Except for the growing threat of HIV infection, the risks posed by pregnancy are the most important consideration in choosing a method of contraception. For the patient with a disease condition that makes pregnancy dangerous, effectiveness may be the most important consideration. The patient with heart disease should realize that a barrier method that is only 70% effective is probably not adequate to her needs. For the patient who could not accept induced abortion in any form, the safety of the fetus in the event of conception may be paramount. It would be unwise to insert an IUD in a patient who would not allow its removal if she became pregnant with the device in place. The medical care practitioner might be liable for an injury to the patient even if she refused to follow his or her advice when the pregnancy occurred.