Doctor Knows Best? Tubal Ligation in Young, Childless Women

When a gynecologist asks a twenty-one-year-old patient about her use of contraception, he is surprised that she would like to have a tubal ligation. The patient says that she would "never want to bring a child into this screwed up world." She has discussed tubal ligation with her boyfriend of one year, and he has told her that he accepts her decision. She asks her doctor if she can schedule the procedure as soon as possible. Her gynecologist mentions that he is concerned that she is very young and may eventually change her mind about having children. She insists that she has thought about it carefully and is certain that she wants the procedure. Her doctor feels very uncomfortable about this request. He consults the hospital ethics committee. Should he do as the patient asks or suggest that she wait at least six months and reconsider?