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When It Comes to Contraception, Young People Have the Right to Confidentiality

Posted: 13/02/2012 00:00

Every now and again, a story about young people and contraception hits the headlines. My ears always prick up when I hear the phrase "children as young as [insert teeny number] could be..." because I know that whilst it's important to focus on what the youngest and most vulnerable young people may need, these stories are often distorted to generate moral outrage. In the same way that an 11-year-old in a secondary school 'could be' set a maths GCSE paper, it would be fairly peculiar to do so unless there were unusual circumstances and, in fact, the GCSE paper would much more reasonably and sensibly be given to an older child.

Bearing this in mind, our starting point should be to acknowledge that most young people who are under the age of 16 are not having sex and do not require contraception. Furthermore, evidence shows that high quality sex and relationships education, provided by parents and at school, combined with access to free, confidential sexual health services, helps delay the age young people first have sex and means they are more likely to use contraception when they do. In other words, we do best for young people if we offer them a comprehensive set of information and services before they become sexually active.

Of course, we also need to make sure we are providing appropriate guidance, support, information and services to young people who are sexually active. Young people, both under and over 16, have a right, enshrined in law, to a confidential consultation with a health professional independently of their parent/carer. When asked, the vast majority of parents would much rather that their children had access to support from a trained healthcare professional, than being denied access to information and services that they need.

Just as we must trust maths teachers to deliver GCSE maths, we must also trust that, wherever it is delivered, contraceptive advice and treatment is provided by suitably qualified professionals working to strict professional and legal standards (including the Fraser guidelines). We are not talking here about dinner ladies popping in an implant during the lunch break. We are talking about the provision of services by doctors or nurses - the only people allowed to fit implants.

In order to provide services, the professional must be satisfied that the young person understands the decisions they are making and they are the young person's best interests. They will need to assess the young person's capacity to consent to the treatment and they will also usually encourage the young person to talk to their parents/carers. They will also be using their professional judgement to consider the young person's circumstances, the risk of harm they are exposed to, whether they are in a safe relationship, whether they are being exploited and their vulnerability to other dangers. All this as they encourage a young person to trust them enough to share their fears and needs.

In some cases, after that process has been gone through, the professional will judge that it's appropriate for a young person - even one who is 13 - to be fitted with an implant.

At Brook we know how important it is to trust young people, and for young people to trust us, in order to work effectively with them to be sure they are not being coerced into sex and are able to properly consent to sex and take responsibility for their sexual choices. We also know just how important it is to be able to trust the professionals responsible for these decisions and to recognise that they are often dealing with multiple risk factors and indicators of vulnerability when they make these important assessments.

I talk to sexual health professionals every day. All of them have a real desire to ensure that young people are protected and safe from harm, to help them to negotiate their relationships safely and to only have sex when they are genuinely ready. They do an amazing job, these professionals, and they need our support to do that.

No-one wants to undermine parents/carers but we need to accept the fact that young people have a right to seek confidential information and advice. It may be that some young people are not able to go safely to their parents/carers - another factor in their vulnerability. It is better that they are able get the support they need than to go without and make decisions which they may later regret or end up in risky situations.

I want young people to be safe and not to have sex too early or have relationships that will hurt them. Providing young people with a whole range of support, information, advice and services is vital to enable them to have healthy relationships. Not to do so, and not to support the professionals that do so, is simply wrong.

 
Every now and again, a story about young people and contraception hits the headlines. My ears always prick up when I hear the phrase "children as young as [insert teeny number] could be..." because I ...
Every now and again, a story about young people and contraception hits the headlines. My ears always prick up when I hear the phrase "children as young as [insert teeny number] could be..." because I ...
 
 
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03:14 PM on 02/13/2012
As far as I am aware the age of consent has not been reduced therefore health professionals providing contraception devices to young teens are aiding and abetting a criminal offence, are they not?

It is odd that to participate in many activities at school and elsewhere parental consent is required yet parents are not consulted in this matter. Things seem to be a little out of balance in this anything goes society.
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Thismortalcoil
Science is the poetry of reality
07:13 PM on 02/13/2012
No, it is not a criminal offence for health care professionals to offer health care, even if it is in the form of contraception. If a teenager gets pregnant, is it aiding and abetting for a doctor to deliver the baby?

A complex process is undertaken before the professional decides whether the contraception is appropriate - that's what these people are trained to do.

And clearly it's working - teen pregnancies where this service is offered are down by 22%. Think about how many lives this service has transformed for the better.
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AlanDente
Noses: made to hold glasses
10:45 PM on 02/13/2012
Drugs are illegal but we counsel and treat addicts. Beating up your partner is illegal but we counsel offenders. Racist hate-crime is illegal but we seek to educate hate-criminals. Speeding is illegal but offenders are sent on weekend courses.

The law is there to serve the people, not the other way around.
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famullar
01:48 PM on 02/13/2012
There is post; can the gays be allowed to continue living the lives they are living? Can a man Gay or a lesbian produce any babies? No. It is also against the religion to marry any one of the same sex. Obviously these days people have moved away from the religion as they always want to party with any but the result is evident. The children are spoiled brats as we call them and have no interesting the religion or the good part of life. They want to go with the times. Is that what we want? No But we have this and we stuck with it. Why? The leaders are supposed to guide us but we have few who want to go marry one of the same sex. "It's a simple story — a love story. It's universal. And everyone loves a cute dog." JEAN DUJARDIN, star of The Artist, describing the film's popularity, especially the role played by Uggie, a Jack Russell Terrier, upon winning Best Actor at the BAFTAs in London Sunday. The movie won seven in total, equally The King's Speech haul last year
I thank you Firozali A.Mulla DBA
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Ppenguinator
Life's too imprtant to be taken seriously.
11:19 PM on 02/13/2012
After several readings, I still don't see the point of your post, or what, if anything, it has to do with the article it is attatched to.
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Thismortalcoil
Science is the poetry of reality
12:11 PM on 02/14/2012
Me too, I'm baffled.
07:54 AM on 02/13/2012
Could someone explain the 'point' of having children. They are only your own for about the first 5 years.
09:24 PM on 02/13/2012
The point of having children is to provide lucrative employment for a whole range of ' experts' and consultants etc. Mr Blake is one such ' expert' but in his he doesnt have any particular qualification, so he is a 'Charity; expert instead.
07:04 AM on 02/14/2012
Ah I am obliged to you Gearoid. Re 'qualifications', am I right in thinking that he is qualified as he has hair and as far as I can see, dosent wear glasses. In other words not old and wise.
06:14 AM on 02/13/2012
The way this story was reported originally, part of the fuss was that this intervention has been undertaken without reference to the GP. If that is correct then I'd say that is pretty bad, from a medical safety point of view if nothing else.

Otherwise it's a tricky issue and many objectors probably apply their own ideas of a typical 13 year old to the situation, which is not who we're talking about.

There are drugs you can give people to stop them drinking (alcohol then makes them throw up)
Maybe these are implantable, I'm not sure.
Would they give these to teenagers to prevent pregnancy (and other drink related outcomes such as death in a car) if the teenager was known to be getting drunk a lot ?
And would they tell the parents ? Or is that somehow different ?

Presumably I can't ask the school if there's anything they would do without my consent, as to answer that question would put them in a tricky situation.
If the school can't/won't tell me my 13 year old child is sexually active, can they tell me the child is drinking or taking illegal drugs ?
Can anyone hold a parent responsible for things they don't apparently have a right to know ?
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Thismortalcoil
Science is the poetry of reality
09:44 AM on 02/13/2012
Firstly it is not the school who are providing the implants, it is highly trained doctors and nurses.

Secondly, they encourage the teenagers to discuss it with their parents or carers. If the teenagers still feel they can't discuss it with their parents or carers, then presumably the parents in question need to address their parenting skills.

The fact is that some teenagers are going to have sex before they are 16. They are less likely to do this if they come from a caring and supportive family where they have been able to discuss sex openly, but not all teenagers have this advantage.

If your only options were a 13 year old daughter with an implant or a 13 year old daughter with an unwanted pregnancy, what would you choose?
12:25 AM on 02/15/2012
the figures for under 16years old is 1% of all deaths from cervical cancer the actual figure is far higher than that of the number of under16 year olds who die in child birth. you can see the figures and graphs on the office of national stats websites and related documents.
01:26 AM on 02/13/2012
next week this bunch will provide toddlers with miniature bottles of whisky to ensure they learn to hold their drink.

schools are not allowed to put plasters on cuts they can not give a child an aspirin, in many cases they cannot help a child take prescription medicines, they can though give them a powerful contraceptive
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Thismortalcoil
Science is the poetry of reality
09:46 AM on 02/13/2012
thereiver, you seem to have missed the bit where it's not schools providing them with the contraceptive, but doctors and nurses.
11:42 AM on 02/14/2012
actually you miss the point, school nurses are not allowed to carry out the treatment i pointed out without the consent of the parent. a parents consent is also required for minor hospital procedures carried out by Doctors. the giving of these medications are the only ones that are exempt from the rules regarding the treatment of young people. if a parent wishes their child to have contraception then fine. even though they would be encouraging the child to commit an offence under the sexual offences legislation.
it is also ironic that the same health authorities are insisting on young girls have injections related to cervical cancer a cause of which has been identified as being linked to early sexual activity then give the same girls an injection to help them have early sexual activity.
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AlanDente
Noses: made to hold glasses
10:49 PM on 02/13/2012
Insurance and clinical governance issues surrounding the application of medicines within a school by non-medically trained staff is a separate issue.

The irony is that it IS medically trained staff who provide the implants!
12:01 PM on 02/14/2012
the RCN guidelines for school nurses states,
A note on consent
As a registered nurse or specialist community public health
nurse, you must obtain consent before you give any
treatment .

this relates to writing to the parents (from pre school upwards) , however later it then details how to set up a drop in centre in relation to Contraception and drugs/alcohol etc
these are deemed not to require any consent