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Hysterectomy an abuse of human rights

Andy Rickell

Published 09 October 2007

Removing the womb of disabled girl Katie Thorpe would constitute an abuse of her human rights and would set an alarming precedent argues Scope's Andy Rickell

In January of this year, the case of a young disabled woman in Seattle who underwent serious non-essential medical procedures at the wish of her parents, divided opinion internationally and triggered a huge ethical and human rights debate.

Known only as "Ashley X", this disabled nine-year-old girl with complex support needs underwent what many would consider highly invasive operations including; a full hysterectomy, the removal of her breast buds, and hormone injections to ensure she would never grow into an adult. Many argued, as Scope did, that these interventions benefited her parents more than they did Ashley (they said she would be easier to care for). At the time we raised concerns that a similar case could happen in the UK.

Shortly after the Ashley X emerged, a similar case in Britain came to light with a mother, Alison Thorpe, seeking to remove her daughter's womb in order to spare her the discomfort of menstruation. Nine months on, Ms Thorpe has the backing of surgeons who now are seeking legal consent to carry out a hysterectomy on Katie, a 15-year-old with cerebral palsy.

Scope recognises that it can be tough bringing up a disabled child and that parents often have to make difficult decisions. We work with tens of thousands of disabled people and their families each year and are acutely aware of the challenges they face every day in caring for their children.

However we believe this surgery to be a fundamental abuse of Katie's human rights and indeed an unnecessarily extreme and disproportionate medical intervention to manage menstruation - which after all is just a natural part of developing into a woman.

This case raises fundamental ethical issues about the way our society treats disabled people and indeed illustrates a profound lack of respect for disabled people's human and reproductive rights. No-one would countenance a hysterectomy that was not medically necessary for a non-disabled woman.

Scope is deeply concerned that doctors are supporting the parents in this case. To all intents and purposes this is enforced sterilization and, if approved, could set a legal precedent that would have alarming repercussions for young disabled girls across Britain.

Our stance is entirely in accordance with United Nations Convention on the Rights of Persons with Disabilities which was signed by the UK in March. Article 23c of the Convention makes specific reference to the protection of disabled people's reproductive rights, stating that disabled people should 'retain their fertility on an equal basis with others'.

Britain has signed up to the UN Convention, indicating that it supports the principles enshrined in the treaty. Scope is lobbying the Government to ratify this so it impacts on British law and gives disabled people better protection. The case of Katie Thorpe powerfully illustrates why this is urgently needed.

Scope is taking a strong stance on this issue because we believe that subjecting a child to a non-essential hysterectomy could never be considered to be in her best interests. A hysterectomy is an extremely invasive procedure, it would be particularly painful and distressing for a child, and we do not believe it can be justified.

A key question in this complex case is who is really representing Katie's wishes? The wishes of her mother and the medical professionals consulted are clear, but what about those of Katie herself? It is obvious to us that the wishes of parents do not necessarily match the best interests of the child in every situation.

Scope believes all disabled people should be entitled to an independent advocate who can use their specialist skills to ascertain and communicate views and preferences they may find difficult to communicate themselves.

We do not believe that a child should be modified for society's convenience, but instead that society needs to adapt and become more inclusive of disabled people. We want Government to introduce additional legal safeguards - including a duty to seek court approval for any invasive non-essential surgery and the right to an independent advocate for any child or adult in this situation. There needs to be clear framework in place for dealing with ethical decisions of this complexity, which places the rights, and best interests, of the disabled person at the heart of any decision.

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7 comments from readers

Jenny Webb
09 October 2007 at 10:57

I read this story with a mixture of bewilderment and horror! What on earth must the doctors be thinking, let alone the girl's mother! It's a barbaric proposal. I hope it never happens!

Gillian Fell
09 October 2007 at 11:57

I'm still shuddering after hearing the case of Ashley X. There's something really quite sinister going on. What's the logical extension of this sort of thing? This article should be read in conjunction with Victoria Brignell's who writes the Crips Column blog. Particularly this entry: http://www.newstatesman.com/200701120005

stateswoman
10 October 2007 at 17:00

It is easy to talk emotively of 'rights' and everybody's 'rights'. Also, one man's freedom is another's slavery.

We should stop being so emotive about certain situations. A very disabled person, mentally or physically, should not be in a position to reproduce equally handicapped progeny. There are far too many sorrows, difficulties and complications in life. It is disgusting that so many can go on preaching coldly about the rights of peopling our world with disablement. Some decisions are hard but are essential for the greater good.

stateswoman
10 October 2007 at 17:08

Many decisions are hard. There are times, nevertheless, when we need to be objective for the greater good. It is unfortunate that serious mental and physical handicaps need to be considered individually. There are uncountable problems in society today and the ongoing, emotive campaign for the rights of severely handicapped people is less than helpful. Clearly, it is not advisable for certain types of handicaps to be allowed to risk creating, duplicating and replicating these handicaps. Hard decisions need to be made.

Jane Greene
10 October 2007 at 17:55

Do you have any evidence at all for your suggestion that someone with Cerebral Palsy would 'duplicate' their disability into the next generation, stateswoman? By talking of hard decisions do you mean a policy of euthanasia or sterilisation? Maybe you mean both?

stateswoman
10 October 2007 at 19:31

No, I certainly do not suggest the former or the latter as a policy. Each case needs to be considered on its own merits and against the needs and wishes of those nearest and dearest together with professional consultation of the highest calibre. What we don't need is undeserved and unwarranted criticism of decisions made between all the parties here mentioned based on one's individual, quirky morality.

Jane Greene
11 October 2007 at 09:27

Stateswoman, implicit in your previous statement was the suggestion that disabled people should not be allowed to breed.

You wrote: "Clearly, it is not advisable for certain types of handicaps to be allowed to risk creating, duplicating and replicating these handicaps. Hard decisions need to be made."

You are clearly arguing for sterilisation or worse. Either that or you can't work out the natural consequences of your statement. I suggest you stick to your own advice - we really don't need undeserved and unwarranted intervention by someone of your questionable morality. The rights of this young woman are as important as yours. Your argument is based on and ill thought out preference for eugenics.

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About the writer

Andy Rickell

Andy Rickell is the Executive Director at Scope, a UK disability organisation whose focus is people with cerebral palsy. His role is to champion the leadership of disabled people. Andy has cerebral palsy himself and was one of the original authors of the Disabled People's Rights and Freedoms Charter.

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