Respecting Autonomy in Population Policy: An Argument for International Family Planning Programs

Abstract

This paper addresses whether universal, general education programs are enough to satisfy basic criteria of human rights or whether comprehensive family planning programs, in conjunction with universal education programs, might also be morally required. Even before the Reagan administration instituted the 'global gag rule' at the 1984 conference in Mexico City, prohibiting funding to nongovernmental organizations that included providing information about abortion as a possible method of family planning, the moral acceptability of family planning programs has been called into question. This paper makes a moral argument for family planning by appealing to both data and theory: data about the efficacy of universal and comprehensive family planning education programs at reducing fertility and infant mortality and theory about what is required for the establishment of autonomy. It reasons that universal educational programs are insufficient for the promotion of autonomy and, therefore, argues on substantive autonomy grounds for comprehensive family planning programs in addition to universal education programs. IntroductionFor several decades, the international population community has debated the relative merits of 'comprehensive' family planning and education programs versus 'universal' education programs as a means to improve women's autonomy and reduce unwanted fertility and infant and child mortality. Both comprehensive family planning and universal education programs have been demonstrated to reduce fertility and infant mortality. Generally speaking, however, comprehensive family planning education programs are frequently framed either as morally inappropriate or as a tradeoff with other possible government projects.Apart from efficacy and resource questions, there are also deeper questions regarding rights and autonomy that have been overshadowed by the view that comprehensive family planning programs cross a moral boundary (by introducing information about fertility and women's health concerns) where universal education programs do not. In this paper, we address the normative question of whether a simple universal education program is enough to satisfy basic criteria of human rights or whether a comprehensive family planning education program, in conjunction with a universal education program, may also be required. In the next section, we outline the historical and international backdrop upon which this discussion about universal education programs and family planning programs rests. Then we offer empirical support of how family planning programs offer autonomy. Next we argue on fairness grounds for family planning programs in addition to universal education, before we conclude.

Public health: How much evidence is needed to support our policies?

“…First, some public health interventions arguably enhance individuals' ability to make choices, rather than curtailing it. 17 This places such interventions beyond the scope of the constraint problem. Second, how much constraint is justified is again an ethical and political question on which additional data will usually bring little to bear.…”