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Word Count: 524
When advising a patient a physician must communicate the truth accurately and clearly The physicians and patients knowledge and preference result in a plan of action Such a plan must be for the patients good A physician must not formulate or endorse a plan that he perceives to be of harm to the patient A plan that involves risk is acceptable if the potential benefit to the patient outweights the risk in the mind of both patient and physician Birth control may be of benefit to a sexually active couple who are not prepared for a child provided it does not violate their conscience Abortion can be used as birth control but it has been condemned because it does harm by taking a human life Methods of birth control that act partly or entirely as abortifacients represent the same ethical dilemma as more invasive methods of abortion The incidence of conception in a woman using oral contraceptives is unknown but recent data 1 indicates an ovulation rate of 47 on the low dose pill Older literature estimates the rate to be between 2 and 10 2 The likelihood of implantation given the histologic appearance of the endometrium is considered very low 3 therefore the conception rate is essentially the rate of ovulation times the chance of fertilization For unprotected intercourse the fertilization rate is approximately 20 4 The effectiveness of cervical mucous changes in preventing fertilization has not been well studied so sensitivity analysis is needed to estimate the range of possible conceptions Given the foregoing a womans chance of conception any given month is approximately 1 47 X 20 ignoring the role of cervical mucous changes On oral contraception a woman has 13 cycles per year On the average then a woman will have one abortion every eight years she uses oral contraception 13 X 8 X 1 A corollary is that on the average a physician induces one abortion
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