For what reasons should parents be informed if clinics give minors prescription contraceptives?
Planned Parenthood and the American Civil Liberties Union (ACLU) are up in arms. This time they are working to overturn a ruling by the Health and Human Services Department. This requires government-financed clinics to notify parents when teen-age minors are given prescription contraceptives.
In acting on a suit brought jointly by the ACLU and the New York State Department of Health. Manhattan Federal Judge Henry F. Werker at least temporarily blocked the rule. Shortly thereafter, Planned Parenthood Federation of America and the National Family Planning and Reproductive Health Association (a national association of clinics) brought a similar suit.
Reasons For Secrecy
In the second case, Judge Thomas A. Flannery stated: “It is quite clear that as a result of these regulations substantial numbers of adolescents will become pregnant and will either elect abortion or suffer the consequences of unwanted pregnancies.” He then ruled: “The regulations are unlawful” on the grounds that they violated the intent of the law passed by Congress authorizing federal money for family planning services.
On the surface of it, this seems ridiculous because in reauthorizing these services (so-called Title X) in 1981, Congress explicitly amended the original act to provide for parental involvement. The amendment reads: “To the extent practical, entities [clinics offering contraceptive services] which receive grants or contracts under this subsection shall encourage family participation in the projects assisted under this subsection.”
The issue as viewed by the judges and defended by ACLU and Planned Parenthood is simple: the law set up by Congress funding contraceptive programs was clearly aimed at reducing the number of teen-age pregnancies. Sexually active youngsters will be scared off from applying for contraceptives if they know their parents will be informed. In our culture, sexual activity on the part of teen-agers is inevitable, irreversible, and increasingly an accepted lifestyle. Willy-nilly, teen-agers will choose to be sexually active.
The end result of the new ruling, therefore, will simply be to bring an immense increase of pregnancies among young girls 12–17 years of age. This in turn will serve only to produce a whole series of socially disastrous effects. Bearing babies at such an early age will physically harm young girls; abortions will increase dramatically; unwed mothers wholly incapable of responsible motherhood will endeavor to rear children; and the total effect economically will be devastating both for those involved and for the country at large that must in the end pay most of the bills.
The original act of Congress passed in 1970 sought to prevent or at least to mitigate just such horrendous consequences. In that year, Congress added “Title X” to the public Health Service Act. It provided for federal support to Planned Parenthood organizations and many other agencies, including a large number of clinics that offer contraceptives to young girls—free if they cannot afford to pay. In practice, these organizations have reckoned any 13-year-old girl who comes to them without funds as a separate family unit, not seeking to inform the girl’s parents and making no reference to her family’s resources. Planned Parenthood and similar agencies assured the government that this would drastically reduce teen-age pregnancies, as well as dramatically cut down the incidence of venereal disease. Of course, it did nothing of the kind.
Why Congress Changed Its Mind
That was in 1970. Since then, the number of teen-age pregnancies has increased dramatically and venereal disease has reached epidemic proportions. So has government support of the agencies who predicted that federal subsidies to their organizations would reduce both of these evils. Planned Parenthood alone has received more than $50 million for its international programs and far above $250 million for its programs here in the United States. These figures represent direct federal subsidies alone, without reference to astronomical funds received from sources besides the federal treasury. Other agencies and clinics likewise have been granted huge public support from federal, state, and local tax funds to participate in this program. At the present time, over 5,000 clinics are involved, serving more than 615,000 minors. Their aim is to prevent herpes, teen-age pregnancies, unwanted children, and motherhood for young girls with no ability to function responsibly as mothers. All to no avail!
Meanwhile, numerous studies made it increasingly obvious that parent involvement could help. Life magazine published a study indicating that 75 percent of Americans believe parents ought to be notified if an abortion is being considered for their child. A similar study by Decisionmaking Information of Santa Ana, California, corroborated their results. It is difficult to think that these parents would feel different if their children were being given prescription drugs to prevent conception—especially if the drugs could affect the lifetime health of their children.
Two researchers, Shah and Zalnik, studied 15- to 19-year-old women and reported the conclusions in the Journal of Marriage and the Family (May 1981). They proved what any sensible person would know—that adolescents with views on premarital sex resembling those of their parents are relatively uninvolved. Those whose views are formed more by teen-agers than by parents are liable to have relatively high levels of premarital sexual experience. Moreover, those in the latter group who are sexually active as teen-agers are much more liable to use contraceptives in an inconsistent and irregular fashion—thus making the risk of pregnancy far greater. Another research team headed by Dr. Brent Miller of the College of Family Life at Utah State University found that teenagers who maintain open communication with parents and who are subject to any significant parental discipline are less likely to become sexually active. When parents become involved, teen-age sexual activity is simply much less likely to occur. Family therapist Dr. Salvadore Minuchin sums it up: “The great majority of parents are concerned with their children’s well-being. Intervening within the family network is a support for adolescence.” In 1981, therefore, Congress passed the amendment to the Health Services Act authorizing parental involvement in the program subsidized by the federal government.
New Federal Guidelines
To implement this amendment, former Secretary Richard Schweiker, acting for the Department of Health and Human Services, announced a new set of regulations to guide these federally funded programs. In his rationale for the new guidelines, Schweiker noted that over the years government agencies, and private agencies sponsored by the government, have built a “Berlin Wall separating parents from their children.” The result was harmful to children, parents, and the American people.
Viewed in the perspective of American history and of Western culture as a whole, these regulations seemed to be the mildest sort of endeavor to implement the intent of Congress to involve parents. (1) They apply only to agencies subsidized by the federal government. (2) They require parents to be notified when minor children have been provided with contraceptive material. Parental permission is not necessary. They are to be sent notice only after the fact. (3) The rules apply only to drugs or materials on prescription—that is, to items recognized as potentially harmful to the health of the child. (4) They protect the child by withholding notice to parents if this might bring danger to the child; such as physical abuse, ejection from the home, or if there is any history of mistreatment in the home. (5) The agencies must respect state laws that require involvement of parents.
Immediately following the announcement of the new regulations, Planned Parenthood and other agencies that depend heavily on federal subsidies raised a vigorous protest. This led to the two adverse decisions by Judges Werker and Flannery.
Why Take A Stand?
As evangelicals, we strongly support the new ruling of the Health and Human Services Department for the following reasons.
First, it is not at all clear that this ruling will result in more teen-age pregnancies. Even a study from the Allan Guttmacher Institute (an arm of Planned Parenthood and thoroughly opposed to the health department’s ruling) shows that the overwhelming majority of teen-agers currently receiving assistance from “family” planning clinics will continue to use contraceptives. But it also says something about the minors who now receive prescription drugs and devices from the clinics. Only 4 percent indicated that they would continue to be sexually active but not use contraceptives if they knew their parents would be notified.
Offsetting the danger of increasing pregnancy among this 4 percent would be the strong impact of parental involvement. We know that this dramatically reduces the sexual activity of minor children. The impact of parents upon the thinking and practice of their teen-age children is far greater than Planned Parenthood wants to believe.
Second, the new regulations inviting and encouraging parental involvement protect teen-agers. Contraceptives are not universally safe, especially contraceptive pills and intrauterine devices (IUDs). That is why they are prescriptions. Twelve- and 13-year-olds do not know their own medical history. A long list of potential side effects can be listed if contraceptives are taken indiscriminately. No doubt, as some are quick to point out, pregnancy is a greater danger for a 12-year-old than the prescription materials. But self-control is safest of all, so parents can help their children make that choice. And if the child is sexually active, studies clearly show that parental influence protects the child by providing expert medical advice in light of a child’s personal history. Further, sexually active teen-agers in communication with parents will use contraceptives more carefully and consistently. But only if the parent knows!
Third, notification of parents will, as former HHS Secretary Schweiker puts it, help chip away at the wall that separates parents and children. This was the intent of Congress as expressed in the Family Life Statute: “Prevention of adolescent sexual activity and adolescent pregnancy depends primarily upon developing strong family values and strong family ties; and since the family is the basic social unit in which the values and attitudes of adolescents concerning sexuality and pregnancy are formed, programs designed to deal with issues of sexuality and pregnancy will be successful to the extent that such programs encourage and sustain the role of the family.”
The new regulations will expand and strengthen the support systems provided by the family and now under such widespread attack. Eunice Kennedy Shriver, widely known for her work among pregnant teen-agers writes: “I have found that counseling the child without the parent is empty and futile. It perpetuates misunderstanding and widens the gap between generations. What is more, it does not work.
“There are, however, some significant examples where mobilizing the family support system has made a difference. In the adolescent pregnancy programs I have worked with, such as the one at the Johns Hopkins Hospital in Baltimore, research has shown that when the family is involved, the young women are more likely to stay and finish school, have a better chance of getting a job, are less likely to have an early repeat pregnancy, are more likely to take better care of their babies, and have more respect for themselves.”
Fourth, these regulations will help protect the legal rights of parents. After all, parents are morally, legally, and financially responsible for the acts of their minor children. It makes no sense to take out of the web of family controls a matter that affects not only the permanent social and psychological well-being of a child, but also its physical health and safety. In his defense of the regulations, Schweiker stated: “In every other area of their lives, parents are involved and held responsible. It is paradoxical that when it comes to prescribing drugs and devices with potentially serious health consequences, federal policy does not recognize parental responsibility and involvement.” We agree.
Of course, a parent’s rights are by no means absolute. The government must also protect the rights of the child. But neither are the rights of the child absolute, and a wise and humane government will recognize the legitimate rights and privileges of both.
Do The Guidelines Violate Family Rights?
The American Civil Liberties Union has launched a particularly vigorous attack against these regulations protecting a parent’s right to know. They describe it as government interference with the family. But the regulations really mean that government is calling a halt to Planned Parenthood’s interference with the family. According to public statements, made when it serves their purpose, Planned Parenthood staff make “every effort to involve parents of any adolescent who consults them.” But in practice, it is another story. They strenuously try to create an absolute right to privacy for minors (see Congressional Record, Sept. 15, 1982). Along with other similar organizations Planned Parenthood is fighting to keep parents uninformed so they cannot become involved even if they want to. The regulations, it should be noted, do not require parental involvement. The requirement says only that parents be notified, so that they may, if they wish, work with their children in the family problems they face. To keep the parents in ignorance (which is what Planned Parenthood wants) makes any parental involvement impossible.
ACLU’s urgent defense of the civil rights of teen-agers is also misguided. Civil rights do not include the right to be free to permanently injure one’s self. Nor do full civil rights apply to minors, so we have schools and other support systems for children and teen-agers. They need special protection and guidance, including whatever wisdom and love their parents may have for them. To deprive them of this in the name of liberty is really to deprive them of truer and greater liberty in their maturity.
No doubt the militant action against parental involvement in their children’s sexual problems stems in some instances from honest mistakes. But it can also be maliciously deceptive. Evangelicals must become more involved in the rapidly changing social structure if they wish to preserve their liberties and values. A militant but highly dedicated minority is concertedly seeking to transform our society by a socially structured dismantling of traditional morals and values. As evangelicals, we do not defend parental involvement because it is traditional. We support it because to do so is good for our nation and for all people. And we want to leave our children a heritage comparable to what we received.
KENNETH S. KANTZER
