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PRINCIPLES REGARDING REPRODUCTIVE RIGHTS, FAMILY PLANNING AND SEX EDUCATION

The American Medical Student Association:

1.             BELIEVES that reproductive health services, reproductive rights and reproductive health education­—as a means for women and adolescents to have self-determination in all aspects of their reproductive lives, including sexuality, health, and parenthood—are essential to women’s and families’ overall health and well-being; and SUPPORTS universal and ready access to men’s and women’s reproductive health services and education as a means for improving health disparities. (2006)

2.             In regard to reproductive rights, AMSA:

a.             SUPPORTS full access to the entire range of reproductive services, and improving access in rural and urban areas; (2006)

b.             BELIEVES matters of reproductive health to be private and sensitive, and SUPPORTS the right of patients to make these decisions in confidence with their physician without the interference of any third party; (2006)

c.             RECOGNIZES patients’ right to have accurate, unbiased information regarding the full range of their reproductive health options, and STRONGLY URGES all physicians to provide evidence-based, scientifically accurate information and to counsel patients on the entire range of options available for any reproductive health issue, regardless of any moral or religious beliefs about particular options. (2006)

3.             In regard to contraception:

a.             BELIEVES that unintended pregnancies can place an undue burden on women and their families; (2008)

b.             BELIEVES birth control to be a form of preventive medicine;

c.             SUPPORTS responsibly safe and cost-effective birth control, as follows:

1.             primary forms of birth control methods that prevent conception should be encouraged through:

a.             education, which should include the potential and limits of varying contraceptive methods in preventing pregnancy as well as protecting from sexually transmitted diseases, and (1997)

b.             increasing availability of those methods; (1997) including legislation that would increase subsidies for birth control for low-income women and students or that would provide safe birth control prescriptions over the counter; and (2008)

2.             as a secondary means, emergency contraception and/or abortion, with totally informed consent, should be fully accessible to all. (2008)

d.             BELIEVES that the display and sale of contraceptive devices and the distribution of contraceptive information to all persons should be legal;

e.             SUPPORTS the proposal that cost be no barrier in the availability of birth control information, devices and medications;

f.              SUPPORTS contraceptive equity—insurance coverage for contraceptive devices and medications, including emergency contraception, at the same rate as other covered medications—for both private and public insurance, to achieve fair access and lower costs to patients; (2006)

g.             URGES the strong opposition of legislative initiatives, which impair a physician’s capacity to respect the right of a woman to self-determination in matters of reproduction;

h.             SUPPORTS over-the-counter availability of emergency contraception, and other contraceptive medications deemed as safe and effective by the FDA for over-the-counter use, to all women regardless of age; (2006)

i.              OPPOSES the infiltration of politics into the scientific decision-making process of the FDA, especially with regard to contraceptive devices and medications; (2006)

j.              URGES counseling about and access to emergency contraception as the standard of care for victims of sexual violence; (2006)

k.             TAKES THE POSITION and STATES publicly that a convenient, effective, and safe form of contraception for either men or women has not yet been produced and should become the goal of government and industry co-sponsored development programs; (2006)

4.             In regard to abortion:

a.             BELIEVES that all women, regardless of age, social status or marital status have the right to obtain a legal, safe, voluntary abortion; (2006)

b.             SUPPORTS the use of federal, state, and local funds to provide abortions for women who are unable to afford them; and OPPOSES restrictions on the availability of funds for family planning clinics that offer, counsel for, or refer for abortion; (2006)

c.             BELIEVES that voluntary induced abortions should be available from all public hospitals on the same basis as any other medical or surgical procedure;

d.             OPPOSES policies that restrict funding for training residents and medical students in abortion procedures at federally funded institutions; (2006)

e.             BELIEVES that all medical schools should include education on abortion as part of their mandatory curricula, as set forth in AMSA’s Principles on Medical Education; (2008)

f.              BELIEVES that all Obstetrics/Gynecology and Family Medicine residencies should offer training in abortion procedures; (2008)

g.             OPPOSES any  policy at the local, state, or federal level that causes delay and increased medical risk in the delivery of abortion services to women of any age, including but not limited to, prohibiting abortion counseling and referral in health care settings which receive federal funds. (1992)

h.             OPPOSES the use of explicit visual and/or verbal representation of the products of abortion that tend to produce emotional trauma rather than provide useful information to a woman considering an abortion; (2003)

i.              BELIEVES that the question of when a conceptus acquires personhood is a complex, religious, moral and personal question that cannot be answered by medical science, and OPPOSES all legislation attempting to define personhood of a conceptus;

j.              Regarding clinic violence, AMSA:

1.             SUPPORTS a woman’s right to an abortion performed in a safe and secure environment;

2.             CONDEMNS the violence directed against abortion clinics and family planning centers as a violation of the right of access to health care; (1985)

3.             SUPPORTS the Freedom of Access to Clinic Entrances law, and urges its enforcement to the fullest extent wherever possible; (1995)

4.             CONDEMNS any inflammatory rhetoric that encourages violence surrounding the abortion debate; (1995)

5.             STRONGLY URGES all health professional organizations/associations to publicly condemn violence directed against abortion providers, clinic workers and patients; (1995)

6.             STRONGLY URGES all health professional organizations/associations to demand the investigation and prosecution of perpetrators of clinic violence by all appropriate law enforcement agencies, including federal, state and local governments. (1995)

k.             OPPOSES the prohibition of intact dilation and extraction abortion. (1999)

l.              In regard to medical abortifacients:

1.             SUPPORTS the continued research and clinical use of all pharmaceutical abortifacients. (1998)

2.             RECOGNIZES that pharmaceutical abortifacients, although effective, do not replace the need for surgical abortion. (1998)

5.             In regard to sex education:

a.             BELIEVES that appropriate, evidence-based sex education will contribute to health and well-being by improving adolescents’ understanding of sex and sexuality and by reducing risky sexual practices, unintended pregnancy, and the transmission of sexually transmitted infections among adolescents; and that sex-education programs should be evaluated on these outcomes to determine their effectiveness. (2006)

b.             BELIEVES that educating children and adults about sexuality from birth to adulthood should come from many sources including, but not limited to, schools, health professionals and home. (1995)

c.             BELIEVES that sex and sexuality education should be based on, though not limited to, the following principles:

1.             enhancing self-esteem, such that young people feel good about themselves and are not available for exploitation and do not exploit others;

2.             understanding love and self-respect as the basic components of a person’s sexuality;

3.             preparation for making responsible decisions in critical areas of sexuality, based on a universal value of not hurting or exploiting others;

4.             contributing to knowledge and understanding of the sexual dimension of our lives, focusing on feelings, communication and values;

5.             emphasizing situational and life skills; (1995)

6.             using honest and open communication and avoiding scare tactics to help young people develop knowledge of human sexuality; (2006)

7.             helping young people understand that lesbian, gay, bisexual and transgender people exist in their communities and should be treated with respect regardless of their sexual orientation or gender identity; (2008)

8.             recognizing that lesbian, gay, bisexual and transgender youth are students as well, and provide a safe environment for young people to be open about sexual orientation and gender identity; (2008)

9.             increasing knowledge of the unique health needs specific to adolescents, including lesbian, gay, bisexual and transgender youth; (2008)

10.           helping young people understand the need for equal opportunities for men and women; (2006)

11.           understanding that parenthood requires responsibilities and interpersonal skills that strengthen family life, such as communication and compromise. (2006)

d.             SUPPORTS the establishment and the administration of comprehensive, evidence-based sexual education programs that include adequate information on and discussion of abstinence, contraception, barrier methods and other evidence-based safer sex and family planning practices; and strongly URGES the federal government and local school boards to provide preferential funding for such programs; (2006)

e.             SUPPORTS education that is age appropriate, nondirective and starts at a young age; (1995)

f.              SUPPORTS the establishment of programs for parents regarding adult sexuality, adolescent sexuality and their role as sex educators, with funding not compromising existing sex education programs;

g.             URGES that physicians and medical students play a more integral role in teaching youth about sexuality. (1992)

h.             SUPPORTS the use of randomized controlled trials to determine the effectiveness of sexual education programs (as outlined in 5.a) and refuses to support any additional federal funding for abstinence-only programs—as allowed under Section 510 of Title V of the Social Security Act or otherwise—as long as these programs are found to be either ineffective or less effective than comprehensive sexual education programs. (2002)

i.              STRONGLY recommends that individuals conducting sexual education programs receive standardized training and material to be distributed to students and that students should be randomly polled on the amount and type of information received to insure the program meets its original goal: increasing comprehensive sexual education. (2002)

j.              STRONGLY URGES neutral, third party scientific oversight of the content of federally- or state-supported sex education curricula. (2006)

6.             In regard to fertility and sterility:

a.             BELIEVES that every person has the right to control his/her own fertility;

b.             SUPPORTS sterilization as an acceptable form of birth control when totally informed consent has been given by the individual involved;

c.             SUPPORTS the availability of sterilization of adults without requirements concerning parity and marital state;

d.             BELIEVES that it is preferable, but not required, that a marital partner give informed consent for his/her spouse’s sterilization;

e.             OPPOSES sterilization by other than free, uncoerced choice or as a genocidal or discriminatory device;

7.             In regard to sexually transmitted infections:

a.             SUPPORTS the reporting to proper authorities of each case of a sexually transmitted infection in accordance with the laws of each state, and URGES the medical community to recognize its contribution to the incidence of sexually transmitted infections as a consequence of laxity in such required reportings. (2003)

b.             SUPPORTS the widespread availability of safe and effective vaccines for sexually transmitted infections when and if they become available; (2006)

8.             In regard to the rights of pregnant women:

a.             STRONGLY URGES pregnant women to avoid practices, which may be hazardous to themselves or their fetuses; (1987)

b.             ENCOURAGES women to consult with a health care professional, but SUPPORTS the legal right of women to make the ultimate decisions regarding their pregnancies and births; (1987)

c.             OPPOSES any new legislation or interpretation of existing laws, which would criminalize any otherwise legal actions by pregnant women, whether or not such actions are deemed to be medically injurious to a fetus; (1987)

d.             OPPOSES any policies that excessively punish pregnant women, above and beyond non-pregnant women, who commit criminal acts that may also harm their fetus based on concern for/injury to the fetus, including, but not limited to, illicit drug use; (2006)

e.            OPPOSES court ordered medical interventions, irrespective of the indications for such procedures, where the woman is legally competent of informed consent; (1987)

f.             URGES the active support of legislation designed to expand options available to childbearing women, including federal financial support for those unable to provide for a child, federal support of child-care programs for working and student mothers, and federal financial support for prenatal and postnatal health care; (1988)

g.            BELIEVES every pregnant woman in the United States has the right to and must be guaranteed access to comprehensive maternity and infant care regardless of location or ability to pay.  Where:

1.             Comprehensive maternity and infant services should be defined as the full range of maternity and well child services, including but not limited to early and continuing prenatal care, medical, psychosocial, educational and nutritional services, and postpartum care including family planning services, inpatient neonatal services and well-child services up to the age of 5 years. 

2.             The pregnant woman has choice of providers from among all types of licensed medical and health providers, including physicians and state licensed midwives and certified nurse midwives, health departments and community health centers.

3.             Pregnant women should have the choice of licensed facilities in which to deliver, including Joint Commission on Accreditation of Hospitals, certified hospitals and accredited birthing centers.

4.             In providing for such services, it must be recognized that early prenatal care is for the benefit of the child and that early care is of the essence. Therefore, incentives and education on the issue of the importance of prenatal health care to encourage the mother’s early participation should be considered.

5.             Pregnant women should have the choice to deliver at home and be attended by their choice of consenting physicians, state licensed midwives and certified nurse midwives.