Benjamin Hale
  Associate Professor, Philosophy and Environmental Studies
Sustainability, Energy, and Environment Community
Office SEEC S238A
Campus Box 488
University of Colorado at Boulder
Boulder, Colorado 80309-0488


What's Fair, What's Right?
Respecting Autonomy in Population Policy
co-authored with Lauren Hale

Full paper available upon request

This paper was presented at the Health Promotion Ethics Conference in Ghent, Belgium.

It is currently being revised for publication.

September 18-20, 2007

For several decades the international demographic community has debated the relative merits of “substantive” family planning and education programs versus “universal” education programs as a means to improve women’s autonomy and reduce unwanted fertility and infant and child mortality. Both substantive and universal education programs have been demonstrated to reduce fertility and infant mortality. Generally speaking, however, substantive education programs are frequently framed as a tradeoff with other possible government projects. Apart from efficacy and resource questions, there are also questions regarding justice, rights, and autonomy. In this paper, we address the normative question of whether a simple universal education program is enough to satisfy basic criteria of human rights, or whether a substantive education program, in conjunction with a universal education program, is too much to demand of a government.

The International Conference on Human Rights in Tehran in 1968 was the first international forum to declare that “parents have a basic human right to determine freely and responsibly the number and spacing of their children.” This sentiment has been reaffirmed in all subsequent United Nations Conferences on Population, although the policy implication has varied.

  • At the 1974 Conference in Bucharest, policy discussions focused on economic development, resulting in the “development as contraception” model of slowing population growth. This policy met with significant objection. Many countries in the developed world argued that overpopulation is the cause of, rather than a consequence of, underdevelopment.

  • In contrast to the 1974 Bucharest conference, which highlighted development goals to reduce population, the 1984 Conference in Mexico City emphasized setting demographic targets and urged for family planning as a mechanism for reducing rapid population growth. This too met with significant objection. Some countries, the United States in particular, refused as a matter of policy to accept some of the substantive implications of family planning programs.

  • The tide-turning 1994 Conference in Cairo shifted the international dialogue towards emphasizing gender equality by providing women with greater opportunity: through expanded access to education, health services, skill development, employment, and political participation. The resulting “Programme for Action” from this conference included recommendations to use both universal education and family planning services. Thus, the debate was seemingly over with the “Cairo Consensus,” in which both feminists and traditional demographers were satisfied. Unfortunately, resource questions regarding the extent to which these substantive educational programs are possible still linger, and they are therefore seen as desirable but not necessary.

Evidence demonstrates that family planning reduces fertility above and beyond traditional development indicators such as women’s education. In this paper, we explore the notions of substantive and formal autonomy in an attempt to address the dual normative claims that substantive family planning education programs are unnecessary and that universal educational programs are sufficient for individual autonomy. We find that universal educational programs are insufficient for the promotion of autonomy, and therefore we argue on substantive autonomy grounds for family planning programs.