Support Patient Care and Confidentiality at Hillsboro School Based Health Center
Elleanor Chin
Tomorrow night (May 24, 2016) the Hillsboro School Board will consider a proposal to provide contraceptive health care in addition to other primary care. However, the proposal before the board requires parental consent to provide contraceptive care to minors. In addition, the Board is already under pressure not to provide comprehensive reproductive health care at all.
Objecting to “handing out contraceptives” at Hillsboro’s School-Based Health Center (SBHC) comes down to opposing comprehensive preventative health care for teens. Hillsboro School Board has already concluded that offering health care services at Century High School’s campus, in partnership with Virginia Garcia Memorial Health Center (VGMHC), is beneficial to the student population and the community as a whole, particularly underserved and vulnerable members of the community. There is no reason to deny a full spectrum of health services, under the same confidentiality guidelines protecting minors seeking healthcare elsewhere. On April 1, the Hillsboro Tribune ran a guest opinion, by Hillsboro resident Lynn Harris asserting that Hillsboro’s School Board should interfere in the specifics of health care offered at the SBHC on narrow, ideological grounds. In support of her argument she offered a number of misleading, unsupported claims about public health.
Harris assumes that teens and families who disagree with her specific views on sexuality are not learning or teaching “morality” and “the vast majority” of families will effectively provide all of the education and resources needed for reproductive health. Whatever Harris’ grounds for judging the private sexual morality and parenting behavior of others, the School Board should not be in the business of endorsing or proliferating those views.
Contraception is part of comprehensive preventative care. Pediatricians, adolescent medicine guidelines, and women’s health specialists all follow this position. SBHCs offers other preventative care, including OB/GYN care. Questions about the effects of hormone-regulating medications on adolescent girls and young women include their use for a number of purposes, including managing acne, endometriosis and polycystic ovarian disease. Hinting that offering “birth control” might be uniquely harmful is fear-mongering, not science.
Providing teens scientifically based, medically accurate information on contraception and access to contraception reduces teen pregnancy and STDs. Blanket instructions to avoid sex (for moral or health reasons), pretending teens are not sexually active, and preventing teens from getting accurate reproductive health information all lead to worse health and welfare outcomes, not better. Oregon law on sexuality education incorporates this research-based medical position, Harris’ vague comments notwithstanding. (Her outright assertion that there is no data on the benefits of comprehensive and accurate sexuality education is simply false).
Oregon law gives minors the right to obtain and consent to medical care at age 15, without additional parental consent. Harris and others who share her views are suggesting that the School Board should change the terms of the doctor-patient relationship in one narrow area, preventing health providers from offering the care and medical advice called for by that patient’s circumstances, because of concerns about “promiscuity,” (a term of moral judgment, not medical assessment).
Harris’ objections to contraceptive care are unscientific and inconsistent with Oregon privacy law and public health policy. For these reasons alone, the School Board should disregard them, but there is another reason. Interfering in contraceptive care is profoundly lacking in compassion. Harris assumes that all or a majority of families are like hers, with parents (presumably) able to provide guidance and support reflecting their own beliefs on intimate relationships, combined with the close parent-child bond enabling their children to respond to and adapt that advice. Young people in less fortunate families should be left to fend for themselves.
Harris assumes away the young woman who has no parent or guardian able to offer compassionate advice and modeling on healthy sexual behavior, the teen whose parent is mentally ill, violent, addicted, or even sexually exploiting the teen. SBHCs serve families facing a number of economic, health, and emotional challenges. Why should the School Board tell SBHC health providers that they cannot counsel a frightened or confused teenager how to safely use a condom if it will prevent an unwanted pregnancy? Should Harris’ belief, and the beliefs of others like her, that sex should be limited to procreation, and discussed only at home, mean that a teen who is being raped by her boyfriend (or step-father) cannot get comprehensive health care?
The Hillsboro School Board cannot solve or manage every problem of its most vulnerable constituents. But they have already decided to partner with an experienced health care provider to support a valuable community service. There is no reason for the School Board to selectively restrict a single facet of the health care offered on its campus, to cater to the fears of a vocal minority.
To communicate with the School Board on this issue you can do the following:
Email: Please urge the Hillsboro School Board (schoolboard AT hsd.k12.or.us) and Board Chair Wayne Clift (wayne.clift AT hsd.k12.or.us) to prioritize the health and rights of students by allowing the High School Health Center to provide birth control consistent with Oregon law and allow students to decide when and how to notify their parents.
Call: Please leave a respectful message for Board Secretary Val Bokma at 503-844-1789 explaining why you think the board should not put students’ safety at risk by requiring advance notice to parents.
Attend: The board will discuss the issue during its next meeting, which starts at 7pm Tuesday in the Hillsboro School District Administration Center, 3083 NE 49th Place in Hillsboro.
Elleanor Chin is the Vice-President of the Oregon Chapter of the National Organization for Women. These are the views of Oregon NOW and of Elleanor personally, as an Oregonian, writer, and mother of three.
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