Measure 2 could put girls' lives at risk

Dr. Monique Karaganis

Recently, Jim Minnery wrote a Compass piece ("Honesty on Measure 2 vital for teen girls," July 8) in support of Ballot Measure 2 that ignored some very key issues, glossed over others and took our organization to task for opposing the measure. After careful and thorough discussion, the Alaska Chapter of the American Academy of Pediatrics has recently decided to oppose Measure 2 and we thought our concerns were worth sharing with your readers.

Laws like Measure 2, while well-meaning, increase the risk of harm to adolescents by delaying access to appropriate medical care -- delays that may prove extremely dangerous and potentially life-threatening. That is why so many Alaska doctors, nurses, school counselors, teachers, Planned Parenthood and the YWCA have joined us in opposing this measure.

Of course adolescents facing an unintended pregnancy should be strongly encouraged to involve their parents and other trusted adults in decisions regarding pregnancy termination. The good news is that both nationally and in Alaska, most do. But laws like Measure 2 that mandate parental involvement do not achieve their intended benefit of promoting family communication. No law can mandate family communication.

And, unfortunately, not all teens live in homes where communication is possible -- or even safe. Many national studies indicate that in some homes, mandating that a teen talk to her parents may, in fact, precipitate a family crisis. One study said that one-third of minors who do not inform parents already have experienced family violence and fear it will recur. Research on abusive and dysfunctional families shows that violence is at its worst during a family member's pregnancy and during adolescence. A mandate like this will put teens living in these kinds of homes at risk.

The judicial bypass system envisioned by the authors of Measure 2 just won't work in Alaska. How is a teen from an abusive home in the middle of Alaska's harsh winter going to even get to a court or to law enforcement to deal with the abuse? Scared, pregnant teens don't need a judge; they need medical care -- without delay. Their claims that teens can tell a school nurse or neighbor are just plain wrong! Teens would actually have to get a signed and notarized statement from either a grandparent, stepparent, sibling over the age of 21, law enforcement official or DHSS official who has investigated the abuse. That's not as simple as the proponents are pretending; in fact, it's extremely difficult for any teen, let alone one who is scared and pregnant, to handle.

And that is the real danger of Measure 2. The most damaging effect of mandatory parental notification laws is that they delay and obstruct a pregnant adolescent's access to timely professional advice and medical care. Teenagers are already twice as likely as adults to delay the diagnosis of first-trimester pregnancy. In states where family mandates are in place, there is evidence that many teens delay care even longer, waiting until they reach their 18th birthday, or until they are showing, making any decision about the pregnancy and its medical implications much more difficult -- and dangerous.

Timely access to medical care in Alaska is often already difficult at times. Our geography and our medical systems make any new barriers to care very problematic -- and potentially dangerous. Laws like Measure 2 that may encourage teens to delay important and critical care will put them in real danger.

Of course, the Alaska Chapter of the American Academy of Pediatrics acknowledges and respects the diversity of beliefs about abortion and affirms the value of voluntary parental involvement -- in fact, we encourage it. But for the reasons stated above, we believe that Measure 2 is dangerous to some of Alaska's most vulnerable teens, may delay critical care and will put patients at risk. Therefore, we are urging a no vote on Measure 2.

Dr. Monique M. Karaganis is a pediatrician and secretary for the Alaska Chapter of the American Academy of Pediatrics.