Parental paternalism as an equity issue: A case study of parental influence on adolescents’ reproductive health in Medellín, Colombia
Bibliographic record
Abstract
In bioethics, parental paternalism in adolescent healthcare is typically analyzed through the lens of autonomy and consent, emphasizing parents’ role and adolescents’ capacity to make independent decisions. However, this approach may overlook the role of parental self-interest in shaping healthcare decisions, particularly in the context of reproductive health, and may contribute to inequitable outcomes for adolescents. This exploratory empirical bioethics study examines these dynamics through an equity lens, offering a broader perspective on how relational and social factors can differentially constrain adolescents’ reproductive choices, such as the use of contraceptives. In 2024, semi-structured interviews were conducted with parents of adolescents aged 10–19 in Medellín, Colombia. Participants were recruited through a sexual and reproductive health clinic and community networks. Transcripts were analyzed using the public health ethics principle of equity. Of the 28 participants, 79% were mothers, and together they had 35 adolescents with a mean age of 14. While parental paternalism is typically framed as solely altruistic, some participants described influencing adolescents’ contraceptive decisions to avoid assuming caregiving roles as young grandparents. In a context like Colombia, where adolescent pregnancy is prevalent and grandparents often provide care, such motivations raise equity concerns about how parental self-interest may unequally constrain adolescents’ reproductive choices. These findings highlight an underexplored equity concern: when parental self-interest shapes adolescents’ healthcare decisions, it can create unjust disparities in their ability to make reproductive health choices. Equity-oriented approaches must address how family dynamics can reinforce structural barriers to adolescent health and well-being.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.006 | 0.003 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".