The principle of respect for autonomy and the sterilization of people with intellectual disabilities

[摘要] ENGLISH ABSTRACT:The implementation of eugenic policies reached its peak during the zo centurywhen thousands of people with intellectual disabilities and other undesirablequalities were involuntary sterilized. Although most of the eugenic policies havebeen removed, countries such as South Africa, still make legally provision for theinvoluntary sterilization of people with intellectual disabilities.Torbjërn Tannsjë (1998) used the argument from autonomy to argue thatinvoluntary sterilization practices are wrong because it involves compulsion.According to him, society should never interfere with people's reproductive choicesand people should never be required to qualify for the right to have children. Theaim of this assignment was to systematically assess the argument from autonomyas far as the policy of involuntary sterilization of people with intellectual disabilities isconcerned. To this end, the concept of autonomy and the principle of respect forautonomy are discussed and applied to the intellectually disabled. It is argued thatautonomy and respect for autonomy are useful concepts to apply to some peoplewith intellectual disabilities. These individuals should not be automatically assumedto be incompetent, but their competence needs to be determined on an individuallevel, with reference to the complexity of the decision to be made. Special effort isneeded from health care professionals to obtain (where possible) informed consentfrom people with intellectual disabilities. The application of the principle of respectfor autonomy to matters of reproduction leads to the conclusion that people withsevere to profound levels of disability, are unable to provide informed consent forsexual intercourse. Therefore some form of paternalistic protection is needed forthese individuals. People with mild to moderate intellectual disabilities who arehowever competent to consent to sexual intercourse should never be prohibitedfrom procreation by means of involuntary sterilization. State interference in mattersof reproduction should be limited to interventions where (i) children are seriouslyharmed by parents and (ii) to protect those who are incompetent to consent tosexual interactions with others. Apart from these exceptions, the intellectuallydisabled is entitled to the same procreative rights as all other citizens.

[发布机构] Stellenbosch University