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H.H.S. Asks Rule Requiring Notice of Birth-Control Use

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Washington--Nearly a year after he first made the proposal, Secretary of Health and Human Services Richard S. Schweiker last week said he would publish the final version of a controversial rule requiring federally-funded family-planning clinics to notify the parents of teen-agers who receive prescriptions for birth-control drugs or devices.

The announcement turned out to be one of the Secretary's last before his surprise resignation last Wednesday.

The news that the department was moving ahead with the proposed rule brought immediate reactions from interested groups. The day the Secretary announced his plan, the Planned Parenthood Federation of America filed suit in the Federal District Court for the District of Columbia. The complaint, filed on behalf of several of the group's affiliates, a physician, a parent, and a teen-age girl, charges that "there will be irreparable injury for which there is no adequate remedy at law" unless the department is enjoined from implementing the rule.

The next day, the American Life Lobby, a "pro-life, pro-family" organization, sent strongly worded telegrams opposing the rule to President Reagan and David Stockman, director of the Office of Management and Budget.

The criticism that the Secretary's announcement elicited was a continuation of the controversy that has been going on since the rule was first proposed on Feb. 22, 1982. The rule falls under Title X of the Public Health Service Act, which funds between 4,000 and 5,000 family-planning clinics. It would require the clinics to notify parents within 10 days of the date that "unemancipated minors" receive prescription birth-control drugs or devices.

Sent to the Office of Management and Budget last week, the rule will not become final until 30 days after it is published in the Federal Register. A spokesman for the department said officials are hopeful that the rule will be published by mid-February.

In announcing the plan to proceed with the rule-making process, Secretary Schweiker said the department "has a deep responsibility to protect the health and safety of minor adolescents who are given prescription birth-control drugs or devices paid for with taxpayer dollars."

'Public Comment'

Critics, however, who represent a wide range of political opinion, see otherwise. During the "public comment period" for the measure, they offered their opinions in the 120,000 letters and petitions that the department received.

In these comments, there was "a very considerable amount of support," according to the spokesman.

Although the department found it impossible to sort the comments into straightforward classifications--those favoring and those opposing the rule--some themes emerged, a department spokesman said.

Those who favored increasing parental involvement in the sexual conduct of young people argue that the rule does not go far enough; clin-ics, they said, should require parental permission before they distribute prescription birth-control methods to teen-agers.

Many of these critics oppose any federal involvement in birth-control programs, and view the rule on teen-agers as a poor political compromise that supports neither families nor their ultimate goal of terminating goverment intervention in birth-control matters.

On the other side, those who advocate open access to birth control for teen-agers argued that the rule will increase the rate of teen-age pregnancy, violate the privacy of those who seek birth-control services, and exceed the limits of the federal law under which it is promulgated.

Last week, after the Secretary's announcement, critics of the rule continued to raise three of the main issues that emerged from the comments--health, privacy, and Congressional intent.

Teen-Age Pregnancy

"There is a lot of concern about the impact [the regulations] will have on the increase in teen-age pregnancy. The notification is going to inhibit a lot of women who would seek outside help from doing so," noted Arnold F. Fege, director of government relations for the National Parent-Teacher Association (pta).

The pta took no official position on the rule, but Mr. Fege said organization officials had hoped that hhs might adopt a more "deliberative" course that evaluated the impact of the regulation on teen-agers and their families before issuing any final rule.

"We wanted more information on the impact," Mr. Fege said. "We had no indication that the present system was not working, and we think the department did not do a very good job in defining the problem."

The suit filed by Planned Parenthood argues that minors will "forgo prescription devices and use less effective methods," which will lead to more unintentional pregnancies.

Department officials respond that research data do not support these claims. But the critics counter that human nature and modern society being what they are, it is unlikely that teen-agers will agree readily to involve their parents in their birth-control planning. To think that they will, opponents of the rule say, ignores many characteristics of modern life--troubled families, working parents, and the like.

"They won't trust you because they know you have to tell their parents," said Peggy Rufner, who worked as a school nurse for 30 years and is now the executive director of the National Association of School Nurses. Advocates of parental notification believe that it will help hold families together, Ms. Rufner said, but it often leads students to keep their fears of pregnancy or venereal disease to themselves, in her view.

"I feel badly about it, but I know what the realities are," Ms. Rufner said.

Some conservative groups, also concerned about the rule's impact on families, argue that it should demand more, not less, parental involvement.

"We're very disappointed in Secretary Schweiker and the Administration, which is supposed to be pro-life and pro-family because those regulations, as we understand them, require parental notification after the fact," said Gary Curran, legislative director for the American Life Lobby, a 108,000-member "pro-life, pro-family" organization.

"In other words, they are perpetuating the intrusion of the federal program into the family relation, specifically inserting a federal program between parent and child," Mr. Curran said. "We find that absolutely outrageous. We believe that if the administration is to live up to its beliefs, it should require parental consent in advance."

The issue of privacy, also raised in many of the comments submitted to hhs, is also of concern to Planned Parenthood and others who argue that it will violate teen-agers' constitutional right to privacy.

The government, however, responds that teen-agers have a choice about whether to seek prescription birth control from a clinic. If they choose to do so, they will be told first about the requirement. "At that point, it's up to the teen-ager," the hhs spokesman said.

Also at issue, for some, is the question of what the Congress intended when it enacted a measure "encouraging" parental participation in teen-agers' birth-control planning. That clause was in the Omnibus Budget Reconciliation Act of 1981.

The Planned Parenthood suit argues, too, that the rule exceeds the statutory authority of the law, and is "arbitrary and capricious."

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