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Emergency Contraceptive Pills -

Ethical or Unethical

Presentation By:
Ankit Verma
Shadab Ahmad
 Contents
 Introduction
 Doctors’ Suggestions
 India in 2010
 Ethical Aspects
 Use of Pills- Ethical or Unethical
 Counter Arguments
 Ethical Aspects on Religious Grounds
 Ethics involved in Advertising and Marketing
 Conclusion

 The Basics First
 An emergency contraceptive
pill is a contraceptive method
which, if used after
unscheduled intimacy, may
prevent pregnancy


 They are called Emergency

Contraceptive Pills because
they are meant to be used in
an emergency situation

The y are  not re comme nde d as standard 

contrace ptive s
 Basics…
 An Emergency Contraceptive Pill (ECP), a.k.a. the
Yuzpe Regimen contains an elevated dose of oral
contraceptives containing estrogen (ethinyl
estradiol) and a progestin (levonorgestrel or
norgestrel) is taken within 72 hours of unprotected
intercourse
 This method has been in use for over 20 years.
 Gravol pills are often given in addition to the ECP, to
reduce nausea - a common side-effect

 Basics…
 Currently, the two types of pills in the market are the
I-pill from Cipla (now Piramal) and Unwanted-72
from Mankind
The hormone in these is LNG of
1.5 mg, to be taken as a single
tablet
Other brands like EC2 (Zydus) or
Norlevo (Win Medicare) have
0.75 mg of LNG, to be taken as
two tablets 12 hours apart, which
decreases vomiting
 What The Doctors Say
 Each such tablet contains 1.5 mg of levonorgestrel,
a synthetic hormone
 Statutory warning : Use only in emergency
situations, not as substitute for condoms or low-dose
oral contraceptives. Does not prevent sexually
transmitted diseases such as AIDS
 Possible side-effects : Vomiting, nausea, fatigue,
abdominal pain, diarrhea, dizziness, headache, early
or late onset of next period and increased menstrual
bleeding. Some women might suffer ectopic
pregnancy

 Doctors Say…
 Effectiveness :
1.Various sources indicate that their efficiency is 74% or
more
2.Some studies found them 89% effective
3.The number of women who take the pills and still
become pregnant is only about 2%
4.Doctors believe that most women who take EC Pills
would not have become pregnant anyway
 India in 2010
 The proportion of women knowing the methods of
birth control like oral pills and condoms varies from
about 2 percent in Meghalaya to 80 percent in
Himachal Pradesh
 21% pregnancies are unplanned, contributing 6.5
million induced abortions every year
 A survey, Indian Adolescents – Changing
Sexual Behavior, claims that teenage pregnancy has
doubled between 2004 and 2009

Source : Jansankhya Sthirata Kosh, http://www.jsk.gov.in/

 India in 2010
 65% of the girls who get pregnancy before marriage
prefer to abort without letting their families know
 This is not widely known that Emergency
Contraceptive Pills are included in the National
Family Planning Program

Source : Jansankhya Sthirata Kosh, http://www.jsk.gov.in/

 Teenagers ininIndia
Teenagers India
Source : The Times of India, ZEENIA F BARIA , Jul 3, 2010

2 0 %  te e ns have  
watche d porn be fore  
the y re ache d 1 3

By the  time  the y 

re ach 1 6 ,  5 0 %  te e ns 
have  alre ady 
watche d porn

About 5 0 %  of te e ns 

have  kisse d some one  
of the  opposite  se x

9  out of 1 0  te e ns 

think pre marital se x 
is fine
Find it plausible? At least in our opinion, it is...
 Some Good And Some Not So Good News :


 The good news is that the number of medical

termination of pregnancies has started to dip
 The bad news, however, is that the country still records
large number of MTPs
 In 2008, 6.41L abortions across 12,510 institutions
 Highest number of such abortions- Tamil Nadu(89,194)
followed by UP
 Tamil Nadu has banned the sales of ECPs under
provisions of the Drugs and Cosmetics Act


Source : The Times of India, Kounteya Sinha, Thursday, 16 September 2010
 Emergency contraception - Ethical
aspects
 The ethics of providing EC Pills has been questioned
by some, arguing that it acts by preventing
implantation
 Scientific evidence does not support this concept, but
shows that EC Pills act before fertilization
 Placing obstacles to the access of EC Pills is unethical
as it transgresses the ethical principles of autonomy
and justice
 Far from inducing abortions, EC Pills reduce unwanted
pregnancies and prevent abortions


 Ethical Or Unethical
 The ethics related to EC Pills
use can be seen from two
opposite perspectives
 There are those who believe
that the use of EC Pills is
unethical and those who
believe that limiting access
to EC Pills is a violation of
basic ethical principles
 Use of EC Pills - Unethical
 Some people question the ethics of using EC Pills
arguing that its mechanism of action is prevention of
implantation and that the fertilized egg is equivalent
to an unborn child
 Consequently, they maintain that prevention of
implantation is an early abortion, which they
condemn
 Counter Arguments
 This ethical objection of the use of EC Pills is not
valid, as it is based on the false premise that the
mechanism of action consists prevention of
implantation
 This incorrect concept stems from the supposition that
synthetic hormones used for EC Pills would alter the
characteristics of the endometrium in such a way
that it would interfere with implantation
 But all mechanism of action studies have shown
that EC Pills interfere with the ovulatory process
 Arguments Continued…
 EC Pills either inhibit or delay ovulation beyond the
period of sperm survival in the woman’s body
 The primary problem is that old textbooks on
contraception state that interference with
implantation is one of the mechanisms of action of
the EC Pill
 But now, there is sufficient scientific evidence for pre-
fertilization effects of emergency contraception
 Use of EC Pills - Ethical
 Placing barriers to the use of pills is a transgression of the
ethical principles of respect to the autonomy
 EC pill is a very effective instrument for the prevention of
unwanted pregnancy, and consequently of induced
abortion
 If the pills are used as they are meant to be, far from
‘inducing abortion’, it can be a very important instrument
to improve the health and well-being of women
 The pills are again very helpful in the cases of forced sex
or when the health conditions of woman are not good
enough to have a baby
 Counter Arguments
 Social conservatives oppose all forms of abortion on
absolutist grounds, allowing only rare exceptions
where the life of the mother is truly at stake
 Some people argue that easy access to EC Pills would
stimulate women, particularly adolescent girls, to
promiscuity and abuse of sexual freedom
 Earlier, due to ethical issues and social stigma
attached to getting pregnant before marriage, girls
used to avoid unprotected intercourse but now even
teenagers think it is easy and casual to consume a
pill and prevent pregnancy
 On Religious Grounds
 Religions vary widely in their views of the ethics of birth control
 The Roman Catholic Church accepts only Natural Family
Planning and only for serious reasons, while Protestants
maintain a wide range of views from allowing none to very
lenient
 In Islam, contraceptives are allowed if they do not threaten
health, although their use is discouraged by some
 Hindus may use both natural and artificial contraceptives,
however they are against any contraceptive method which
works after fertilization
 A common Buddhist view of birth control is that preventing
conception is ethically acceptable, while intervening after
conception has occurred or may have occurred is not
 Lies, Sex Aur Dhokha
 Quoting what was told to Spiderman
"With great power comes great
responsibility“, marketers should also
be fully aware of the responsibility
which comes along with yielding such
a powerful force on consumers
 The fact that they have been made into
OTC (over the counter) drugs by which
it means that they can be sold without a
doctor's prescription and companies
can directly communicate to ab ham hain te nsio n 
free
consumers is one reason which has led
to the issue
 Dhokha Continues…
 Morning-after-pills are emergency
contraceptives but the way they are
being presented in the advertisements,
more and more women in the age
group of 16 to 35 are falling prey to
them
Abortion say accha hai pregnancy ko rokna

The ads give false hope of a ‘tension-free’ sex-life,

claiming that ECP is 100 percent effective with no side-
effects
They do not mention that ECP should be used only for
emergencies, thus leading to misuse and complications
 Conclusion
 Creation of awareness about ECP should be the government’s
responsibility, and not just that of pharma firms’
 Ethical guidelines should be laid out by the Indian Council of
Medical Research and made binding on the firms
 A conference in India indicated that ECP could make a major
impact at reducing country's millions of legal and illegal
abortions each year
 It should be allowed only in the case of danger to life of the
pregnant woman, grave injury to mental or physical health of
the woman, pregnancy caused by rape, risk of child being
born with severe physical/mental handicaps or failure of any
contraceptive device or method
 Conclusion Cont…
 Although there is general agreement that emergency
contraception protects against unwanted pregnancy,
the magnitude of the protective effect continue to be
a matter of debate
 This debate may well never be concluded because, to
settle the question, a randomized trial would have to
be conducted comparing pregnancy rates in treated
and placebo groups
 But.. This would be unethical 
 References
 Alcorn R. Does the birth control pill cause abortions? 3rd edition.
Eternal Perspectives Ministries. Gresham, OR. 1998.
(http://www.epm.org/bcp.html /)
 Kahlenborn C. How the pill and other contraceptives work. Can a
Christian take the Pill? ? Life Advocate 1997;12(7).
(http://mttu.com/Advocate/7_97/feature.htm/)
 Facts about family planning. Health brochure series. American
Academy of Natural Family Planning. St. Louis. 1999.
(http://www.aanfp.org/fpfacts.htm/)
 Birth control pills: contraceptive or abortifacient? American Life
League. Stafford, VA. 1999.
(http://www.all.org/issues/pillab.htm/)
 http://ec.princeton.edu/questions/dedicated.html
 http://www.religioustolerance.org/abo_emer0.htm
 http://www.tehelka.com/story_main46.asp?filename=Ne140810Proscons.asp
 http://www.jsk.gov.in/family_planning_method.asp/

Thank You!!