The Mentally Disabled Women: Sterilization at the Request of Others

On December 13, 2006, the United Nations General Assembly,as reported in the
International Herald Tribune approved the “first convention protecting rights of world’s 600 million disabled people.” According to the article,the convention “guarantees that the disabled have the inherent right to life on an equal basis with the able-bodied and requires countries to prohibit discrimination on the basis of disability and guarantee equal legal protection. Countries must also ensure the equal right of the disabled to own and inherit property, to control their financial affairs, and to privacy over their personal lives.” The convention will enter into force when it is ratified by 20 countries. One of the issues that concern disability activists is the “forced sterilization of girls and women because of their disability, forced institutionalization and substitute decision making.”

It is my understanding that governmental ordered (forced) permanent sterilization of mentally disabled women in the United States has been abolished in the past several decades. Sterilization, to prevent pregnancy, of a woman who is mentally unable to provide informed consent varies in the different states but can be performed only on the direct request of a legal guardian with physician recommendation and/or court approval. The obvious medical rationale for performing such a procedure would be to prevent harm if further pregnancy or delivery would endanger the life or health of the mother. However, if this is not the case, the social rationale would be to prevent harm to the child if the mother is mentally unable to provide appropriate care or as a consequence of the pregnancy an unnecessary burden placed on society or the guardian with regard to the financial or other responsibilities to care for the child. Another social argument would be to prevent any genetic basis for the mental handicap to be passed on to future generations—eugenics. The latter argument for mandatory sterilization, as originally approved by the Supreme Court in 1927, was overturned in 1942 by the Court.

Here is the ethical issue to my visitors: Do you find any excuse for the permanent sterilization of a mentally disabled woman ethical on the basis of a decision by others without the woman’s own personal and informed consent? How about non-surgical, non-permanent contraceptive medication use without consent? ..Maurice.