Monday, June 07, 2004

Slate posts cont'd....

This next is a thesis on whether Plan B, the "emergency contraceptive" recently rejected for over-the-counter availability by the FDA.

I have to admit, this is not my area of expertise (and a female friend of mine feels squeamish as to whether men should even have any input into women's reproductive decisions), and also, that I didn't actually read the Slate article that I posted under in the Fray. But really, the question I decided to address was posed by another Frayster, la_rana, who was asking another poster, Isonomist, if children, who have not fully developed adult-reasoning, should nevertheless have the adult choice of using Plan B. I tried to reformulate his question and answer it here; I then reformulated my response into the more stand-alone screed below.


Subject: Progress CAN be made -- and it HAS been made in other countries.

I hate to upset my countrypeople, but while we may have most of the world's weapons of mass destruction, other countries are beating us at the weapons of mass contraception.

Forgive me for that, it was irresistible.

There's a report linked to at the end showing the sex ed and available contraception... work. Sorry, kids. We're one of the most abstinence-only focused, and getting the worst results. You may have to cry "coincidence," or conclude that G*d is punishing us again (for, I don't know, gay marriage, or not burning the things a woman sits on during her "unclean" time, or maybe it's all of the masturbation).

I don't know exactly where I fall on Plan B, but to engage the rhetorical point here, I think the issue is not whether the full capability for decisions determines whether Plan B should be available or not; I think the question is, which set of consequences should a child have the option of selecting (in their admittedly poor judgement)?

This sounds like a weird formulation, even to me.

But let's try it. If Kid A makes a bad decision (or, as Iso points out, is coerced as young kids usually are), they have a limited set of options, but still options. The ideal option selection would be 1) Tell a responsible, caring, understanding adult, and make the decision in consultation with them. This option has two problems: there may not be this adult available (i.e. there may only be the sexually abusive father, or any of many less drastic problematic adults), and the kid may not have the wherewithal to bring this to an adult's attention.

Option 2) The kid tells no one, starts showing sooner or later, and then goes one of several courses: an illicit abortion to avoid excess adult involvement (i.e. parents); the parents (or some other adult) becomes aware of it and helps the child get as safe an abortion as possible; or the adults find out and the child for seem reason bears the baby to term (which for a young child is a potentially lethal course).

Option 3) The kid uses Plan B, available at the drug store; maybe she gets sick from side effects, maybe she doesn't, but perhaps her secret stays safe (with two more possible ancillary courses: adults never find out, and the sexual activity/abuse may continue, or the adult finds out and approaches the child or the child reconsiders and approaches an adult, and hopefully changes the circumstances).

I'm not sure if that's too complicated or too simplistic a synopsis.

Pressing onward, in this universe of choices, I would say it's not easily predictable what children with their under-developed reasoning may do. However, if we look at the options, I think most would agree 1) is in all ways preferable. 2) is risky, and can turn out anywhere on a gradation of "best" to "worst" possible results. And then option 3) seems to address the immediate problem; i.e. it has a dramatically lower chance of death (safer than a young child bearing a child, and safer than a backalley abortion [though I don't know if these are actually common or used as a spectre more often, but it certainly is a possibility and a bad outcome]), but it allows the child to possibly continue being sexually active or being coerced into sex.

In a universe of bad options, it seems to me not to be a simple factor of "should adult consequences be available/imposed on a child who made the adult decision of sex (or was forced into it". It's "what universe of adult choices should a possibly confused child be able to make?" And I would say in that regard, Plan B seems to be a choice that on the whole, we'd *want* as part of the universe of choices for a child; after confiding in a responsible adult, it seems like the second best possible outcome -- the child may suffer side effects, but gets to avoid the risks of abortion and the risks of bringing a child to term, as well as avoiding the substantial adult burden of *raising* a child, which is a heavy burden, especially for someone without the adult that they can/should talk to. (Plan B also avoids a later, usually more difficult decision of whether to abort or not if your beliefs follow the idea that life begins some point after conception but before the last trimester).

So I think it's just one of those "best of a bad situation" cases. If it's prescription only, that requires the child have the sense of mind to go to a doctor. If it's available and relatively safe, it's just another sub-optimal choice among many. The only way to truly address this is to continue doing all we can within reason to prevent abuse, and to educate [] and make options [] available [] as we do so. We can do it -- other countries have much lower teen pregnancy (and abortion) rates; we have to decide what "moral" and "adult" and "consequences" means to us in an imperfect universe, in the US's imperfect universe, and then we'll be ready to catch up.


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