COMMENTARY

Male Contraception: Will It Work?

Arthur L. Caplan, PhD

Disclosures

October 15, 2018

Hi. I'm Art Caplan and I head the Division of Medical Ethics at the NYU School of Medicine. We're going to get into a tough subject in this particular opinion piece. Can you trust men? Why am I bringing that up? Probably, many women are thinking about that all the time, but we've seen recent advances and announcements about male contraception. We're starting to get closer to pills and gels that might actually achieve pretty effective contraception in men.

Historically, the burden, when it comes to drug forms of contraception, has always been placed on women. It's partly due to biology—controlling the availability of eggs. We obviously have had condoms for some time to try to prevent unwanted pregnancy, but in terms of taking a pill or using some sort of agent, men have been off the hook. It's been up to the woman to worry about that.

Well, that's about to change. Some people may say, "Great. Then men can worry about birth control right alongside women." But that raises the question I brought up: Can we trust the men? They don't pay the consequence if birth control isn't used; they're not going to have to carry a pregnancy that they didn't plan for or perhaps they don't even want. Their incentive to use birth control really relies on trust, doing the right thing, having integrity, and being ethical.

I'm not against those forces; they're very important and they lead many of us to do the right thing. In their dating life, many men still enjoy sleeping around and one-night stands; they're not worried about who they impregnate because they don't plan to see the woman again.

The fundamental question behind the use of male contraception and bringing it to market has very little to do with its efficacy. Of course, the US Food and Drug Administration has to approve it and say that it works, and we want to be sure that it's safe.

At the end of the day, the fascinating fact about male contraception is that it's a matter of trust. It's a matter of men doing the right thing. Women have a heavy-duty incentive: to avoid an unwanted pregnancy. Oftentimes, men can avoid or dodge the consequences. So, can we trust them to do the right thing?

My personal view is that it's going to take a lot of education before male contraception reaches the level of familiarity of use that we see with many women. You'll have to let me know through emails and other communications whether you think male contraception has a future if it depends on trusting men.

I'm Art Caplan, from the Division of Medical Ethics at NYU. Thank you for watching.

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