This article appears in the February 1999 edition of the Catholic Medical Quarterly
A LOST GRANDEUR
Boots the chemist, for so long a jewel in the High Street, has abruptly lost its traditional reputation for conventional retailing. Jesse Boot its founder, a Victorian entrepreneur combining high religious principles, large scale philanthropy and a sharp check on operating costs would find its current decision to encourage under - age sex an inconceivable transformation. That it should open an experimental children's family planning clinic, with free contraceptives, in the Archdiocese of Glasgow indicates a certain lack of prudence. Cardinal Winning has responded by saying "This is absolutely disgraceful and totally unacceptable. It erodes the principles of morality and undermines the role and authority of parents. The place has gone sex mad. There is no doubt this will encourage, children to start experimenting with sex".
Dr. Tina Mackle, the doctor in charge, said that if a 13 year old girl asked for the emergency morning after pill, she would consider prescribing it. In her view, "young people have a right to a confidential medical service and that includes contraception".
A company spokesman said "We are not encouraging teenage sex. We know that it goes on and we are trying to provide appropriate services".
If the trial is successful, and it will be judged on commercial grounds, the clinics will be extended to branches of Boots throughout the country; there are over 1,100 of them situated in old town centre sites and out of town malls. Drop-in clinics for contraceptive procedures will alternate with medical check-up clinics and all the other combinations of health care salons which have arisen in recent years. The aim, towards which the Family Planning Association has worked tirelessly for many years, will be largely achieved.
The rationale behind this move is based on the majority ruling of three to two Law Lords in the Gillick case, in 1985, by which doctors are allowed to prescribe contraceptives to children under the age of 16 without the knowledge or consent of their parents. At the time, it was envisaged that in the majority of cases the doctor would be able to persuade the child to inform her parents, and only in exceptional cases would a prescription be given without their knowledge. The judicial process, stirred by Victoria Gillick against the local authority having the power to prescribe contraceptives to her daughters, was remarkable in that of the nine eminent judges involved, through the Appeal Court and the House of Lords, five found in her favour and four opposed. Lord Fraser's judgement stated that a doctor can overrule the parent's rights (and duty) only if he is satisfied that the girl can understand his advice. Lord Scarman said this understanding must include moral and family relationship questions as well as long term problems associated with the emotional impact of pregnancy, its termination and the risks of sexual intercourse.
The late Lord Devlin regarded the case of Gillick v West Norfolk Health Authority, at the time, as socially the most important to come before the courts in that decade.(1) In his view, 'the upbringing of a child up to a certain age, in this case 16, must be subject to parental control.... except in cases where parental control has clearly broken down'. He quoted Lord Radcliffe, whom he regarded as the greatest lawyer of his generation, as saying that parental relationships deserve special protection from outside invasion or even voluntary relinquishment.
It is quite evident that such fine pronouncements, made nearly fourteen years ago, bear only slight resemblance to what is happening today.
The Working Paper on the Age of Consent in relation to Sexual Offences, under the chairmanship of Lord Justice Waller, (2) stated: -
'In our opinion, sexually immature girls need protection from sexual intercourse on two grounds. First, when an immature girl has sexual intercourse with a man, her gradual development towards sexual maturity can be affected. She may he introduced prematurely into a world of adult feelings with only an adolescent's ability to control them. Secondly, an immature choice is not a free one. Immature girls are open to exploitation, particularly by older men, but also by boys of their own age or slightly older, who know what they want and are not deterred by using all kinds of psychological pressure to get their way. We think it is true that most girls are not eager to have sexual intercourse before they reach 16. The present law is, we consider, one factor strengthening their resolve to say "no"'.
We all know that by the age of 14, very few girls have set themselves intelligent and sensible moral standards and consequently are greatly influenced by friends in their 'peer group'. And yet this new initiative by Boots empowers one doctor, at a first consultation, to decide whether the girl is sufficiently mature.
What has happened in the intervening years? A widespread cry for formal sex education with the result that conception rates, abortion rates and the incidence of sexually transmitted diseases soared.
In America over 1 billion dollars was spent in the years 1971-1996 by the government to prevent pregnancy in adolescence. An analysis of the results in 1986 by the Alan Guttmacher Institute, the research arm of the International Planned Parenthood Association, published in Family Planning Perspectives, says: -
The final result to emerge from the analysis is that neither pregnancy education nor contraceptive education exerts any significant effect on the risk of premarital pregnancy among sexually active teenagers. A finding that calls into question the argument that normal sex education is an effective tool for reducing adolescent pregnancy.
In this country, the 1992 report, 'Health of the Nation' produced by the Conservative government, announced plans to reduce sexually transmitted diseases and under age pregnancies by 50% by the year 2,000. The report recommended as in America, more teenage contraceptive clinics, more sex education and at a younger age. The results were as expected:-
conceptions per 1000
attendance at clinics per 1000
abortions per 1000
In the light of this evidence, we ask Messrs. Boots to reconsider their decision to establish these clinics. Our members have always enjoyed excellent relationships with the firm in the past, as a leading pharmaceutical company; it would be a tragedy if this goodwill is shattered. An even greater tragedy is reported on page 5 demonstrating the harms that under age prescribing can cause.
As an indication of the extent to which it is currently practised, recent figures from the Department of Health indicate that the number of occasions on which under 16s were prescribed the morning after Pill in 1989 was 2,200. In 1996 it had risen to the astonishing figure of 22,300: the greater part of this prescribing came from GPs. Over the same period the pregnancy rate among girls aged 14-15 in England rose from 7,922 to 8,200.
- Letter to The Times, July 29, 1983.
- Working Paper on the Age of Consent in relation to Sexual Offences, HMSO, June 1979.