Posted on | August 20, 2014 by J.C. von Krempach, J.D.
There are people who have compassion with the weak, the sick, the handicapped and the elderly. And then there are so-called “humanists”.
According to the world-renowned champion of “humanism”, it is “immoral to allow babies with Down-syndrome to be born“.
Always the same story: old distinguished white-haired professor proffers a crazy theory, some years later someone will start putting it into practice…. Karl Marx was such a guy: he himself didn’t kill anyone with his own hands, but the ideology that bears his name was one of the most murderous in history. Same goes for Dawkins: from now on nobody should pretend he wasn’t aware how dangerous his ilk of “humanism” is.
‘Baby Gammy’ raises awareness for true nature of ‘surrogacy motherhood’. But the European Court of Human Rights has no qualms…
Posted on | August 12, 2014 by J.C. von Krempach, J.D.
After two weeks of media reports on baby Gammy, is difficult to discern which version of the story is the one we should believe. Is it true that the Australian couple who used the services of a Thai “surrogate mom”, upon learning that one of the two children that the “surrogate mom” was expecting suffered from Down syndrome, asked her to have an abortion? Is it true that, when finally the “surrogate mom” gave birth to both children, the wannabe “parents” took the healthy child home to Australia, leaving the “surrogate mom” with the handicapped one? Is it true that they were aware that they were in fact having two children instead of one? Or is it true, as they claim, that the agency that was handling the “surrogacy pregnancy” never informed them of the second child and its handicap?
Whatever may be the case, one thing is certain: such cases are bound to occur, and even with great frequency, wherever the practice of “surrogacy motherhood” is accepted. Surrogacy motherhood is the quintessential expression of a mentality that is unwilling to accept parenthood as a gift, but that assumes that everybody has an entitlement to have a child. And of course, once this “right to a child” is accepted, it soon evolves into a “right to a healthy child”. Children that suffer from mental defects or physical malformations need not be accepted, because our self-given entitlement is to have only children that fully correspond to our ambitions.
Children, it appears, are now a commodity. It is a “flesh-for-cash” business. In other words: a new form of trafficking, or of slave trade.
It is a strange coincidence that more or less at the same time when the Gammy story surfaced the international media, the European Court of Human Rights (ECtHR) has issued two judgments in which it castigated France for not having given full legal effect to the “surrogacy agreements” French couples had concluded abroad.
Upon reading those judgments in closer detail, it appears that the Court did not intend to explicitly recognize the use of “surrogacy moms” as a new human right.
For all practical purposes, however, this is what those judgments do. Bizarrely, they argue that this is in the best interest of the children concerned, as it might spare them all uncertainties regarding their entitlement to the French citizenship as well as regarding the legal recognition of their “family lives”.
This reasoning is (as is habitual with Europe’s undeservedly “prestigious” human rights institution) completely unfounded, both legally and factually. Both cases concerned children who were created in vitro in a California based fertility clinic, using the sperm of their French fathers and the ova of American women who, according to this peculiar business model, “donated” them. Being the children of French citizens, they always were under French law entitled to French citizenship – irrespective of whether the State was, or was not, going to recognize the “motherhood” of their fathers’ respective spouses (who, in both cases, were infertile, and biologically completely unrelated to the children). The truth is: no application for French citizenship seems to have been made – and therefore, no such application had been rejected. How can it then be claimed that the State had violated anybody’s rights?
The second limb of the Court’s reasoning is equally bizarre. In order to give legal recognition to the children’s relationships with women who are not their mother, the Court obliges the French authorities to adopt legal decisions that would sever all legal relationships with the women that are, indeed, their mothers. Just another step in the Court’s gradual re-definition of “family life”, which from a well-defined biological reality is turned into some kind of social role-play…
It is very good that the Gammy case has, at least for some days, shed some light on the implications brought about by the horrible practice of “surrogacy motherhood”.
Maybe if such cases come up in the media with greater frequency, this will at last trigger some kind of reflexion process even at the ECtHR…
Posted on | August 5, 2014 by Lisa Correnti
At a recent Family Planning Conference in Kampala co-hosted by Uganda’s Ministry of Health and UNFPA, sexual health advocates and development partners addressed young people on access and information for modern contraceptives — leaving out though — how these contraceptives could result in contracting HIV/AIDS, increasing breast cancer risk and rendering them sterile.
UNFPA champions sexual and reproductive rights throughout the developing world which includes comprehensive sex-ed to the very young, and access to modern contraceptives and so-called “safe” abortion. Abstinence programs don’t seem to make the agenda.
Prioritized and distributed through intermediaries like International Planned Parenthood Federation and Marie Stopes International are long-acting hormonal progesterone contraceptives not only among married women but among adolescent girls. These implants and injectables are being promoted among adolescent girls despite a black box warning for osteoporosis, a double risk of breast cancer and increased risk of HIV transmission.
The injectable depo provera is not recommended for more than 2 years of use due to irreplaceable bone mineral loss. Women also experience prolonged bleeding and delay or loss of fertility. The drugs manufacturer Pfizer does not recommend its use for women that want to have more children.
Reproductive rights advocates, the World Health Organization and US agencies are all aware of the serious nature of these progesterone only hormonal contraceptives. Yet, the scale-up throughout developing countries continues. Why? Because these stakeholders view pregnancy as the worse outcome weighing it up against the risk of possible health issues from injectable use.
The same reproductive rights advocates who loudly yell for sexual and reproductive health policy as a human right have colluded in the coverup of information about the serious side effects of progesterone contraceptives.
This week civil rights attorney Willie Gary visited members of the U.S. Congress informing them he will bring suit against Pfizer for fraud and requested lawmakers take action to stop funding Depo Provera and Norplant 2 through development assistance programs.
While rich foundations may continue to fund global abortion providers for the distribution of these injectables – funding from the US should soon end.
Posted on | August 1, 2014 by J.C. von Krempach, J.D.
Following the flat refusal of the European Commission to take any action in response to the successful European Citizen Initiative ONE OF US, the organisers of the initiative have now filed a formal lawsuit against the EU’s executive.
In the 30-page complaint (which we make available online on this blog for the convenience of our readers), the citizens’ committee meticulously exposes the lack of argument and intellectual poverty of the Commission’s answer to the initiative, which had been signed by nearly two million citizens. It comes to the conclusion that this response was inadequate, and hence violates the Commission’s obligations.
It will be very interesting to follow the further developments of this lawsuit. The inadequacy of the Commission’s response to the initiative will be clearly apparent to anyone who reads the well-drafted complaint, and it is unlikely that the EU judges will be able to find any words of praise for the way in which the Commission has reacted to a legislative proposal that would ban the funding of abortions through the EU budget. But the fundamental question that the Court will have to answer is a different one: whether or not EU Regulation 211/2011, which provides the legal basis for such formal petitions, gives the Commission the right to give inadequate responses to unwelcome citizens’ initiatives.
In other words, this is not about abortion anymore. It is a real test case for democracy in Europe. The outcome of this lawsuit will determine the future not of the ONE OF US initiative (which in any case has spelt out a political agenda that seems likely to remain on the table for years to come), but of the European Citizen Initiative as an instrument of participative democracy.
The Court thus faces a dilemma: on the basis of a strict reading the wording of Regulation 211/2011 it may well find that the Commission has a nearly unlimited margin of appreciation in dealing with successful citizens’ initiatives, and thus may turn them down on the basis of the flimsiest reasoning (or, in the extreme case, without any reasoning at all). But that would simply mean that it makes no sense for citizens to use this new instrument. On the other hand, if the applicants’ claim is upheld, this would mean that the Commission’s monopoly of initiative would have come to an end.
The Court may be strongly tempted to wriggle out of this dilemma by finding some formal subterfuge for not dealing with the complaint. But such a strategy would not work out: rejecting the complaint on formal grounds would simply mean that citizens have no possibility to legally challenge the Commission’s response to their initiative, even if that response is clearly inadequate. And this would in turn mean that the citizen’s initiative, which was introduced in 2011 to add an element of democracy to the EU, is nothing than an empty promise.
There is no way out: the EU’s citizens want to know what a European Citizen Initiative is really good for. And the Court, one way or the other, must give them an answer.
Posted on | July 30, 2014 by Roger Kiska, J.D.
Last month, the Grand Chamber of the European Court of Human Rights decided the case of Fernández Martínez v. Spain. Much has been written about the main judgment, a decision that upheld the religious autonomy of the church by the slimmest of margins—the votes of nine judges to eight. But less has been said about Judge Dmitry Dedov’s two-page dissenting opinion, which raises a few eyebrows. If his views take hold it could mark the end of religious freedom as we know it.
Firstly, some brief facts. In 1984 Mr Martínez, a Catholic priest, applied to the Vatican to be excused from the obligation of celibacy. Before they responded—and this took some time—he got married and had five children. In 1991 he started work as a teacher at a Catholic religious and morals state school under a renewable one-year contract. Under the terms of a treaty between Spain and the Holy See, the contract would be renewed by the Ministry of Education as long as the local Bishop continued to give his approval.
In 1996 an article about the Movement for Optional Celibacy of Priests was published that made Martinez’s dissent from the celibacy rule public. Nine months later, the local Bishop withdrew his approval of Martinez as a teacher, and his contract was not renewed. Martinez sued the Spanish government and his case made it through the Spanish domestic courts to the Grand Chamber of the European Court of Human Rights, which narrowly rejected Martinez’s application, thus maintaining the autonomy of the Catholic Church to dismiss its clerics.
Judge Dedov clearly disagreed with this ruling. He began his dissent with a lofty view of the court’s ‘task’. He thought it was to ‘balance the rights and place them into some hierarchy’. But no one has actually given him or the court the legal or political mandate to establish any ‘hierarchy’ of rights. No authority was cited on this point too. In fact, the court has never attempted to develop a system where certain rights would always trump others. Rather, it has always stressed that attention must be given to the facts and circumstances of the particular case.
However, the court’s task so defined gave Judge Dedov room to be unapologetic about his prejudices against the celibacy rule. He said that the Church was not entitled ‘to persecute [its] members for exercising their fundamental human rights’. He went on to say, ‘If the Convention system is intended to combat totalitarianism, then there is no reason to tolerate the sort of totalitarianism that can be seen in the present case.’ One wonders what those who survived the horrors of real totalitarianism in the twentieth century would say.
In the end, the thrust of Judge Dedov’s opinion is this: ‘[T]he celibacy rule contradicts the idea of fundamental human rights and freedoms. This, in my view, should be used as a principal reason for finding a violation of Article 8 of the Convention.’ It is one thing for a judge to disparage a religious practice. It is quite another for him to criticize it on the basis of human rights.
If Judge Dedov wrote the main judgment, would he order the Church to change its rules? He does state that ‘optional celibacy is the best way out of this problem’. What would he say about monks, nuns and ascetics of other faiths, or all the other priests that remain today with the Catholic Church? We get a hint of this when he discusses what he regards as Spain’s chief failure: ‘[T]he State has failed, not just to abstain from interference concerning the applicant, but also to exercise its positive obligation with respect to at least 6,000 priests of the Catholic Church [in Spain].’ It appears that in Judge Dedov’s world, the State must liberate the woeful prisoners of celibacy.
With respect, he cannot be right. The celibacy rule does not contradict human rights for the simple reason that one can choose not to abide by it. There is a clear difference between not having a right and choosing not to exercise it. Judge Dedov dismisses the argument from free choice for the rather opaque reason that ‘family life cannot be subjected to any transaction’. He seems to be saying that one cannot choose to sacrifice one’s ability to have a family in order to be a priest, or for any other reason. But people make such sacrifices all the time, and for various reasons. Taken to its logical conclusion, Judge Dedov’s position is fundamentally absurd and illiberal. With no legitimacy he imposes his value system and his version of a ‘hierarchy of rights’ on the Convention by elevating Article 8 to the status of an inalienable natural right. That in any case flatly contradicts the wording of the article. The lack of citation of any authority is stark, although to his literary credit Judge Dedov does mention The Hunchback of Notre Dame and The Thorn Birds in support of his disdain for the celibacy rule. But one wonders if that goes anywhere remotely beyond confirming his pride and prejudice.
Ultimately, Judge Dedov’s dissent clearly reveals that he was not content with interpreting and applying the law. If judicial preconceptions are not contained, religious freedom will be extinguished by those whose very role is to protect its existence. It can only be hoped that the court continues to be the guardian of human rights through the rule of law, and not the rule of judges.
Posted on | July 28, 2014 by Stefano Gennarini, J.D.
Must read article on First Things online.
I have now spent a lot of time with other people’s bodies—very old bodies and very new bodies, severely disabled, sick, or just plain worn-out bodies, bodies in labor, bodies that are well and strong, and the bodies left behind by death. Looking back, I realize that changing my mind about abortion was actually one of the least significant steps toward becoming truly pro-life. There are things that can be learned—can be said—only in the language of bodies. There is a specific wisdom to be gained through the experience of being with actual people: their actual pregnancies, illnesses, births, and deaths. And many of the lessons that bodies teach can barely be translated into words.
Posted on | July 25, 2014 by Grégor Puppinck, Ph.D
The European Centre for Law and Justice recently published a detailed study on the European Court of Human Rights (ECHR) case law on assisted suicide in the International Journal of Human Rights. Here is the summary.
Claire de laHougue and Grégor Puppinck, doctors in law, published a study on behalf of the European Centre for Law and Justice, analysing the progressive elaboration of the European Court of Human Rights (ECtHR) of a “right to assisted suicide” under the European Convention of Human Rights (ECHR). This “right” is established from a succession of judgments from the Pretty v. the United Kingdom case to the Alda Gross v. Switzerland judgment (n° 67810/10) of 14th May 2013 where the Court condemned the current Swiss legal framework on assisted suicide by four votes to three, reckoning that it lacked precision and ought to be governed by legal norms and not deontological ones.
Upon the request of the Swiss government, the Court decided to refer the Gross case to the Grande Chamber to be retried. The chamber’s judgment of May 2013, followed the Pretty v. the United Kingdom (n° 2346/02, 29th April 2002), Haas v. Switzerland (n° 31322/07, 20th January 2011) and Koch v. Germany (no 497/09, 19th July 2012) cases whereby the Court gradually specified the outlines of a right to assisted suicide. According to the Court, such right results from the fact that “in an era of growing medical sophistication combined with longer life expectancies, many people are concerned that they should not be forced to linger on in old age or in states of advanced physical or mental decrepitude which conflict with strongly held ideas of self and personal identity”. (Gross, para. 58).
In the Pretty case, the Court had stated : “[t]he applicant in this case is prevented by law from exercising her choice to avoid what she considers will be an undignified and distressing end to her life. The Court is not prepared to exclude that this constitutes an interference with her right to respect for private life as guaranteed under Article 8 para. 1 of the Convention.” (Pretty, para. 67). The Court also specified that: “Article 2 [guaranteeing the right to life] cannot, without a distortion of language, be interpreted as conferring the diametrically opposite right, namely a right to die; nor can it create a right to self-determination in the sense of conferring on an individual the entitlement to choose death rather than life.” (Pretty, para. 39).
In the Haas judgment, the Court affirmed the existence, in the article 8, of “an individual’s right to decide by what means and at what point his or her life will end, provided he or she is capable of freely reaching a decision on this question and acting in consequence” (Haas, para. 51) and it introduces the hypothesis that the States could have “a positive obligation to adopt measures to facilitate the act of suicide with dignity” (Haas, para. 61).
In the Koch judgment, the Court carefully limited its appreciation of Stat’s positive obligations under Article 8 on the procedural aspect by asking that a jurisdiction should judge on a case-by-case basis, on the validity of individual requests for assisted suicide.
According to the Court, suicide is an expression of individual autonomy. Consequently, the primary reason for a “right to assisted suicide” would not be due to suffering or the inevitable death, but due to respect for individual freedom. To base the right to assisted suicide on individual freedom makes incoherent reserving access to assisted suicide to only bedridden individuals whose freedom is strongly affected by their state. Logically, according to this approach, exercising a “right to assisted suicide” should be reserved for persons whose physical and mental capacities are intact.
With this approach, the State’s responsibility would not be to prevent suicide and protect people’s lives but solely to ensure the quality of the suicidal will to die, to protect his freedom and to prevent abuses of a state of weakness. By adopting such reasoning; the court transcribes contemporary post-humanism, revolutionizing a foundation of the Convention: human dignity would no longer be inherent in human nature, but relative and reflexive, absorbed by individual freedom.
The issue of the existence of such a “right to assisted suicide” under the ECHR is currently suspended on the Grand Chamber’s judgment in the Gross v. Switzerland case (n° 67810/10). However, contrary to the Court’s customs and for a reason unknown to the public, the hearing before the Grande Chamber which should have taken place last April was cancelled and postponed sine die.
Gregor Puppinck & Claire de LaHougue(2014): “The right to assisted suicide in the case law of the European Court of Human Rights”, The International Journal of Human Rights, DOI: 10.1080/13642987.2014.926891 ; http://dx.doi.org/10.1080/13642987.2014.926891
Posted on | July 24, 2014 by Grégor Puppinck, Ph.D
After the Spanish representative and General Secretary for the World Action of Parliamentarians José Eugenio Azpiro, and Angel Pintado, Senator and President of this organization introduced the conference, different professionals intervened in the debate. A scientist (Dr. Nicolás Jouve), a doctor (Dr. Ana Martin), a philosopher (Pr. Christophe Tollefsen) and Grégor Puppinck, expressed their views.
Grégor Puppinck, director of the ECLJ (European Center for Law and Justice) in Strasbourg, first highlighted the fact that, though it reflects a minority opinion in Europe, this Bill fits perfectly within the European Court of Human Rights’ case-law and complies with all European and international conventions. Indeed no international convention that would create the right to abortion exists. On the contrary, the Spanish Bill offers to protect the right to life within the framework of international conventions. He then described how abortion should no longer be considered from a unilateral but from a bilateral and even multilateral perspective.
The notion of the ‘right to abortion’ has to be questioned since it implies that abortion is a positive and subjective unilateral right, which only takes into account the interest of the mother. Such a view leads to the denial of the existence and value of the unborn child against which this right applies. This is the perspective from which the Spanish law adopted by the previous government used to stand. This unilateral approach to the right to abortion is ideological since it is based on the negation of a part of reality (the child) and since it makes the will of a third person (the mother) prevail in it. As of any ideological approach, its full implementation is damaging: if such a right to abortion existed, all limits would have to be suppressed and abortion would have to be authorized without any time limit condition.
What stands against the right to abortion is reality: the embryo, the fetus, the unborn child, all really and truly exist. What’s more, they possess all the characteristics of a human being at each stage of his development. To acknowledge this reality, the legislation on abortion has to take into account both the interest of the mother and that of the child in a bilateral juridical perspective. Those interests should then be balanced when they are contradictory and proportionate measures that protect both mother and child should be adopted. This is how a relative right to abortion is conceived: abortion is primarily an exception to the child’s right to life. That’s why in many countries, including France, it was not legalized but decriminalized. If the unborn child had no value, no law would be needed to authorize abortion.
The bilateral approach is however insufficient to comprehend the issue of abortion in any consistent way. From the social point of view, the issue of abortion has to be dealt with from a multilateral perspective in order to place the mother-child relationship in its natural context. This multilateral approach, which involves different players including the family and society, is necessary in order to go beyond the conflicting bilateral relationship between the mother and the child and to remedy the causes of this conflict. Those causes are often independent from the mother-child relationship and often reside in social, economic and affective difficulties.
Society is indeed an essential player in this mother-child relationship. It is responsible for the protection of their health as well as social and economic interests. Abortion is therefore a ‘public’ rather than a private problem, as highlighted by the Spanish senator Beatriz Elorriaga and different speakers during the conference. Indeed it is the state’s duty to protect the unborn child’s right to life. Abortion is also a real issue of public health in countries, including Portugal, where it is carried out at a high rate. Rather than protecting an almost unlimited right to abortion, the conference advocates for the development of social services to help the mother and the child along with efficient alternatives to the VTP, especially when the child is handicapped. Finally, if demographic considerations play an important part, ethical and familial considerations are also central is this Bill and it is necessary for all persons involved in the act of abortion to be associated with it. The Bill purports to support families, make them more responsible and to give medical staff the option to act in all honesty.
The Bill is therefore above all based on “the observation of the true existence of the conceived child” (Grégor Puppinck) and his right to existence. It provides for an exception to the right to life of the unborn child in the first 14 weeks of pregnancy if the latter results from rape, and in the first 22 weeks if there exists a threat to the life of the woman or the child. This risk has to be asserted by a committee of independent experts. Finally abortion is authorized until the full term of pregnancy if there is an “incompatibility with life” that had not been diagnosed during the first 22 weeks and which is medically certified. This time period of 22 weeks corresponds with the level of viability as established by the World Health Organization. In addition, the advertising of abortion is prohibited and doctors and medical staff are given the option to use conscientious objection whenever they do not wish to carry out this act. A minor’s parents have the right to be informed of the pregnancy of their child. The pregnant woman also has to be informed of the fact that she is entitled to a period for reflection.
Members of the conference explained that in spite of the spread of “systematic abortion” in many countries and of the generalization of the perception of abortion as a right, this Bill is not singular. It mirrors a parallel trend towards the increasing protection of the unborn child, in the United States in particular. Thus the Hungarian Secretary of State, Bence Rétvari explained that in his country, the rights to life and to the protection of family are constitutional rights. In the US, numerous states have reduced the legal time limit for abortion (for example, North Dakota has limited it to 6weeks of pregnancy). An estimated 49% of the population considers that it is an immoral act. The Spanish Bill seeks to pioneer this domain.
The Bill should be examined in the coming months and adopted by December 2014.
At the end of the conference, speakers and representatives adopted the Madrid Declaration, committing to the defense of life and the right of the unborn. The Declaration establishes fecundation as the ‘Big Bang’ of life; it concludes that “nothing is more progressive than the defense of human life.”
Posted on | July 22, 2014 by Wendy Wright
A key senator admitted today the U.S. Senate will not ratify the UN Disabilities Treaty. Senator Menendez, chairman of the Senate Foreign Relations Committee, told the committee the treaty does not have the votes to pass the full senate.
A series of amendments voted on by the committee confirmed concerns raised by four-dozen groups – ranging from disability rights to legal and global norms experts – who urged senators not to ratify the UN Disabilities Treaty. In a letter to senators, 48 groups (two joined after publication) caution the treaty will not help Americans here or abroad, but would encroach on Americans’ rights, open the U.S. to foreign intrusion on family issues and abortion, and reduce U.S. prominence as the world leader on disabilities rights.
The committee recommended the treaty by a vote of 10 – 6, along with three amendments agreed to unanimously: to protect parent’s right to homeschool children; to protect U.S. sovereignty; to declare UN committee’s recommendations have no authority to change U.S. laws.
One amendment, introduced by Sen. Marco Rubio, stated the treaty could not be used to promote a right to abortion, repeating the U.S. statement when the treaty was adopted at the UN. It was defeated by pro-abortion senators along party lines.
U.N. treaty committees frequently intrude on countries’ sovereign prerogatives, especially on abortion – regardless of countries’ reservations or amendments.
“The U.S. is the world’s undisputed leader in protecting the rights of persons with disabilities – all without the U.S. ever having ratified the CRPD,” the groups said. The U.S. advises countries on ways to assist people with disabilities and provides foreign aid to help countries implement the Disabilities treaty,
Some claim the treaty places no obligations on the U.S., yet requires other countries to change their laws to accommodate U.S. citizens abroad. But U.S. ratification “will not – and cannot – place any obligation on other countries, least of all to accommodate U.S. citizens,” notes the groups.
Ironically, Sen. Menendez said he couldn’t support the pro-life amendment because, he claimed, it could prevent disabled persons from getting sexual and reproductive services — indicating a belief that the treaty could be used to radically alter U.S. law.
Posted on | July 22, 2014 by Rebecca Oas, Ph.D
The Guttmacher Institute just published a report looking at community influences on the sexual activity of young people in a province of Kenya, and found that in communities that used abstinence education as the main HIV prevention message, young men were more likely to delay sexual activity. Additionally, young people were more likely to abstain when AIDS was acknowledged as a cause of deaths in the community – when the connections between sexual activity, HIV/AIDS, and death are publicly admitted, young people experience less pressure toward early sexual activity and feel more empowered to abstain from it.
The issue of delaying sexual debut among young people recently became a contentious issue at the UN during the Commission on the Status of Women. The document under consideration was about prevention of HIV/AIDS among women and girls in Africa. The Friday Fax reported:
“In a surprise move, the Dutch delegate intervened to amend the resolution on behalf of the US and other countries in Europe and Latin America. They could not accept a mention of “delay of sexual debut” in a paragraph on helping women and girls protect themselves from HIV. Among the other defenses against HIV left in were condoms, gender equality, and gender sensitivity.”
In contrast, the Guttmacher report refers to delayed sexual debut as a “positive behavioral outcome” and acknowledges that it “is an important HIV prevention strategy.”
Pointing out that most previous studies on the timing of sexual debut focus on individual-level rather than community-level variables, the authors look for correlations between the age of sexual initiation and practices and norms within the broader community.
Among the factors correlated with delayed sexual debut:
- Abstinence being taught to youth as the primary AIDS prevention message
- Young men with greater “abstinence self-efficacy”
- Public acknowledgment of AIDS as the cause of deaths within the community
“Self-efficacy” referred to young men expressing the belief that they could say no to sex and planned to do so in the future. This finding is particularly important given the context of what is commonly referred to as “comprehensive sexuality education” (CSE) in UN documents. C-FAM recently published a briefing paper by a group of Spanish experts who point out that the curricula favored by CSE proponents “usually rely heavily upon the concept of “risk reduction” [condoms] since they assume “risk avoidance” [abstinence] is not possible.”
Empowering young men to believe that abstinence is both possible and beneficial leads to later sexual initiation, which in turn is linked to having fewer sexual partners and a reduced risk of contracting HIV. The same report found that “condom self-efficacy”, or a sense of empowerment to use condoms during sex, was not significantly associated with delayed sexual debut. If anything, reliance on condoms could have a perverse effect:
“Earlier debut was associated with reporting a larger number of sources of pressure to have sex and with living in a community where HIV programming was part of community festivals (typically in the form of condom distribution).”
As these results show, young people are capable of making informed decisions, but they do not do so in a vacuum – the values and priorities of the broader community play an important role in encouraging and empowering them to do so. This is particularly critical in HIV-ravaged sub-Saharan Africa, where a tyranny of low expectations around sexual behavior can have deadly consequences.
The ECHR does not impose an obligation on Contracting States to grant same-sex couples access to marriage
Posted on | July 17, 2014 by Grégor Puppinck, Ph.D
The European Court of Human Rights, sitting as a Grand Chamber, in the case of Hämäläinen v. Finland, Application no. 37359/09, 16 July 2014 reaffirmed:
Regarding article 8 of the European Convention on Human Rights:
“71. The Court reiterates its case-law according to which Article 8 of the Convention cannot be interpreted as imposing an obligation on Contracting States to grant same-sex couples access to marriage (see Schalk and Kopf v. Austria, no. 30141/04, § 101, ECHR 2010).”
Regarding article 12 of the European Convention on Human Rights:
*96. The Court reiterates that Article 12 of the Convention is a lex specialis for the right to marry. It secures the fundamental right of a man and woman to marry and to found a family. Article 12 expressly provides for regulation of marriage by national law. It enshrines the traditional concept of marriage as being between a man and a woman (see Rees v. the United Kingdom, cited above, § 49). While it is true that some Contracting States have extended marriage to same-sex partners, Article 12 cannot be construed as imposing an obligation on the Contracting States to grant access to marriage to same-sex couples (see Schalk and Kopf v. Austria, cited above, § 63).”
Regarding the alleged “European standards and consensus” that would prevent states from defining marriage as the union between one man and one woman:
“73. From the information available to the Court (see paragraph 31 above [(Belgium, Denmark, France, Iceland, Norway, Portugal, Spain, Sweden, the Netherlandsand the United Kingdom(Englandand Walesonly)])., it appears that currently ten member States allow same-sex marriage.” (…) “74. Thus, it cannot be said that there exists any European consensus on allowing same-sex marriages.”
Posted on | July 16, 2014 by Rebecca Oas, Ph.D
Ireland has once again come under fire for their laws protecting the lives of both pregnant women and their children. The Geneva-based Human Rights Committee characterized this provision of Ireland’s constitution as “unacceptable cruelty.”
The Dublin-based group Family and Life reminded the committed chairman that there is no international right to abortion, a position the chairman called “breathtakingly arrogant.”
C-FAM’s Austin Ruse reports at Breitbart London here.
Family and Life’s report is here.
Stay tuned for more in an upcoming Friday Fax.
Posted on | July 14, 2014 by Rebecca Oas, Ph.D
As summarized in the previous installments, the “unmet need” concept has been used to frame overpopulation alarmism in the language of women’s rights. Nonuse of contraceptives is redefined as an unmet need, which is then rephrased as unfulfilled demand or, most frequently, lack of access. Access, in turn, is framed as a human rights issue.
Access: an advantageous misconstruction
“Access” is a very important concept for advocacy efforts: if ensuring access to something is paramount, then nothing can be allowed to stand in the way, including the conscience of anyone who is (or even could be) involved in its provision. This question was recently debated in the US Supreme Court in the Hobby Lobby religious freedom case. On its face, access seems inoffensive in that it implies no coercion to actually use the accessible thing. But the flip side of the coin is mandated complicity in making the thing accessible. Even if there are no users, there still must be providers.
Furthermore, when it comes to contraceptives and other controversial things, merely having providers is still not enough – access must not only exist, but it must be ubiquitous in order that it become accepted, and, ultimately, used.
The papers in the recent series on unmet need in Studies in Family Planning were first presented at a conference in Kenya titled “Is Access Enough? Understanding and Addressing Unmet Need for Family Planning.” Clearly, the participants’ answer is that access is not enough – not when only 4-8% of “unmet need” is access-related.
Of course, as the authors of the papers are quick to point out, the definition of “unmet need” doesn’t actually involve access at all. Bradley and Casterline write:
“Often asserted is that estimates of unmet need represent the proportion of women who want to practice contraception but are prevented from doing so by inadequate access to supplies and services. As we demonstrate below, however, the standard algorithm does not include any direct measures of the desire to practice contraception or any direct measures of access to contraception.”
In practice, this works out to false advertising covered by plausible deniability. Advocacy groups parrot the meme that women a) want contraceptives and b) have no access to them, and donors send them money. When skeptics point out that access is greater and demand is lower than the advocates will admit, the scholars behind the “unmet need” concept are able to stand at a safe distance and defend their much-misinterpreted creation by technicalities.
If the “unmet need” definition doesn’t attempt to measure women’s desire for contraceptives or their access, what exactly does it measure? Simply put, it uses questions and answers from the Demographic and Health Survey (DHS) to determine whether a women who is married (or in non-marital union), sexually active, and presumably fecund wants to have a(nother) child in the next two years, and if not, if she is using a modern contraceptive to avoid it. If she is not, the survey inquires as to why not.
The exact formulation has undergone changes over the years, but one thing that has been eliminated is any question regarding the intensity of a woman’s feelings regarding the prospect of pregnancy. Older versions of the survey asked how “happy” she would be if she became pregnant, or how much of a “problem” it would be, according to an intensity scale. Removing these indicators means that the questions about whether the woman wants to have a child fall into the realm of “all other things being equal.”
However, all other things are not equal, as evidenced by the range of answers to the question about why women aren’t using contraceptives despite their alleged “unmet need.” Some women and their partners express a religious or cultural opposition to the use of contraceptives – a rationale that will not be swayed by increased availability or improved formulations. But the most frequently cited reason for nonuse of modern contraceptives was concern over side effects.
“Reluctance to try contraceptive methods because of fear of side effects or health risks can also be argued to be, in part, a consequence of insufficient or erroneous information,” write Cleland, Harbison and Shah. They note that when barriers to access and lack of knowledge are addressed, concerns about adverse health effects persist – in regions with both high and low levels of contraceptive use. They also admit that these concerns can’t be explained away in terms of rumors and hearsay: “in high-use countries these concerns are more likely to be based on personal experience than on perceptions.”
These are women who have already indicated via DHS questionnaires that they are not looking to have a child in the next two years, yet their concern about the side effects of contraception clearly outweigh their concerns about the impact of childbirth or parenting. Given that these women with “unmet need” disproportionately live in countries with high levels of poverty and high maternal mortality rates by global standards, it is important to look at their answers in context. They have weighed the costs and benefits of contraception against the very real possibility of a risky birth and another mouth to feed and chosen to forego contraception. All things are not equal, and while they may not have had a great desire – much less a demand – to be pregnant at that moment, they clearly weren’t sufficiently opposed to the idea of pregnancy to avoid it by state-of-the art family planning.
Whose choice anyway?
To family planning advocates, access is just the beginning: acceptance and ultimately uptake are the end goal. Like good salesmen, they believe in their product and want to encourage its consumption, but unlike most merchants, their primary funding isn’t dependent on convincing average people to pay for their offerings: that’s what philanthropists and wealthy donor states are for. These funding streams cover not only the manufacture and distribution of contraceptive commodities, but also a wide variety of targeted marketing campaigns. As John Bongaarts writes:
“With a given level of demand, an increase in [contraceptive] use produces a corresponding decline in unmet need. The evidence also shows, however, that programs can have a second effect by raising the demand for contraception. This effect is expected according to diffusion theory and may be attributed to program [information, education, and communication (IEC)] messages concerning the benefits of family planning and the diffusion of ideas about them.”
Further, Cleland, Harbison, and Shah add:
“[S]ocial opposition and, to a lesser extent, lack of knowledge are important barriers to contraceptive uptake in such settings. Skilled use of mass media, together with more localized approaches targeting influential groups—such as school teachers and traditional and religious leaders—are required to disseminate information concerning methods and defuse initial opposition.”
In other words, where religious objections exist, the most effective way to bypass it is to co-opt local religious leaders and recruit them to promote contraception.
Another paper in the series examines the use of natural methods of family planning and concludes that designers of family planning programs “may underestimate the dislike for modern methods, attributing the nonuse of contraceptive technologies to problems of access or lack of education, rather than a negative perception of modern medical contraception.” The authors do suggest that family planning advocates might consider promoting some natural methods, but then double down on the need to reprogram women’s thinking:
“These results highlight the need for large-scale behavior-change communication to debunk misinformation concerning modern medical contraception, complemented by changes in family planning counseling so that women can be reassured on a one-to-one basis.”
But “large-scale behavior-change” is not a terribly appealing thing to offer to women in developing countries, particularly when it is targeted toward getting them to discard aspects of their religion or culture that don’t sit well with the population control crowd.
The architects of “unmet need” are masters of rebranding, though: Cleland, Harbison, and Shah refer to “the acceptability of contraception and associated services” – which almost certainly includes abortion – with the phrase “psychosocial access.”
You have to hand it to them for cleverness – it’s hard to envision a better way to characterize a woman’s moral objections to freely available contraceptives as a problem of lack of access.
Posted on | July 14, 2014 by Stefano Gennarini, J.D.
Representatives of the G77 and China held a meeting this afternoon with NGOs to invite them to lobby their governments and garner support to conclude the Sustainable Development Goals (SDG) draft this week. A working group of the General Assembly has been working on this draft for over a year, and Friday is the deadline for the Zero Draft of the SDGs. That document would be the basis for negotiating a new set of development goals for the period from 2015-2030.
The representatives of Bolivia and Brazil said that there are some wealthy countries that are trying to derail the process for the zero draft. Wealthy countries are questioning whether it is wise to even come out with a proposal for the SDGs by the end of this week. The purpose of the meeting was clearly to get NGOs to lobby in favor of an outcome this week. What was less clear is who would be responsible for derailing the negotiations this week.
The motivations behind the attempt to block an outcome this week may be many. While the representatives of Brazil and Bolivia suggested it could be because the present draft, with 17 goals and over 140 targets, is unwieldy and unmarketable. It must be more than just a disagreement about the number of goals if wealthy countries are willing to scrap almost 2 years of work on the draft of the SDGs. It may be because wealthy countries don’t feel that draft SDGs further their interests enough, and they see not way of rectifying that by the end of the week.
More likely, the real disagreement may be about “means of implementation”. The G77 is promising that there will be no agreement unless a formal outcome is secured by the end of the week. Wealthy countries are understandably less eager to commit to specific ways to finance the SDGs.
Needless to say, NGOs were as divided on the current draft as governments, and questioned the G77 reps as to why they should back their current effort. Several representatives of civil society were disappointed that their concerns did not appear in the draft.
If there is no agreement by the end of the week, it is likely that the secretariat will prepare a draft SDG project for the General Assembly to begin negotiations in the fall. This means that Jeoffrey Sachs will have his say once more in the U.N.’s development goals. Sachs is the Secretary General’s right hand man when it comes to development policies, and has already had his hand in several SDG proposals.
What this would mean with regards to language about sexual and reproductive health or reproductive rights, which are often euphemisms for abortion, remains to be seen. But all indications are that a negotiated document has a better chance of being sanitized. The current SDG draft is fairly sanitized, and there is a chance that it might limit itself to a singular reference to reproductive health, without mentioning reproductive rights or comprehensive sexual education—both are loaded terms. On the other hand, Sachs is a known advocate for “voluntary” population control and rapid fertility reduction (see proposal above). His latest proposal on the SDGs includes these terms. The Secretary General, and the U.N. secretariat under him, is strong a supporter of reproductive rights.
Posted on | July 14, 2014 by Stefano Gennarini, J.D.
It took the United Nations a whole week to conduct a first reading of just over half the draft scheme to replace the Millienium Development Goals next year. But countries expressed optimism this morning that they will be able to finish up the first reading by tomorrow and complete a second reading by Friday.
The Chairs expended significant efforts this morning warning countries to stop making new proposals and start taking out redundancies and repetitiveness from the draft. ” Resist urge of changing anything at the 11th hour” said the Kenyan ambassador who is co-chairing the negotiations with Hungary.
The Kenyan ambassador gave mixed messages about where things stand for “sexual and reproductive health” and “reproductive rights.” He never mentioned this explicitly, but as always, this subject is on everyone’s mind as negotiations come to a close. Unfortunately those terms are often euphemisms for abortion and draw opposition from U.N. member states. The only time they have been defined in the UN context was in in 1994 at the ICPD conference and they include abortion in that text, even though the ICPD recognizes that countries may prohibit abortion if they choose.
On the one hand, the urgency of having to resolve negotiations by the end of the week could prompt the chairs to revert to the language from the Rio+20 UN Conference in 2012. That document omits “reproductive rights” but mentions “sexual and reproductive health”. The chairs could also revert to a simple mention of “reproductive health” as in the MDG scheme. Even better, if these policies go without mention in the Sustainable Development Goals. C-FAM’s recent paper gives several reasons why this is a desirable outcome.
The co-chairs of the negotiations struck a note of warning also for NGOs after delegates last week complained that they were being aggressively lobbied in the U.N. halls, among them also abortion groups. The chairs touted NGO involvement in the negotiations as unprecedented and a success, but also warned NGOs that they could outstay their welcome. The Hungarian pleaded that NGOs abide by the “unwritten rules of the game”, and the Kenyan warned about reporting on the negotiations ongoing in the General Assembly. ”We cannot allow the bridge of trust to be broken” he warned.
As of this writing, the Open Working Group has read through only 1 of 17 goals. Completing the draft by Friday is going to be a tall order indeed.
Posted on | July 4, 2014 by J.C. von Krempach, J.D.
In the last week judges in the US and Europe have issued two very important judgment on religious freedom. One is the US Supreme Court’s judgment in the “Hobby Lobby” case, which upheld the right of a Christian company to not pay, as part of the so-called “Obamacare” health insurance system, for his employees’ contraceptive drugs which he deemed to be abortifacient, and thus not in line with his religious convictions. According to this decision, the employer’s religious freedom supersedes the state’s interest in supplying (allegedly?) abortifacient drugs to everyone who wants them.
The other one is a decision by the European Court of Human Rights, upholding a French law that prohibits the wearing of headscarves (known as niqab, burqa, or chador) and other gear that makes the wearer unrecognizable: according to the Court, the State’s margin of appreciation on these matters is wide enough to justify such a law, even if it sets limits to the right of Muslim women to live according to what they claim are the precepts of their Religion.
It appears that “religious freedom” is interpreted very differently on both sides of the Atlantic. In the US it seems to enjoy greater recognition than in Europe.
As for myself, I do not see any need for concealing the fact that I consider myself a “religious” person, and therefore have a great sympathy for other believers, including Christian employers who do not want to be forced to spend the money of their company on abortifacient drugs, or Muslim women who feel that not wearing a burqa endangers their modesty. Nevertheless, while I can agree with the outcome of both decisions (including the one where “religious freedom” has not prevailed), I am wondering whether “religious freedom” really was an appropriate argument to build a case upon.
With this, I do not want to downplay the achievement of the lawyers representing “Hobby Lobby”, who indeed seem to have won back an important civic liberty for their fellow citizens. But what I want to say is that “Obamacare” is not an attack on religious freedom, but on freedom at large.
There is no need here to enter into the subtleties of whether a given contraceptive really is a contraceptive, or whether it is an abortifacient. The Christian faith prohibits both, so that (if “religious doctrine” were the criterion) one is as good or bad as the other. But the appropriate criterion should not be the religious belief held by the employer. Instead, the decisive fact is that pregnancy is not a disease, and preventing or disrupting it is not “healthcare”. The use of contraceptive means or abortifacients are, at best, the corollaries of a freely chosen lifestyle. One has, in particular with regard to abortion, some pretty good arguments why people should not be free to chose such a lifestyle – but even admitting (for argument’s sake, not because I believe it) that such lifestyle choices should be allowed, it nevertheless remains that those making them should make them at their own expense. If my neighbour has the right to choose such a lifestyle, in a free society people should at least have the right to find that choice horrible and disgusting, and to openly say so. Not being compelled to finance the use of contraception and abortion by others is not a privilege for the followers of this or that religious belief, but it simply is part of that greater good that is called “freedom”.
The problem with Obamacare is not that it violates the religious freedom of Catholics, but that it violates the freedom of everyone. It is a truly totalitarian law, and as long as it exists the US cannot be called a free country. The normal and expedient answer to such a law is to simply repeal it, not to adopt a specific law on religious freedom that can be invoked by “religious believers” to circumvent it. Thus, while I wholeheartedly congratulate Hobby Lobby to its success, I do hope that ways will be found to repeal Obamacare as a whole.
As for that ECtHR decision on Islamic headscarves, It seems to me that in a truly liberal society everybody should be free to dress up as he or she wants, and that the state should only be allowed to interfere where it is strictly necessary. It is therefore a patent absurdity to assert, as the Court has done, that States should enjoy a wide margin of appreciation in adopting such laws. No, on the contrary: their margin of appreciation must be very narrow if we do not want to give way to new forms of totalitarianism. If the margin of appreciation is so wide as the Court says, what will it say if a country adopts a law that prohibits women from wearing trousers?
There are good reasons for a legislator to prohibit the wearing of burqas and similar headscarves. One is that wearing such headgear prevents other people from knowing whom they are speaking or interacting with – it is thus an interference with the legitimate rights of third persons. Another reason is that any headwear that prevents the identification of a person is a potential security risk: if we all were wearing headscarves that conceal us beyond recognition, the world would be a dangerous place.
The French government has put forward all those reasonable arguments, which indeed suffice to supersede an alleged religious freedom and justify the ban of Islamic headscarves. But the ECtHR has rejected those arguments, and instead has made the absurd claim that States have “a wide margin of appreciation” in adopting laws that supersede “religious freedom”. This is yet another instance where this Court has exhibited a disturbing degree of intellectual laziness. How long will this tragicomic farce of a “Human Rights Court” be allowed to go on?
What we need is not “religious freedom”, but a sound understanding of freedom in the wider sense.
Posted on | July 2, 2014 by Rebecca Oas, Ph.D
(This is the second part of a look at the “unmet need” for contraceptives in the developing world. Part one can be found here.)
Previously, I discussed how the concept of “unmet need” for contraception formed the basis of a widespread fallacy that women in the developing world are denied access to modern family planning methods. As it turns out, when asked directly why they aren’t using these commodities that they supposedly “need,” women respond that they don’t want them, don’t require them, have religious or other objections to using them, and are concerned about potential risks to their health.
This isn’t new – women said the same thing back in 2011, when the Guttmacher Institute reported that only 8% of “unmet need” was due to lack of access or cost. In other words, you can lead a woman to contraceptives, but you can’t make her use them. What is important is the increased frankness among the architects of the “unmet need” concept about the fact that the phrase is (and always has been) an advocacy construct. Summarizing the history of the concept, Cleland, Harbison, and Shah write:
“[S]upporters of the international family planning movement were obliged to demonstrate the existence of a need, or potential demand, for averting pregnancy in the poor, high-fertility countries of Africa, Asia, and Latin America and the Caribbean. … [T]he concept of unmet need has played an important role in family planning research, evaluation, and advocacy. Unmet need has proved to be an invaluable bridge between a human rights and feminist approach to fertility control and a demographic–economic rationale.”
In a paper from the same series, Bradley and Casterline add that “unmet need” serves “as a conceptual bridge between concerns regarding population growth and the inability of women and couples to achieve their reproductive goals without coercion.”
Given the history of distrust between population controllers and feminists, this “invaluable bridge” is not trivial. The common ground between their camps is essentially this: women have the right to control the number and spacing of their children, and must be able to access modern contraceptives to achieve their reproductive goals. To the feminists, this is an assertion of women’s autonomy; to Malthusian population alarmists, it’s a less coercive way of achieving a reduction in population growth – at least as long as women’s desired fertility is sufficiently low.
To feminist groups, particularly those in the Global South, there remains some skepticism toward population groups’ exuberant interest in giving women what they want. Simply, the people having the most children are not the ones consuming the most resources. When North American and European elites encourage women in developing countries to have fewer children – and generously provide them with the means to reduce their fertility – in the name of catastrophic climate change, it’s hard not to be a bit cynical.
The irony of this position was evident at the 2012 Women Deliver conference, where a group of experts were flown across the world to a developing country to hold court in a luxurious convention center. During a lunch plenary session, the air conditioning was so efficient at keeping the outside tropical climate at bay that the audience shivered and several panelists expressed their discomfort – not only with the cold, but with the knowledge of how much energy was being expended to produce it. Princeton ethics professor Peter Singer then tossed out the loaded hypothetical question of whether concerns about overpopulation could potentially end up trumping women’s right to have the number of children that they want (More description of the panel discussion here).
Feminist groups could get behind the “unmet need” concept as long as it was about giving women the means to achieve their goals. Population alarmists were content to frame the push for contraceptive access in terms of women’s rights as long as the exercise of those rights resulted in fertility reduction. But Singer’s hypothetical question – and the highly-charged discussion it triggered – demonstrates how shaky the “bridge” between the two groups really is.
And it’s about to get shakier, now that advocacy groups are losing “lack of access” as a compelling argument. It’s not very hard to ask for money in the name of giving poor women something they allegedly want and don’t have. It’s quite a bit harder to convince people to give you money to essentially reprogram women in the developing world to value having children less and ingest pharmaceuticals about which they have legitimate health concerns.
For twenty years, population control groups have taken refuge behind the “unmet need” label – a label that has been widely if incorrectly reworded as “lack of access” to great effect by activists. In the words of Cleland and colleagues:
“At the 1994 International Conference on Population and Development, addressing unmet need replaced fertility reduction as the central justification for investment in family planning. Its legitimacy was further strengthened in 2007 when it was added as an indicator to the Millennium Development Goals (MDGs) and again in 2012 at the London Summit on Family Planning.”
The relevant goal is MDG 5B, which is to “Achieve, by 2015, universal access to reproductive health.” This target was a controversial late addition to the MDGs in 2005, and once again its focus is on access, with “unmet need” as one of its indicators.
The question now becomes: can the “unmet need” brand maintain its legitimacy as it attempts to pivot from a provision-of-access model to a behavior-change model, and will it lose support from feminists (especially those in developing countries) as it becomes harder to disguise the fertility reduction agenda that’s been lurking there along?
Posted on | July 2, 2014 by Stefano Gennarini, J.D.
A new paper from Mark Bradford, president of the Jérôme Lejeune Foundation USA, one of the world’s leading organizations that help children with down syndrome and their families, details how children with Down syndrome are being exterminated, and what policies could help end this inhumane form of violence and discrimination. You can read the paper published by the Charlotte Lozier Institute here.
In the United States, approximately 6,000 individuals are born each year with Down syndrome (trisomy 21). The live birth incidence is about one in 700.[i] Down syndrome is the most common genetic cause of intellectual disability, with the U.S. population estimated to be between 250,000 and 400,000 people, and the worldwide population at six million.
Down syndrome is a highly complex genetic medical condition; it is also a highly complex sociological phenomenon that is iconic in its significance to questions regarding quality of life, selective abortion, and the extent and legitimacy of research into medical treatment to enhance cognition in the intellectually disabled. Iconic, because Down syndrome provides the initial test of how society responds to difference and disability when offered increasingly sophisticated means of prenatal screening technologies in a pro-abortion culture.
The most recent study of abortion following a confirmed prenatal diagnosis of Down syndrome showed that, depending on several factors such as time of prenatal diagnosis, geographical region, ethnicity and religious belief, abortion rates range from 61% to 93% in the United States.[ii] In France, where prenatal screening has been enshrined in public policy, the rate increases to at least 96%.[iii]
With such a high termination rate, research done by Dr. Brian Skotko, co-director of the Down Syndrome Program at Massachusetts General Hospital, is particularly striking. He has shown that:
- 99% of people with Down syndrome are happy with their lives
- 97% of people with Down syndrome like who they are
- 99% of parents said they love their child with Down syndrome
- 5% of parents felt embarrassed by their child
- 97% of brothers/sisters, ages 9-11, said they love their sibling[iv]
Individuals and families living with Down syndrome overwhelmingly report satisfaction with their lives, but the majority of parents continue to elect abortion following prenatal diagnosis. The contrast presented in these two sources raises critical questions about how prenatal diagnosis is delivered, the perception of support for the intellectually disabled and their families, and the stigma that still remains regarding intellectual disability.
Posted on | June 27, 2014 by Grégor Puppinck, Ph.D
Human rights and eugenics: the more precautious approach of the ECHR.
Short comments on A.K. v. Latvia (no. 33011/08) and M. P. and others against Romania, no. 39974/10, 15/04/2014
Recently, the ECHR ruled on two cases of wrongful life and wrongful birth actions, regarding an allegation of medical negligence in antenatal care leading to the non-abortion and the birth of two handicapped children.
A.K. v. Latvia
In the most recent judgment, A.K. v. Latvia case (no. 33011/08), delivered on the 24th of June 2014, the majority of the Fourth Section found (six votes to one) a violation of the procedural aspect of the right to private life (Article 8 of the Convention) of Ms. A.K., who, on June 2002, gave birth to a daughter with Down’s syndrome (she was aged 40). She alleged before the ECHR that she had been denied adequate and timely medical care in the form of an antenatal screening test (AFP) which would have indicated the risk of her fetus having a genetic disorder and would have allowed her to choose whether to continue or to abort the pregnancy. She also complained that the national courts, by wrongly interpreting the Medical Treatment Law and not condemning her gynecologist for medical negligence in antenatal care, had failed to establish an infringement of her right to respect for her private life.
At the national level, Ms. A.K.’s civil claim for damages against the hospital was rejected by the Latvian courts. They found that the applicant was to blame for the fact that the antenatal screening test had not been carried out, as she had not turned up for the test and had not informed her doctor about the risk of genetic illness running in her family (her eldest son has schizophrenia). The courts also found that she was not in a high-risk category merely on account of her age and that there was no causal link between the birth of her daughter with Down’s syndrome and the failure to ensure that she had the prenatal test.
The ECLJ intervened before the ECHR as third party in the case and submitted written observations. A large number of European Down’s Syndrome organizations joined in a coalition opposing the creation of a “human right to eugenics”. They published a declaration named “Stop Eugenics Now” presented at a conference hosted at the Council of Europe in July 2012.
Regarding abortion, the Court recalled that “the decision of a pregnant woman to continue her pregnancy or not belongs to the sphere of private life and autonomy and that, as a consequence, legislation regulating the interruption of pregnancy touches upon the sphere of private life” (§63). But while the applicant argued that she was denied the right to have an AFP test and, consequently, the right to choose to abort her disabled child, the Court considered that the “case does not directly concern the applicant’s decision whether or not to continue her pregnancy but rather questions whether she was provided the necessary information and whether her medical care complied with domestic law.” The Court added that “In this respect, the Court’s case-law confirms that where a complaint concerns the exercise of the right of effective access to information concerning health, it is linked to private and family life under Article 8” (§ 63).
Consequently, the majority of the Fourth Section did not enter into the moral question of the case, i.e. the issue of “wrongful birth” and eugenics, but limited itself to examining the way in which the internal courts assess the applicant’s complaint: “With regard to the principle of subsidiarity, the Court considers that it was primarily the domestic courts duty to investigate the inconsistencies identified above, in proceedings affording the applicant the necessary procedural safeguards, and to decide whether the antenatal medical care offered to the applicant by Dr L. was compatible with her rights under Article 8 of the Convention in all the circumstances of the case. Accordingly, in the circumstances of the present case, it is appropriate for the Court to limit itself to examining the procedural aspect of Article 8” (§ 93).
It is unusual and remarkable that the Court decides to abstain from entering into a controversial and ideological matter – the right to eugenics – and leaves the decision to be made by the national authorities. One may consider that such a decision is aimed at avoiding controversies; another may believe that it implements the Member States demand for more respect of the principle of subsidiarity and for more judicial self restraint. The Court probably acted for both.
Finally, limiting itself to the procedural aspect of Article 8, the Court concluded to the arbitrariness of the internal courts’ decisions due to various discrepancies, especially factual ones (§94). Importantly, the Court refused to allow pecuniary damages to the applicant, ruling that there is no “causal link between the violation found [on account of the manner in which the applicant’s civil claim in negligence was treated by the domestic courts] and the claim in respect of pecuniary damage. Accordingly, no award can be made under this head” (§ 98). The applicant claimed 48,748 euros in lost income, since she is unable to work as a result of the need to take care of her child; and 204,294 euros by way of an allowance for her child.
Judge Kalaydjieva and Judge Mahoney each drafted a separate opinion to the judgment. In its separate opinion, Judge Kalaydjieva agreed with the majority of judges but pointed out that the applicant’s complaint, in so far as it concerns flaws of the domestic courts’ scrutiny, should have been analyzed under article 6 of the Convention. Judge Mahoney formulated a dissenting opinion, considering that it is not the ECHR’s duty, as an international Court, to assess the evidence already assessed by the internal courts. He also esteemed that the nature of the procedural shortcomings identified by the majority leads to the “dilution of the serious notion of arbitrariness” and “to the substitution of the ECHR for the national courts”, which will finally “run counter to the effective functioning of the Convention system in accordance with the principle of subsidiarity” (§ 2). As to the “factual discrepancies” identified by the majority of the Fourth Section, judge Mahoney considered that, taking into account the facts of the case, they are “hardly indicative of arbitrariness or a failure to sufficiently address the right to respect for private life”(§ 3). Judge Mahoney’s opinion has to be taken into account, especially in regard to his long experience at the Court, as registrar before being elected as a judge.
M. P. and others v. Romania
The Court also ruled with some degree of self restraint in the recent decision in M. P. and others against Romania, (no. 39974/10, 15/04/2014). This case was introduced by two parents and their child conceived by artificial insemination and born without tibia. They considered that the child’s right to life was infringed by his birth as a disabled child as a result of medical negligence (wrongful life action). They also considered that the birth of their disabled child had infringed the parent’s right to the protection of their private and family life (Article 8 of the Convention). Therefore, they claimed that they had the right to receive compensation for a “wrongful life” and a “wrongful birth”, as the birth of their child was due to the negligence of the doctors who failed to notice the absence of tibia of the child at the various ultrasound scans.
On the “wrongful life” claim, the Court abstained from deciding on an alleged right of a handicapped child of “not being born, or that of not being the result of the doctor’s mistake, or that of being alive, healthy and not suffering as a result of another’s negligence” (§ 43). The Court avoided deciding “whether this alleged right could be included in or contrasted with” the applicant’s “right to decide how and when his or her life should end, provided that he or she was in a position to freely form his or her own will and to act accordingly” (§§ 42-43).
According to the recent case law of the ECHR, such decisions to end one’s own life is a right guaranteed within the right to respect for private life (Article 8 of the Convention). The Court found that it is unnecessary to deal with this issue because the complaint is inadmissible for another motive.
Regarding the “wrongful birth” claim, i.e. the right of the parents infringed by the birth of the handicapped child, the Court reaffirmed its previous controversial ruling in Costa and Pavan v. Italy, (no. 54270/10, § 50, 28 August 2012), according to which “the parents’ desire to conceive a child unaffected by a genetic disease [is] a form of expression of their private and family life” and therefore falls within the scope of Article 8 of the Convention. Looking to the merits of this complaint, the Court noted that the national authorities acknowledged the alleged violation of parent’s rights and afforded them redress, concluding that the parents were no longer victims in the sense of the Convention.
The ECLJ, together with two Romanian NGOs, also intervened as third parties in the procedure and submitted written observations.
 “The domestic courts’ approach to the applicant’s claim discloses the appearance of arbitrariness. The cumulative effect of the failings identified was that the domestic courts did not properly examine the applicant’s claim that she had not received medical care and information in accordance with domestic law in a manner sufficient to ensure the protection of her interests”
Posted on | June 26, 2014 by Rebecca Oas, Ph.D
A new special issue of Studies in Family Planning focuses exclusively on the “unmet need” for contraception, particularly in the developing world. (All articles are available for free download at the preceding link).
Perhaps the most important single message in this series of articles is that women in the developing world don’t necessarily need increased access to modern contraceptive methods – they need behavior modification to increase their use of them.
The concept of unmet need has met with criticism from economists and public health experts, who point out that “need” does not equal “demand” – much of it exists among women who reject the very thing they supposedly “need,” for reasons of religion, health, and other factors.
Adding to the confusion, advocacy groups have taken the shaky “unmet need” concept and further distorted it to mean “lack of access.” In 2012, the United Nations Population Fund (UNFPA) reported that “staggering 222 million still do not [have access to modern contraceptives]”, adding that the “222 million women have an unmet need for contraception.”
As I wrote last year, this simply isn’t true. Data from a 2011 Guttmacher Institute publication revealed that only 8% of women in developing countries, when asked, attribute their non-use of modern contraceptives to issues of access or prohibitive cost.
Saying that 222 million women have an “unmet need” for contraceptives is misleading enough, given that it does not mean “unmet demand” or even “unmet desire” – often quite the opposite – and implies a very condescending view of women’s ability to assess their own priorities. But to equate it with “lack of access” is a blatant falsehood, albeit one that has a lot of appeal for fund-raising and advocacy groups, as evidenced by this example that appeared in my email earlier this month (see the right panel):
The Guttmacher Institute just published its updated survey data showing why women in the developing world aren’t using modern contraceptives, and once again, access is not the reason: lack of access accounts for 4%, 6%, and 8% of “unmet need” in Latin America, Asia, and Africa, respectively.
The most surprising aspect is the way they announced the publication of the report on Twitter:
So, it’s not about access after all. It is rather interesting that Guttmacher would choose to lead off their social media announcement of this new paper with a statistic that is basically a repeat of something they published five years ago, particularly since so much effort has gone into funding increased access to contraceptives around the world in the intervening years. For instance, Melinda Gates’ role as a global contraception advocate began in earnest with a TED talk in 2012, and billions of dollars for family planning were pledged at the London Summit co-organized by the Gates Foundation and the UK government.
If women’s self-reported lack of access has not changed much since 2011 (the latest Guttmacher numbers come from a survey of studies ranging from 2006 to 2013), is there cause among proponents of the “unmet need” concept for celebration because the need is low, or frustration because the global surge of attention hasn’t done more?
I’ll address the future of the “unmet need” concept in a companion piece. For now, here are some figures that might prove useful the next time you hear the “222 million” figure.
The recent Guttmacher paper by Gilda Sedgh and Rubina Hussain focuses on developing regions of the world which contain the highest number of women with “unmet need.” Because the “unmet need” definition depends on survey data from the Demographic and Health Survey (DHS) questionnaires, the questions regarding family planning are directed toward women who are married or otherwise partnered.
Women with “unmet need” are defined as married, being of reproductive age, are fertile, do not want a child in the next two years or at all, and are not using contraception.
In Africa, which has the highest reported level of unmet need (23.5% of married women), 8% of those women cite lack of access as the reason they do not use contraceptives. In comparison, 28% cite concern about side effects, and 24% say they, their partners, or both, are opposed to the use of contraceptives. So, 8% of 23.5% – 1.88% – of surveyed married women in Africa have a lack of access to contraceptives.
That’s less than 2% of married women without access to contraceptives in the region of the world experiencing the greatest poverty and highest rates of hunger – the UN’s World Food Programme says that 24.8% of people in Sub-Saharan Africa don’t have enough food to eat.
The numbers are even lower in Asia and Latin America, where less than 1% of married women say they lack access to contraceptives (0.9% and 0.5%, respectively – see graphs below)
Rather than taking these findings as an excuse to celebrate the nearly-complete campaign to deluge the world in pills, condoms, IUDs, injectables, and other contraceptive commodities, the authors of the Guttmacher paper say “there is a pressing need to further strengthen family planning services,” with a shift toward encouraging women to stop worrying and love the very things they are concerned will harm them.
More on the future directions of “unmet need” in part two.keep looking »