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Is it ethical to use drospirenone-containing combined oral contraceptives?: authors' response
  1. Jürgen Dinger, MD, PhD1,
  2. Samuel Shapiro, FCP(SA), FRCP(E)2
  1. Director, Berlin Center for Epidemiology and Health Research, Berlin, Germany;
  2. Visiting Professor of Epidemiology, Department of Epidemiology, University of Cape Town, Cape Town, South Africa;

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Dr Pittrof's response1 to our review of recent studies on the association of oral contraceptive use and the risk of venous thromboembolism (VTE)2 discusses the ethical implications of the study results on clinical decision making. His arguments are based on four principles of bioethics, as outlined in the sixth edition of Beauchamp and Childress' landmark textbook on biomedical ethics.3

One of us (JD) remembers with great pleasure Beauchamp's and Childress' lectures at the Kennedy Institute of Ethics at Georgetown University. Their undogmatic and brilliant intellectual contributions have influenced several generations of bioethicists since the late 1970s. Their approach to the establishment of principles that provide general normative frameworks in bioethics (‘principlism’) has been criticised since the late 1980s, when several different methods and types of moral philosophy began to be proposed as alternatives or substitutes (such as Impartial Rule Theory, Casuistry and Virtue Ethics). However, these new approaches are, in fact, not inconsistent with an undogmatic and broad interpretation …

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  • Competing interests Jürgen Dinger was previously an employee of Schering until 2004. He presently conducts, and in the past has conducted, studies which are/were supported by research grants from manufacturers of contraceptives. Samuel Shapiro presently consults, and in the past has consulted, with manufacturers of products discussed in this article.