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Goodbye 2020!

This has been a really difficult year, hasn't it? I hope that you and your families are all well, both physically and mentally. Furthermore, I hope that pandemic passes soon and that 2021 is much better.
I have been retired for about 5 years, but my heart goes out to the dedicated people who are taking care of patients. They, and the public health workers, all deserve hero status.

I wish all readers a happy and safe holiday.
Richard

Pay Attention, Healthcare Workers!

            Family planning could bring more benefits to more people at less cost than other single technology now available....         James Grant
            Either we reduce the world’s population voluntarily or Nature will do this for us, but brutally.                                                    Maurice Strong 

            Two physicians who are concerned about human population just published an article titled “Doctors and overpopulation 48 years later”. It is based on an article that was published almost a half century ago.
            The original “Doctors and Overpopulation” was signed by 52 physicians. The first paragraph states: “Many regard overpopulation as the supreme dilemma of our age....” It goes on to say that most people consider overpopulation to only be a problem of developing countries, but that Britain would soon be overpopulated. The population of the USA rose by 121 million, from 210 to 331 million, in those 48 years. Global population has doubled since 1972. 
            Our medical profession helped cause overpopulation by improving health so people live longer. Decreasing childhood mortality has had a huge effect in increasing population growth, but it is perhaps the most humane action in the history of medicine. The authors of “Doctors and Overpopulation” take some responsibility for our rapid growth. 
            What could those doctors recommend to combat overpopulation? They list 5 actions, all of which are still relevant today: Convince the government of the seriousness of overpopulation; Increase family planning services, including access to vasectomy; Keep abortion legal and available to all women; Empower women; Include population studies at all levels of education and use mass media to spread information on the subject.
            One of the authors of the current article, Dr. John Guillebaud, was also one of the 52 original signers. Guillebaud is a family planning guru and retired professor of reproductive medicine in London. The other author, Jan Gregus, is a gynecologist and philosopher in the Czech Republic. He recently presented a paper at the World Congress of Bioethics on the ethics of small families.
            They write about 5 roots of overpopulation: the decline in mortality and population momentum (the large number of young people who have yet to have their families). These 2 causes cannot be changed, but the other 3 can be. There are millions of women who want to control their fertility but don’t have access to reliable contraception; access to family planning services can help. Even more women and men are forced by custom and convention to desire large families. Social norms in some societies force women to be mothers because that is the only role open to them. Education can help here—especially by non-traditional methods such as telenovelas. The Population Media Center has done an excellent job of using electronic media to educate and empower women and to show the advantages of small family size. 
            I strongly agree with Guillebaud and Gregus in condemning reproductive coercion. It was unnecessary in India and in China, but coercive programs there and elsewhere have done great harm not only to the affected people but to the movement to slow population growth.
            They also talk about the effect of large international conferences, and lament the fact that the huge Cairo conference in 1994 “failed to articulate the threat of unremitting population growth on a finite planet....” Instead, that conference highlighted the importance of reproductive health services. It also promoted education of girls and women and supported “...childbearing needs to become a woman’s personal choice, and not her obligation or a matter of chance....”
            Another conference, held last year in Nairobi on the 25th anniversary of the Cairo conference, followed the global trend of ignoring overpopulation. To quote Guillebaud and Gregus, “Despite... much evidence that unremitting population growth is one of the ‘upstream’ driver[s] of climate change... at the Nairobi population conference the word population was nowhere....”
            Yes, there is a taboo against talking about population as a cause of environmental problems. In addition to climate change, the authors list 13 other global crises related to overpopulation—but you seldom see the media making this connection. They call for a “taboo-free talk”. Thanks, Drs. Guillebaud and Gregus; that has been the goal of Population Matters-USA for the past 25 years!
            There is good news! Physicians have been slow to recognize the concept of overpopulation, and to acknowledge the connection between medical care and environmental problems. This article, “Doctors and overpopulation 48 years later”, was a step in the correct direction. Earlier this year the equivalent journal in the USA, Contraception, ran a similar editorial: “Family planning, population growth, and the environment.” I only wish that both articles were published where more people could read them.

© Richard Grossman MD, 2020
 

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