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"Birth Control" means not having babies. "Contraception" means not conceiving. If they wanted to use RU-486 for birth control (without respect to conception), they'd have the women take it on the first day of each month and be done with it (or, more likely, 1st and 15th just to make sure) — and it would work fine. But the way it would work is by causing a miscarriage of any nascent pregnancies which might have happened during the previous month (or two weeks), and for some people that's not morally acceptable. So these researchers are jumping through incredible hoops to measure hormone levels and so on to figure out when ovulation is going to take place, so that the drug can be taken just before that. That's very difficult to determine, it turns out, which is why their reliability was so lousy. For something like this, a 5% failure rate per year makes it close to useless. 5% per lifetime would be acceptable. In other words, if for every twenty couples who used this, one got an unexpected pregnancy over a lifetime's use, that would be an acceptable failure rate. With a 5% failure per year, you'd expect nearly all of the twenty couples to get at least one unexpected pregnancy over a lifetime's use. As you can see, that's not good enough. In fact, that failure rate is nearly the same as for the legendarily terrible "rythm method". Let's consider the moral shading here: traditional birth control (i.e. contraceptive) pills work by actually preventing release of eggs, so no fertilization can take place. The carefully-synchronized use of RU-486 as proposed in this study would not prevent either ovulation or fertilization of eggs, but would prevent a fertilized egg from being implanted in the uterus of the woman. (Evidently, under UK law that's acceptable.) A simple twice-per month schedule of taking RU-486 would cause any implanted egg to be aborted. The practical effect in all three cases is the same of course (no babies), but to some people the difference between miscarriage and prevention of conception is critical (like, say, the UK courts). I just have to wonder whether prevention of fertilization is ethically the same for some as prevention of implantation of a fertilized egg. (To me, all three are ethically the same, but that's because I don't consider abortion to be unconditionally immoral.) Regardless of the direction they ride around Robin Hood's barn, this may still be important. Traditional birth control pills (er, "contraception pills") work in a woman by simulating the hormonal balance which appears during pregnancy for 21 days out of every 28, and this causes other changes to take place which ordinarily would be needed to prepare for the upcoming baby (which isn't really coming). The most common side effect is changes in the woman's breasts (including some growth and quite often soreness), and it can alter other things as well. RU-486 used monthly would not be expected to have those kinds of effects, which might be a good thing since for some women the side effects of normal birth control pills are unacceptable. So this might present an alternative — as long, that is, as they can improve that reliability figure. (discuss) |
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