[Potential parenthood for the mentally handicapped; the role of the physician]

* What responsibilities and options do physicians have regarding contraception, pregnancy and parenthood in people with mental disability? The issue encompasses the assessment of parenting capability and mental competence, and options for supporting responsible parenthood and preventing irresponsible parenthood. * Parenting capability is a combined trait of both parents. Family and friends may support that capability. * According to a recent description, parenthood is 'good enough' when there are no indications for neglect or abuse, and when there is no involvement of the Child Care and Protection Board. * Mental competence regarding pregnancy signifies that the person involved can understand and weigh the consequences of pregnancy for themselves and others, including the future child. * If parenthood is likely to be irresponsible and the person is sexually active and refuses contraception, a physician has three options: persuasion, pressure or coercion. The latter is legally allowed only in cases of mental incompetence. * People with mental disability will continue to have children, regardless of whether their environment considers it responsible. Although informal caregivers will provide the primary support in this situation, adequate professional support is desirable.