Voluntary sterilization of competent adults is legal in all states in the United States at this time, and any effort by statute or by a public hospital to require spousal consent would be unconstitutional. The legal problems existing in connection with voluntary sterilization essentially involve the meaning of "informed consent" and how it can be obtained. Among the most important features of the new Department of Health, Education and Welfare sterilization regulations are the 30 day waiting period which must elapse between the date informed consent is given and the date the sterilization is performed; total prohibitions against sterilization of persons under age 31, mentally incompetent or institutionalized, and elaborate informed consent requirements. The regulations apply to programs or projects for health services which are supported in whole or in part by Federal financial assistance.
The impact of population change upon children is the focus of the 1979 Planned Parenthood regional and affiliate population education workshops. Participation is the workshops is stressed through the use of questionnaires, games and activities addressing the causes and consequences of population change in developing and developed countries. An opportunity is provided to examine and evaluate demographic changes and concerns. Other activities emphasize understanding motivations for parenthood. Various population education mediums used by Planned Parenthood affiliates include speakers bureaus; free literature; seminars; symposiums and newletters.
Family planning experts toured China in August 1977, and reported their impressions. They observed that sex outside of marriage, even public displays of affection, are disapproved of, and venereal disease has been conquered. The status of women, socially and economically, is equal to that of men. Chinese marry much later than Westerners - in the mid-20s for both men and women, both rural and urban. The preferred family size is 2 children, with communities setting total quotas. Although there are no formal sex education programs, the use of birth control is widespread in China.
Minors are being recognized as having Constitutional rights, and this development is clearly evident in the area of sex-related health care. The Supreme Court has decided 3 major cases dealing with the rights of minors to sex-related health care. In a New York case the Court held that minors are entitled to purchase nonprescription contraceptives. In a Missouri case the Court held that minors, like adults, have a constitutional right of privacy with respect to abortion and that a blanket requirement of parental consent for a minor's abortion violates this basic right. In the 3rd case, the issue was the constitutionality of a Massachusetts statute which povided that an abortion could not be performed on an unmarried woman under the age of 18 without the consent of both her parents. Although it is now clear that parents do not have blanket veto power over their children's access to sex-related health care, the question remains as to whether they may have more limited rights - such as the right to be consulted or notified about their child's request for such care. The states of Maryland, Montana, and Utah have enacted laws requiring that parents be notified before an abortion is performed on a minor. Although none of these statutes has yet been tested in court, a similar legal issue was raised recently in Michigan, where minor children had been prescribed contraception without notification of the parents. The lower court has ruled in favor of the parents on 2 occasions, but the case is now being appealed. Many lawyers believe that any blanket requirement of parental notification will be held to violate minors' newly won Constitutional right of privacy.
In Thailand, birthrates among married women have declined by almost 1/2 over a 5-year period. Simultaneously, the proportion of women using contraception has doubled, knowledge of at least the rudiments of contraception has become close to universal, and family size preferences have dropped markedly. Authors John Knodel and Nibbon Debavalya, writing in a recent issue of "International Family Planning Perspectives and Digest," report a concurrent development of one of the world's largest family planning programs. They conclude that existing evidence suggests a relationship between improved fertility regulation and the growth of the family planning programs. The most significant features of the transition between 1968-1975 have included a decline in birthrates among rural women that is twice that of their counterparts and a nearly tripling of the proportion of women who had "ever" used contraception (from 19 to 51%). Also, the impact of the family planning program has been heightened by supportive factors in the Thai culture, the most important of which is the relatively high status of women in that country.
