by Rebecca Oas, Ph.D. May 21, 2015.
NEW YORK, May 22 (C-Fam) The World Health Organization (WHO) has issued guidance proposing that adolescents should get sexual information from non-professionals without either parental consent or the protections of a typical counseling structure. The guidance comes as Health ministers from around the world meet in Geneva this week to make decisions about global health policy for the coming year.
The WHO guidance paper calls for the “opportunistic use of counseling skills” by healthcare providers at all levels – including those who are not professional counselors. These “brief sexuality-related communications,” or BSCs, would take place at the initiation of the health worker, without having established a formal trust-based counseling relationship with the patient, and without any expectation of follow-up later.
To that end, WHO trusts healthcare workers with minimal relationships to adolescents as better judges of what is in their best interests than their own parents.
The WHO guidance makes two recommendations: that BSC should be provided for both adults and adolescents, and that healthcare providers at all levels should be trained to do it. WHO grades these recommendations as “strong” despite the quality evidence supporting both being low.
Throughout the guidance, WHO takes care to refer to the recipient of these communications as the “client” rather than the “patient,” in order to avoid giving the impression of a “hierarchy in which the health-care provider knows best,” but it is unclear if or how they are meant to convey this to the person seeking care, who may feel intimidated regardless. Of particular concern, the BSC approach is proposed for use with adolescents – defined by WHO as ten to nineteen years of age – under confidential circumstances and without parental consent.
WHO refers to the BSC approach as being a “necessary” intervention for adolescents, although it “should not be chosen in preference over other effective interventions such as comprehensive sexuality education in schools.”
While WHO occupies a place of great influence in matters of public health, and has made great progress in reducing and even eradicating some of the world’s most dangerous diseases, its continuing pressure on issues of sexual morality threatens to erode its reputation and trust among more conservative governments. In particular, its 2012 technical and policy guidance on abortion urged that medical care standards be lowered to maximize the availability of abortion.
As with previous sessions, the 2015 World Health Assembly—the governing body of the WHO- -is continuing to debate health standards and practices that are controversial in many countries, some of which have been explicitly rejected by the world’s governments. “Comprehensive sexuality education” (CSE) is a particularly hotly debated term, and some member states’ objection to it was a major reason for the failure of the recent Commission on Population and Development to produce an agreed outcome.
Meantime, the WHO secretariat– the bureaucratic support system of that governing body–has issued several recommendations, including one on adolescent health that has as one of its five guiding principles the notion that young people as young as ten should be able to have a “safe sexual debut, when ready and wanted.”
C-Fam has issued a briefing paper discussing the problems with the WHO’s guidance on BSC, which can be accessed at www.c-fam.org under Friday Fax.
Source: Center for Family and Human Rights