Sterilization of mentally retarded girls

: About 1000 sterilizations are performed in mentally retarded women in Germany every year out of about 30,000-50,000 operations. Considering that 10 out of 1000 people are mentally retarded, they are overrepresented in this procedure. There are no clear regulations concerning their sterilization because of the historical antecedents of abuse of the rights of the mentally retarded. A 1933 law about hereditary health resulted in the forced sterilization of 300,000-400,000 persons mostly based on ideological indications. During the 1972 reform of the penal code the attempt to regulate sterilization with abortion and set very stringent conditions for minors and competent persons did not succeed. In 1987 federal medical association guidelines and the Einbecker recommendations were published permitting sterilization if it was in the well-meant interest of the mentally retarded person and the indications analogous to abortion could be considered. The consent of legal representative, guardian, and possibly both parents had to be secured, and the guardian court had to be given prior notice. The patient had to be advised and without her consent the operation could not be carried out. A draft proposal to become law in 1992 would forbid sterilization of minors: the consent of the guardian court is needed for incompetents of age if pregnancy would likely result without sterilization and it could not be prevented by other means. The handicapped oppose the sterilization of mentally retarded and the use of genetical criteria laid down in the regulation for indications for legal abortion. In 1990 the federal parliament passed the law on the rights of guardianship and care for those of age forbidding forced sterilization and sterilization of minors. This legislation will give clear guidelines for doctors. Some legal uncertainties still exist that can be used responsibly for the interest of the patient.