Protecting the reproductive rights of children and young adults with disabilities : the roles and responsibilities of the family, the state, and judicial decision-making

Abstract

Angela was an eleven-year-old girl with Rett’s Syndrome, a progressive neurological disorder that results in severe intellectual and physical impairment and epilepsy. 1

Angela could not talk and had “neither the coordination or the mental faculties to be able to use sign language.” 2

She acted “as a three month-old baby would.” 3

In her ninth year, Angela’s menstrual periods commenced, and while her epilepsy was controlled by medication, seizures could occur when she had a heavy menstrual period. 4

Excessive bleeding during these periods led to an “Implanon” medical procedure being performed, but this, together with oral contraceptive pills, proved to be unsatisfactory. 5

The bleeding caused Angela to become anemic and experience other problems. 6

Personal hygiene was also an issue. 7

Medical advice, supported by at least three medical practitioners, proposed that a hysterectomy be performed on the child, leaving the ovaries and tubes intact to provide her with normal hormones. 8

Therefore, “only the source of bleeding would be removed.” 9

It was submitted that the effects on Angela would be relatively minimal and the menstrual problems would be resolved. 10

As the nature of her disability was “such that she would not have the psychological capabilities to consider a pregnancy into the future,” this possibility would also have been taken care of.