Students in middle and high schools in the United States have access to various on-site healthcare services offered freely. The reason is that most school campuses have school-based health centers that provide universal access to healthcare even for students lacking health insurance (Nardo, 2014). Normally, these centers are funded by states, private foundations, and federal grants. Additionally, they are jointly managed by school administrators, government agencies, and community medical organizations. Currently, most of these centers offer extensive health services including dental work, counselling, and birth control. The distribution of birth control to middle and high school students raises ethical issues such as lack of parental consent and the adverse effects of hormonal contraceptives.
About 11% of SBHCs across the country provide long-term reversible contraception such as injections and intrauterine devices that are contentious due to their long-acting nature and invasiveness compared to contraception such as the pill (Wang et al., 2018). In 21 states, minors can obtain intrauterine devices without parental approval. A significant number of these states do not differentiate by age when giving minors self-directed birth-control rights, allowing those as young as 11 year olds to gain access. Middle and high school students can also obtain birth –control outside campus, which supports the argument that easy access to contraception may enhance sexual activity among the youth. Organizations such as the American Academy of Pediatrics have suggested that long-acting reversible contraceptives are effective in preventing teen pregnancy because there is no need to remember to take them daily (Nardo, 2014). The efficacy of providing birth-control to teenagers is shown by reports from Colorado indicating that provision of contraceptive implants to low-income women and adolescents reduced teen pregnancies by 40% (Wang et al., 2018).
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Regardless of the debate, distributing birth-control in middle and high schools raises several ethical issues. One of the ethical issues that emerges from distributing birth control to adolescents with parental consent is the lack of legal or mental ability to make sound decisions. Children in middle and high schools are aged between 12 and 17 years, meaning that they are minors and cannot make critical decisions about their health due to lack of sufficient information (Wang et al., 2018). Parents have the right to make decisions for their children before they attain the legal age of 18 years. Distributing birth-control to middle and high school students infringes on this parental right.
Peer pressure during adolescence raises ethical issues in distributing contraceptives to teenagers. Though research studies do not link birth-control with increase in sexual activity among teenagers, it does not act as a deterrent or demand them to consider their choices carefully. Teenagers experience significant peer pressure and can engage in activities lead to regret. Provision of contraceptives does not allow students to make informed choices.
The other ethical issue is the effect of hormonal contraceptives of the development of teenagers. Considering that middle and high school students are not physically mature, contraceptives can lead to hormonal imbalances that can adversely affect their health (Wang et al., 2018). Sex hormones such as progesterone and estrogen are known to influence brain development during adolescence. Some contraceptives contain these synthetic hormones and taking them during this sensitive developmental period can have long-term implications on mental health.
Distributing birth control to middle and high school students may help reduce teenage pregnancies, but there is also a need to consider the ethical issues raised by such policies. One way of minimizing the ethical concerns raised is by seeking parental consent because teenagers are minors.
References
Nardo, D. (2014). Should teens have access to birth control? . San Diego, CA: ReferencePoint Press.
Wang, T., Lurie, M., Govindasamy, D., and Mathews, C. (2018). The Effects of School-Based Condom Availability Programs (CAPs) on Condom Acquisition, Use and Sexual Behavior: A Systematic Review. AIDS Behav; 22 (1): 308–320.
