Prescribing Minors with Emergency Contraception - Essay Example

21 November 2005 Ethics vs. Professional Responsibilities of Prescribing Minors with Emergency Contraception Teen Pregnancy has always been a major concern, but since the turn of the 20th century, it seems to have become even more pronounced. Along with this issue comes the problem of ethic and moral dilemma's. Should minors be prescribed emergency contraception or is it just another avenue to be given which offers the wrong message to teenagers According to the National Campaign to Prevent Teenage Pregnancy, the statistics of this occurrence of teenage pregnancy taking place are staggering, to say the least. The National Campaign shows that out of a population of 9,762,000 girls, aged 15-19, 835,930 of them are pregnant or will be so. Following along these same statistical guidelines, the amount of pregnancies out of these that result in live birth are currently at, 475,754 or 57%, which equals to a smidgen over half (The National Campaign to Prevent Teenage Pregnancy 2001). These cited percentages are gathered from the Alan Guttmacher Institute, from 1990-1999. If these statistical records are traced back to 1972 to compare how pregnancy rates for teenage girls have changed, it is found that there is a dramatic increase from 1972 to 1986. According to the Alan Guttmacher Institute (2000), teen pregnancy was at 62.4% in 1972 which gradually increased to 72.5% in 1980. Progressing along through the next eight years, at 1986 it was found to be at 69,6% and 1988 marked 74.4%, then hitting the year 2000 showed a impressive decrease which is found to be 48.2%. Although this is still almost half the teenage population, it is obvious there is a great variation in the percentile from 1990 to 2000. Some people might view the decline in teen pregnancy as being due to proper sex education in schools taking place. Yet others might consider the decline to be stemming from the fact of emergency contraception. One such medical element that is considered to fit this profile is the, "morning after pill". There has been quite a bit of controversy over this emergency contraceptive pill and many nurses, pharmacists, and doctors have lost their jobs or removed themselves from their location of employment due to their non-agreement with making it readily available for teenage girls. Many view sex education in school, and the emergency contraceptive issues as ones that over step their bounds, in regards to the parent/child relationship. It should be the parents place to decide if their 15 year old daughter needs sexual protection, not the school systems, nor the health clinics, where they can readily go and ask for the morning after pill or condoms. Quite a bit of disagreement is due to how easy the FDA wants to make it for teenage girls to be able to get (WorldNet Daily 2003). Those in legislative seats who approve or disapprove of these new drugs want to especially see this pill made available for over the counter while others do not, due to the ethical ramifications. One of the main issues for those not wanting to allow it to be provided over the counter is the idea that it gives off the wrong message to teenagers such as, promiscuity is o.k. The fear of rising sexually transmitted diseases is another sliding scale issue in this equation. It is claimed that allowing such easy access to an emergency contraceptive, like this one, for teenage kids, will cause STD's to rise quite considerably. Sexually transmitted diseases pose more of a threat to a teen's body, more so than an unwanted pregnancy could possibly ever do. In 2004, Maria Bizecki was fired from her position as a pharmacist due to the fact that she failed to provide the morning after pill to a young teenage girl. Her stand on the issue was pertaining to the ethical and social matters involved with filling prescriptions of the pill to minors (Western Catholic Reporter 2004). Maria is opposed to offering drugs such as the morning after pill to destroy unborn life. Especially since protective sex has been such a big issue throughout the world and teenagers who are going to engage in it should have the sense to use proper protection to avoid pregnancy better. Although the dilemma with teenage pregnancy is a tough one, one thing that must be remembered is the rights of each individual person. The right to proper medical care of personal choice, as well as the right of privacy during that medical care. One of the guidelines laid out by the NMC (2005) is to provide effective medical care and to protect those in the public who are under his or her care. Whether or not a nurse, pharmacist, doctor, etc. has a difference of opinion with regard to this pill, they still owe it to their patient to respect their right and their own personal choice. There should be mutual respect and the patient should be allowed to state and choose what the preference of birth control is. This is a designated right that comes with medical treatment. One example of differing opinions that got in the way of proper care and the right of the patient is evidenced in the article within the Sacramento Bee, detailing five nurses who quit their jobs rather than pass out the "morning after" pill (Sacramento Bee 1999). The Nurse's felt that by passing the pill out it was going against all moral, ethical, and religious beliefs they had implemented into their lives. Furthermore, they felt that after so much discussion of proper protection during sexual intercourse had been discussed for years, why was there a need to pass out a pill to destroy life The ethical concerns related to this pill are far reaching and many other nurses and health professionals agree with this. Although there might be agreement in not wanting to dispense this pill, pharmacists can not ignore federal regulations nor can doctors, and nurses, or any healthcare provider that is required to offer appropriate care and prescription drugs (Bennett 1999). Research details the Government of the UK's new policy on the morning after pill as insinuating it will lower teenage pregnancy (The Christian Institute 2001). The existing policy for the morning after pill has been approved for prescription use for a number of years now, allowing doctors who practice in many family clinics to readily prescribe this pill. What the new policy's main goal is is an attempt to reduce the present high levels of teenage pregnancy. Ultimately though, it is sending a message to teenager's that is ethically incorrect. Although this might not be the legislations intent, it is what is happening. It is evident by the many teen girls who request the pill at various health clinics all over the UK. Ethics seem to be abandoned in order to keep teen pregnancy down but this does nothing at all to help in preventing an escalation in teenage STD's. Yet, the Government claims they will have teenage pregnancy down by half by the year 2010. Many argue that this new policy is wrong due to the following implications it carries: * promotes teenage promiscuity * encourages unsafe sex * risks the health and in certain cases, the lives of young girls * has virtually no safeguards * undermines the role of parents (The Christian Institute 2001). According to the Dept. of Health (2001) in the UK, teenage STD's are increasing. The Department admits that the country is in a very poor state of sexual health. This also theorizes that ethics and moral values are being tossed to the curb in order to promote a pill that actually solves nothing but increasing sexual activity among teenage kids. It is leading teenagers down a very immoral path with a focus on sex and no regard to consequence. In regard to the STD rate, the Dept. reports that there are now 1 million visits to the genitourinary medicine/sexually transmitted disease clinics. Also, there is no evidence of HIV reductions and 1999 saw one of the highest percentage rates of this disease ever recorded (The Christian Institute 2001). The research included in this study, also found information from UnAids (2004) in regards to the contraction of HIV and promiscuity. The statistics from UNAid showed that almost 5 million were infected by the HIV virus this past year. Although it is stated that HIV is one of the easiest avoidable diseases, it is also the easiest for teenagers to contract by being lead to believe, consensual sex, at a young age, is safe by using the morning after pill, instead of condoms, or other forms of protection. All it takes is one time to forget to use a condom and if you are with a person that is a carrier of the virus you will contract it. It seems teenagers are sceptical about this though and way to risky, a reason that they should not be having sexual intercourse to begin with. Furthermore, in regard to teenage pregnancy, there is a great dilemma within the government, not only involving ethics but also the cost that teen pregnancy places on the government (Smith 2005). The cost to have a baby is very expensive and most teenagers are not prepared for a financial situation such as this. Ethically, and morally, the tax payer would step in to insure the right thing is done but this places a heavy financial burden onto taxpayers, which presents more moral problems. This financial stress is what sometimes leads teenagers to abortion choices. Also, this typical situation is why, the morning after pill has become so steadfast among teenagers in the UK. This pill, that is currently used in the UK is medically known as the "Levonelle2" and has ingredients within it of several contraception's (Net Doctor 2005). Though it is popular and now available over the counter, quite a few places will not pass it to teenagers due to the moral beliefs that they have. The three specific uses of this contraceptive are: rape victims couples who have had a condom break women who have been lured into having sex by alcohol or drug use (Net Doctor 2005). The guidelines show that this pill was not specifically designed for teenage girls so this perhaps could be one of the ethical dilemmas involved with it. In summarizing the dilemma of teenage pregnancy here, what should be understood is that teen sex should not be happening in the first place but unfortunately it is. Health education in public schools and safe sex devices being readily given out to underage kids is one of the leading causes of promiscuity in teenagers, although some don't agree with this popular belief. The percentages speak for themselves. Another moral problem that unwed teenage mothers are apse to face is the fact that they are not ready for the economic facets of the world. Also, affordable child care, in order for them to continue their education would be difficult and expensive to find. They'd also be faced with prejudice and discrimination in the job market and various other areas of public life (One Parent Families 2004). This is not something that the UK wants for their young people so there needs to be some implementations now to sway the deciding factors that are leading down this very path of hardships for teenage girls. The moral and ethical equations need to come back into the picture instead of being shoved aside to allow for pharmaceuticals to manufacture and promote a pill that is not ethically correct for young people to have, and far from responsible to use. References Alan Guttmacher Institute (2000). http://www.agi-.uk.org Bennett, Sarah (1999). New Drugs Create Ethical Dilemma. The Cincinnata Enquirer, 1 Delvin, David (2005). The Morning After Pill. NetDoctor.Com http://www.netdoctor.co.uk/sex_relationships/facts/morningafterpill.htm Department of Health (2001). Teenage Pregnancy: The Morning After Pill. http://www.dh.gov.uk/PublicationsandStatistics/fs/en Frank, Natalie (2004). HIV/AIDS among Women: UNAID Association. http://www.realsexedfacts.com/femalesexualhealth.htm#50702071 Nursing and Midwife Council (2005). Guidelines in Healthcare. http://www.nmc-uk.org/(10u5jirtesc045hjtsvfbl)/aSection.aspxSectionID=7 O'Keefe, S. (2004). Crisis Pregnancy: Pregnancy Decision Making. Crisis Pregnancy Agency Report 1. 1-38 One Parent Families (2004). Teenage Pregnancy in Scotland. Scottish Charity http://www.opfs.org.uk/factfile/teenpreg.html The National Campaign to Prevent Teen Pregnancy (2000). http://www.teenpregnancy.org/about/faq.asp The Christian Institute (2001). The Morning After Pill: Promoting Promiscuity. http://www.christian.org.uk/html-publications/promotingpromiscuity.htm#government Sacramento Bee (1999). Five Nurses Quit Rather than Agree to Dispense "Morning After Pill". http://www.morningafterpill.org/nurses.htm Smith, David (2005). Oh, Baby, This Is a National Dilemma. Economics in UK.Com http://www.economicsuk.com/blog/000180.html Western Catholic Reporter (2004). Pharmacist Swallows Bitter Pill. http://www.wer.ab.ca.news/2004/1018/pills101804.shtml World Net Daily News (2003). FDA Advisers: Make 'Morning After' Pill Easy to Get. http://www.worldnetdaily.com/news/article.aspArticle_ID=36193 World Net Daily (2003). The Morning After Pill. http://www.worldnetdaily.com/news/article.aspArticle_ID=38704 Read More