Wingfield M, Healy D L, Nicholson A
Department of Obstetrics and Gynaecology, Monash Medical Centre, Clayton, Vic.
Med J Aust. 1994 May 2;160(9):536-8.
Optimal gynaecological care for women with intellectual disability is complex. Many of these women suffer unique problems with regard to menstrual hygiene, sexuality, contraception and susceptibility to sexual abuse. Complex medical, ethical, social and legal issues must be carefully considered to address these problems. We discuss the "gynaecological" management of intellectually disabled women, with particular reference to contraception and menstrual suppression. We advocate endometrial ablation as an alternative to hysterectomy for women with intractable menstrual problems. Some ethical issues are reviewed which must be addressed to determine which approach is in the patient's "best interest" and adopts the "least restrictive option". Finally, we present Federal and State laws governing informed consent for medical procedures for women and children with intellectual disabilities.
为智障女性提供最佳的妇科护理非常复杂。这些女性中的许多人在月经卫生、性行为、避孕以及遭受性虐待的易感性方面都存在独特的问题。必须仔细考虑复杂的医学、伦理、社会和法律问题，以解决这些问题。我们讨论智障女性的“妇科”管理，特别提及避孕和月经抑制。对于有顽固性月经问题的女性，我们主张采用子宫内膜切除术替代子宫切除术。审查了一些伦理问题，这些问题必须得到解决，以确定哪种方法符合患者的“最大利益”并采用“限制最少的选择”。最后，我们介绍了关于智障妇女和儿童医疗程序知情同意的联邦和州法律。
