Afternoon Inquisition

AI: Secret Sacred Information

A few weeks ago, in my most recent installment of Skepchick’s Guide to the Uterus, I discussed the latest information on the withdrawal method. A new study reveals that pulling out is equally as effective at preventing pregnancy as condoms. Sure, it has it’s flaws, and it doesn’t prevent against STIs.

A couple of people argued that, in the heat of the moment, pulling out doesn’t happen. Others argued that the STI issue is too big to ignore. And others said that teaching people that withdrawal is as good as a condom for preventing pregnancy will result in most people choosing to forgo condoms for the better feeling, easier, cheaper, and always available “pearl necklace” option. (Don’t look that up if you’re at work.)

One suggestion was that we should not even teach withdrawal as an effective pregnancy prevention option because of the fact that people will use it irresponsibly, especially teenagers who are not experienced enough sexually or disciplined enough to know when it’s time to get out.

While I still disagree that withdrawal should remain stigmatized, the last suggestion got me thinking, and I wonder where you guys stand on the idea of this question.

Is it ever a good idea to keep information away from the public, information that could benefit many, to protect them from possibly using it irresponsibly?  Does it matter what the information is? Does the ratio of possibly benefiting from vs possibly misusing the info matter? Does it matter who is receiving and possibly distributing the information?

The Afternoon Inquisition (or AI) is a question posed to you, the Skepchick community. Look for it to appear daily at 3pm ET

Elyse

Elyse MoFo Anders is the bad ass behind forming the Women Thinking, inc and the superhero who launched the Hug Me! I'm Vaccinated campaign as well as podcaster emeritus, writer, slacktivist extraordinaire, cancer survivor and sometimes runs marathons for charity. You probably think she's awesome so you follow her on twitter.

Related Articles

51 Comments

  1. @Simon39759: This.

    Besides, the way to go about it is this:

    Withdrawing is % effective, with perfect use, however, most humans aren’t going to perfectly use it, and this is why … thus, it is not the best option for most people.

    I am for people making their OWN decisions and choices based on the full information. I am pro-choice, after all.

    And, don’t we get all up in arms when the anti-choice crowd lies or feeds misinformation, or leaves important information out altogether? It would be hypocritical for us to do it too.

  2. Restricting information is a not a good idea. A little bit will always leak out. And as everyone knows, A little knowledge is a dangerous thing. When it comes to public health and safety, Information must be given completely. How to, how not to, pros cons, all of it. Only then can people make an informed decision. If you want to say “Don’t do it” you have to say why.

  3. I have a very good reason why it is sometimes good to withhold information. Unfortunately, I can’t tell you because people with nefarious motives could misuse this reason to justify withholding information from the public.

    I am a Hedge

  4. Don’t people have information on how to use condoms and still use THEM imperfectly… like putting it on too tight then being too much of a chicken to say anything when you take it off and realize there’s nothing in, so you simply suggest that you and your partner stand up and go for a walk, no a run, no let’s get on a trampoline and jump HARD.

  5. Here, the subject is sex education. Not long ago we all told each other how terrible “abstinence only” education was, because it left out vital facts. Should we not be just as all-inclusive about this information? To expand on what Marilove said above, it is important to include in your presentation all of the pros and cons of a particular method. If you cannot properly articulate all of the information, you do not belong presenting it.

    In the more general sense, yes, there are good reasons not to give the public all of the information. Not all of my neighbors need to know exactly how to waterboard someone or the six best ways to kill another human with just your hands. It is precisely because we cannot trust everyone to use that information responsibly that it does not need to be spread about willy-nilly.

    (And, yes, I know that anything can be found on the intertubes these days. Let’s just not make it too easy.)

  6. Information wants to be free (or at least only nominally monetized). I am highly skeptical of the success rates in the earlier study. I’m not a physician or biologist, but I do vaguely recall that it possible for some sperm to be in precome, which would mean even with pulling out there still would be a potential for pregnancy. I suppose that’s what they mean by “when done properly” but as has been noted: condoms are possibly the simplest invention EVER and yet people manage to not understand how to use them.

  7. I’m not sure to what extent there are processes of making simple things really dangerous that is not common or easily accessed knowledge. It seems to me that there may be times when not making this type of information known serves the public interest, but that’s assuming it’s a responsible entity that has possession of the information. And with the internet I suspect most information like this could/would seep out eventually and find some potentially fertile ground.

  8. Restricting information is never a good idea, especially for teenagers. They’re not as dumb as we think, and they often know when they’re being lied to or when someone is being condescending, and it makes them just not take teachers seriously. We’ve all seen how it works out when you take restricting information to the extreme – abstinence only sex ed and a corresponding rise in unintended pregnancies.

    The important question is this. If the withdrawal method is effective, then why shouldn’t we encourage people to use it? Of course there is the risk of STDs, but you get that same risk with any type of contraception other than condoms. BC pills certainly don’t protect against STDs either.

    I do have some concerns about the withdrawal method. First of all, this one study is far from conclusive and I would like to see more research. There’s also a huge difference between perfect use and actual use. I think it’s difficult for many people to achieve this, especially young men who don’t have much experience. Some men will never be able to withdrawal in time. I wouldn’t encourage any woman to trust her partner enough to pull out in time. However, it’s better than nothing and I think people in general are competent enough to understand that it has risks so a condom or hormonal contraception is best, but if they’re not going to use anything anyway, they can at least use the withdrawal method as a last resort.

    So basically, I’m not completely convinced by this study, but if further evidence shows it to be extremely effective, then there’s no reason to discourage people from using it.

  9. The problem I see here is that we’ll take the example subject, say, “It’s not good to withhold information,” and apply it across the board to every other conceivable instance where there is a question of whether information should be disseminated or withheld.

  10. Have any studies looked at the effectiveness of the withdrawal method “as typically used”, rather than “with perfect use”?

    I know that condoms lose *some* effectiveness when they’re not used ideally, but something tells me that condoms ‘as typically used’ are much more effective than withdrawal ‘as typically used’ – though when we compare the stats of ‘perfect use’ the numbers become comparable.

  11. I listened to half a talk by George Lakoff yesterday, and he said that there is an assumption, most prominently on the left, that the marketplace of ideas is somehow neutral and that if we only make sure that all the information is out there, people will make an informed, logical decision based on the facts.

    But that is not how people make decisions, and the framing of the information is really the most important factor. I think this situation is a prime candidate for that way of thinking.

    I am all for maximum information, but I think it will take more than that if we want to succeed in the goal of the fewest possible pregnancies and STDs.

    We need to somehow reframe sexual responsibility and sexual pleasure in a way that acknowledges the reality of who’s getting knocked up (when they don’t want to) and why.

    I’ve got no answers, but Lakoff just really got me thinkning. He’s got a new book out. I have only just started it, but the bits I’ve gleaned so far seem very much on the money.

    http://www.amazon.com/gp/product/0143115685/ref=pd_lpo_k2_dp_sr_3?pf_rd_p=486539851&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=0226467716&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=0N5YVPDQYRV6QHBV7EZH

  12. @sowellfan:

    Yes. The study I discussed compared perfect use and typical use to both condoms and withdrawal… they found little difference when comparing typical to typical and perfect to perfect.

    @mikespeir:

    In the case of the example, I have a hard time believing that this information is too dangerous to trust the public to handle.

    But the question is whether there are times when the public cannot be trusted with information that could help them because others (or even the people it’s intended to help) may abuse, misuse, or irresponsibly use that information.

  13. @CarsonOJennick:

    I don’t think that giving people the information will result in them making good, informed decisions.

    People are already making bad decisions. And will continue to do so. But they can’t make good decisions if they don’t have all the facts.

    Information doesn’t make people make good decisions… but it does make them responsible for the decisions they make.

  14. @Elyse: Agreed that they were comparing typical to typical and perfect to perfect in regards to methods, though I’d argue that when discussing pregnancy the difference between 2% and 4% is very significant.

    I should clarify that I think getting the information out there is always the better choice, but that we shouldn’t put too much hope into the idea that it will help.

  15. You can practice condom use without having sex, so that when you actually need to use one, you do it right.

    You can’t practice withdrawal without having sex, so it shouldn’t be your first choice for pregnancy prevention.

    I think _teens_ should be taught that _for them_, as inexperienced, intermittent fuckers, withdrawal is risky, if not as risky as a full, committed and deliberate load of baby juice to the cervix.

    Leave the “withdrawal appears to be pretty good if you can get it right”-information somewhere responsible adults can get at it, but leave it out of the high school syllabus.

  16. And to actually answer the AI: Keep information away from the public. No. Keep it out of the high school syllabus. Sometimes. Think carefully about how it’s presented. Definitely.

    Example: The Norwegian Radiation Protection Agency recently published advice for how to reduce exposure to cell phone radiation. The article is full of caveats. “No damage has been shown.” “The exposure from ordinary use is insignificant to start with.” “This is really just super caution.” Except what a significant portion of the public will walk away with is: “The RPA says cell phone radiation could be dangerous.”

    When we do nuclear radiation in science class, cell phones inevitably become a topic, and I tell my students they shouldn’t worry. Other teachers aren’t so sure, and the NRPA is to be blamed for contributing to that.

    Yes, minute effects of prolonged use may show up, or evidence against such effects may keep piling up, but in the mean time, _not worrying_ is the better option.

  17. @Elyse:Then I’m afraid we might not all agree on what “helpful” is in certain situations. There are people who think, for instance, that it would be helpful if classified information were made public. In other words, they think society would be better off without such. I disagree.

  18. mikespeir:”The problem I see here is that we’ll take the example subject, say, “It’s not good to withhold information,” and apply it across the board to every other conceivable instance where there is a question of whether information should be disseminated or withheld.”

    I don’t see that as a problem.

    “There are people who think, for instance, that it would be helpful if classified information were made public. In other words, they think society would be better off without such. I disagree.”

    Why? Why is it classified? Because they don’t want the wrong people to find out about it? Who are the “wrong people?” Possibly if we’re at war and we don’t want our enemies to know what we’re planning, you could maybe use that excuse, but I’d like to hear the explanation.

    Otherwise why isn’t information available to everyone? The major reason is that we’re afraid people will overreact to bad or shocking news. Well, we’ve spent a good deal of time making people ignorant and making sure no one does anything really radical like intensive teaching of critical thinking skills, so it’s no wonder.

    How about let’s concentrate on making the public aware enough to be able to handle the information, or at least give it a shot, before we imply that there is some information they can’t handle?

    To date I haven’t heard any explanation about why some secrets should be kept that didn’t end up being essentially “Someone would be embarassed.” Not good enough. We tell parents to teach their kids about the real world and how to handle it, but many parents haven’t learned how to do that.

    I admit, it’s a big problem to overcome, but it’s better to tackle the problem than to just say “some things should be kept from the public.”

  19. Who is “we” vs “the public”? We here aren’t exclusively medical professionals. Obviously, you were able to find the research, even if it is not something that is traditionally taught.

    So, should scientists and other researchers withhold such information “for the public good?” Heck no. I like that all kinds of information is easily searchable and that I can make informed decisions based on that.

    Should this be taught in schools as a safe and effective means of birth control? Maybe and with lots of caveats. (If vetted by further research.)

  20. Is it wrong to keep THIS type of information out of the public hands? Yes.

    To my mind it’s a matter of proper education. Yes, disclose the information but at the same time teach people what to do with the new information. Information without understanding will potentially lead to more unwanted teen AND adult pregnancies.

  21. I particularly liked this article on information dissemination in public health: K Grill, S O Hansson. Epistemic paternalism in public health. J. Med. Ethics 2005;31;648-653

    I think the most persuasive points (besides a person’s autonomy and right to know) are that withholding information, or outright lying, creates problems because a) people may know they are being lied to, or that information is being withheld, and this creates anxiety; b) even if they don’t know that they are being lied to, when the truth is revealed, it will create feelings of resentment and distrust; and c) if lying and withholding information is something that people know authorities do, they won’t trust those authorities, and may turn to other authorities that may not, in reality, be more trustworthy (and may create pseudoscientific beliefs in the population – i.e. turning to alternative meds).

    From the article:
    “In summary, we have found epistemic paternalism about public health to be a very problematic position, possibly to the degree of being self defeating. Withholding information about threats to public health interferes with people’s ability to make informed choices in both the private and the political parts of their life. Furthermore, such a practice is likely to give rise to more confusion and unwarranted anxieties than it can prevent. This applies even if the practice of withholding is restricted to information that is uncertain.”

  22. 1. There probably are rare circumstances under which withholding information is best.

    2. This is not one of those circumstances.

    3. I for one would much rather “finish” inside with the raincoat in place than outside with it off.

  23. Does any one hold the opinion that the kids won’t think of, or try, the withdrawal method if adults don’t tell them of it? I learned of it from my second girlfriend. Fortunately, nothing bad happened. We weren’t together long, and a few months later she was pregnant from an affair with a married man. All-in-all, it doesn’t seem to me the optimum way of learning about birth control.

  24. @Elyse: Okay, that makes sense. Yeah, I didn’t see a “we” in the question, just in some of the responses. I think it’s interesting that there are different levels of “we” and our responses might change depending on which group we’re talking about, we as in all of us, the researchers, teachers, parents, etc.

    And I totally just typed “wee” the first time around…

  25. I’m going to agree with Bjornar, and say that information shouldn’t be withheld, but there should be triple-checked care taken in how the information is presented.

    Case in point: a service group I am a member of raises money for the chapter by selling concessions at a sports arena. (This is a college group.) Dress code is black pants, no jeans of any kind. Repeated emphasis on NO jeans, NO black jeans, NO it’s not okay to wear black jeans, black jeans are NOT okay. Fully 1/3 of those who worked our last event showed up wearing black jeans…and these are intelligent, aware, civic-minded college students.

    Granted, the consequences of wearing black jeans don’t have the potential to be as life-altering as the consequences of misunderstanding birth control information (unless you count the embarrassment of having to rent outsized, misshapen, elastic-waisted polyester pants from the venue as “life-altering”), but I think you’re picking up what I’m putting down here.

  26. So I work in the HIV field (not as a doctor) but one of the things we learn in “Testing and Counseling” is that exposure does not equal infection. That is, you can be exposed to the virus without acquiring it. This is usually met with a quiver of terror and the sentiment that we better not tell people that. Because if you put that information out into the world and someone became infected based on that knowledge then you would feel bad about it. Kind of random, but relevant.

  27. @Ms. September 2008: It’s sort of the same idea with seatbelts or any public safety measure: the safer people feel, the riskier their behaviour. With seatbelts, risky driving increased. It is possible that knowing exposure doesn’t equal infection could increase risky behaviour in the same way; it might be a reason to personally wouldn’t think it a reason to make it unavailable.

  28. This question draws a false dichotomy. We are not limited to ether hiding the truth from the public or being completely open to everyone at all times. If teens are at an age where pulling out is not an effective method of birth control because they don’t have the willpower then it might be best to gloss over that option or to offer it with the heavy emphasis on STDs. There is a time and place for everything. There are few people who would think it a good idea to tell your six year old daughter about your acid trips when you were a rodie with that death metal band. Maybe when your kid is in her thirties you could start sharing some of your more colorful life experiences. And between six and thirty you just have to keep checking the web to make sure no one posts incriminating pictures of you.

  29. I pretty much agree with Simon39759 and jblumenfeld. There are a few exceptions, such as information that parents should have the right to veto to their children until their children are old enough to handle it, such as sexuality, drugs, alcohol, etc.

    The obvious overall question is “Who decides what information is worthy of dissemination or not?” I really have mixed feelings about government secrecy. There are some things that should be kept secret, such as weapon designs, military plans, etc. OTOH, government secrecy is easily abused, as was pointed out above.

    Overall, I prefer “sunshine” over secrecy.

  30. Personally, I’m really glad that “use a condom OR ELSE!!!11!” was the message me and my peers got as teens because it took a lot of pressure off of teenage girls to get the boys to wear condoms. I would *not* have wanted to trust the self-control of a teenage boy as my method of birth control.

    And as a child of spooks, yeah, I’m really okay with information being withheld.

  31. I think with regards to birth control and teenagers, it’s probably best to restrict the options to things that actually work for teenagers, as that is the information they need. You can leave the list open ended without mentioning every hairbrained idea that might potentially reduce the odds of getting pregnant.

    The sucess of abstinence only is debatable, but surely, the pulling out method is not an effective birth control method for teenagers. There are far better and more reliable methods available to teach the kids about. So why complicate the matter by adding an option they can’t even use (or in all likelyness won’t use properly) when it seems difficult enough already to use the options they CAN use in a reliable way?

    It’s not like you’re actively going to prevent them from finding any mention of it, and if the question comes up, or someone is really looking for alternatives (for whatever reason) you could provide the information, with all the disclaimers attached. But why risk it? I think the odds of it being mistaken as a reliable BC method are far higher when they DO know about it compared to when they don’t even consider it and use something else instead.

    I suppose that, as with free speech, the freedom to not say something is dependent on the consequences. Some things are more damaging when divulged compared to when they’re kept secret. The only problem is objectivity in deciding what falls in which category.

  32. That’s the same argument Fundamentalist Christians use to not teach other birth control, especially condoms.

    “To protect them from the responsibility of using it wrongly, ” we will only tell them that they should practice abstinence.

  33. Well, I’m not suggesting to keep it a secret from them at all costs. I’m just saying it’s not that high on the list of birthcontrol methods you need to tell them about.It is a little more reliable at preventing pregnancy than nothing at all, although in quite a few cases, the two will probably inadvertently be the same thing.

  34. exarch: Give them the knowledge (ie, the medically accepted birth control methods) and give them as much extra information as you can to allow them to make an informed decision. Then step back.

    Of course you shouldn’t tell them EVERY crackpot birth control idea, for the simple reason that they don’t work. You can’t make sure every teenager makes the best decision possible, but you CAN make sure that if they make a bad decision, it isn’t because they didn’t have all the facts. THAT’s what the philosophy of “Let’s protect them from too much knowledge” does. There is no such thing as “too much knowledge” There is “not enough knowledge” and there is “unequipped to handle knowledge” but it’s our fault if they are unequipped to handle it.

    It only seems that way because common sense isn’t.

  35. @exarch:

    But the thing is, many kids are not using birth control at all! And for years we were taught that if you go in at all without a condom, you’re already pregnant… understanding that pulling out is almost as effective as a condom will at least arm them with the information that, if they’re already making a poor decision, could save them from making an even worse mistake.

  36. Except to avoid causing widespread panic, or to protect legitimate state secrets, information of value to the public should never be withheld.

    However, we can choose what to publicize and what not to. On the issue at hand, for example, I agree that discussing the finer points of withdrawal in a sex ed class would probably only serve to confuse already contentious information about contraceptive choices and STDs. A simple, unified message of “use a condom every time if you don’t want STDs or pregnancy” is appropriate, because it’s the best overall option – it doesn’t require significant pre-planning (e.g. Oral Contraceptives often are not effective for at least several days after beginning), has the least overall risk (in terms of preventing undesirable outcomes combined with potential side-effects), etc.

    For adults, I think having all the information available is a good thing, but I still wouldn’t go about promoting withdrawal, simply because it relies upon individual discipline at a point when such discipline is notoriously lacking in most folks. And, people tend to overestimate their ability to do the “right thing” under stress.

  37. exarch: Of course you shouldn’t tell them EVERY crackpot birth control idea, for the simple reason that they don’t work.

    One might argue that this is precisely the reason you should tell them every crackpot birth control idea (and explain why they’re flawed), if only so they know what doesn’t work and don’t go trying whatever random urban legend happens to be making the rounds at the time.

    *looks up* And here I go contradicting myself. Hell.

  38. BonnieBeth: “One might argue that this is precisely the reason you should tell them every crackpot birth control idea (and explain why they’re flawed)”

    Careful there. You’re getting dangerously close to real EDUCATION… and that’s just crazy talk.

  39. I suppose I will need to elaborate on the logic I’m using here:
    I am (perhaps mistakenly so) assuming that you only have a limited time available to teach kids about contraception (not even taking into account the potentially limited attention span of the students themselves on this subject until giggling and clownery takes over), there probably isn’t time to spend that much attention on every crackpot birthcontrol idea and why it doesn’t work.

    So it seems most important to get the basics through first (abstinence, condoms, the pill, pessarium, etc…).
    Then if you manage to get to the withdrawal method and other less reliable BC methods, by all means.
    If after that you even have time left to discredit the crackpot stuff, even better.

    But I figure there’s enough to explain already that you don’t need to risk telling only half the story (the wrong half) to an audience that really needs to hear the second half in order to not make mistakes.

    Hence my stance: it’s better not to tell them (unless you’re sure you can give them the whole story).

Leave a Reply

You May Also Enjoy

Close
Close