals in any sexual relationship that could result in pregnancy, issues of reproductive autonomy, freedom, equality in reproductive decision-making and risks-both of side effects and of unintended pregnancies-are significant. Historically, however, women have been attributed the greatest responsibilities simultaneously with the most restrictions on their freedom of choice and access to reproductive care. In this paper, we extend our prior "shared risk" model of male contraception to one of "shared risk and responsibility" to ethically inform this discourse. This updated framework more fully captures the complexity of this novel technology and may be of use to regulatory and legal agencies grappling with an intervention that poses medical risks to the member of the relationship who does not face risks of becoming pregnant.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Eunice Kennedy Shriver National Institute of Health and Human Reproduction
ID : R01HD098039
Informations de copyright
© 2024 American Society of Andrology and European Academy of Andrology.
Références
Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016;374:843‐852.
Shah I, Ahman E. Unsafe abortion in 2008: global and regional level and trends. Reprod Health Matters. 2010;18:90‐101.
Martin CW, Anderson RA, Cheng L, et al. Potential impact of hormonal male contraception: cross‐cultural implications for development of novel male preparations. Human Reprod. 2000;15:637‐645.
Heinemann K, Saad F, Wiesemes M, White S, Heinemann L. Attitudes towards male fertility control: results of a multinational survey on four continents. Human Reprod. 2005;20:549‐556.
Glasier AF, Anakwe R, Everington D, et al. Anderson RA would women trust their partners to use a male pill? Human Reprod. 2000;15:646‐649.
Pacia D, Brown B. Leaked supreme court opinion, structural sexism, and our moral imagination. Hastings Bioethics Forum. 2022. Accessed January 2024. https://www.thehastingscenter.org/leaked‐supreme‐court‐opinion‐structural‐sexism‐and‐our‐moral‐imagination/
Fung B. “The Quiet Racism of Abortion Bans,” The Atlantic. 2012. Accessed January 2024. https://www.theatlantic.com/health/archive/2012/08/the‐quiet‐racism‐of‐abortion‐bans/261665/
Dehlendorf C, Rodriguez MI, Levy K, Borrero S, Steinauer J. Disparities in family planning. Am J Obstet Gynecol. 2010;202:214‐220.
Fletcher J, Yee H, Ong B, Roden RC. Centering disability visibility in reproductive health care: dismantling barriers to achieve reproductive equity. Women Health. 2023;19:17455057231197166.
Campo‐Engelstein L. No more larking around! Why we need male LARCs. Hastings Center Report. 2011;415:22‐26.
Hannaford PC, Iversen L, Macfarlan TV, Elliott AM, Angus V, Lee AJ. Mortality among contraceptive pill users: cohort evidence of Royal College of General Practitioner's Oral Contraception Study. BMJ. 2010;340:927.
Iversen L, Sivasubramaniam S, Lee AJ, Fielding S, Hannaford PC. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioner's Oral Contraception Study. Am J Obstet Gynecol. 2017;216:580.
Maguire K, Westhoff C. The state of hormonal contraception today: established and emerging non‐contraceptive health benefits. Am J Obstet Gynecol. 2011;205:S4‐S8.
Sandset PM. Combined oral contraceptives increase risk of venous thrombosis according to oestrogen dose and type of progestogen. Evid Based Med. 2014;19:194.
Skovlund CW, Mørch LS, Kessing LV, et al. Association of hormonal contraception with depression. JAMA Psychiatry. 2016;73:1154.
Daniels K, Mosher WD, Jones J. Contraceptive methods women have ever used: United States, 1982–2010. Natl Health Stat Report. 2013;62.
Samuelsson E, Hedenmalm K, Persson I. Mortality from venous thromboembolism in young Swedish women and its relation to pregnancy and the use of oral contraceptives‐an approach to specifying rates. Eur J Epidemiol. 2005;20:509‐516.
Amory JK. Male contraception. Semin Reprod Med. 2023;41:279‐286. doi:10.1055/s‐0043‐1777757
Mommers E, Kersemaekers WM, Elliesen J, et al. Male hormonal contraception: a double‐blind, placebo‐controlled study. J Clin Endocrinol Metab. 2008;93(7):2572‐2580.
Behre HM, Zitzmann M, Anderson RA, et al. Efficacy and safety of an injectable combination hormonal contraceptive for men. J Clin Endocrinol Metab. 2016;101(12):4779‐4788.
Clayton EW, Kodish E. Baby aaron and the elders. Hastings Center Report. 1999;29(5):20‐21.
Minkoff H. Teaching ethics: when respect for autonomy and cultural sensitivity collide. Am J Obstet Gynecol. 2014:298‐301.
US Food and Drug Administration. Development and Approval Process (Drug). Accessed March 27, 2019. https://www.fda.gov/Drugs/DevelopmentApprovalProcess/default.htm
Blacksher E. Public health ethics. Ethics in medicine. University of Washington. Accessed October 10, 2019. http://depts.washington.edu/bhdept/ethics‐medicine/bioethics‐topics/detail/76
Truog RD. The ethics of organ donation by living donors. N Engl J Med. 2005;353:444‐446.
Campelia G, Abbe C, Nickels LM, McElmeel E, Amory JK. Shared risk’’: reframing risk analysis in the ethics of novel male contraceptives. Contraception. 2020;102:67‐69.
Held V. The Ethics of Care: Personal, Political, and Global. Oxford University Press; 2006.