Scottish Council on Human Bioethics

15 Morningside Road, Edinburgh EH10 4DP, Tel: 0131 447 6394 or 0774 298 4459

INFORMING CHOICE:
New Approaches and Ethics for Sex and Relationships Education in Scotland

February 2004

CONTENTS

Introduction: The Incorporation of Ethics into Sex and Relationships Education

Part 1: Setting the Scene

Chapter 1. The Scottish Situation

• 1.1 Introduction
• 1.2 Scotland’s Sexual Health
• 1.2.1 Teenage Pregnancy
• 1.2.2 Sexually Transmitted Infections
• 1.2.3 Abortion
• 1.3 Scottish Sexual Behaviour
• 1.3.1 Analysis of the NATSAL Survey
• 1.4 Some Recent Initiatives
• 1.4.1 Healthy Respect
• 1.4.2 SHARE
• 1.4.3 Sexual Health and Wellbeing Network
• 1.4.4 Walk the Talk
• 1.4.5 Think About It?
• 1.5 Policy Context
• 1.5.1 Towards a Healthier Scotland (1999)
• 1.5.2 Teenage Pregnancy (1999)
• 1.5.3 Legislative Context and Guidance
• 1.5.3 (a) The McCabe Report
• 1.5.3 (b) The Standards in Scotland’s Schools Act, 2000
• 1.5.4 Enhancing Sexual Wellbeing in Scotland (2003)
• 1.6 Conclusion

Chapter 2. Initiation of Teenage Sexual Activity

• 2.1. Introduction
• 2.2 Biological Factors
• 2.3 Psychological Factors
• 2.3.1 Non-sexual needs
• 2.3.2 Risk Behaviour
• 2.3.3 Risk Behaviour and Cognitive Development
• 2.3.4 Psychiatric Disorders
• 2.3.5 Sexual Abuse
• 2.3.6 Self Esteem
• 2.4 The Family System
• 2.4.1 Family Background
• 2.4.2 Parental Values
• 2.4.3 Parental Monitoring and Communication
• 2.5 The Extra-Familial System
• 2.5.1 Peer Pressure
• 2.5.2 Media Pressure
• 2.5.3 Socio-Economic Factors
• 2.6 Conclusion

Chapter 3. International Comparisons

• 3.1 Introduction
• 3.2 The Netherlands
• 3.2.1 Superior Sex Education
• 3.2.2 A Culture of Openness
• 3.2.3 Better Forward Planning
• 3.2.4 What has therefore happened in the Netherlands
• 3.3 The United States
• 3.3.1 Setting the Scene
• 3.3.2 The Abstinence Debate
• 3.3.3 Does the Abstinence Message Work?
• 3.3.4 What has caused the recent decline in Teenage Pregnancy?
• 3.4 Uganda
• 3.4.1 Abstinence from Sexual Activity
• 3.4.2 Multiple-partner declines
• 3.4.3 Condom Use
• 3.4.4 How did Uganda do it?
• 3.5 Conclusion

Part 2: Ethics

Chapter 4. The Discussion of Ethics in Sex Education

• 4.1 Introduction
• 4.2 Why Ethics?
• 4.3 An Ethical Approach to Sex and Relationships Education
• 4.3.1 Self-Determination
• (a) Competence
• (b) Information Provided
• (c) Understanding
• (d) Freedom of Choice
• 4.3.2 Do No Harm
• 4.3.3 Best Interest
• 4.3.4 Ethics and Human Rights
• 4.4 Conclusion

Chapter 5. Conclusion and Recommendations

• 5.1 Ethics: A Collaborative Goal
• 5.1.1 Full Information Provision
• 5.1.2 Freedom of Choice
• 5.1.3 Do No Harm
• 5.1.4 Best Interest
• 5.1.5 Rights
• 5.2 Conclusion

Appendix 1. Summary of Recommendations

Appendix 2. Articles from the UN Convention on the Rights of the Child

Bibliography