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Directive counseling on long-acting contraception.

E Moskowitz and B Jennings

The Hastings Center, Briarcliff Manor, NY 10510, USA.

National rates of unintended births are a major public health concern. The availability of highly effective long-acting contraceptives has prompted some public officials to promote the coercive use of these methods to reduce such problems as intergenerational poverty and child abuse. Broad-brush public policies that require long-term contraceptive use are unethical. However, persuasion to use these methods can be appropriate. One place for exerting ethically justified influence is in family planning counseling. The dominant nondirective counseling model, which excludes the possibility of vigorous persuasion, is overly rigid. Family planning professionals should develop practice protocols that permit and guide the exercise of directive counseling to use long-acting contraception.

Related articles in AJPH:

Ethical and health implications of directive counseling on long-acting contraception.

E L Gollub and S L Isaacs
AJPH 1997 87: 1867-1868. [PDF]  

Directive counseling should emphasize disease protection not pregnancy prevention.

C A Pearson
AJPH 1997 87: 1868-1869. [PDF]  

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				J. G. Mauldon Providing Subsidies and Incentives for Norplant, Sterilization and Other Contraception: Allowing Economic Theory to Inform Ethical Analysis J. Law Med. Ethics, September 1, 2003; 31(3): 351 - 364. [PDF]