Paransky Ora I, Zurawin Robert K
Department of Obstetrics and Gynecology, Section of Pediatric and Adolescent Gynecology, Baylor College of Medicine, Houston, TX 77030, USA.
J Pediatr Adolesc Gynecol. 2003 Aug;16(4):223-35. doi: 10.1016/s1083-3188(03)00125-6.
The controversial history of the reproductive rights of the mentally retarded has led to the formulation of laws in the past century designed to protect women from forced sterilization. Significantly, however, in their official ethical guidelines, The American College of Obstetricians and Gynecologists states that "sterilization should not be denied to individuals simply because they also may be vulnerable to coercion" (Int J Gynaecol Obstet 1999; 65:317). Recent advances in medical and surgical methods of contraception and control of menstrual abnormalities have led to a re-evaluation of the management of adolescents with special needs. Physicians, the courts, parents, and caretakers need to be aware of the latest medical and surgical options available, the current applicable laws in each state if such exist, and the ethical guidelines to determine what treatment option is in the best interests of the patient. This review examines the history of the sterilization of the mentally retarded, the latest surgical and pharmacologic treatments available, and the current legal environment and proposes an algorithm to facilitate the management of menstrual hygiene and contraception.
智障者生育权利方面存在争议的历史促使在过去一个世纪制定了旨在保护女性免遭强制绝育的法律。然而，重要的是，美国妇产科医师学会在其官方伦理指南中指出，“不应仅仅因为某些人可能容易受到胁迫就拒绝为其实施绝育手术”（《国际妇产科杂志》1999年；65:317）。避孕及月经异常控制方面医学和外科方法的最新进展促使人们重新评估有特殊需求青少年的管理方式。医生、法院、家长及看护人员需要了解现有的最新医学和外科选择、每个州当前适用的法律（若有）以及伦理指南，以确定何种治疗方案最符合患者的利益。本综述考察了智障者绝育的历史、现有的最新外科和药物治疗方法以及当前的法律环境，并提出一种算法以促进月经卫生和避孕的管理。
