{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:46:49Z","timestamp":1783637209870,"version":"3.55.0"},"reference-count":25,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Ethics"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:p>Since USA constitutional precedent established in 1976, adolescents have increasingly been afforded the right to access contraception without first obtaining parental consent or authorisation. There is general agreement this ethically permissible. However, long-acting reversible contraception (LARC) methods have only recently been prescribed to the adolescent population. They are currently the most effective forms of contraception available and have high compliance and satisfaction rates. Yet unlike other contraceptives, LARCs are associated with special procedural risks because they must be inserted and removed by trained healthcare providers. It is unclear whether the unique invasive nature of LARC changes the traditional ethical calculus of permitting adolescent decision-making in the realm of contraception. To answer this question, we review the risk\u2013benefit profile of adolescent LARC use. Traditional justifications for permitting adolescent contraception decision-making authority are then considered in the context of LARCs. Finally, analogous reasoning is used to evaluate potential differences between permitting adolescents to consent for LARC procedures versus for emergency and pregnancy termination procedures. Ultimately, we argue that the invasive nature of LARCs does not override adolescents\u2019 unique and compelling need for safe and effective forms of contraception. In fact, LARCs may oftentimes be in the best interest of adolescent patients who wish to prevent unintended pregnancy. We advocate for the specific enumeration of adolescents\u2019 ability to consent to both LARC insertion and removal procedures within state policies. Given the provider-dependent nature of LARCs and the stigma regarding adolescent sexuality, special political and procedural safeguards to protect adolescent autonomy are warranted.<\/jats:p>","DOI":"10.1136\/medethics-2018-104855","type":"journal-article","created":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T16:21:04Z","timestamp":1528993264000},"page":"585-588","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Consenting to invasive contraceptives: an ethical analysis of adolescent decision-making authority for long-acting reversible contraception"],"prefix":"10.1136","volume":"44","author":[{"given":"Rosemary Talbot","family":"Behmer Hansen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavita Shah","family":"Arora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,6,14]]},"reference":[{"key":"2020050722465431000_44.9.585.1","unstructured":"Centers for Disease Control and Prevention. 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Long-acting reversible contraception: Implants and intrauterine devices, 2017."},{"key":"2020050722465431000_44.9.585.3","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1001\/jamapediatrics.2015.3152","article-title":"Involving Parents in Pediatric Patients' Decisions About Long-Acting Reversible Contraception","volume":"170","author":"Hoopes","year":"2016","journal-title":"JAMA Pediatr"},{"key":"2020050722465431000_44.9.585.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.NHL.0000287968.36429.a9"},{"key":"2020050722465431000_44.9.585.5","first-page":"1295","article-title":"Constituting children\u2019s bodily integrity","volume":"61","author":"Hill","year":"2015","journal-title":"Duke L J"},{"key":"2020050722465431000_44.9.585.6","unstructured":"An Overview of Minors\u2019 Consent Law. 2018. https:\/\/www.guttmacher.org\/state-policy\/explore\/overview-minors-consent-law"},{"key":"2020050722465431000_44.9.585.7","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jpag.2016.07.002","article-title":"Barriers and Facilitators to Adolescents' Use of Long-Acting Reversible Contraceptives","volume":"30","author":"Pritt","year":"2017","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2020050722465431000_44.9.585.8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2300"},{"key":"2020050722465431000_44.9.585.9","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.ogc.2015.07.008","article-title":"Increasing Use of Long-Acting Reversible Contraception to Decrease Unplanned Pregnancy","volume":"42","author":"Lotke","year":"2015","journal-title":"Obstet Gynecol Clin North Am"},{"key":"2020050722465431000_44.9.585.10","unstructured":"Clare C , Squire M-B , Alvarez K , et al . Barriers to adolescent contraception use and adherence. Int J Adolesc Med Health. 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Children of Choice: Freedom and the New Reproductive Technologies. Princeton: Princeton University Press, 1996."},{"key":"2020050722465431000_44.9.585.20","unstructured":"ACOG Committee on Gynecologic Practice. Increasing access to contraceptive implants and intrauterine devices to reduce unintended pregnancy, 2015."},{"key":"2020050722465431000_44.9.585.21","unstructured":"Centers for Disease Control and Prevention. US selected practices recommendations for contraceptive use, 2016. 2017. 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