Chapter 2: Definition of Terms

Lexicon Is Lingo - What’s In a Word?

Confucius, the ancient Chinese philosopher, was asked what he would do to set the world right. He responded, “I would insist on the exact definition of words.”

This quote echoed in my ears during the 1993 hearing on HB564, Missouri’s universal health care reform bill.

In remarks addressed to the House Committee conducting the hearing, Ms. Judith Widdicombe — the bill’s key author and founder of Missouri’s largest abortion clinic — stated that she supported parental involvement. However, when a committee member asked if she supported parental consent, she responded “NO.” (Parents often assume that parental involvement means, or at least includes, parental consent!)

Another prime example of the importance of the definition of terms is displayed in a presentation prepared by Dr. Willard Cates, Jr., M.D., M.P.H. and two colleagues titled “Abortion As A Treatment For Unwanted Pregnancy: The Number Two Sexually- Transmitted “Disease.” Dr. Willard Cates spoke on behalf of:

- the U.S. Department of Health Education, and Welfare (now the U.S. Department of Health & Human Services).
- Public Health Service, Center for Disease Control Bureau of Epidemiology.
- Family Planning Evaluation Division located in Atlanta, Georgia.

The presentation was made during the 14th Annual Scientific Meeting of the Association of Planned Parenthood Physicians in Miami Beach, Florida, on November 11, 1976.

In May 1993, Missouri passed SB380, the Missouri Outstanding Schools Act (OBE) and the health care reform bill, HB564. However, long before this, Missouri had begun promoting public and private schools as centers for one-stop shopping which includes health and social services. How does the government define “health”? According to the Missouri Department of Health (DOH), the definition now includes “pre-pregnancy risk prevention,” referrals, and follow-up in an effort to achieve federal health goals including “increasing to at least 90% the proportion of–people aged 19 and younger who use contraception.” 1

The World Health Organization (WHO) redefined health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.”2 Brock Chisholm was WHO’s director from 1948-1953. In a lecture to psychiatrists and top government officials entitled “The Psychiatry of Enduring Peace and Social Progress–Re-establishment of Peacetime Society,” Chisholm stated, “–If the race is to be freed from its crippling burden of good and evil it must be psychiatrists who take the original responsibility.”3 In an age when reforms are constantly redefining the fields of education and health, it is imperative that parents insist on the exact definition of words. The following glossary is an effort to clarify definitions in the social revisionists’ lexicon. It is crucial that parents understand the meaning of terms that have reformed the fields of education and health. They mean more than they sound.

Unless otherwise footnoted, the source for these terms is the U.S. Congress, Office of Technology Assessment, Adolescent Health Vol. I Summary and Policy Options:

Abstinence Education: “(A)n educational or motivational program which
A. Has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
B. Teaches abstinence from sexual activity outside marriage as the expected standard for all school age children;
C. Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
D. Teaches that a mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity;
E. Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
F. Teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society;
G. Teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and
H. Teaches the importance of attaining self-sufficiency before engaging in sexual activity.” 4

Adolescent Health: “–A fully realized view of adolescent health would also consider the impact of social (e.g., families, schools, communities, policies) and physical (e.g., fluoridation, automobile and highway design and construction) influences on health and would be sensitive to developmental changes that occur during adolescence.”

Adult: For purposes of consent to hospitalization or medical, surgical or other treatment or procedures, any person eighteen years of age or older. 5

Advocacy: “Refers to support, coordination, and linkage to experts, individuals, groups, and institutions who may help adolescents. May be provided by parents or others known to an adolescent.”

Agenda: “Program of things to be done, a list of things to be dealt with at a meeting.” 6

At-Risk: “A phrase used to describe an adolescent in an environment, having an existing health problem, or exhibiting behavior, that may result in a poor health outcome.” “(A) student who, because of limited English proficiency, poverty, race, geographic location, or economic disadvantage, faces a greater risk of low educational achievement or reduced academic expectation.” 7

Broad-Based Programs: “Typically, programs that take a comprehensive rather than a narrow approach to addressing a single health problem, such as by involving multiple service systems or strategies (e.g., a pregnancy prevention intervention that would involve teaching of life skills and vocational training, as well as provide sexuality education) and possibly by measuring multiple theoretically and practically related outcomes (e.g., avoidance of school dropout as well as pregnancy prevention).”

Case Management: “Identification, referral, follow-up, and outreach for physical, emotional, psychological, academic, transportation, counseling, or other “health” care related “needs” reimbursed by Medicaid. 8

Communism: “1. Any economic theory or system based on the ownership of all property by the community as a whole 2. a) a hypothetical stage of socialism, as formulated by Marx, Engels, Lenin, and others, to be characterized by a classless and stateless society and the equal distribution of economic goods and to be achieved by revolutionary and dictatorial, rather than gradualistic, means b) the form of government in the U.S.S.R., China, and other socialist states, professing to be working toward this stage by means of state planning and control of the economy, a one-party political structure, and an emphasis on the requirements of the state rather than on individual liberties.” 9

Community 2000: “–Blend federal, state, and local resources with community leadership, volunteers, private and public service providers, families, and schools. The Division of Alcohol and Drug Abuse, as the lead agency, acts as a catalyst. “It takes a village to raise a child–” 10

Comprehensive Services for Adolescents: “The elements of comprehensive health and related services for adolescents are not entirely agreed upon. They include, at a minimum, care for acute physical illnesses, general medical examinations in preparation for involvement in athletics, mental health counseling, laboratory tests, reproductive health care, family counseling, prescriptions, advocacy, and coordination of care, the more comprehensive may include educational services, vocational services, legal assistance, recreational opportunities, child care services and parenting education for adolescent parents. Not all services are available at all centers, but a well-functioning, comprehensive services center would provide for the coordinated delivery of care both within the center and between the center and outside agencies and providers.” (Centers are considered to be anywhere children may be found such as schools, child care facilities, preschools, churches, private, public or parochial schools, learning centers, common community gathering places, etc. Also see page 62 of Missouri HB564).

Conduct Disorder: “–A mental disorder–displays at least 3 of 13 specified behavioral symptoms (e.g., truancy, lying, stealing, fighting).”

Confidentiality (of the physician/patient relationship): “The state or quality of being confidential, that is intended to be held in confidence or kept secret. –By and large, the confidentiality of the relationship between health service providers and minors and the disclosure of confidential information by health service providers to the parents of minors or other third parties are not addressed in case or statutory law. See also parental consent requirement and parental notification.”
“The school records may include, by state statute, ‘school health records,’ but these are not the school-based clinic records–the school records are subject to the federal Family Educational Rights and Privacy Act, known as the Buckley Amendments–School-based clinic records are not school records and therefore are not governed by the Buckley Amendments.” 11

Contraception: “The prevention of conception or impregnation by any of a variety of means, including–prevention of implantation–and sterilization of the male or female partner.” (Editor’s note: another term for “failed contraception” is “baby.”)

Core Competencies: “Content specific areas of knowledge, skills and values prepared by the Missouri State Department of Elementary and Secondary Education”. 12

Disease: “–Largely socially defined. Thus, criminality and drug dependence are presently seen by some as diseases, when they were previously considered to be moral or legal problems. (See also Health).” 13

Dropout Prevention (includes pregnancy prevention): “A major education study, ‘Dropout Rates in the United States: 1988’ cites only two behavioral factors significantly associated with dropping out of school: marriage and/or pregnancy–Forty-three percent of the females who drop out do so because of pregnancy, parenthood, or marriage.” 14

EPSDT (Early and Periodic Screening, Diagnostic, and Treatment Program is the same as HCY ‘Healthy Children and Youth’ program):
“State and federally funded, state-administered program under Medicaid–to provide preventive screening exams and follow up services–to Medicaid-eligible children under age 21.
“EPSDT is a comprehensive health care program for children which includes–screening–pregnancy testing would be covered.” 15
“EPSDT can link at-risk adolescents to pre-pregnancy risk education, [and] family planning–” 16

Educational Neglect: “As defined by DHHS’s [Department of Health and Human Services] National Center on Child Abuse and Neglect–can take several forms–(e.g., refusal to allow or failure to obtain recommended remedial educational services.”)

Emancipated Minor: Any person eighteen years or older

Emotional Neglect: “As defined by DHHS’s National Center on Child Abuse and Neglect,–refusal of recommended, needed, and available psychological care, delay in psychological care, and other emotional neglect (e.g., other inattention to the child’s developmental/emotional needs not classifiable under any of the above forms of emotional neglect, such as inappropriate application of expectations or restrictions.”)

Exit Learner Outcome “(ELO) a statement describing the knowledge, skills, and values which build gradually and are ultimately possessed by students who graduate.” 17

Family: “A family is a group of persons who share values, goals, resources, and have a commitment to one another over time and space.” 18 Types of families listed included “Unmarried couples with or without children, and gay and lesbian couples.” Webster’s New World Dictionary defines “family” to be “a social unit consisting of parents and the children that they rear; the children of the same parents; a group of people related by ancestry or marriage.”

Family Planning: “The regulation, by birth control methods, of the number of children that a woman will have.” 19
Family Planning Programs Authorized by Title X of the Public Health Service Act: “–Contraceptives may be distributed without parental consent or notification–low-income individuals are targeted–they are required to offer a broad range of family planning services to all who want them, including adolescents.”
“Those requesting information on options for the management of an unintended pregnancy are to be given non-directive counseling on the following alternative courses of action, and referral upon request:
- prenatal care and delivery
- infant care, foster care, or adoption
- pregnancy termination.” 20

Fascism: “A system of government characterized by rigid one-party dictatorship, forcible suppression of opposition, private economic enterprise under centralized governmental control, belligerent nationalism, racism, and militarism, etc.: first instituted in Italy in 1922. See also NAZI.” 21

Free Enterprise: “The economic doctrine or practice of permitting private industry to operate under freely competitive conditions with a minimum of governmental control.” 22

Health (as defined by the World Health Organization in 1948): “–A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity, it includes not only the more conventional fields of activity but also mental health, housing, nutrition, economic or working conditions, and administrative and social techniques affecting public health.”

Juvenile Justice System: “–Includes law enforcement officers and others who refer juveniles to the courts–which–oversee the execution of child protective services–and less frequently, agencies that provide protective services and care (e.g., foster care) for juvenile victims of abuse and neglect–agencies intersect with the child welfare or social services system.”

Key Skills: “Descriptors for the Core Competencies that result in an accumulation of knowledge, skills, and values over time.” 23

One-Stop Shopping: “A setting for health care services that delivers an entire set of comprehensive health (and, often, related services.”)
“Statewide areas of critical need for learning and development shall include: establishing family schools, whereby such schools adopt proven models of one-stop state services for children and families.” 24

Parental Authority: “–Parental authority to control their children’s access to medical treatment for which they can legally give their own consent has been limited. Parents may not have a right to limit access to medically necessary services where the minor’s right to consent to the service is established by statute or is constitutionally protected.” 25

Parental Consent: “–Courts and legislatures have carved out a variety of exceptions to this requirement–”
“A parent is not required to consent for services such as family planning, sexually-transmitted diseases or prenatal care.” 26
“–It would be inappropriate to list any service, particularly with any procedure for parents to ‘check off’ or refuse consent for the service, if it will ever be provided based on the minor student’s own consent.” 27
“State law permits treatment of minors for the conditions of pregnancy–Family planning care includes screening for pregnancy–and if appropriate the prescription of birth control methods–includ[ing] pill, injection or implants–Laws which cover the right to privacy and the prevention of discrimination due to age have been used in defending the provision of care to minors without parental consent.” 28
SEE ALSO: FAMILY PLANNING PROGRAMS.

Prenatal Care Services: Include “coordinating pre-pregnancy risk prevention activities–arranging for transportation–link[ing] at-risk adolescents to–family planning–”

Primary Care: “General or family practice, internal medicine, pediatric or obstetric and gynecological care as provided to the general public by physicians licensed and registered pursuant to chapter 334, RSMo;” 29

Problem Behaviors: “Those behaviors that have been deemed socially unacceptable or that lead to poor health outcomes (e.g., unprotected sexual intercourse).”

Related Intervention: “A preventive or other service that may enhance health (e.g., social services, vocational training, educational services, food, housing, mentoring).”

Reproductive Health Care: “A wide range of services–including–(i.e., examination and treatment of the female reproductive organs,) and preventive services–(e.g., counseling, prescribing contraceptive methods, dispensing contraceptives.”)

School-Linked Health Centers: “–School health center for students (and sometimes the family members of students–) that provides a wide range of medical and counseling services and is located on or near school grounds and is associated with the school–”

Sexually Active: “Denotes ever having had sexual intercourse (as opposed to currently being sexually active.)”
Skills: “The abilities to think critically about, apply, and communicate to others the knowledge one possesses.”

Socialism: “The ownership and operation of the means of production and distribution by society or the community rather than by private individuals, with all members of society or the community sharing in the work and the products. 3. The stage of society, in Marxist doctrine, coming between the capitalist stage and the communist stage, in which private ownership of the means of production and distribution has been eliminated.” 31

Strands: “The divisions of a particular subject matter into knowledge, skills, and values.” 32

Unintended Pregnancy: “All abortions plus live births and fetal deaths to females younger than 18 plus live births and fetal deaths with spacing less than 12 months for females ages 18-34, plus out-of-wedlock births to females with less than a college education.” 33

Values: “The attitudes one has about the knowledge and skills one possesses.” 34

[1] Missouri Department of Health, Healthy Missourians 2000 Vol. II, p. 139.
[2] , Preamble of the World Health Organization Constitution, SIECUS Circle, pp. 281, 466.
[3] SIECUS Circle, pp. 280, 466. Refers to George Brock Chisholm’s, “The Psychiatry of Enduring Peace and Social Progress Re-establishment of Peacetime Society” in Psychiatry, Vol. 9, Feb. 1946, pp. 1-35.
[4] Federal Register/Vol. 62, No. 49/Thursday, March 13, 1997, Notices, pp.12031.
[5] RSMO 431.061
[6] New World Dictionary, Second College Edition p. 25.
[7] “Goals 2000: Educate America Act,” Part A, Sec. 912, (L) Definitions, p.219.
[8] Author’s definition based on the “Medicaid Interagency Cooperative Agreement.”
[9] Webster’s New World Dictionary Second College Edition, p. 287.
[10] Missouri Department of Mental Health Division of Alcohol and Drug Abuse.
[11] Adolescent Health Volume 1: Summary and Policy Options, pp. 164. Also School-Based Health Clinics: Legal Issues, pp. 43-44, The National Center For Youth Law and the Center For Population Options
[12] “Learning How to Learn” Definition of Terms, distributed by a Missouri school district.
[13] James R. Kimmey, M.D., M.P.H., Show Me Health Reform: Glossary of Terms and Concepts, p. 11, St. Louis University School of Public Health.
[14] U.S. Department of Education-Office of Civil Rights, Teenage Pregnancy and Parenthood Issues, July 1991, p. 3.
[15] Letter from the U.S. Department of Health and Human Services refers to: MOB: BBH, SC 55MO.
[16] State Medicaid Manual, Part 5, Revision 4, 1990, p. 5124.
[17] “Learning How to Learn,” Definition of Terms.
[18] Handout from 28th Annual Crucial Early Years Conference; “Changing Families:
Strategies for Early Childhood.” Workshop sponsored by the University of Missouri-St.
Louis; Ferguson-Florissant School District; St. John’s Child Development Center
and St. John’s Mercy Medical Center.
[19] Webster’s Second College Edition New World Dictionary, p. 505.
U.S. Department of Health & Human Services Program Guidelines for Project Grants for Family Planning Services, Title X federal family planning funds.
[20] Webster’s Second College Edition New World Dictionary, p. 508.
[21] Webster’s New World Dictionary, Second College Edition, p. 556.
[22] “Learning How to Learn” Definition of Terms.
[23] Outstanding Schools Act, Missouri’s education reform bill SB380, 1993, p. 13.
[24] Abigail English, J.D. and Lillian Tereszkiewicz, M.P.H. School-Based Health Clinics: Legal Issues, Center for Population Options and National Center for Youth Law.
[25] “Teen Clinic.,” St. Louis County Department of Community Health and Medical Care.
School-Based Health Clinics: Legal Issues p. 26.
[26] Missouri Department of Health, Division of Maternal, Child and Family Health, June 30, 1993 letter.
[27] Revised Statutes of Missouri 1993, Health and Welfare, 191.500, Financial Assistance Program for Certain Students, p. 1083.
[28] “Learning How to Learn” Definition of Terms.
[29] Webster’s New World Dictionary Second College Edition, p. 1351.
[30] “Learning How to Learn” Definition of Terms.
[31] Missouri Department of Health, Healthy Missourians 2000 Volume II, Nov. 1992, p. 139.
[32] “Learning How to Learn,” Definition of Terms.