International aspects of ethical problems in obstetrics and gynaecology

Until the middle of the twentieth century, family planning was commonly con demned as an immoral enterprise. This chapter argues that ethical disapprov al made access to fertility regulation difficult, and that while the rich a nd educated were often able to access the services they needed, typically t he poor could not. Thus, ethical interpretations caused much of the differe ntial fertility observed between social classes, ethnic groups and ultimate ly much of the explosion in population that has characterized the last 50 y ears. Since the 1960s human rights have been interpreted to encompass the r ight to decide the number and spacing of children and as a result access to contraception has improved. Where several methods of contraception (backed up by safe abortion) are available, fertility always falls. But, unfortuna tely, consensus has not been reached on how to specify particular sets of r ights (e.g. decision-making for adolescents), and no consensus exists on ho w to balance the opposing rights of the mother and fetus in the case of abo rtion. The ethics of the one-child family in China is also noted.