Hobson's choice: reproductive choices for women with learning disabilities

This paper examines the present law in England and Wales concerning the sterilisation of women who are unable to give valid consent to medical treatment. In particular, it considers why sterilisation is frequently presented as the only meaningful reproductive choice that can be made by or on behalf of women with learning disabilities. In addition, the paper assesses the extent to which the best interests test, as formulated by the English courts, has been successful in the promotion of dignity and autonomy of women with learning disabilities. It is submitted that some of the issues presented to the courts have not received adequate consideration and others have been considered which are not relevant to the determination of the best interests of these patients. Furthermore, the best interests of the adult patient are determined by reference to the 'Bolam' test. This paper questions whether the Bolam test is the appropriate mechanism for determining the patient's best interests, having particular regard to the Australian model of decision-making for the intellectually impaired.