Philosophy, University of Nottingham, Nottingham, UK
J Med Ethics. 2024 Sep 20;50(10):708-711. doi: 10.1136/jme-2023-109264.
Some National Health Service healthcare boards in the UK will approve a request for female sterilisation only if the patient first accepts a trial period of 1 year with an intrauterine device (IUD), a form of long-acting reversible contraception. In this article, I argue that this requirement is not justified by appeal to any of (or any combination of) promotion of informed consent, paternalistic concerns regarding patient regret in later life and health service budgetary considerations. Informed consent and patient autonomy may be promoted by a mandatory waiting period, but the concomitant imposition of an IUD trial during this period cannot be justified on these grounds. As long as elective vasectomy is offered by the healthcare system, elective female sterilisation should be accessible under reasonably similar-even if not identical-conditions.
英国的一些国民保健服务医疗委员会仅在患者首先接受宫内节育器 (IUD) 为期 1 年的试用期后,才会批准女性绝育的请求,IUD 是一种长效可逆避孕措施。在本文中,我认为,这种要求没有得到任何(或任何组合)理由的支持,包括促进知情同意、对患者晚年后悔的家长式关切以及对医疗服务预算考虑的关切。通过强制性等待期可以促进知情同意和患者自主权,但在此期间强制进行 IUD 试验不能以此为理由。只要医疗系统提供选择性输精管切除术,那么在合理相似的条件下——即使不完全相同——也应该可以进行选择性女性绝育。