Sterilization

STERILIZATION Any medical or surgical intervention which renders a patient, female or male, incapable of reproduction, organically or functionally, temporarily or permanently. TYPES OF STERILIZATION A. SURGICAL METHODS B. NON-SURGICAL METHODS SURGICAL METHODS: Involve the suppression of the reproductive organs (male or female) by operating on any of their different parts and cause organic sterilization. NON-SURGICAL METHODS: Involve a blockade of the maturation process of the ovum using pharmacologic agents (anovulatory drugs), which inhibit ovulation and cause temporary or permanent sterility in women (functional sterilization).

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SURGICAL METHODS EMPLOYED IN FEMALES: 1. OPHORECTOMY - extirpation of the ovary. 2. SALPINGECTOMY - ligation or extirpation of the Fallopian tube. 3. HYSTERECTOMY - removal of the uterus.

SURGICAL METHODS EMPLOYED IN MALES: 1. CASTRATION 2. VASECTOMY -

extirpation of the testicles. ligation or extirpation of the Vas deferens. 3. EMASCULATION - suppression of the male genital apparatus. NON-SURGICAL METHODS: Involve a blockade of the maturation process of the ovum using pharmacologic agents (anovulatory drugs), which inhibit ovulation and cause temporary or permanent sterility in women (functional sterilization). 2

CLASSIFICATION OF STERILIZATION FROM THE LEGAL VIEWPOINT. A.

EUGENIC STERILIZATION performed for the purpose of hindering the conception of undesirable or mentally unfit offspring. A sort of social engineering – to design a society that is free from individuals afflicted with social diseases or grave mental defects. 1. idiots, imbeciles, morons, insane persons 2. with congenital and inherited diseases and carriers of defective genes

B. THERAPEUTIC STERILIZATION the consequence of extirpating a pathologic reproductive organ, which endangers the life of the patient (extirpation of cancerous uterus). C. CONTRACEPTICE STERILIZATION whether organic or functional, is the intentional prevention of conception which consists in suppressing ovulation in the female, thus rendering her sterile. D.

PUNITIVE STERILIZATION: Done as a punishment for crime or antisocial behavior, particularly rape and other sex-related offenses. This is compulsory or involuntary sterilization.

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ETHICAL EVALUATION ON STERILIZATION A. INDIRECT OR THERAPEUTIC STERILIZATION: is considered licit since the intervention is not directed towards sterilization, but sterility results from the extensive extirpation of pathologic tissues. B. DIRECT STERILIZATION: By its very nature has one sole immediate effect: to make procreation impossible. This includes the socalled “preventive sterilization” (Pregnancy can aggravate some diseases, thus the risk of getting pregnant is removed by sterilization). Direct sterilization, whether temporary or permanent, is UNETHICAL, despite the good intention and is condemned by the church. Direct sterilization is against the dignity of the human person. It harms the integrity and the very essence of matrimony by voluntarily and artificially separating the unitive and procreative aspects of the conjugal act.

C.

4 POST-CAESARIAN STERILIZATION:

From the ethical standpoint, this is not justifiable because it is a form of direct sterilization to prevent conception. (being questioned by modern obstetrics) WHAT COULD BE DONE IN THESE CASES? 1.

There have been cases of 9 or more consecutive caesarian operations which have delivered live babies without maternal nor fetal complications. Therefore, it cannot be affirmed that a woman who has had 3 or 4 caesarian will present grave problems. One has to evaluate in each case whether or not a real pathologic situation exists.

2.

In those cases wherein the obstetrician judges that after successive caesarian operations the uterus has become pathological due to scars or adhesions and therefore, may rupture with a subsequent pregnancy, he would have to advise the woman to resort to licit methods of avoiding conception.

3.

An alternative solution would be to perform elective hysterectomy if the uterus is indeed pathological (due to scars adhesions, danger of rupture, etc.). This would then be a case of indirect sterilization whereby a diseased organ is removed. 5

On repeat Caesarian sections:

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McNally – reported 130 CS “results make one supports the capabilities of uteri subjected to repeat CS are underestimated and that majority of scars, even in advanced parity, remain intact”.

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Dr. Robert Cosgrave, Margaret Hague Maternity Hospital, Jersey city, U.S. – Re: sterilization after 2 or 3 CS: “there should be no set limit, provided the integrity of the uterus is maintained”. 6 SUMMARY ON THE ETHICAL CONSIDERATIONS ON STERILIZATION

It is LICIT to perform only INDIRECT STERILIZATION: Therapeutic Sterilization: - Surgical intervention - Extirpation of diseased organ - Pharmacologic agents It is morally STERILIZATION:

ILLICIT

to

perform

Eugenic Sterilization Preventive or punitive Sterilization

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DIRECT