January 19th, 2010 by cat
The second class of ‘Norplant for Teens’ policy supplies Norplant systems to consenting teenagers. The government would offer these consenting teenagers Norplant systems for free or for a very low price. For example, the government could charge the reasonable fee of ten dollars, if it wanted to generate revenues and still make Norplant extremely affordable for teenagers. This price could help pay for the program, e.g., the suggested fee could generate about $50 million dollars. It is important though to make sure that the Norplant systems are affordable so that the teenagers have an incentive to choose it. This type of program would be more effective because the Norplant systems will be generally going to sexually active teenagers — the economic argument applies to the policy.
One problem with the proposed policy is difficulty in getting informed consent from a teenager. We have no assurance that the teenager knows all the options she has, like IUD birth control, or that she understands what the drug actually does. Somehow we need a comprehensive method for making certain that teenagers know about their bodies, different forms of contraception, and the implication of each one’s use. For example, we cannot assume that all teenagers understand that Norplant does not protect against sexually transmitted diseases (STDs). A responsible Norplant for Teens program must offer detailed sexual education and counseling.
The second problem with a consent driven Norplant for Teens program is that the sexual education and the Norplant services must be accessible for teenagers. If the program is not accessible to the majority of teenagers, then it will not benefit them no matter how good the program is. There is good evidence that placing such a program in traditional clinics would not target the majority of teenagers. Studies have shown that in both the United States and England, many teenagers believe that the clinics are not meant for them. Both male and female teenagers have reported that they feel uncomfortable in these clinics. Likewise, 38.7% of boys polled incorrectly thought that parental permission was needed to go to the clinic. In order for a Norplant for Consenting Teens program to work, it must occur in an environment that has access to most all teenagers and makes them feel comfortable.
January 19th, 2010 by cat
There are two classes of policies we could adopt to implement a ‘Norplant for Teens’ policy. The first would make Norplant implants mandatory for all female teenagers. This blanket policy would be the most effective, for no teenager could fall through the cracks. The number of teenage pregnancies would be directly related to the failure rate of Norplant systems, i.e., 0.5%. This can reduce the number of accidental pregnancies by over a factor of one hundred.
A critical problem with a mandatory ‘Norplant for Teens’ public policy is that it infringes on several recognized constitutional rights. First, since some religions object to birth control, a mandatory Norplant policy would violate those citizens’ right to religious freedom. Second, the Supreme Court recognizes that the Constitution implies rights that “promise that a certain private sphere of individual liberty will be kept largely beyond the reach of the government”. These rights protect the ability to make particular decisions that are considered fundamental for preserving ‘autonomy’ and ‘individual dignity’.
Decisions about procreation, contraception, and marriage have all been recognized as protected by these rights. A mandatory Norplant policy directly conflicts with these rights. Finally, for over two hundred years, any medical treatment performed without consent, unless in emergency cases, has been considered battery by Anglo-American law. As mentioned earlier, Norplant is a drug and its insertion is a medical procedure. To not allow individuals to refuse this ‘treatment’ would violate the long recognized and protected right to self-determination. This right protects individuals from “severe” intrusions of their “personal Privacy and bodily integrity”.
Second, because the government would have to supply Norplant systems to every female teenager, the policy would not be cost-effective. There are just too many teenagers and Norplant is too costly for the economic argument to apply. Putting costs aside, making Norplant mandatory for teenagers completely disregards that Norplant is a drug — levonorgestrel. It has particular health risks and is not safe for everyone. In the previous section I reviewed a considerable amount of side effects that individuals may not want. Furthermore, evidence determining whether or not synthetic hormone contraception causes or increases chances of breast cancer is still inconclusive. This is particularly true of Norplant, since it is a relatively recent drug. Likewise, few comprehensive studies exist that investigates the effect Norplant has on teenagers. Forcing female teenagers nationwide to get Norplant systems may be invoking serious health risks. The only way to avoid violating all the aforementioned rights and to remain cost-effective is by offering, not mandating, Norplant to consenting teenagers.
January 19th, 2010 by cat
A purely economic argument for distributing Norplant systems to teenagers makes the policy very compelling. I will presume that the government can purchase a large quantity of Norplant systems, implement them, and maintain them for five years for about $700 per unit. If we sent a buyer to Sweden and purchased them from Leiras instead of Wyeth-Ayerst Laboratories, the cost would go down to about $200 per unit. There are ten million sexually active teenagers in the United States. Presuming that each successive year, five million different teenagers become sexually active, the total of sexually active teens over five years would be 30 million. If we supplied every one with Norplant birth control, the cost would be $21 billion in the poor scenario and $6 billion in the relatively good scenario.
Each year, babies born to teenage mothers will cost the government six billion dollars in social services over the next twenty years. That the cost is spread out over the years actually makes the situation worse, considering the figure does not account for inflation. Meanwhile, the taxpayers’ cost caused by teenage pregnancies over five years will well exceed $30 billion.
This is still $9 billion more than in a very poor Norplant scenario. Furthermore, the difference between the costs will grow further apart with time. The difference in cost is even more alarming when you remember that both female and male teenagers are sexually active. The number of sexually active females should be much lower than accounted for. To keep the scenario very poor, however, this high number could assume that many non-active females will also opt to get a Norplant birth control system.
A common concern about a Norplant birth control subsidy program, or just the drug itself, is that it will encourage teenagers to avoid using condoms and visit attending health clinics less regularly. Presently no information confirms this hypothesis. However, evidence suggests that condom birth control use does not significantly differ from teenage Norplant users and their oral contraceptive using peers. Norplant use does not seem to affect the teenage attendance of health clinics either. Neither the number of follow-up clinic visits, the rate of duration of the follow-up, nor the rate of return significantly varied between observed Norplant using teenagers and their oral contraceptive using counterparts. This evidence suggests that the increase in the use of Norplant in teenagers would not likely affect their condom use or their regular attendance of clinics.
