Adding a sterilant to drinking water or staple foods is a suggestion that seems to horrify people more than most proposals for involuntary fertility control. Indeed, this would pose some very difficult political, legal, and social questions, to say nothing of the technical problems. No such sterilant exists today, nor does one appear to be under development. To be acceptable, such a substance would have to meet some rather stiff requirements: it must be uniformly effective, despite widely varying doses received by individuals, and despite varying degrees of fertility and sensitivity among individuals; it must be free of dangerous or unpleasant side effects; and it must have no effect on members of the opposite sex, children, old people, pets, or livestock.



Physiologist Melvin Ketchel, of the Tufts University School of Medicine, suggested that a sterilant could be developed that had a very specific action—for example, preventing implantation of the fertilized ovum. He proposed that it be used to reduce fertility levels by adjustable amounts, anywhere from five to 75 percent, rather than to sterilize the whole population completely. In this way, fertility could be adjusted from time to time to meet a society's changing needs, and there would be no need to provide an antidote. Contraceptives would still be needed for couples who were highly motivated to have small families. Subfertile and functionally sterile couples who strongly desired children would be medically assisted, as they are now, or encouraged to adopt. Again, there is no sign of such an agent on the horizon. And the risk of serious, unforeseen side effects would, in our opinion, militate against the use of any such agent, even though this plan has the advantage of avoiding the need for socioeconomic pressures that might tend to discriminate against particular groups or penalize children.



Most of the population control measures beyond family planning discussed above have never been tried. Some are as yet technically impossible and others are and probably will remain unacceptable to most societies (although, of course, the potential effectiveness of those least acceptable measures may be great).



Compulsory control of family size is an unpalatable idea, but the alternatives may be much more horrifying. As those alternatives become clearer to an increasing number of people in the 1980s, they may begin demanding such control. A far better choice, in our view, is to expand the use of milder methods of influencing family size preferences while redoubling efforts to ensure that the means of birth control, including abortion and sterilization, are accessible to every human being on Earth within the shortest possible time. If effective action is taken promptly against population growth, perhaps the need for the more extreme involuntary or repressive measures can be averted in most countries.