Monday, 8 October 2007

Mother knows best

Hitting the headlines this weekend was the story of the mother who wants her daughter to have a hysterectomy. There is no medical need for this operation, but the girl has cerebral palsy and her mother is concerned that her daughter will be "confused" by menstruation and that it will cause her "indignity".

Presumably the mother speaks from her own experience when she speaks of menstruation involving "tears...pain...embarrassment". Menstruation is a very personal issue. Janet Street Porter, writing in The Independent about a new pill that will prevent periods talks of the "horror of menstruation." For other women it's no more than a minor inconvenience. Is it right to force you own view of menstruation on to someone else. Why assume that it will cause pain and embarrassment to the daughter when many women experience no such thing?

And why undergo surgery - which always carries some risk - when there is a handy pill that will do the same job? Pills have safety issues, too, and who knows how preventing part of a woman's normal biology will affect her health? The experts, as ever, are divided.

This story has echoes of the "pillow angel" story. Who benefits from the hysterectomy - the child, or the mother? If the mother is the primary carer is it necessarily wrong to do something that is "just" in her interest? Surely it's in the child's best interest to have her mother feel she can cope with caring for her? Without care at home this girl would need to be cared for by the state, costing money that could be spent elsewhere. Carers save the NHS billions of pounds each year.

As ever, although the mother says this is all about her child, any court decision on whether or not doctors can carry out the hysterectomy will have wider implications. Disability groups perhaps fear the thin end of the wedge, that having gone this far society will ask why not give hysterectomies to women with Downs, with MS, with ADHD, with any nasty antisocial habits we'd rather not perpetuate. How many steps is it from one hysterectomy to mass sterilisation of "life unworthy of life"?

As with many ethical debates our personal views and experiences colour our reactions. We perhaps react more strongly where a child is involved. We have our own views on the right and proper way for a mother to treat her child. Should we accept these emotions as part of the evidence in considering an ethical case, or is ethics an absolute, like a mathematical problem where it is possible to come to the right answer?

I don't have the answers. We have books in the library to help you think through ethical issues. You'll also find stories on ethical issue to get you thinking on our current awareness page.

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