Policy as Ethics: Sterilisation of Girls with Intellectual Disability

Any public policy could be seen as an ethical issue, but only some are represented as such and debated using ethical terms. If a policy is generally accepted by the community, then it will not be seen as a controversy meriting debate. If a policy is contentious, protagonists may call upon a variety of paradigms to advance their positions or seek resolution, using, for example, legal arguments, or medical justifications. If there is no such agreed paradigm, the controversy may be framed as an ethical issue.An illustrative example is the debate concerning the sterilisation of young women who have intellectual disabilities. Are there any circumstances in which it is justifiable for parents to arrange for the sterilisation of their daughter who has an intellectual disability such that she is unable to make such a decision for herself ? There is a debate about the role and responsibilities of the family in deciding whether or not to seek sterilisation, and, in contrast, the role of the state in demanding that such decisions be monitored and authorised. The issue is fundamentally ethical, but attempts to resolve it have been medical and legal. The debate has been conducted through the procedures of guardianship boards and courts, through academic articles, and in mass media. The problem is seen by some as a private matter, by others as a medical one, by some as an example of prudence and care and by others as an example of eugenics.This paper offers an explanation of why some issues are deemed by the community to be ethical in nature. It provides an ethical analysis of the sterilisation debate, reveals an over-emphasis on rights at the expense of other ethical strategies and concludes that informed ethical commentary can further resolution where medically informed legal approaches have been unsatisfactory.