CARE OF THE YOUNGER PATIENT – HOW SHOULD ‘YOUNGER’ BE DEFINED WHEN CONSIDERING PATIENTS SEEKING CONTRACEPTION?
Should it be by chronological age or by sexual and emotional maturity? If the latter is the yardstick, then the younger patient may be 13 or 30. The emotional tasks of adolescence, and the normal ages at which they are accomplished, have been described by Christopher (1992). The degree of emotional maturity, and the speed with which it is reached, varies widely between individuals, so that the professional offering help needs to be constantly aware that a consideration of the actual age of the patient is not enough to understand the emotional, sexual and contraceptive needs and difficulties.
For the main body of this chapter, the younger patient will be taken to mean the teenager or adolescent. Among these, doctors will see very few who are under 15 years old. These very young girls will be dealt with separately at the end of the chapter. It is estimated that 18 000 15-year-old girls took formal advice on contraception in 1990 in England. In total, all those under 16 years comprise less than 4% of the total workload of what is regarded as a young person’s clinic in a large city (Brook Advisory Centre, 1990). However, they are an important group, not only in terms of health care in its widest sense, but because they fall into a special category as regards legal and ethical considerations.
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