Under what conditions is it ethical to offer incentives to encourage drug-using women to use long-acting forms of contraception?


Jayne Lucke, University of Queensland Centre for Clinical Research, Building 71/918, Royal Brisbane and Women's Hospital Site, Herston, Brisbane, Queensland 4029, Australia. E-mail: j.lucke@uq.edu.au


Aims  To stimulate debate by examining ethical issues raised by Project Prevention, a US-based organization that offers $US300 to addicted individuals who agree to either undergo surgical sterilization or use long-acting forms of contraception.

Method  An analysis of key ethical questions raised by Project Prevention.

Results  The important issues for debate are: (i) what are the reproductive rights of drug-using women; (ii) does a substantial cash incentive undermine the ability of addicted women to make free and informed decisions about long-term contraception; and (iii) how can we best assist addicted women to access good reproductive health care and obtain treatment for their addiction?

Conclusions  We need more research on ways in which small non-cash incentives for reversible methods of contraception could be used in a morally acceptable and effective way to promote the sexual, reproductive and general health of addicted women.