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Ethical Issues in the Care of Handicapped, Chronically III, and Dying Children

There is presently broad consensus that involuntary sterilization of an incompetent patient should be done only in the following unusual circumstances, and then only after approval by a court:

1. If the progeny would be so severely damaged that their lives would be arguably worse than nonexistence (eg, a disorder such as Lesch-Nyhan syndrome), OR a retarded female's physical or psychologic health would be seriously jeopardized by a pregnancy and/or abortion (eg, severe heart or lung disease), AND

2. There are no alternative, less restrictive ways of avoiding pregnancy (such as segregation, supervision, behavior control, or reversible forms of contraception), AND

3. There has been a court order, following a process designed to ensure that the procedure is necessary to protect the interests of the patient.