So why does a disjunction between the law and medicine suddenly emerge the moment that the discussion turns to the contraceptive pill, the morning-after pill or the abortion pill? Are there any guidelines out there for medical professionals and the public?
For example, in Taiwan, contraceptive pills are legally available only with a prescription, so the first issue is whether it is acceptable for doctors in Taiwan to prescribe the pill or the morning-after pill to underage girls without their parents’ consent. The second issue is whether parental consent should be required when the pill is being prescribed to treat conditions such as acne, polycystic ovary syndrome, endometriosis or primary dysmenorrhea in girls of this age. If one consulted Taiwanese doctors on these two questions, they would give a wide range of responses.
The British Medical Association recommends that doctors observe the same degree of confidentiality for patients under 16 as they would with adults, with the exception of cases involving child abuse or child welfare considerations. The association’s guidelines also say that if under-16s are capable of seeking medical advice on their own initiative, then they should be allowed to use their right of consent to any medical treatment the doctor sees fit to administer. As regards to birth control advice and provision of treatment, the association is of the opinion that adolescents should not be pushed to tell their parents about their decisions.
Courts in the US and the UK have intervened in many cases involving procreation and the right to life, including on birth control policy and on cases of paralyzed individuals or those in vegetative states to be allowed to die or to be taken off life support. By comparison, Taiwanese courts have had very little to say on the legal philosophy, ethics or effects on individual freedoms surrounding these issues, suggesting that there is still much room for improvement in Taiwan in terms of the public’s understanding of their medical rights and the law.
Chiang Sheng is an attending physician at Mackay Memorial Hospital’s obstetrics and gynecology department.
Translated by Paul Cooper