Inside The Ethics Committee: Preventing Pregnancy in Homeless Women
Homeless women who are addicted to drugs often turn to sex work for money. Some become pregnant, often many times, with tragic consequences - their children often end up in care. What lengths should a medical team go to to encourage these women to use contraception?
The number of people sleeping rough on Britain’s streets is rising, and the need for supported housing continues. But providing a roof over someone's head is just the start. A nurse specialist, working in day centres and hostels, provides health services for the homeless. It’s an ideal opportunity to try to engage with clients, who usually fall under the radar of the general practitioner. Physical health problems associated with living outside are common, and many suffer from mental health problems and drug addiction.
Sex work provides a means for women to escape the streets at night, and fund a drug habit. But the chaotic nature of these women’s lives means contraception use is sporadic and pregnancies occur. Many of the women who have suffered the loss of several children to the care system still don’t have long term contraception in place.
- What lengths should the medical team go to to encourage these women to avoid unwanted pregnancies?
- Should they offer them money?
- Would this be ethical?
- Do we have the right to interfere in this way when people lead chaotic lives?
Joan Bakewell is joined on the panel by Ann Skinner, Founding Director of Resolving Chaos and Chair of Homeless Link, Deborah Bowman, Professor of Ethics and Medical Law at St George’s University of London, Richard Ashcroft, Professor of Bioethics at Queen Mary College, London and Dr Tamsin Broom, Sexual Health Consultant at Sandyford , Glasgow.
Beth Eastwood is producer of Inside The Ethics Comittee