QUESTION: Does a minor have the right to request contraception from a doctor without

parental consent?

Ethical Debate Format

Opening - EINS
1. The pro side student A will be given 3 minutes to state their case. - MANAIA
2. The con student A will be given 3 minutes to state their case. - JANICE
3. The con side student B can ask 1 question to the pro side. - JODIE
4. The pro side student B will be given 3 minutes to answer the question and give a summary. -
ULIANA
5. The pro side student A can ask 1 question to the con side. - MANAIA
6. The con side student B will be given 3 minutes to answer the question and give a summary. -
JODIE
7. SUMMARY - EINS

PRO - ULIANA & MANAIA

CON -JODIE and JANICE

Eins will start:

Doctors are not required to keep medical information confidential unless clinic is funded through
Title X. If under 13, consent is required.
Key Points - MANAIA
~ According to the 2014 study by CDC 9.4% of people newly diagnosed with HIV were 19 years
old and younger. According to CDC STD surveillance report (2015) young people and gay and
bisexual men continue to face the greatest risk of becoming infected with an STD, and there
continue to be troubling increases in syphilis among newborns. Adolescent being at higher risk
Americans ages as evidenced by 15 to 24 years old accounted for nearly two-thirds of
chlamydia diagnoses and half of gonorrhea diagnoses. With that in mind it is important to
provide adolescents with education as well as easy access to birth control, most effective being
condoms, to prevent STIs and STI transmission.
References
CDC, (2015) Diagnoses of HIV infection in the United States and dependent areas, Surveillance
Report, Atlanta: CDC, 2015. Retrieved from
https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-us.pdf
CDC, (2015) STD Surveillance ReportRetrieved from
https://www.cdc.gov/nchhstp/newsroom/2016/std-surveillance-report-2015-press-release.html
Nonmaleficence - avoidance of harm and possible abortion
Conclusions. Imposing a parental consent requirement for contraceptives, but not abortions,
appears to raise the frequency of pregnancies and births among young women.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448454/

Key Points - JANICE

As a parent and financial consequences
Prefrontal cortex and adolescents not being able to make decisions
 Physically and intellectually they may parallel an adult lack the experience and resources to be
responsible consequences
Brain is considered under developed till age 25 (developmental theories)
Thoughts (brain), feelings (emotions identity vs. role confusion), and actions/experience
(physically ready, but without emotional/cognitive development increased risk for depression)
Erickson: identity vs role confusion.
Poor impulse control, high-risk behaviors
Free access to contraceptives is almost like promoting sexual behavior?
Early sexual activity may have higher risk for mental health issues in the future
Vaccine consent, why is there an exception for obtaining contraceptives?
Consent needed for work permit, drivers license
HIPAA violations (insurance billing) + (VERACITY) MDs to report prescriptions for
contraceptives
Under Affordable Care Act parents are required to provide insurance 18
Why is age so much lower to obtain contraceptives lower (age 14) as compared to:
(State of Hawaii) Legal age 21 to obtain alcohol and cigarettes
Therefore, who is responsible for the consequences of these actions?
General Torts: parents are liable for damages/until age majority
Definition of age of majority = 18
Need consent for work permit, drivers license.
Parents still responsible for the effects and consequences of various contraception that their
children are using
Health consequences such as adverse effects; if she fails to take contraception as directed or
contraception fails; parent will be responsible for this child as well
If in an emergent situation and need to disclose health/medication history, need to know
REFERENCES:
NOLO (2017). Parental responsibility laws in Hawaii. Retrieved from
http://www.nolo.com/legal-encyclopedia/hawaii-parental-
responsibility-laws.html#
PBS (2014). FAQ: what are the penalties for not getting health insurance. Retrieved from
http://www.pbs.org/newshour/updates/faq-penalties-getting-health-
insurance/
Potter, Perry, Stockert & Hall (2013). Fundamentals of nursing (8th Ed.). St.Louis: MO: Elsevier.
Wilson, Shannon, & Shieids (2015). Nurses drug guide 2015.
Hoboken, NJ 07030: Pearson.

Key Points - JODIE

Religious standpoint and USAs core values
Declaration of independence
Life, Liberty and the pursuit of happiness
How have we deviated? Staying true to the roots.
Veracity, Honesty, Accountability (Checks and balances)
Family values and communication
Avoidance vs involvement of parents
10-commandments Honor your father and mother, and in ephesians Children obey your
parents, but Fathers do not exasperate your children, instead bring them up in the training and
instruction of the Lord.
 As parents we are unable to control the actions, but goal is to be involved

Manaia #1
1. Biologic - Puberty begins around 10-11 (period 12-13) for girls and boys around 11-12

2. Its a natural cycle to begin producing hormones that stimulate libido (sexual desire) and the
maturation of reproductive organs

3. Roughly 1% of the world is asexual (no desire for sexual activity)

4. The chances of meeting someone or having children who are asexual are relatively low

5. You cant stop this natural process from occurring

6. But you can try to prevent negative consequences such as unwanted pregnancy, STI,

7. This ties with non-maleficence - the means to do no harm - to prevent an unwanted

pregnancy which could lead to abortion or abandonment or STI that can leave to health issues
such as HIV, HPV, - some are treatable but some are not curable - which could lead to
premature death

8. According to the CDC - roughly 9.4% of new case cases of HIV were 19 years and younger

9. Two thirds of chlamydia case and half of gonorrhea cases are between the ages of 15-24

10. Minors are going to engage in sexual activity with or without contraception

11. With or without having a strong open relationship with their parents

12. Wouldnt you want them to have access to sex education and contraceptives and be safe to
prevent unwanted pregnancy and STIs

Janice #2
Adolescents may be physically mature but cognitively they are not mature until 25 so as a
parent legally Im responsible for my child as a minor financially therefore I should know about it.
In Hawaii, the responsiblilties including life insurance, I also have to sign consent forms for
vaccinations/drivers license/work permit, why should it be different for contraceptives? Child
may be irresponsible plus contraceptives have side effects, as a parent I am responsible for
those effects therefore I need to be involved as her parent. As per page 608 the Pearsons
Nursing Drug Guide, one of the contraindications for the estrogen-progesterone combo is being
an adolescent whose epiphysial plate isnt fully fused.

Jodie #3 Question: You have talked about unwanted pregnancies, STIs, and natural sexual
desires. What data do you have to back up your points? How credible is it?
Uliana #4
1) The 2013 data shows that 5.6% of school students had had sexual intercourse for the first
time before age 13 years. While 47% of high school students reported having sexual intercourse
before graduating. Nationwide 15% of high school students reported having already had four or
more sexual partners.
Additionally, between 1991-2013, the proportion of students who ever had sexual intercourse
decreased from 54% to 47%. Also the percent of adolescents who are having sex at earlier
ages has decreased since 1988 and contraceptive use has increased since the 1990s. Together
these two factors have contributed to the U.S. reaching its lowest teen pregnancy and birth
rates in years. To back up my point that easily available contraception is effective I would like to
add that since 1991, the birth rate for teenagers aged 1517 has declined 68%.

References
Resource Center for Adolescent Pregnancy Prevention. Statistics. Sexual activity. (n.d.).
Retrieved March 1, 2017, from http://recapp.etr.org/Recapp/index.cfm?
fuseaction=pages.StatisticsDetail&PageID=555
Hamilton, B. E., Martin, J. A., Osterman, M. J. K., & Curtin, S. C. (2014, May 29). Births:
Preliminary data for 2013. National Vital Statistics Report, 63(2). Retrieved from
http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_02.pdf

2) In 2009, Hawaii passed a law requiring that any state funded sexual health education
programs be age-appropriate, medically accurate, and factual, providing education on
abstinence, contraception, and methods of disease prevention, develop relationships and
communication skills to form healthy relationships that are based on mutual respect and
affection and are free from violence, coercion and intimidation, develop skills in critical thinking,
problem solving, decision making and stress management to make healthy decisions about
sexuality and relationships, encourages student to communicate with their parents, guardians
and/or other trusted adults about sexuality, informs students of available community resources.
As a result Hawaii had the largest drop in abortion rates from 2010 to 2014 (a decrease of
almost 30%) by David Crary (2015).
References
Hawaii: Board of Ed Passes New Sex-Ed Requirement (n.d.) Retrieved March 9, 2017 from
http://www.siecus.org/index.cfm?fuseaction=Feature.showFeature&featureID=2411

3) Clearly parental consent is a barrier for minors to receive medical contraceptives. According
to the study by Zavodny (2004), imposing a parental consent requirement for contraceptives
appears to raise the frequency of pregnancies and births among young women.
References
Zavodny, M. (2004). Fertility and Parental Consent for Minors to Receive Contraceptives.
American Journal of Public Health, 94(8), 13471351.3)

4) Social justice. It is also important to note that preventing unwanted pregnancy is beneficial for
the whole society as it saves money. According to the study by Adam Thomas (2013), the role of
nationwide mass media campaigning could reduce by more than 20,000 the number of children
born into poverty. This study concluded that taxpayers (Medicare) would save $4.30 for every
dollar that the government spends on the program. If one assumes that the program would cost
$250 million annually, the cost per avoided pregnancy would be $2,300; the cost per avoided
birth would be $6,300; and taxpayers would save $1.70 for every dollar that is spent on the
program.
References
Thomas, A. (2014) "The Role of Mass Media Campaigns in Preventing Unintended Pregnancy."
Journal of Media and Communication Studies 7.1 Retrieved from
http://www18.georgetown.edu/data/people/att24/publication-75206.pdf