As the pharmacist, what is the most appropriate action to take when a 14-year-old requests emergency contraception?

• A. Refuse to provide contraception due to age
• B. Assess competency using Fraser Guidelines and provide EC if appropriate
• C. Provide emergency contraception immediately without assessment
• D. Refer to GP for discussion later

Answer: (B)

When a 14-year-old asks for emergency contraception, the priority is to judge whether they can consent for themselves using Fraser Guidelines. This means checking that the young person understands what emergency contraception does and how to use it, understands the risks, benefits, and alternatives, and understands the consequences of not taking it. They should be able to appreciate the health implications and make a voluntary decision without being pressured, and the clinician must be satisfied that giving the treatment is in their best interests.

If the adolescent demonstrates this understanding and is capable of consent, you can provide emergency contraception and offer clear counselling on how to use it, what to expect (including possible side effects and the importance of follow-up or future contraception), and that it does not protect against sexually transmitted infections. You should also discuss the option to involve a parent or guardian, but their consent is not required if Fraser Guidelines are met and confidentiality should be preserved.

If the adolescent does not meet these criteria, you should not proceed without involving a parent or guardian and following local safeguarding policies. Refusing solely on age or providing EC without any assessment would not support the appropriate, patient-centered approach.