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The ethics of State-sponsored and clinical promotion of long-acting reversible contraception.

Wale, J. and Rowlands, S., 2021. The ethics of State-sponsored and clinical promotion of long-acting reversible contraception. BMJ Sexual & Reproductive Health, 47 (3), e11.

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LARC BMJSRH Accepted Version 130520.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial.


DOI: 10.1136/bmjsrh-2020-200630


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.

Item Type:Article
Uncontrolled Keywords:contraception ; Ethics ; Promotion
Group:Faculty of Media & Communication
ID Code:34004
Deposited By: Symplectic RT2
Deposited On:14 May 2020 11:22
Last Modified:14 Mar 2022 14:22


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