Declaration on the sexual and reproductive health in adolescence
| Autor | M. Casado |
| Páginas | 43-58 |
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The Opinion Group of Bioethics and Law Observatory, based at the Parc Científic de Barcelona, was formed to study the ethical, social and legal implications of new biotechnology techniques from a scientific and multidisciplinary point of view, and to make specific proposals for legislative action.
The Group itself was created with a view to participating in the university-society dialogue and making its voice heard in the wider society; more specifically its aim was to make submissions to the public, administrative and political bodies which regulate and control research and the application of new technologies. To achieve these aims it is also necessary to maintain a fluid relationship with the media, so as to improve the quality of information available.
In this particular case, the group has studied the problems of sexual and reproductive health in adolescence and the validity of the concept of Informed Consent of Minors. This issue demands informed social debate if we are to achieve a consensus for appropriate action, in keeping with the already existing legal provisions for protection of minors, whose interests are given special attention under Spanish legislation.
As tends to occur with issues in Bioethics, there is a great need for multidisciplinary dialogue encompassing ethical, philosophical, anthropological, legal, social and health aspects of the issue. In addition, the debate needs to be solidly based on technical and scientific input from the disciplines whose advances underlie the field.
On this occasion, the group has been coordinated by Dr. María Casado, and has received submissions from specialists in anthropology, law, nursing, philosophy, medicine, pedagogy, psychology and sociology as acknowledged in the annex.
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Over the last 10 years voluntary termination of pregnancy has increased more among women younger than twenty years than among any other age group, and in excess of the total trend for Spanish women. In Catalonia, there has been an alarming increase in abortions among women younger than 15 years of age since 1999. This situation demands a review of the causes underlying this problem, questions the effectiveness of our present prevention campaigns, highlights their insufficiency and raises important moral and legal problems.
Another source of concern lies in AIDS transmission figures. HIV infection through heterosexual relations continues to rise. Furthermore, on the basis of age, incubation periods and symptoms, it is evident that a significant proportion of patients were infected in the early years of their lives.
Thus, the situation has become a major public health problem and both Ethics (which seeks human happiness, through examination of human moral issues) and Law (which seeks to regulate for the real problems facing society) must concern themselves with this issue, and propose behavioural guidelines which are acceptable to the majority, and yet respectful of minorities through scrupulous observance of their Human Rights, and this also includes the rights of minors.
Public discussion of sexual and reproducive health among adolescent minors suffers from a lack of information and rigour. We must study the main arguments in favour of enabling minors to take the necessary means to control the consequences of their actions, both in terms of their own health and in terms of possible pregnancies. While young people today are afforded multiple possibilities to be sexually active, many adults are still reluctant to accept their right to make decisions with regard to contraception.
General consensus has already been reached among education and health experts on the need to establish programmes - or at very least, to implement the already existing programmes - which aim to provide help to adolescents on matters of sexuality.
Media coverage of adolescent sex issues has increased recently, both due to the last World Summit for Children and also the outcry in response to
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health programme proposals to install condom machines in schools, subject to discussion and referendums. Regardless of their merits or weaknesses, these campaigns, designed to raise awareness of the risks of HIV infection, have led to a visceral, obscurantist reaction. We have a duty to expose and highlight the injustice and the ideological stances underlying these reactions which, though noisy are nevertheless the views of a minority. At the same time, we must stress the need for ongoing, systematic work and not just isolated campaigns which may lead to undesirable effects.
This document aims to provide information and different points of view, both for the purpose of participating in the public debate and offering guidelines to the government and legislators for implementation and application of the provisions currently available under our laws; or for modification of aspects of the law to achieve compatibility of the rights of the minor, the rights of parents and the responsibilities of our public authorities in education and health. It must not be forgotten that our legislation is underlain by a general principle of protection of the best interests of the minor, and this demands an effective safeguard of their rights.
The society in which we live is a plural one, made up of individuals and groups with their own interests and varied sensitivities, all potentially in conflict, and in which the individual is not a mere cog in the machine of common will. In such a society the function of the state’s structures is to reconcile the various views through the enactment of parliamentary laws, in accordance with Constitutional principles, to apply these laws and to adopt whatever measures are needed to make them effective. In this context, we must be especially concerned with the welfare of minors, who are still at a learning stage and will be the builders of the future.
As an integral part of human life, society should strive to transmit a positive, pleasant and responsible conception of sexuality. Achieving this will require the participation of both the family and the school. However, it is clear that there is a certain hypocrisy in our society with regard to young people and sexuality: on one hand, there are factors which promote young people’s sexuality, while on the other, their educational and health needs in this area are not provided for. Young people are at a learning stage; for harmonious development of their personality they require a multi-faceted, integrated and balanced sexual education, with a reflective, dialogue-based approach. In short, they need sexual education which fosters the development of
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personal autonomy and moral and social consciousness, enabling them to become responsible citizens.
We must address the causes of the rising numbers of unwanted pregnancies among adolescents in societies with markedly high levels of personal freedom and access to information. To do this, we must ask what models of adult behaviour, masculinity and femininity we give to young people...
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