Two Somerset branches of the supermarket chain Tesco's are to take part in a pilot scheme in which a company pharmacist may dispense the morning-after pill (MAP) free without prescription to those under 20, but without lower age limit, after an interview. Named records are not to be kept and no one else will know of the request.
This initiative, allowed in a named area under a Ministerial Order of August 2001 called 'Patient Group Directions', is the latest manifestation of a government programme that aims to reduce the under 18 conception rate by 50% by 2010. While the aim is laudable, the means is not. We should be concerned about this liberalisation of the MAP availability for at least four reasons.
First, the MAP can work as an abortifacient. The Levonelle-2 preparation used in this initiative is a progesterone-only MAP whose makers acknowledge sometimes works by preventing implantation of a fertilised ovum.
Second, the supermarket pharmacy, even having a quiet room away from the queue, is the wrong context for a young distressed girl to make such a request and to receive counselling and care. Even exchange of essential medical and social information will need time and sensitivity. Issues include side effects (nausea and/or vomiting in 25%), what to do if the girl vomits within three hours of taking the tablet, and the 'failure' rate of perhaps 15% of all potential pregnancies. A discussion of the social context is equally essential (eg. coercion by an older man, concomitant alcohol and drug use).
Third, these arrangements remove all accountability of the child to the parents and other health professionals in the discredited belief that this has a negative effect on teenage conception rates. The evidence suggests otherwise. For example, in the ten months after the Gillick case of 1984 it was unlawful in England for doctors to provide contraception to girls under 16 without parental knowledge and consent. Under 16 family planning clinic attendance fell by over 30% but conception rates remained unchanged.[1] Accountability to parents, it seems, was not only a disincentive to family planning clinic attendance but also to sexual activity.
Accountability to parents and others also has the important benefit of affording the young girl protection from exploitation by older men. This is one important reason for there being an age of consent in this country.
Finally, this government strategy is underpinned by the disastrous assumption that there is no right or wrong in teenage sexual activity - just choice. As teenage conception rates continue to rise, they conclude that the choices are not being made accessible enough.
The amoral assumptions of a health service with an increasingly dominant atheistic worldview are damaging our nation's children. When a society chooses to ignore God's wise rules for living, the practical outworkings in damage limitation often look desperate and disturbing. Like what has just appeared in our supermarkets.
