Should doctors advise people to limit the number of children they have for the sake of the environment?
mchawk | August 10, 2008 at 03:13 pmby
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The poll was put after a BMJ editorial that posed the same question:
Several readers have pointed out that the BMJ’s recent coverage of climate change has ignored a key issue—the need for population control... They may be right that "population" and "family planning" are taboo words. The BMJ hasn’t actively avoided these issues, but we could do more to highlight them. As Guillebaud and Hayes portray it [in their article in this issue of the BMJ], every week an extra 1.5 million people need food and somewhere to live, amounting to "a huge new city each week, somewhere, which destroys wildlife habitats and augments world fossil fuel consumption."
Population control need not be coercive, they say. Half of pregnancies worldwide are unplanned. Simply by meeting women’s unmet contraceptive needs, several developing countries have halved their fertility rates. Clear evidence points to the demand for contraception increasing when it is available, accessible, and properly marketed. Guillebaud and Hayes call on doctors to take an active role in overcoming barriers to the universal availability of contraception and ensuring that patients and the public understand the environmental consequences of population growth. Controversially...they say that doctors should advise patients on limiting family size for environmental reasons and should set their own example.
Not everyone will agree that this is a doctor’s role. Most will agree, however, that it is the role of doctors to deal with uncertainty...[that] doctors should not just manage therapeutic uncertainty but should force it into the open ... that guidance from the UK’s General Medical Council explicitly states that doctors must help to resolve uncertainties about the effects of treatment. This means being open about uncertainty with patients and the public..
Even as someone who thinks there might be too many people in the world already, I find this a rather cold assessment of the situation - perhaps the very definition of "clinical."
But I have to offer thanks to the BMJ's editors for having the guts to broach such a contentious issue. I don't entirely agree with The Guardian's assessment of the BMJ article, saying it "calls on GPs to encourage the view that bigger families are as environmentally dubious as owning a patio heater or driving a gas-guzzler", but that raises the point that the topic of poplulation control is one of those political third-rails - if politicians touch it, their career dies.
But, when so many of the world's resources are running so low that it has brought us to war, is this not the exact time that we and politicians should be having this discussion?
Perhaps the lead should not be left to doctors, and certainly not to politicians. Should the choice not be left to prospective parents? But should their decision to have children at all be made only when they have all the facts and have considered the larger ramifiactions of parenthood - even if discussion children in terms of 'carbon footprint' may seem shocking?
So it is perhaps the educators who have failed. Irrational protests against sex eduacation has taken that subject off the syllabus in a number of countries. Such short-sightedness has left Britain with the highest rate of teen pregancy in Europe. To show such willful lack of responsibility is a failure of us all to see the 'bigger picture' - that we have finite land on which to grow finite crops to feed what must be a finite population.
The questions are difficult and any 'solution' frought with danger.
But the questions must be asked, nonetheless.
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