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or intellectual disability 28 . Of those, only the early English case of Re M [1988] appears
to seriously consider sterilisation specifically on eugenic grounds.
Re M [1988] was an English case concerning a 17 year old girl with Fragile X
syndrome. She was described as physically normal but with the mental age of 5 or 6. It
was said that she had become sexually aware and that there was a “real danger of
sexual intercourse and her becoming pregnant” (Bush J, p. 1). Part of the evidence
considered by the court included medical evidence that any child M might have had a
50% chance of inheriting Fragile X syndrome. In response to this evidence, the judge
said that people should not be sterilised because they are handicapped, “or likely to give
birth to children who might equally be so” (Bush J, p. 2). The judge said he was
persuaded that the medical professionals proposing the surgery were not considering
M’s case from a eugenic point of view. They were simply concerned that if M became
pregnant, she would have to be monitored more carefully.
Whilst the decision indicates that the intention of the sterilisation is to prevent M from
getting pregnant and giving birth to a disabled child, the judge denies that this intention
has any part in the decision (p. 2). The doctors couch the decision in terms of both
discomfort to M from the extra testing she would require during pregnancy and what
was said to be a real risk of surgical complications from the inevitable recurrent
abortions she would require if she were not sterilised (p. 2). The court did not question
why M would have to undergo extra testing or why abortion would be the only possible
outcome if the foetus was disabled.
In this way, both the judge and the doctors detach their subjective judgements from the
decision and the value judgements which guide a decision to terminate a potentially
disabled foetus remain implicit. One of the doctors even suggested that the operation
should be viewed as contraception and not sterilisation “because of the emotive feelings
that the use of the word sterilisation arouses” (p. 1). Medical evidence provided the
justification and the sterilisation was approved on the grounds that pregnancy, testing
and abortion would be unnecessarily painful experiences.
28 Re H [1993], T v T [1988], Re M [1988], Re D [1976].
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