Moskowitz E H, Jennings B, Callahan D
Hastings Cent Rep. 1995 Jan-Feb;25(1):S1-8.
Realizing the promise of long-acting contraceptives depends on continuing efforts to distinguish appropriate from inappropriate policies and practices. The current debates concerning Norplant and other long-term methods generally have based ethical judgment on too slim a reed. It is insufficient and overly divisive to limit the tools of analysis to questions of freedom and coercion. A richer perspective is needed. We have sketched out an alternative approach that rests on a close, case-by-case analysis attentive to the social dimension and consequences of contraceptive decisionmaking, as well as to the individual interests at stake. The approach also takes special note of the need for access to long-acting contraceptive, the possibility for mistaken nonuse as well as mistaken use, and our country's past and present biases and power imbalances. We do not claim that this method will make judgments about justifiable or unjustifiable influence easy or automatic. However, it should prove adept at underscoring the factors that require particular scrutiny. Perhaps more importantly, the approach highlights that influences for the use of long-acting contraceptives ought to be judged, not merely dismissed.
实现长效避孕措施的前景取决于持续努力区分恰当与不恰当的政策及做法。当前关于诺普兰及其他长效避孕方法的辩论，通常将伦理判断建立在过于薄弱的依据之上。将分析工具局限于自由与强制的问题是不够的，而且会造成过度分裂。我们需要更丰富的视角。我们勾勒了一种替代方法，该方法基于逐案的细致分析，关注避孕决策的社会层面和后果，以及所涉的个人利益。这种方法还特别注意到获得长效避孕措施的必要性、误用和不用的可能性，以及我国过去和现在的偏见及权力失衡。我们并不声称这种方法会使对合理或不合理影响的判断变得容易或自动。然而，它应能有效地突出需要特别审查的因素。也许更重要的是，这种方法强调，对长效避孕措施使用的影响应该进行评判，而不仅仅是不予考虑。
