[Sterilization and the mentally handicapped: who decides?]

At the moment sterilization of mentally handicapped persons is carried out in a medical and a legal vacuum in Belgium as well as abroad. To give an adequate answer to the problem of sterilization of mentally handicapped adolescents in medical practice, Dr. J. Denekens undertook an extensive literature review and an empirical investigation comprising case-studies of 52 adolescents, their parents and family doctors. The adolescents, between the ages of 16 and 21, were selected at random from students attending schools for mentally handicapped persons in the province of Antwerp during the school year 1989-1990. This study and investigation resulted in the formulation of medical and ethical criteria to assist decision makers confronted with a request for sterilization from or on the behalf of a mentally handicapped person who may be unable to decide this issue alone. These criteria have been ordered in a useful and practical algorithm that enables a motivated, logical and ethically responsible decision to be taken. A proposal of procedure for such a sterilization request has been elaborated. The medical-ethical criteria, the algorithm and the procedure proposal come out right in time as the European Parliament is discussing a motion that deals with the legal part of the subject.