Márquez-González Horacio, Valdez-Martínez Edith
Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Cardiología. Ciudad de México, México.
Instituto Mexicano del Seguro Social, Coordinación de Investigación en Salud. Ciudad de México, México.
Gac Med Mex. 2018;154(6):649-656. doi: 10.24875/GMM.18004429.
Menstrual hygiene in adolescents with intellectual disability (ID) represents an extra burden for parents or primary caregivers, especially in developing countries, where social institutions, including the health system, lack the capability to help this group of teenagers and their families; hence, hysterectomy to eliminate menstrual bleeding is considered a morally acceptable resource. Hysterectomy to solve the "problem" of menstrual hygiene reflects obstacles that affect the care provided by the physician to the adolescent with ID: on one hand, the criterion of social value about a "poor quality of life," and on the other, discrimination when only socioeconomic conditions are considered rather than the lack of a social network of support and special education. In Mexico, current medical support for girls and adolescents with ID for the management of menstrual hygiene is unsatisfactory. The practice of hysterectomy with the single purpose of menstrual hygiene is ethically and morally unfair and maleficent.
智障青少年的经期卫生对父母或主要照料者而言是一项额外负担，在发展中国家尤其如此，在这些国家，包括卫生系统在内的社会机构缺乏帮助这群青少年及其家庭的能力；因此，通过子宫切除术来消除月经出血被视为一种道德上可接受的办法。通过子宫切除术来解决经期卫生“问题”反映出影响医生为智障青少年提供护理的障碍：一方面是关于“低生活质量”的社会价值标准，另一方面是仅考虑社会经济状况而非缺乏社会支持网络和特殊教育时的歧视。在墨西哥，目前对智障女童和青少年经期卫生管理的医疗支持并不令人满意。仅以经期卫生为目的进行子宫切除术在伦理和道德上是不公平且有害的。
