Objectives To review ethical aspects of the promotion and provision of long-acting reversible contraception (LARC). Specifically, to examine (1) the tension between informational exchange and the active promotion of LARC methods to new and existing contraceptive users by healthcare professionals; and (2) the distinct ethical issues arising from the promotion of LARC methods by state-sponsored actors and healthcare professionals. Methods Narrative review and ethical analysis. Findings There is an ethical difference between raising awareness/informational provision and actively promoting or prioritising specific contraceptive methods. It matters whether the policy choice is made, or the promotional activity about contraception is undertaken, by individual healthcare professionals at a local level or by more remote state-sponsored actors, because the relationship between the promoter and the (potential) contraceptive user is of a different kind. Imposing a dual responsibility upon healthcare professionals for raising awareness/informational exchange and the active promotion of LARC creates an unnecessary tension and barrier for the delivery of patient-centred care. Conclusions This review highlights the need for ethical reflection on the central role of the promoting agent and the distinction between facilitating informational awareness and active promotion of LARC. LARC methods should not be prioritised in isolation and without regard to the wider implications of public promotion. A balanced narrative and information-sharing programme that respects the individual interests of each contraceptive user is called for, especially in direct professional/service user relationships. No assumption should be made that user decision-making will necessarily be determined and influenced solely by the relative effectiveness of the contraceptive method.

中文翻译：

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国家资助和临床推广长效可逆避孕的伦理

目标 审查促进和提供长效可逆避孕 (LARC) 的伦理方面。具体而言，检查 (1) 信息交流与医疗保健专业人员向新的和现有的避孕用户积极推广 LARC 方法之间的紧张关系；(2) 由国家资助的行动者和医疗保健专业人员推广 LARC 方法所产生的独特伦理问题。方法叙述性审查和伦理分析。结果 在提高意识/提供信息与积极促进或优先考虑特定避孕方法之间存在伦理差异。无论是由地方层面的个人医疗保健专业人员还是由更偏远的国家赞助的参与者做出政策选择或开展有关避孕的宣传活动，这都很重要，因为发起人和（潜在的）避孕用户之间的关系是不同的。将提高意识/信息交流和积极促进 LARC 的双重责任强加给医疗保健专业人员，这对提供以患者为中心的护理造成了不必要的紧张和障碍。结论 本综述强调了对促进剂的核心作用以及促进信息意识和积极促进 LARC 之间的区别进行伦理反思的必要性。不应孤立地优先考虑 LARC 方法，也不应不考虑公共宣传的更广泛影响。需要一个平衡的叙述和信息共享计划，尊重每个避孕用户的个人利益，尤其是在直接的专业/服务用户关系中。