The ethical and legal framework of sterilization of people with intellectual disabilities

This paper examines recent decisions authorising the sterilization of people with intellectual disability. It examines how social policy in rejecting historical eugenics-based arguments moved towards normalisation, care in the community programmes and ‘supported living policies’ encouraging the devolvement of responsibility to the family. It describes how during this century the medical model gave way to a social model conception of disability and a greater awareness of rights of people with intellectual disabilities to enjoy intimate relations. Contemporary discussion has engaged in a rights-based framework described as a paradigm shift heralded by the UN Convention on the Rights of Persons with Disabilities (CRPD) where arguments about dignity and bodily integrity against coercive practices take on a more pivotal role. Using recent cases, the paper examines how social policies have influenced contemporary cases where courts have authorised sterilizations of people with intellectual disabilities without their consent. The paper questions whether the bests interests test under the Mental Capacity Act 2005 (MCA) adequately serves the interests of people with intellectual disability and also whether the least restrictive alternative provisions under the MCA are being consistently applied by the Court of Protection in these cases.