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Thursday, 29 August 2013

Court Decides That Disabled Man is to Have a Vasectomy

A court recently decreed that a disabled man in Britain be given a vasectomy for because it's in his "best interests".

The man in question, known in the media as DE, is described as having "severe learning disabilities." I'm not a qualified diagnostician, but given that his reported IQ is around 40, I'd venture a guess that his diagnose goes beyond learning disabled to intellectually disabled (the media does tend to use these diagnoses interchangeably, although they're quite different.)

DE is 36, lives with his parents, and has a girlfriend with whom he's been for several years (and who also, according to the media, has "severe learning disabilities.") The two had a child together in 2009. DE has said that he doesn't want more children. His parents and his doctors petitioned the court to force DE to get the vasectomy on the grounds that he doesn't have the mental capacity to agree to it, and the judge agreed that a vasectomy was "overwhelmingly in his best interests." Read more here 

Several experts testified at the hearing, and the judge said of the order that DE get the vasectomy: "...the court does not make such an order lightly, conscious as it is that for the court to make an order permitting the lifelong removal of a person’s fertility for non-medical reasons requires strong justification." Read more here Here are some of the things that I hope were considered.

DE's Vasectomy: Consent Issues

Experts at the court hearing testified that D.E. has the capacity to consent to sex. Yet, the Telegraph reported that DE's mental age is between 6 and 9. Read more here I don't know what the absolute minimum age where any kind of for sexual activity is in Britain, but I doubt it's much lower than Canada's age, which is 12 years old when the other party is less than two years older and not in a position of authority Read more here .  I recognize that DE is legally, because of his age, an adult, and that these tests of mental age aren't always accurate. But it's incumbent on the people surrounding both both DE and his girlfriend to make sure that they understand the physical and emotional issues surrounding sex, to ensure that the dynamic is appropriate and non-abusive, and that they understand, to the greatest extent possible, the need for contraception and protection against disease.

The fact that DE won't use condoms is indeed problematic. However, assuming that these two are a monogamous couple, this wasn't the least invasive alternative. An IUD or a monthly injection for his girlfriend is more effective than a condom, doesn't require keeping track of a pill each day,  and would still leave both the option of having another child if they ever chose to. Was this investigated? If not, we've add a weird little layer of sexism onto this that really didn't need to be there.

And, if the couple is non-monogamous, a vasectomy won't protect them against disease.

Bottom line, however, if experts feel that this man is able to consent to sex, and clearly doesn't want to experience a consequence of sex, then he should be able to consent to an operation that will prevent that consequence. I find the court's ruling on his capacity very confusing.

DE's Vasectomy: A Slippery Slope

Are we ever not on a slippery slope when it comes to this sort of thing?

These two weren't using condoms (at least not consistently, obviously, because they have a kid that his grandmother is now raising.) I heard constantly growing up (and constantly told the kids that I used to work with) that if they can't talk about protection with partners and be responsible about it, then they need to consider whether they're really ready for sex. And I'd probably tell these two exactly the same the same thing. But I'm sure they heard that from a variety of people, as many teens (and adults) who end up with an unexpected pregnancy do because they...just didn't use protection.

However. We don't forcibly sterilize non-disabled people who chronically won't use condoms while they talk about how they don't want children, after they've already fathered a child that they can't support. We don't bring courts in to determine whether sterilization would be in the best interest for them, their psychological health, and the continued well-being of their relationship. Read more here

We allow people who make these sorts of decisions to continue to have control over their sex lives and their reproductive faculties, and say to them, "If you're going to make these choices, you have to live with the consequences of these decisions. Here are your options if you want to avoid those consequences." We even have services in place to deal with what happens when people continue to have unprotected sex because they, say, don't like condoms. And while I find it very difficult to understand why people can be cavalier about unprotected sex, that's not really the issue right now.

The issue is that this particular person who was being cavalier about unprotected sex was sterilized.

And now we have to ask, where do we start making the exception? A comment on one of the articles suggested that everyone with an IQ under 80 be forcibly sterilized. I've worked with people who's IQ's were significantly below 80 who could clearly explain to me that they always needed to use a condom when having sex to prevent pregnancy and disease. And I've heard people with IQ's significantly above 80 talk about having habitual unprotected sex. So I'm not buying that.

DE's Vasectomy: Not a Good Precedent to Set

The judge said that rulings like this will be made on an individual basis, but I'm not comfortable with that. I'm uncomfortable with this double standard for how we treat non-disabled people vs disabled people, and I'm uncomfortable with the idea that the court has been officially been empowered to compel someone to undergo a sterilization procedure.

I'm seeing a lot in this case in this confuses me, and I hope it's because we just haven't been privy to the debate that went on behind the scenes, and not because all the issues weren't explored thoroughly. The stakes are just too high one this one.


  1. Hmmm, Sarah. Forced to be sterilized. So DE didn't want more children, yet could consent to unprotected sex, but is it clear if he refused to have a vasectomy? Or is there more to this story? Did DE tell his parents he would like a vasectomy? (It doesn't sound like it from this article). Or could some organization have tried to intervene and say he wasn't capable of making such a decision and so the parents had to take it to court and get a legal ruling? The reason I ask this is because when Lindsey decided to have a tubal ligation at nineteen, her doctor agreed. But he warned us that if certain political groups learned that Lindsey had special needs and was making this decision, they might protest and we could be in a long, expensive court battle.(And that was in the good ol' U.S.A.) That never happened, but it was a concern.

    I did write a post somewhat about this last year: http://outoneear.com/should-special-needs-couples-have-babies/

    I don't like the idea of forced sterilization. But I also don't like the idea of people bringing innocent children into the world when they do not have the capabilities to care for them and someone else has to take on those responsibilities. I realize adoption is a possibility but if the adult with mental challenges doesn't agree to that, well then, how should things be handled? Does the child have options? Not that that would be the situation in all cases.

    I liked what you wrote at the end: "a lot in this case confuses me...." It confuses me to. I wonder if there is much, much more to this situation and we aren't getting all the facts. I do think decisions such as this should be made on an individualized basis. But I'd sure have to know a lot more to come to a rational and educated opinion. Thanks for sharing this story. P.S. I would've hated it if some organization would have butted into Lindsey's business because they thought they knew better than she did (or we did as a family). But that's just my viewpoint.

  2. This is a well written and very insightful post, Sarah. It is so unfortunate that decisions like these are made by courts in our pseudo-modern society. Involuntary sterilization is wrong, perhaps with the exception of a serial pedophile. Sex and reproduction and the transmission of our DNA are biological imperatives and the right to bodily integrity is sacred. Systematic sex education is serious a lack in the assistance given disabled people, in fact its a serious lack in the case of teenagers, No one one wants to discuss taboo subjects. There are alternatives for this couple without judicial intervention. Yet, so many details lack in the media portrayal....all, I can say is well done and thanks for bringing this issue to our attention. Best wishes...

  3. A vasectomy is a "Slippery Slope".
    Very icky choice of metaphors.