Anna Jennings Edquist Slater & Gordon


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Anna Jennings Edquist Slater & Gordon

  1. 1. The involuntary, non-therapeutic sterilization of intellectually disabled persons Anna Jennings-Edquist Medical Law, Melbourne 27 June 2014
  2. 2. ©Slater&GordonLimited2014 2! 1.  Key case; 2.  Scope of discussion; 3.  Approaches to the conceptualisation of disability; 4.  Legal approaches to sterilisation; 5.  Competing human rights: Arguments for and against prohibition; 6.  Case studies; 7.  The law today; 8.  Your views Introduction
  3. 3. ©Slater&GordonLimited2014 3! Secretary, Department of Health and Community Services v JWB and SMB (1992) 175 CLR 218 ► “Marion’s Case” •  Marion suffered from intellectual disabilities, severe deafness, epilepsy and other disorders. •  Conditions and life worsened by menstruation. •  Parents sought order for hysterectomy and oophrectomy.
  4. 4. ©Slater&GordonLimited2014 4! Marion’s case ► Court adopted the Gillick test of competence. •  From Gillick v West Norfolk and Wisbech Area Health Authority [1985] 3 All ER 402 (HL) ► Held parents do not have the authority to consent to serious, irreversible medical treatment on child’s behalf unless it is for a "therapeutic" purpose. ► Require court approval for non-therapeutic treatment.
  5. 5. ©Slater&GordonLimited2014 5! Scope of discussion ► When will sterilisation without consent be legitimate? •  When it’s therapeutic or as a measure of last resort to secure ‘best interests’. ►  The issue is statistically a gendered one. ►  ‘Involuntary’ meaning when person is unable to consent to procedure, due to age or capacity. ►  What forms of sterilisation do we mean?
  6. 6. ©Slater&GordonLimited2014 6! Approaches to disability ►  Eugenics - 20th Century. ! ►  Welfarism - 1950s ►  Right based approaches - 1960s ►  The Social/Societal model ☺ •  Considered an umbrella term for range impairments, limitations, restrictions. •  Focus on promotion of rights and engagement with society
  7. 7. ©Slater&GordonLimited2014 7! History of legal approaches ► 1994 Family Law Council report ► 1997 and 2001 reports by the Australian Human Rights Commission ► 2013 Involuntary or Coerced Sterilisation of People with Disabilities in Australia report by the Senate Community Affairs References Committee
  8. 8. ©Slater&GordonLimited2014 8! Arguments for and against ►  AGAINST: ►  Denies right to freedom of choice and bodily integrity ►  Convention on the Rights of the Child ►  Convention on the Elimination of All Forms of Discrimination against Women ►  Violates right to family, parenthood, marriage, reproduction ►  The Convention on the Rights of Persons with Disabilities ►  Convention on the Elimination of All Forms of Discrimination against Women
  9. 9. ©Slater&GordonLimited2014 9! ►  Causes loss of dignity ►  The Convention on the Rights of Persons with Disabilities ►  Convention on the Rights of the Child ►  Form of discrimination ►  The Convention on the Rights of Persons with Disabilities ►  Convention on the Rights of the Child ►  Convention on the Elimination of All Forms of Discrimination against Women ►  Constitutes violence or torture ►  Convention on the Rights of the Child ►  Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment ►  Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
  10. 10. ©Slater&GordonLimited2014 10! Arguments for and against ► FOR: ►  Promotes right to dignity ►  Promotes right to health ►  Promotes right to quality of life ►  Promotes right to proper medical treatment ►  Promotes right to be free from discrimination ►  Promotes support of persons without capacity to consent ►  Practical considerations: ►  menstruation, sexuality and reproduction
  11. 11. ©Slater&GordonLimited2014 11! Re L and M (1993) 17 Fam LR 357 ► “Sarah’s case” •  Doubly incontinent, epileptic, with very limited motor functions and poor communication. •  Conditions worsened by menstruation including hormonal changes. •  Warnick J refused to authorise the sterilisation, stating that he could find no therapeutic justification.
  12. 12. ©Slater&GordonLimited2014 12! Re Sean and Russell [2010] FamCA 948 – (26 October 2010) ► Two unrelated young boys diagnosed with Denys-Drash syndrome. ► High risk of developing potentially fatal tumours on the kidneys and testes, as well as the development of ambiguous genitalia. ► Gonadectomies proposed to reduce risk of cancer. ► Held that surgery was therapeutic, so fell within the scope of parental powers.
  13. 13. ©Slater&GordonLimited2014 13! Re Guardianship of Kennedy (Iowa Apr. 18 2014) ► Guardian (mother) arranged vasectomy of adult son with disability when discovered he was in sexual relationship with coworker. ► Son denies consenting to procedure. ► Court found guardian should did not require court approval for the procedure, because not major surgery. ► Noted she "did not make such arrangement or provide assistance out of malice," and decline to terminate the guardianship.
  14. 14. ©Slater&GordonLimited2014 14! Re Jamie [2013] Fam CAFC 110, 31 July 3013 ► On appeal from 2011 decision in the Family Court. ► Parents of transgender minor sought to commence treatment to suppress puberty then initiate oestrogen. ► Family Court authorised Jamie’s parent to consent to treatment on behalf of Jamie’s behalf because suppressing puberty is not a medical treatment falling within the class of cases described in Marion’s case.
  15. 15. ©Slater&GordonLimited2014 15! Outcome of Senate Report ► Report rejected an outright ban of non- therapeutic sterilisation procedures without consent. ► 28 recommendations made. ► Recommendations complement existing requirement that court authorisation required for sterilisation of children and adults without capacity due to disability. ► Adopted a ‘best protection of rights’ tests.
  16. 16. ©Slater&GordonLimited2014 16! Summary ►  Sterilisation legitimate as a measure of last resort, in order to save persons life or to alleviate serious health burdens (therapeutic). ►  Australian law requires court authority for all non- therapeutic sterilisations when consent cannot be obtained. ►  Court’s must act in ‘best interests’ of child/adult under disability. ►  Court should consider alternative treatments, the consequence of treatment and the wishes of individual and their family.
  17. 17. ©Slater&GordonLimited2014 17! Your thoughts and contributions