The viability of supported decision-making in protecting adolescent girls with intellectual disability from involuntary sterilisation in Nigeria

Abstract

The importance of promoting adolescent reproductive health rights is emerging in Nigeria. Accordingly, medical practice in terms of contraceptive decision-making is evolving such that adolescents who can understand the nature and consequences of a contraceptive treatment can be administered such treatment. Given that adolescent girls with intellectual disabilities are subjected to involuntary sterilisation on an unequal basis with their peers, the need for a strategy to promote their reproductive health and rights is undeniable. Supported decision-making is one strategy for promoting the legal capacity of adolescent girls with intellectual disabilities in terms of decision-making about contraception. The right to supported decision-making as expounded by Committee on the Rights of Persons with Disabilities involves providing assistance to persons with disabilities, including adolescents with intellectual disabilities, to exercise their legal capacity and make decisions affecting their lives. This study therefore examines the viability of supported decision-making in protecting adolescent girls with intellectual disabilities from involuntary sterilisation in Nigeria. Utilising the social model of disability and Foucauldian perspectives, the study assesses the conceptions of intellectual disability, legal capacity and supported decision-making as well as the practicality of law and policy in guaranteeing supported decision-making for adolescent girls with intellectual disabilities. The study also employs empirical research, to interrogate the Committee on the Rights of Persons with Disabilities’ interpretation of supported-decision making for adolescents with disabilities. It finds that adolescent girls with intellectual disabilities are susceptible to involuntary sterilisation in Nigeria. Secondly, the CRPD Committee provides little guidance on how to theorise supported decision-making for persons with intellectual disabilities who require extensive and pervasive support especially as regards determining their ‘will and preference’. Thirdly, the best interests’ standard and the functional approach adopted by the CRPD Committee in interpreting the implication of article 12 for children and adolescents with disabilities leaves room for abuse because the standards for determining them are indefinite. Fourthly, there is ambiguity as to the scope, models and principles of supported decision making. Accordingly, this study recommends that legislative enactment and reform is imperative not only to promote supported decision-making but also to mitigate the involuntary sterilisation adolescent girls with intellectual disabilities. It also recommends that support measures and services be provided for persons with disabilities in general, and adolescent girls with intellectual disabilities in Nigeria. The study further recommends awareness raising and public sensitisation as well as training of policy-makers and relevant stakeholders to address negative pervasive stereotypes and beliefs about persons with disabilities. Lastly, the need for evidence based research to interrogate the applicability and standards of supported decision-making for adolescents with intellectual disabilities and to contribute to the jurisprudence on supported decision-making is emphasised.