Involuntary sterilisation: we still need to guard against it

Rowlands, Sam; Amy, Jean‐Jacques

doi:10.1136/bmjsrh-2018-200119

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…44,45 Imperialism, capitalism and the patriarchy influence the socioeconomic standards by which people and particularly women and their fertility are valued. 46 Medicine holds social power, and patriarchal values are reflected in the institutional structures, 31 where women currently dominate the ground-level workforce but continue to be under-represented in leadership and senior roles. 47 Barriers to female advancement in the profession are largely owing to the 'unconscious (gender) bias' existing at systems and policy levels as well as the individual level.…”

Section: Medicine As a Patriarchal Institutementioning

confidence: 99%

Sex and gender gaps in medicine and the androcentric history of medical research

Merone

Tsey

Russell

et al. 2021

Australian and New Zealand Journal of Public Health

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Section: Medicine As a Patriarchal Institutementioning

confidence: 99%

Sex and gender gaps in medicine and the androcentric history of medical research

Merone

Tsey

Russell

et al. 2021

Australian and New Zealand Journal of Public Health

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“…These abuses have often targeted marginalized groups and there has been a pervasive bias towards sterilizing women. 68 Waiting periods for those considering sterilization have generally been introduced with good intentions as part of a comprehensive package with an emphasis on best practice around consent. As with abortion, the informed consent process prior to sterilization is crucial.…”

Section: Sterilizationmentioning

confidence: 99%

<p>Mandatory Waiting Periods Before Abortion and Sterilization: Theory and Practice</p>

Rowlands

Thomas

2020

IJWH

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Some laws insist on a fixed, compulsory waiting period between the time of obtaining consent and when abortions or sterilizations are carried out. Waiting periods are designed to allow for reflection on the decision and to minimize regret. In fact, the cognitive processing needed for these important decisions takes place relatively rapidly. Clinicians are used to handling cases individually and tailoring care appropriately, including giving more time for decision-making. Psychological considerations in relation to the role of emotion in decision-making, eg, regret, raise the possibility that waiting periods could have a detrimental impact on the emotional wellbeing of those concerned which might interfere with decision-making. Having an extended period of time to consider how much regret one might feel as a consequence of the decision one is faced with may make a person revisit a stable decision. In abortion care, waiting periods often result in an extra appointment being needed, delays in securing a procedure and personal distress for the applicant. Some women end up being beyond the gestational limit for abortion. Those requesting sterilization in a situation of active conflict in their relationship will do well to postpone a decision on sterilization. Otherwise, applicants for sterilization should not be forced to wait. Forced waiting undermines people's agency and autonomous decision-making ability. Low-income groups are particularly disadvantaged. It may be discriminatory when applied to marginalized groups. Concern about the validity of consent is best addressed by protective clinical guidelines rather than through rigid legislation. Waiting periods breach reproductive rights. Policymakers and politicians in countries that have waiting periods in sexual and reproductive health regulation should review relevant laws and policies and bring them into line with scientific and ethical evidence and international human rights law.

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“…Widespread coercive practices using reversible contraception and sterilisation [2][3][4] have arguably produced a legacy of suspicion in some communities about the intentions of promoters and providers of contraceptive services. This review examines two ethical aspects of LARC provision and promotion.…”

Section: Introductionmentioning

confidence: 99%

The ethics of state-sponsored and clinical promotion of long-acting reversible contraception

Wale

Rowlands

2020

BMJ Sex Reprod Health

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ObjectivesTo review ethical aspects of the promotion and provision of long-acting reversible contraception (LARC). Specifically, to examine (1) the tension between informational exchange and the active promotion of LARC methods to new and existing contraceptive users by healthcare professionals; and (2) the distinct ethical issues arising from the promotion of LARC methods by state-sponsored actors and healthcare professionals.MethodsNarrative review and ethical analysis.FindingsThere is an ethical difference between raising awareness/informational provision and actively promoting or prioritising specific contraceptive methods. It matters whether the policy choice is made, or the promotional activity about contraception is undertaken, by individual healthcare professionals at a local level or by more remote state-sponsored actors, because the relationship between the promoter and the (potential) contraceptive user is of a different kind. Imposing a dual responsibility upon healthcare professionals for raising awareness/informational exchange and the active promotion of LARC creates an unnecessary tension and barrier for the delivery of patient-centred care.ConclusionsThis review highlights the need for ethical reflection on the central role of the promoting agent and the distinction between facilitating informational awareness and active promotion of LARC. LARC methods should not be prioritised in isolation and without regard to the wider implications of public promotion. A balanced narrative and information-sharing programme that respects the individual interests of each contraceptive user is called for, especially in direct professional/service user relationships. No assumption should be made that user decision-making will necessarily be determined and influenced solely by the relative effectiveness of the contraceptive method.

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Involuntary sterilisation: we still need to guard against it

Cited by 7 publications

References 10 publications

Sex and gender gaps in medicine and the androcentric history of medical research

Sex and gender gaps in medicine and the androcentric history of medical research

<p>Mandatory Waiting Periods Before Abortion and Sterilization: Theory and Practice</p>

The ethics of state-sponsored and clinical promotion of long-acting reversible contraception

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