Sarah Kate Powell
Health 2030- Section 002
Lee Crandall
19 November 2015

The Issues With Individuals In Society Having The Responsibility To Pay For Insurance That Covers The Cost of Contraceptives When It’s Against The Individual’s Personal Or Religious Beliefs
Introduction:
The term “ethics” can be derived from the Greek term ethos that means habit, custom, disposition or character. Ethics is defined as “a system of moral principals and a branch of philosophy which defines what is good for the individual and society. “ (Ethics, 2014) It is a collection of concepts acquired from philosophies, cultures, and religions. Some of these ethical concepts include the principals of autonomy, beneficence and social justice. Ethics provide a moral pathway in which individuals pick to find their way out of difficult issues. Individuals have many different derived concepts, or moral pathways, controversies that cause ethical dilemmas can become apparent. Such dilemmas can be seen in the health care delivery system of the United States and the policies that are enforced within it. One ethical argument in particular that poses issues and controversy regards society having the responsibility to provide or fund insurance that covers the cost of contraceptives when it is against the individual’s personal or religious beliefs.
Ethical Dilemma/ Policy Issue: The term “conscientious objection” is the refusal to perform a legal role or responsibility because of personal beliefs. Conscientious objection in health care means that some practitioners might choose to not provide certain treatments to their patients as well as some parents may not choose to consent to certain treatments for their children. Under “Conscientious Objection” lies the term “Conscience Clause” which first came about under Roe vs. Wade, during the Supreme Court decision that outlawed abortion. Under the decision many physicians refused to perform an abortion because it was against their personal or religious beliefs. This debate resulted in an action oriented health policy made up of a patchwork of federal laws, which explicitly allows doctors and other direct health care providers the ability to refuse in performing or assisting in an abortion. The issue surrounding abortion has now broadened to society and insurance, where deciding if individuals should have the responsibility to provide or fund insurance that covers the cost of contraceptives when it’s against the individual’s personal or religious beliefs. On both sides of the debate, individuals have valid arguments for why they support or for why they are against this policy; such as their ethical principals and the decision-making processes they apply to the issue. Policy dilemmas have arisen with this enacted health policy, however, due to issues with the uneven distribution in the rights and responsibilities of the stakeholders, along with differences in their moral decisions of what they feel is good or bad and their different perspectives in what is right and wrong (Ethics, 2014). Overall, this causes policy controversy, or an ethical debate.

Arguments For: One side of the healthcare argument poses the idea that is it ethical that individuals in society should not have to pay for insurance that covers the cost of contraceptives if its against their personal or religious beliefs. It comes back to the idea that any type of use of contraception is associated with abortion, which is against many individuals’ morals, beliefs, and values, is the opinion that is held by the key stakeholders on this side of the debate. These stakeholders would include individuals who are pro-life advocates and/or disagree with the performance of abortion, mostly the individuals paying for insurance that covers the cost of contraceptives when its against their personal beliefs. The solution that is most evident on this side of the debate is According to Medical News Today the term contraceptive means the use of any device, drug, agent, practice or procedure that prevents conception or impregnation. In 2013 a group of physicians in the American College Obstetricians and Gynecologist submitted facts to the Supreme Court that stated, “The medical groups’ brief describes the process of establishing a pregnancy, including ovulation (the release of an egg from the ovary), fertilization (the fusion of a viable egg with a viable sperm) and implantation (the implantation of a fertilized egg into the uterine lining). A contraceptive method, by definition, prevents pregnancy by interfering with ovulation, fertilization or implantation. Abortion ends an established pregnancy, after implantation.“ (Sonfield 2014) With this evidence the autonomy of individuals on this side of the debate argue that they should have the choice to opt out of paying for insurance for especially religious leaders. The Little Sisters For The Poor have argued "the government has put them to the impossible choice of either violating the law or violating the faith upon which their lives and ministry are based" (Wolf 2015). The Nuns believed the solution or opt out method that is offered would make them “morally complicit in grave sin” (Wolf 2015). A solution would be for these companies and churches to write to the government or their insurance providers in writing that they would not pay for contraceptives, so the insurer would be responsible to pay for it directly. It can be implied that they are willing providers, so there is no need to force unwilling people to participate in providing contraceptives. Mark Rienzi states, “It is ridiculous for the federal government to claim, in this day and age, that it cannot figure out how to distribute contraceptives without involving nuns and their health plans”(Liptak 2015). These arguments made by individuals on this side of the debate may cause patients or other stakeholders on the opposing side of the issue to label these individuals as selfish. However, such individuals that pose arguments for this policy declare that they are merely concerned about what they perceive to be the potential life of another and would like to guard the life of a future child that may never be born. In this aspect, many individuals pose an argument on another ethical principal that it is the choice of individual to engage in sexual intercourse before planning for a child so it should be their own responsibility to pay for contraceptives. About 99 percent of American Women have used a contraceptive (The Guardian). Many of these women do not know how much these contraceptives actually cost because the cost is being covered by insurance from some individuals who do not support the use or distribution of contraceptives. It is a choice to use contraceptives so many religious leaders believe it should be a choice to pay for the insurance that covers these cost. Along with the ethical principles of autonomy and beneficence, arguments are elaborated on their sense of justice as well, or what is morally right on the matter. They seek to restore what they see to be a choice injustice because these individuals feel as if it is unfair that they don’t have a say in whether they provide money for contraceptives when they believe the use of them is morally wrong. Lately we have noticed that these valid arguments that have been made by the stakeholders on this side of the debate have surely not been overlooked. The Supreme Court has taken necessary steps to evaluate these problems in hope to find a way For-profit and non-profit companies deal with issue by providing each individual with solution that is morally correct to their beliefs.
Arguments Against: The opposing side of the healthcare debate would imply that it is unethical for individuals in society to not have to pay for insurance that covers the cost of contraceptives if its against their personal or religious beliefs. The key stakeholders that are on this side of the debate can be such individuals who are pro-abortion. The solution that is most evident on this side of the debate is duty based. This side has decided that they are only concerned with what people do, and not worried with the consequences that will follow their actions. As seen previously, the individuals posing arguments for this policy offers the idea that individuals who don’t support contraceptives because it is a form of abortion in which would be against the morals of the individual paying for the insurance that covers the cost of contraceptives for individuals who however disagree that contraceptives are a form of abortion. An example that individuals on this side would agree with is found in the article, “Emergency Contraception: A National Survey of Adolescent Health Experts”, in which is says that “a type of contraceptive called postcoital contraception does not interfere with an implanted pregnancy and therefore it is not seen as abortion.” (Gold, N., et al, 1997). The stakeholders on this side argue that individuals on the other side should not feel the way they do about paying for insurance that covers the cost of contraceptives because according to them its not morally incorrect if certain contraceptives do not mess with pregnancy. These individuals believe that there is no significant evidence to enforce such a policy.
Another argument that these individuals pose is that individuals should not be able to opt out of paying for insurance that covers the cost of contraceptives. The individuals on this side of the debate do not understand why religious leaders feel that they should be able to opt out of covering the cost of contraceptives through their insurance because ultimately they don’t understand why it is against religious leaders morals to prevent pregnancy and life. This argument is seen in such debates like the recent Hobby Lobby mandate in which spokesman John Earnest stated, “"We believe that the owners of for-profit companies should not be allowed to assert their personal religious views to deny their employees federally mandated benefits," because they see it as an injustice to human beings (Bravin 2014). Individuals also complain that in for-profit companies religious beliefs against contraception are depriving them of preventative care as stated in the article, Supreme Court Makes Religious Exception to Health-Care Law, “Working for Hobby Lobby or Conestoga, in other words, should not deprive employees of the preventive care available to workers at the shop next door" (Bravin 2014). The idea proposes that every individual should have the choice on whether they use contraceptives or not. They should not be punished and left responsible to purchase contraceptives if it is not covered in their insurance due to the company they work for opting out of covering these expenses.
This causes individuals to continue the argument against the right of choice. Some individuals believe they have choice in whether they implement Planned Parenthood into their lifestyle. Others believe they have the choice to end pregnancy if they were forced to have unwanted sex. While others still choose to have sexual intercourse knowing the possibilities of getting pregnant is high when engaging in such activities. All of these choices seem ethically correct to these individuals on this side of the debate. The combination of ethical principles of autonomy and beneficence, arguments are elaborated on how they view justice as well, or what they perceive to morally right to the individuals on this side of the argument. They seek to restore justice in choice because they believe that it is only fair that insurance covers the cost of contraceptives because it’s primary preventative care.
The collections of these valid arguments that have been made by the stakeholders on this side of the debate have not been overlooked either. The Supreme Court continues to work towards bringing an end to the controversy by providing an agreement for both sides so both types of individuals receive what they need without it being against their personal beliefs, religious beliefs, morals, or values.
Position of Justification: Over the discussion of both sides of this debate it is found that there are underlying plausible reasons for why each side might need to be evaluated more. After examining all of the reasons to the debate above, the most logical and stronger policy option would be that of individuals in society having the right to decide whether to pay for insurance that covers the cost of contraceptives. Although both stakeholders’ opinions could be seen as correct, this issue goes back to first rights such as freedom of religion. The debatable idea that contraceptives equal abortion is proven because contraceptives prevent natural conception and abortion terminates the pregnancy by removing the embryo that was fertilized at natural conception. With the collection of all the ethical principals, it’s proven in the article Relationships Between Contraceptives and Abortion: A Review of the evidence, that “the use of contraceptives is an alternative means of achieving the same as that of what abortion seeks” (Marston and Cleland 2003).
We live in very a diverse society where individuals have many different beliefs. Having the ability to express moral and ethical principles is an individual’s ethical principal of autonomy. Each stakeholder in this debate holds very different autonomist views, and one side is more justifiable. The individuals should have the choice to exempt from this policy, due whether to their morals or religious beliefs. Justice is the primary ethical principal in this controversy. Justice will be brought to the table by guarding the unborn fetus’s life and giving it an opportunity to be born. Individuals are making good intentions to attempt to pursue a part of their ethical principal of beneficence. In the debate, the act of beneficence is widespread, giving the individual the ability to express their debate toward the issue. Opting out of covering the cost for contraceptives is an act of beneficence because it’s defending the unborn child against harm. After evaluating all the ethical principals it seems to be more beneficial to all to not require individuals to pay for insurance that has included the cost of contraceptives in it’s plan.
This policy is justifiable because it fixes the ethical dilemma in this situation. It fixes many issues with individual’s morals, beliefs, and values. It fixes religious leaders from violating the law or violating their faith morals. Finally, it fixes injustice to individuals paying for insurance that covers the cost of ending an innocent life.
Conclusion:
In conclusion, ethics can be a very complicated area of study where situation is usually “right versus right”. A lot of the time there is not only one correct answer, and there will be many situations that have their benefits and drawbacks. In regard to individuals in society having the ability to opt out of insurance that covers the cost of contraceptives when it is against their personal or religious beliefs, choosing those who are for this health policy statement, will eliminate different dilemmas for stakeholders and will ultimately be the best policy option. Short-term this policy statement will bring justice to unborn fetuses and protect individual’s religious morals and beliefs. The U.S. health care system could be restored long-term.

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Work Cited

Alluri, Aparna. "The Cost of Contraception: The Birth Control Methods Your Health Insurance Covers." The Guardian. N.p., 2 Sept. 2014. Web. 15 Nov. 2015. Retrieved from http://www.theguardian.com/money/us-money-blog/2014/sep/02/cost-birth-control-aca-hobby-lobby

Berlinger, Nancy. "Framing the Issue." Conscience Clauses, Health Care Providers, and Parents. N.p., n.d. Web. 18 Nov. 2015. Retrieved from http://www.thehastingscenter.org/Publications/BriefingBook/Detail.aspx?id=2266

Bravin, Jess. "Supreme Court Makes Religious Exception to Health-Care Law." WSJ. N.p., 30 June 2014. Web. 17 Nov. 2015. Retrieved from http://www.wsj.com/articles/supreme-court-exempts-some-companies-from-health-care-law-on-religious-grounds-1404138333

"Duty-Based Ethics." BBC. N.p., n.d. Web. Retrieved from http://www.bbc.co.uk/ethics/introduction/duty_1.shtml

Gold, M., Schein A., Coupey S., (1997). Emergency Contraception: A National Survey of
Adolescent Health Experts. Family Planning Perspectives, 29(1), 15. Retrieved from http://eds.b.ebscohost.com/ehost/detail?sid=f90f8e83-b513-4718-b086-081a8ea7a1da%40sessionmgr112&vid=1&hid=104&bdata=#db=f5h&AN=9706082184

"Insurance Coverage for Contraception Laws." National Conferance of State Legislatures. N.p., Feb. 2012. Web. Retrieved from http://www.ncsl.org/research/health/insurance-coverage-for-contraception-state-laws.aspx

Liptak, Adam. "Supreme Court to Hear New Case on Contraception and Religion." The New York Times. N.p., 6 Nov. 2015. Web. Retrieved from http://www.nytimes.com/2015/11/07/us/politics/supreme-court-health-care-contraception-coverage.html?ref=topics&_r=0

Marston, Cicely, and John Cleland. "Relationships Between Contraception and Abortion: A Review of the Evidence." Relationships Between Contraception and Abortion: A Review of the Evidence. N.p., Mar. 2003. Web. 19 Nov. 2015. Retrtived from https://www.guttmacher.org/pubs/journals/2900603.html

Nordqvist, Christian. "What Is Contraception? What Is Birth Control?" Medical News Today. MediLexicon International, 2 Sept. 2009. Web. 18 Nov. 2015. Retrieved from http://www.medicalnewstoday.com/articles/162762.php

Radnofsky, Louise. "U.S. News: White House Issues Rules on Contraceptives -- Health Law Requirement Still Faces Religious Objections and Is Being Challenged in Court." Wall Street Journal. Dow Jones and Company, 11 July 2015. Web. 16 Nov. 2015. Retrieved from http://search.proquest.com.libproxy.clemson.edu/nationalnewscore/docview/1695346981/824F9933312943DDPQ/1?accountid=6167

Sonfield, Adam. "Contraceptive Coverage at the U.S. Supreme Court: Countering the Rhetoric with Evidence." Contraceptive Coverage at the U.S. Supreme Court: Countering the Rhetoric with Evidence. N.p., 2014. Web. 18 Nov. 2015. Retrieved from http://www.guttmacher.org/pubs/gpr/17/1/gpr170102.html

Wolf, Richard. "Close Breaking News Reports: Two Air France Flights from U.S. Diverted Read Story 2543 377 2 129 Supreme Court Agrees to Rule on Birth Control Insurance Mandate." USA Today. N.p., 6 Dec. 2015. Web. 16 Nov. 2015. Retrieved from http://www.usatoday.com/story/news/2015/11/06/supreme-court-contraception-abortion-obamacare-religious-freedom/75287750/