[Surgical contraception on mentally retarded women]. / La esterilizacion quirurgica en mujeres con retardo mental

PIP: Mentally retarded (MR) women present a difficult dilemma in medicine because of the vulnerability of this population to unscrupulous people, and their ability to conceive. Sterilization remains the only contraceptive methods that can prevent pregnancy among these women without the additional complications found in temporary methods. There are 3 categories of people who should be included in any discussion of this type: 1) MR with IQ's of 55=70; who have reached the 4th grade; who can get married and lead a semi-normal life within society. This group should not be considered for sterilization; 2) MR with IQ's of 40-55; these can generally adapt themselves to society; however, it's possible that the process of the "normalization" is too great an effort which could aggravate the burdens of pregnancy and childbearing; sterilization is recommended for this group; 3) MR with IQ's under 40; this group is severely retarded, requiring supervision; they are incapable of taking care of themselves, especially their personal hygiene, and require sterilization. 24-26.4% of children will be retarded when 1 parent is retarded, and 44-47% when both parents are retarded. In cases where sterilization is recommended: 1) it must be determined that the patient cannot demonstrate voluntary informed consent and that coercion was not used; 2) that the patient cannot raise a child; 3) that the patient is at risk of getting pregnant; 4) it must be proven, through a multi-disciplinary committee that there are no other alternatives in the cases; 5) the legal consent of the patient's guardians must be obtained; 6) in cases where there aren't any legal guardians, the institution or legal authority must follow all legal procedures before the Colombian Institute for Family Welfare according to Articles 599 and 600 of the National Health Code. (Author's modified).^ieng