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FERTILITY CONTROL AGENTS AS A POSSIBLE SOLUTION TO THE WORLD POPULATION PROBLEM MELVIN M. KETCHEL* The world is now facing a severe problem ofhuman overpopulation because the birth rate has generally remained high while the death rate has been dramatically reduced. Plans to lower the birth rate have almost invariably centered upon the concept offamily planning. It is the purpose of this paper to point out that even iffamily planning methods become widely used they maynot necessarily lower the birth rate sufficiently to provide a solution to the population problem and that other methods can and probably will be developed which could solve the population problem without relying on family planning. The use of such methods will raise moral and political questions ofgreat importance, however, and it is my hope that this essay will provide a basis upon which a discussion ofthese issues can begin. Such a discussion would prepare us for making decisions concerning the implementation ofthese methods when they become available and may, ifsufficient support for their use emerges, encourage the development ofsuch methods. Family Planning as a Solution to the Population Problem The pioneers in the family planning movement were primarily concerned with aiding families. When the natural fertility ofthe parents resulted in too many children for the family'swelfare, familyplanning methods were provided to prevent unwanted pregnancies. Somewhat later the family planning movement was strengthened by the inclusion of many people whose major interest was in solving the population problem by lowering the birth rate. It was reasoned that, as more and more couples * Department ofPhysiology, Tufts University School ofMedicine, 136 Harrison Avenue, Boston, Massachusetts, 021 11. 687 learned the techniques oflimiting the size oftheir families, they would do so, and eventually a large percentage of the world's population would practice family planning with the result that the reduction in the number ofchildren born to them would significantly lower the world's birth rate. No other acceptable means ofsolving the population problem have been available, and evenpartial success ofthe family planning approach has been of value. Some hope has been provided by history that family planning methods might eventually dramatically lower the world's birth rate. The term "demographic revolution" has been applied to the transition ofa population with a high death rate and a high birth rate to a population with a low death rate and a low birth rate. It appears that the reduction in the infant death rate which occurs as a country becomes developed makes it unnecessary for each couple to have many babies in order to raise children to maturity, that children become an economic liability rather than an economic asset, and that the aspirations ofpeople to provide more education and otheradvantages for their children encourages them to have fewer children on which to concentrate their efforts. These factors, plus many others, lead to the development ofthe "small family ideal." The decision to have fewer children is implemented primarily by the utilization ofcontraceptive techniques. A demographic revolution occurred in Europe and North America following the Industrial Revolution, and inJapan following World War II, and people concerned about the growth rate of the population ofthe rest of the world hope that the dramatic world-wide reduction in the death rate during the past twenty-five years is the first step in a demographic revolution that will result in a rapid reduction in the world's birth rate. Whether the conditions under which a demographic revolution can complete itselfnow exist in the underdeveloped countries ofthe world is a matter of considerable controversy. Up to the present, demographic revolutions have occurred only when a gradually declining death rate was accompanied by considerable economic and social development. It may be that the levels ofeducation, living standard, and motivation required iffamily planning is to be successful cannot be attained in underdeveloped countries precisely because their high birth rates prevent the necessary economic development. On the other hand, the demographic revolution which occurred in Europe and North America took place essentially with688 Melvin M. Ketchel · Fertility Control Perspectives in Biology and Medicine · Summer 1968 out governmental or organizational influence, whereas at present strong organizations and some governments are working strenuously to lower birth rates. How successful...


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