The authors present guidelines based on their experience with a family
planning program for patients in mental hospitals. They believe that
informed consent for these patients should include an adequate knowledge
base, the patients' competence to make decisions, and the absence of
coercion. Among safeguards are the reversibility of contraceptive
procedures, the separation of the family planning counselor from the
treatment staff to avoid possible covert coercion, and careful choice of
the stage of hospitalization at which counseling occurs. The authors
examine the implications of a patient's refusal to use contraception,
noting the impossibility of involuntary contraception and the ethical and
legal problems regarding sterilization procedures.
Abstract Teaser