August 25, 2012

Behavioral Fatalism

Welcome to the first "real" blog post of Sardonic Ex Curia. It will likely be followed by more, though not on as regular a schedule as my link postings. Therefore, they will be irregular, but (I hope) interesting.

      I have long wondered at the philosophy at the root of the argument that condoms and hormonal birth control ought to be available for teens (and anyone else) to use in preventing pregnancy and disease. Scientifically, that they can prevent pregnancy and disease cannot be doubted. However, my thoughts revolve more around the behavioral questions.

      The first behavioral aspect to which I refer is the argument (used to justify both greater access to all birth control and against abstinence education) that "they are going to have sex anyway". (The "they" may refer to Africans, teens, the poor, college students, or any mix of these.) In conversation with conservative friends, this line - that the sexual urge is so uncontrollable that it will occur regardless of risk of pregnancy or disease - has become so commonly attributed to proponents of contraception that I thought it must be overstated. However, it turns out that the line "going to have sex anyway" is fairly widespread, and proponents of contraception, including teenagers, use it as often a conservative writers. See, for instance, the statement "Some schools only teach abstinence. I don't think that's very good because kids are going to have sex anyway" made by a 16-year old in an interview with The New York Amsterdam News, or the statement by a Canadian "sex therapist and radio personality"  in the Alberta Report that she is "not saying girls should jump every Tom, Dick and Harry....But they're going to have sex anyway. We have to teach them not to settle for mediocre sex. Great sex is not one night stands. It tends to be with people who know you, and who can provide intimacy." The Milwaukee Journal Sentinel provides another example, with an editorial arguing that "It is about grasping reality -- knowing that some youngsters, even knowing the risks, will have sex anyway." Or the statement by a U.N. STI/HIV advisor that "People, especially sexually active people, will have sex anyway because it is a normal part of life and people enjoy it."

Putting aside the somewhat circular statement contained in the last quote, it seems like the philosophy behind these statements is something to the effect of a naturalist fatalism - the idea that, no matter how much the risk of disease or the possibility of pregnancy, the sexual urge is so powerful that many will engage in it regardless of their knowledge of the potential bad outcomes. So, the argument goes, contraception is necessary because it will prevent / reduce the risks associated with sex.

But does that argument work if one extends the naturalist fatalism in question to ALL aspects of behavior? I believe that the argument as one for greater use and availability of contraception eventually turns back on itself. In regards to condoms, to sum up the argument for their greater availability, "condoms should be more available because the natural sexual urge is so powerful that sex will occur regardless of education of risk". However, condoms themselves are inherently unnatural. There is nothing in the history of the sexual urge that indicates an evolutionary predilection to use a barrier during the sexual act. In order to make the claim that condoms are effective in terms of preventing the naturalistic fatalism, one would have to argue the following: "The sexual urge is inherently natural and powerful, and therefore, sex will occur because humans are programmed to do it. However, the sexual urge is not so inherently natural and powerful that humans cannot be programmed to pause before or during the act to use condoms." I suspect there is a fallacy here, in which the "it is natural" meme is twisted to make arguments for condom use work however proponents wish. (I do not get into the questions about condoms raised by Harvard researcher Dr. Steven Green on the idea that condoms may be increasing AIDS in Africa due to risk compensation....another example of the failure to extend naturalistic fatalism to its ultimate conclusion.)

The careful reader will note that I do not discuss hormonal contraception much above. Hormonal contraception does not seem to be subject to the same naturalistic fatalism problem that condoms face. However, I believe it is but one step removed. First, take the example of antibiotics - the problems with individuals failing to finish their entire prescription results in a series of problems, individually and societally, with (for example) both the drug being less effective for the individual and more resistant bacteria developing from the bacteria the lessened dose failed to kill. And, as is well known, some individuals may be naturally more inured to certain antibiotics, making them less effective. While claims for hormonal birth control range to 99% effectiveness, due to these natural and behavioral effects, the actual effectiveness may be lower, and estimates vary from the 91% to the 92% range, with women potentially overestimating the effectiveness of contraceptive types. This may be for several reasons. One may be that drug companies claim a high effectiveness rate for oral contraception, and that is taken as "gospel".  (Curiously, the teen penchant for underestimating risk seems to spread even to contraception - yet another example of failing to take naturalism argument to their utter end.) In addition, antibiotics may interfere with the effectiveness of hormonal birth control, as well as other medications, including tetracycline, commonly prescribed for acne(!), another problematic risk - if sex will occur regardless, why would a woman abstain from sex despite the knowledge that the effectiveness of her hormonal birth control would be reduced?

The argument I am addressing here is solely the one based upon "fatalistic naturalism", and the necessity to confront claims for expanding use of condoms and oral contraception based upon the idea that one can somehow argue that the unnatural use of birth control will occur simultaneously in people that have ireprressible urges to have sex.

1 comment:

  1. Great blog post. I don't think I've heard this argument before. Very interesting. And you've avoided boring us with statistics (thanks), but they do show when there is more contraception use, there are more unintended pregnancies.