Informed choice and the sexual revolution

Dr ES Williams

 Introduction 

A pro-choice dogma now dominates sex education and abortion counselling.  Virtually all sex education programmes are built around the concept of the ‘informed choice’.  While the language may vary, with phrases such as ‘informed decision’, ‘health choices’, ‘responsible decisions’ and so on, the underlying meaning is the same—a young woman is provided with information to enable her to make a choice between the various sexual options that are open to her.   Pro-choice abortion counselling, for example, invites a woman to make an informed choice between three options, parenting, adoption and abortion.  According to the British Pregnancy Advisory Service,  ‘Our current policy is one of adapting to each individual by the provision of information, the provision of support, clarifying that every woman understands all options open to her. This will enable a woman to be respected in her decision and make an informed choice.’_[i] 

Task Force on Informed Choice

The term informed choice first appeared in family planning literature in the early 1970s, and became prominent in family planning policy when USAID stated that its support for family planning programmes was based the two principles of voluntarism and informed choice._[ii]  In 1987, the Task Force on Informed Choice, which consisted of representatives from 17 organisations actively involved in promoting family planning, including the International Planned Parenthood Federation (IPPF), met to develop guidance on how informed choice should be used in family planning programmes._[iii]  In 1994, the International Conference on Population and Development (Cairo) agreed that informed choice in family planning is based on human rights.  During the last decade the concept of informed choice has become an integral part of virtually all family planning, abortion counselling and sex education programmes worldwide.     

The Task Force defined informed choice as ‘effective access to information on reproductive choices and to the necessary counselling, services and supplies to help individuals choose and use an appropriate method of family planning, if desired.’_[iv]  According to the Population Report ‘the purpose of informed choice is to ensure that all clients decide for themselves on health care that best meets their needs’._[v]  The Task Force claimed that ‘the goal of counselling is to have the client arrive at a choice that he/she is satisfied with and, if the choice is to use contraception, to prepare the client to use his/her chosen method effectively.’_[vi]  It concluded that much progress had been made in promoting informed choice and recommended that family planning agencies should develop a training module specifically on informed choice._[vii]  ‘Family planning and health care professionals need to understand that implementation of programmes to promote informed choice will make their job easier, not harder.’_[viii]

The International Planned Parenthood Federation

The International Planned Parenthood Federation has a deep commitment to the concept of informed choice.  According to the IPPF Annual Program Review: ‘The commitment of the IPPF towards empowering young people to make informed decisions and choices regarding their sexual and reproductive health has been solid and unwavering since the early 1990s.’_[ix] The underlying principle which guides the work of IPPF is a rights-based approach, with International Human Rights treaties informing the way IPPF works with the developmental context of young people… This approach enhances young people’s development and reduces health risk behaviours, including unprotected intercourse.  The importance of youth empowerment, informed choice and practices of non-discrimination has enabled the Federation to respond effectively to the needs of young people, to protect and promote their right to accurate, non-judgemental sexual and reproductive health information and services…’_[x]  The IPPF believes that young people ‘need accurate information about safer sex and a broad range of youth-friendly sexual and reproductive health services.  They need personal skills and confidence to practise sexual behaviour that is safe and enjoyable for them, and to negotiate the sexual relationship they want at the time that is right for them.’_[xi] 

The IPPF policy on informed choice states that all FPAs shall facilitate access to a broad range of sexual and reproductive health services.  An article in Population Reports (series J, number 5) declares that ‘managing for informed choice requires commitment by leadership and an environment designed to give clients what they want’.  _[xii]  The ultimate aim of the informed choice is to enable people to choose what they want._[xiii]

In 2002 the IPPF called on the United Nations Special Session of Children to stand by its previous commitments to young people’s sexual rights.  Dr Pramilla Senanyake of the IPPF said: ‘We believe that with the tools to make informed choices, young men and women can not only protect themselves from the risks of HIV, unwanted pregnancy and unsafe abortion, they can also enjoy a better life with the freedom to achieve their aspirations.’_[xiv]  In its note to editors the IPPF claims to be at the forefront of the fight to help young people protect themselves from unwanted pregnancies and HIV and make informed decisions._[xv]

Secular sex education programmes

The dogma of informed choice is now the common currency of virtually all sex education programmes in the UK.  The Sex Education Forum, an umbrella organisation for the main organisation involved in sex education, claims in Framework for Sex and Relationships Education that children and young people want to learn and practise personal skills which will help them ‘to take responsibility for their own and other’s sexual health, to access support and help and to make informed choices and decisions regarding their sexual health and emotional well-being’._[xvi] 

AVERT (an international HIV and AIDS charity based in the UK, with the aim of AVERTing HIV and AIDS worldwide) says that its sex education is about ‘developing young people’s skills so that they make informed choices about their behaviour, and feel confident and competent about acting on these choices’._[xvii]  The FPA declares that ‘if people are to enjoy positive sexual health, they need knowledge and awareness from which to make informed choices, and the confidence to express their sexuality.’_[xviii]  Anne Weyman of the FPA says that high quality sex and relationships education, begun early and well delivered by trained staff ‘remains of vital importance in enabling young people to make informed choices about their sexual health’._[xix]  The Brook Advisory Centres, in its mission statement, says that it ‘exits to enable all young people to make informed choices about their personal and sexual relationships so that they can enjoy their sexuality without harm’._[xx] 

Lovelife, South Africa’s national HIV prevention programme for young people, developed by a consortium of organisations including the Planned Parenthood Association of South Africa, declares that the campaign ‘promotes specific behavioural values, including informed choice and responsible behaviour sexuality, and links young people to counselling and clinical services’._[xxi] 

‘Christian’ sex education and informed choice

CARE, one of the most high profile Christian organisations involved in sex education, is deeply committed to the dogma of informed choice.  It’s new sex education programme Evaluate… informing choice ‘empowers young people to make healthy informed choices, and supports them in delaying sexual experience until a committed relationship, ideally marriage’._[xxii]  CARE’s sex education video Make Love Last helps young people come to a balanced and sound decision about their sexual behaviour.  ‘Young people have the right and need to examine the major options on offer.  Without this opportunity they cannot make an informed choice.’_[xxiii]

The Northern Ireland sex education programme Love for Life, aims ‘to empower young people to respect and value themselves and to support them in making informed healthy choices in the area of relationships and sexuality’.  Oasis Esteem, another Christian organisation involved in sex education, ‘exists to empower and enable young people to make informed choices about sex and relationships, drugs and alcohol and health living through education and training services’._[xxiv]

Love for Life encourages teenagers to make informed choices with regard to their sexual conduct on the basis of factual information and positive self-esteem._[xxv]  Two options are set before children—to have sex or not to have sex.  Because this is seen as a difficult choice, sex education helps by providing teenagers with the information they need to make an informed decision.  In support of the one option children are given information about the joys of sex, the importance of being in a stable relationship and the ability to access contraception.  In support of the other option children are provided with information about the failure rate of contraception and the incidence of STDs.  On the basis of the information provided, children are in a position to weigh up the pros and cons, and then to make an informed decision about which option appeals to them most. 

Secular pro-choice abortion counselling

The idea of ‘informed choice’ is central to abortion counselling.  Pro-choice counselling invites a woman to make an ‘informed choice’ between the three options, based on the information she has received and guided by her feelings.  BPAS states that its ‘current policy is one of adapting to each individual by the provision of information, the provision of support, clarifying that every woman understands all options open to her. This will enable a woman to be respected in her decision and make an informed choice.’_[xxvi]  Planned Parenthood tells its clients that its counsellors ‘will provide information to help women and couples make informed choices’._[xxvii]  Brook Advisory Centres believe that ‘it is every woman’s right to have access to impartial information about abortion, as well as support in making an informed decision about pregnancy.’ ‘Brook believes that young people should be helped to make informed decisions that are right for them in the long term.’_[xxviii]   A Marie Stopes booklet on abortion has been designed to help a woman ‘reach an informed decision’ about the options available to her._[xxix] The Sexwise project, which consists of a website and radio programmes, has been developed jointly by the International Planned Parenthood Federation and the BBC World Service, to speak to people in different regions of the world about sexual health and reproductive rights, which include the right to abortion.  A key aim of Sexwise is to assist people to make more informed choices about their sexuality._[xxx] 

CARE’s crisis pregnancy counselling

CARE’s 162 independent pregnancy-counselling centres provide a classic example of the dogma of informed choice as it relates to abortion.  A pregnancy-counselling centre is a place where a pregnant woman can talk with a trained advisor confidentially.  CARE’s pregnancy counsellors ‘are trained in non-directional counselling, enabling you to discover more clearly how you feel about the situation you are in’.  According to CARE Centres Network website the objective of counselling is to help a woman discover what she wants to do with her pregnancy.   The website explains that ‘a pregnancy counselling centre is a place where you can spend as much time as you want to talk with a trained advisor confidentially.  She will listen to you, give you all the information you need, help you find out what you want to do.’_[xxxi]

And what are her options?  First, she may continue with the pregnancy, second, she may put her child out for adoption and third, she may have an abortion.   The woman is provided with all the information she needs to make an informed choice between these three options.  CARE’s website stresses that ‘it is important for you to have all the information so that you can decide for yourself… Abortion is not an easy thing to do.  You may feel that you need to talk to someone in more detail about your situation before making a final decision.’  CARE’s leaflet Making a Decision is designed to help pregnant women make an informed choice around their options.  The leaflet invites a pregnant woman to consider what she will lose with each option.  ‘Write a list of those things you think you might lose with each of the options.  These may include things like money, accommodation, freedom…’  The woman is then invited to consider what she will she stands to gain from each option. ‘This time go through the list and think of the things you would gain with each of the options.  How important are these gains to you?’

So a leading aim of CARE’s counselling process is to guide a woman to a position where she is able to make her own informed decision. According to CARE’s training manual for crisis pregnancy counselling, Called to Care, ‘to achieve empathy we must balance the ability to remain objective, so we can help the woman make an informed choice whilst identifying with the woman’s perceptions and feelings.’_[xxxii]  One of the main goals of counselling is to bring a woman ‘to the point where she can make a fully informed decision’._[xxxiii]  CARE advisors are trained to give ‘accurate information about all the options open to you so that you can make an informed choice’._[xxxiv]  CARE Centres Network advises a woman: ‘You are entitled to this information so that you and your partner can make an informed choice.’_[xxxv]  CARE confidential provides ‘confidential counselling to help you reach your own informed choice’._[xxxvi] 

Informed choice dogma

The basic presupposition of informed choice dogma is that we live in a universe without moral absolutes.  The International Planned Parenthood Federation believes that the approach of those who advocate sex education and abortion should always be to insist on free and informed choice, and that it is always a mistake to enter into debates on questions of morality._[xxxvii]  Because there is no absolute moral framework that governs sexual conduct, young people can be presented with smorgasbord of sexual activities from which to choose their behaviour.  Once we grasp the presupposition on which the edifice of informed choice is built, we are able to identify three essential characteristics of informed choice dogma.

1. Sexual options 

Informed choice dogma presents young people with options around sexual behaviour from which they can choose how to behave.  Sex education offers young people the choice of delaying sexual activity or practising ‘safer sex’.  Young people are presented with two options and invited to choose the one that makes them feel most comfortable, and whatever choice they make is right for them.  There is no warning that any form of sexual behaviour is wrong.  The effect is to demoralise sexual behaviour.  Informed choice propaganda encourages a young woman to believe that her so-called informed decision to have sex is a morally neutral action—she is not warned of the moral consequences. 

2.  Factual sex information

Informed choice dogma demands that young people are given information about all the options, so that they are able to weigh up the advantages and disadvantages of each option before making their choice.  Before a young woman can decide whether or not to have sex she needs to know all about the dangers imposed by sexually transmitted diseases, and how to protect herself from these dangers.  She needs to be fully informed about contraception, and how to get access to contraceptive services, just in case she chooses to have sex.  What is significant is that the young woman is not told of the moral and spiritual dangers associated with sexual immorality. 

3. What ever she chooses is right for her

Informed choice dogma persuades a young woman that whatever she choice she makes, whether it is to have ‘safer sex’ or to abstain that it’s the right choice for her. The pamphlet Sexual health matters for young women (HEA) explains that ‘whether or not you have sex can be a difficult decision to make.  But in the end it’s what’s right for you, and only you can answer that.  If you’ve decided you’re not ready for sex, then fine.  Remember, it’s your body, your choice and your right to say no.  Only have sex because you want to’._[xxxviii]  The young woman is offered a choice of whether or not to have sex, and her decision depends on what she wants, on her sexual desires, on how she feels at that moment in time, and not on any objective standard of right and wrong.  Notice that if she does not want to have sex, then fine, it is her right to say no.  The corollary is that if she does want to have sex then fine, it is her right to say yes.  The inference is that whatever she chooses is right for her.  All that matters is that she makes her own choice, free from any moral considerations.  She is persuaded to do what she believes to be right in her own eyes.

So we see that informed choice dogma sets before children the proposition that sexual promiscuity and sexual abstinence are moral equivalents.  Both options are open to a girl and the choice she makes is not really important—as the HEA puts it: ‘If you’ve decided you’re not ready for sex them fine.’_[xxxix]  What is important is that a girl makes her own decision, not influenced by anybody else, and especially not by the negative ‘thou-shalt-nots’ of the Bible or the traditional views of her parents.  A girl who chooses to ‘have sex’ is described as having made a ‘responsible choice’ provided she uses contraception.  Sex education even offers to help those who want to ‘have sex’ by teaching them how to negotiate ‘safer sex’ with a partner.  Those who choose not to have sex are reassured that they can always change their mind when they meet the right person or when they feel ready for sex.  And if they become pregnant, sex education offers the option of an abortion.  

To offer children the option of having sex without warning that promiscuity is against the moral law of God is leading them into the path of temptation.  To place before children the choice of sexual intercourse, and suggest that it is for them to make an informed decision on the basis of the facts, guided by how they feel, is damnable advice. Those who do so should take heed of the biblical warning.  Jesus said, ‘Temptations to sin are sure to come, but woe to the one through whom they come!  It would be better for him if a millstone were hung around his neck and he were cast into the sea than that he should cause one of these little ones to sin’ (Luke:1-2). 

Christian responsibility

This examination of informed choice dogma shows that it is fundamentally opposed to biblical morality.  Christian teaching about sexual conduct is completely different.  The Bible makes it abundantly clear that human sexual behaviour is subject to the moral law of God.  And God’s law demands sexual purity, decency and propriety, and declares that fornication, adultery, homosexuality and bestiality are wrong.  Jesus warned that the broad way leads to destruction.  The choice is between obeying God's word or not.  This is a moral choice. 

Any attempt to teach about sexual conduct in a moral vacuum is to promote amorality, which always leads to sexual immorality.  The God of the Bible demands that his people control their bodies ‘in a way that is holy and honourable, not in passionate lust like the heathen, who do not know God’ (1 Thessalonians 4:4-5).  The New Testament warns that we should ‘flee from sexual immorality’ (1 Corinthians 6:18).    Return to top of page