Page 3, 15th February 1980

15th February 1980
Page 3
Page 3, 15th February 1980 — hen doctors keep the parents in the dark

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hen doctors keep the parents in the dark

THE British Medical Association's publication of its latest ethical guidelines — stating that doctors should perform abortions on children without parental consent — has, quite rightly, raised a storm of protest.

Parents. led by Mrs Victoria Gillick of Suffolk, have asked why they are to he denied the right to know of surgery carried out on their children, and have pointed out that this new approach cuts across all previously accepted guidelines for good medical practice.

This new policy, however, is simply the logical outcome of another idea which has been promoted for some time: that of giving contraceptives to teenagers under 16 without reference to parents.

The Suffolk parents have been battling with their area health authority over this for some while.

They sought to have a form printed which would state: "Should my child be prescribed a contraceptive I do not wish to be informed". Their request was turned down, although it had received widespread support, The giving of contraceptive advice, pills and devices to a young person under 16 is defended on the grounds that they are today more at risk of becom ing pregnant than formerly.

It is widely stated that since teenagers are known to be sexually active, the only realistic thing to do is to give them drugs or devices to control their fertility.

Sometimes those who promote this point of view expound on it by saying that "working class" children or those from "deprived backgrounds" are the ones that most require these facilities.

It is stressed that if parents were informed,, the teenagers might object on the grounds Olaf the knowledge that they were sexually active might cause trouble at home.

Such attitudes raise all sorts of questions — particularly where sweeping references to social class are concerned — but perhaps the most realistic way of looking at the subject is to ask if such a policy is likely to succeed in reducing the number of illegitimate births. All the evidence shows that it probably will not.

Research was carried out in America under the auspices of the National Institute of Child Iiealth and Human Development by Professors Melvin Zzlnik and John Kantner, and covered a fiveyear period, from 1971 to 1976.

During these five years the contraceptive programme for

teenagers in America, promoted by Planned Parenthood (American equivalent of the Family Planning Association) and other agencies made great strides.

In addition, abortion became legal and widely available, and instruction in contraceptive techniques became normal in sex education in schools.

Yet over the five years the rate of pregnancy among the 15-19 year age group increased significantly. In 1971, of the girls interviewed 6.4 per cent had experienced a premarital pregnancy — by 1976 this had jumped to 9.3 per cent, an increase of 45 per cent.

This was very obviously related to a nearly equal increase (41 per cent) in the percentage of girls who had experienced pre-marital intercourse, from 26.3 per cent in 1971 to 37.2 per cent in 1976.

The rate of illegitimate births, despite the legalisation and widespread use of abortion, increased from 10.3 per 1,000 in 1971 to 12.1 per 1,000 in 1975—a rise of lf per cent.

The survey showed an interesting percentage for the failure rates of contraceptives. There was a considerable increase in the use of contraceptives: in 1971 only 19.7 per cent of the sexually active girls had used a contraceptive every time they had intercourse, and by 1976 this had grown to 30.2 per cent.

Among those who used a contraceptive on each occasion, the pregnancy rate was 6,1 per cent.

The lessons from this survey have been aptly summed up by someone who certainly does not take an anti-contraceptive view: Professor Kingsley Davis. a member of the board of sponsors of Zero Population Growth, who has pointed out: "The current belief that illegitimacy will be reduced if teenage girls are given an effective contraceptive is an extension of the same reasoning that created the problem in the first place. It reflects an unwillingness to face problems of social control and social discipline, whilst trusting some technological device to extricate society from its difficulties. The irony is that the illegitimacy rise occurred precisely while contraception was becoming more, rather than less, widespread and respectable." In Britain, the number of illegitimate births as a percentage of total live births went up from 7.9 per cent in 1966 to 9.7 per cent in 1977, despite the increased promotion of both contraception and abortion.

And now the BMA has decreed that children can be given abortions without parental knowledge or consent. Perhaps the operations will be performed in the new "day care" abortion units now being established by area health authorities.

Where is this sort of approach going to end? What rights will a child have if it is discovered that, following an abortion at the age of 15, obtained without consent of parent or guardian, she is rendered sterile for life? Unlikely, of course, but certainly possible. On what grounds precisely does a doctor decide that parents are not going to he informed. By speculating on their social status, income, attitudes to life, or religious convictions? And if all this is being done in the name of reducing illegitimate births and thus ensuring social harmony, what sort of evidence exists to show that such a policy is likely to be effective?

We should look again at the Universal Declaration of Human Rights: "The family is the natural and fundamental group of society, and is entitled to protection by society and State."

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