In the NYT's Ethicist column this week, there's a letter from a noncustodial father. Seems his 16-yo, sexually active daughter wants the pill. Mom says no because of side effects and because it increases the risk she'll have condomless sex, exposing her more to STDs. The father wanted to know whether it would be ethical for him to send the kid to the doctor, get the pills, and pay for them.

Randy Cohen (the ethicist) said yes, but tell Mom; don't sneak around. He also said Dad/doctor should reassure Mom that the low-dose pills don't have much in the way of side effects.

What do you think? It's funny -- I always assumed that if I ever had a daughter and she wanted the pill, I'd say "sure"...but I see Mom's point. If the only reason the girl's on the pill is for birth control, she'll still need a condom to protect against STDs. And in that case, why use the pill? If she's that open with her parents, and she's worried about pregnancy after a condom failure one night, there's the morning-after pill. (Responsible condom use ensures you don't have to do that often. I used it twice in a 15-year premarital career.) And there's the question of whether you want your kid to be taking a systemic drug daily with no medical indication past birth control.

There's also the side-effects question: I took the low-dose pill, and hello, horrors. Rapid weight gain, crying jags, wild mood swings. I think it very much depends on the woman.

I think I'd want to question the daughter more closely about why she wanted the pill. I wouldn't be surprised if there were pressure from the boyfriend(s) and curiosity about what it's like bareback -- and that strikes me as the wrong reason at 16. If she were older, and in a monogamous relationship where each partner could have meaningful STD testing before they got sexy, then OK (though at that point my permission would be moot anyway).

What do you think?

amy

If the father does not have custody, than he stands in the position of "friend" to this underage minor. He has no more right to obtain birth control medication for her than he has to obtain prescription narcotics, amphetamines, or breast reduction/enlargement surgery for her. I think that if this is what the father is like, it's no wonder he wasn't given joint custody.

attila

I applaud the father for being involved in his daughter's life and being willing to discuss a subject that most fathers would avoid. However, simply putting her on the pill probably isn't the answer. It sounds like there is a pretty open line of communication between parents and child, but it sounds like there's a lot of talking to be done (STDs, pregnancy, etc.). Even taking the pill correctly takes a fair bit of attention and responsibility.

A twist...I saw a family on a talk show awhile back. Their 15 yo daughter has a baby. The host asked if the girl is on birth control now. The girl responded that her mom doesn't believe in birth control for 15 yo people, and the mom nodded in agreement. What would you do in that situation?

I don't know about the rest of the country, but in NY and MD a 15 year old does not need parental consent to get OCPs. When it comes to sexual matters, we are allowed to see teens on their own without parental consent and to treat without parental consent. They can even have abortions without consent! I'm still not sure whether I agree with this or not, but it certainly makes life easier in the ER and clinics.

attila wrote: I didn't make it clear: The father knew the girl could legally get the pills on her own; she just needed someone to pay for them and the visit. It's not a matter of his going to the doctor and asking for bc pills for his daughter.

amy