Tubal sterilization in mentally handicapped women

When performed for contraception purposes tubular sterilization for mentally handicapped women poses important ethical issues including patients rights body integrity and the notion of informed consent. French law guarantees the respect and safety of all patients but in everyday practice patients rights must be upheld by family and healthcare workers searching for the most adapted solutions for each individual situation. We present here our proposals for everyday practice. Our conclusions are based on an analysis of the notion of handicap as defined by the WHO and on the observed sexual activities of this type of patient. In this context informed consent involves a number of subjective factors pointing out the difficulty encountered in providing clear comprehensible information. Finally we discuss the ethical issue of tubular sterilization which many consider to be a masked form of eugenism. (authors)