LETTERS
Hysterectomy in mentally handicapped
When I read about the removal of uterus from mentally handicapped women both in your newsletter (February-April 1994) and in the British Medical Journal (26 February 1994). I was hoping to find an outright condemnation of this practice by the Form for Medical Ethics. I was surprised and disappointed, to put it mildly. for instead of condemning such practice the Forum has allowed itself to be swayed by the opinion of well known figures in the medical and political fields (Medical Ethics May-July 1994).
In this latter issue of the newsletter, one of your readers, Asha Dutia, has rightly expressed an opinion with which I entirely agree. The only indication for a hysterectomy is medical as for a tumor in this organ. There are no other criteria. Failure to maintain cleanliness or protection from rape or the possibility of giving birth to children who may inherit the traits of their mother and thus be a liability on the State should not enter into consideration.
It is the duty of Society and the State to care for those who, for no fault of theirs, are either physically or mentally handicapped. Once a representative body or a government finds justification for surgical procedures in such retarded and handicapped persons, it is only a step further to other serious medical and surgical procedures and experimentation as were conducted by Nazi Germany during World War II.
The suggestion of guidelines for such procedures is only an exercise in self-deception, persuading oneself that the wrong being committed may be brought within the rules of conscience.
Dr. Samuel J. Aptekar P. 0. Box 1005, Nazareth, Illit Code 17110, Israel.
(We are grateful to Dr. Aptekar for his honest opinion, stated in a forthright manner. We have grappled with doubts when formulating the guidelines. We issued our draft after being convinced that we often have to distinguish between the ideal and the practical. As was pointed out to us by a senior and much respected civil servant, we can, with justification. adopt a dogmatic stand. Realities in the field will, however dictate what will actually come to pass. Under these circumstances we felt it advisable to indicate what is immediately applicable whilst continuing attempts at reaching the ideal.
As can be seen from accounts in our dailies, the issue is far from settled. We await the outcome of the case filed in court by Mr. Gabriel Britto of National Addiction Research Centre and separately. by Dr. Anant Phadke. See Dr. Phadke’s letter below and statement by PARYAY (pages7-8).
Dr. Aptekar has also, kindly, sent us the English translation of the Oath of Asaph. reproduced on the last page of this issue. – Editor)
