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English 103

3:25-4:55 pm Mentally Retarded and the Right to Procreation Discrimination against the mentally retarded has been documented throughout history due to misunderstanding and lack of knowledge of their conditions. More often the mentally retarded were constructed beliefs such as to be infectious, deviant and no more of value than entertainment for society, and put in cages. A history case where the mentally disabled have been unfairly mistreated is during the holocaust in the 1900s. Adolf Hitler used science to justify his inhumane actions towards the mentally disabled. He used Charles Darwin explanation of the idea of evolution through natural selection. In contrast with Darwinism explanation, nature selecting those who are fit to survive, Hitler believed to create a superior human based on genetics. American scientist professor Stein wrote in his article a clear idea of Hitler and his Nazi followers, The business of the corporate state is eugenics or artificial selection... (Stein 51). Therefore the Nazi argument of killing the mentally retarded in order to prevent another breed of genetically inferior Individuals. Hitler authorized physicians to kill the mentally ill through a mercy death to patients who were considered to incurable. Hence, the mentally retarded were killed. This like, other historical cases has been of proof the much sufferer that the mentally retarded have suffered. In modern society, laws have been strictly analyzed and practiced in order to prevent any abuse from any individual resulting from inabilities to speak up against injustices. A sensitive topic of this matter is the mentally retarded and sterilization. The focus will be on whether [or not] reproduction should be accepted in accordance to the individuals' ability to handle the important responsibility of parenthood. Based on critics opinions reproductive rights should be denied to the mentally retarded

2. through sterilization without their consent in regard to concern with lacking the abilities to properly take care of offspring. In order to understand the topic that will be written on, the definition of the term mental retardation needs to be properly understood. The definition that will be used in this essay will be the one adopted by the American Association on Intellectual and Developmental Disabilities. The American Association defines mental retardation as intellectual disability, which is intellectual limitations. It also considers two other terms adopted which are intellectual functioning, defined as ability to learn reason and solve problems, and adaptive behavior, defined as problems with conceptual skills, social skills, and practical skills. Those individuals having poor abilities in those specified areas are considered mentally disabled. Sterilization will be considered to those who are labeled mentally retarded through diagnosis. The first viewpoint considered will be a perspective on how to determine whether an individual who is mentally retarded should be sterilized. In a journal of medical ethics, JP Denekens, H Nys, and H Stuer make a model for doctors to use when approached by guardians to sterilize a mentally retarded individual. The journal focuses on a model that is ethically acceptable to whether [or not] a patient should be sterilized without their consent. The model is encircled around the evidence of six measures which are listed as: conception risk, IQ, age, personality, medical aspects prognosis , and guidance for patient. The journal starts with an introduction on how the mentally retarded have been forced in history to be sterilized because of the belief that mental retardation was hereditary. The authors mention the Buck v Bell case, 1939, where Carrie Buck and her daughter Vivian Buck were sterilized without their consent due to accusation of mental retardation in order to prevent from them from inheriting mentally retarded to their children. In accordance to the six measure, the patient should be sterilized so that it is at their best interest because of concern with inability to properly care for child. Firstly two major criteria reviewed Heredity and Parent Competence. Taking a look at heredity the journal points to a deductive statement

3. with statistics on cases that the patient is sterilized for the reason that their condition is hereditary. The backing for the argument clearly states that it is not for eugenic purposes, but for the safe of the patient that if their condition is hereditary, it can complicate pregnancy and birth. This is a reasonable explanation since it is for the patients' interest. Preventing Competence, in the journal, gives a deductive premise on whether the patient is able to mentally be compatible to accept child's development such as when he/she will no longer be dependent on the patient. The first minor criteria in the journal is the knowledge of sexual reproduction the patient has such as knowing what sexual reproduction is and whether the patient can take care of the offspring without extensive help. Looking at a logical perspective, it is important to know how capable the patient is on proper responsibility for child. The argument is deductive basing it on the universal idea of what mentally retarded is defined to be. That is, not being intellectual enough to care for offspring. The second criteria, which is IQ, is said to not be urgent. This causes the fallacy of ambiguity for the reason that in one section, authors claim for knowledge in conception. Yet, ones IQ needs to be sufficiently high through knowledge. There is a contradiction of ideas which do not fit properly in identification of what is knowledge. Following IQ is Age of patient. This is a very clear and fair judgment since age is the determination of how an individual can change over time. Next, is the very direct and basic judgment made through the personality of the patient. Two examples stated are the suffering from depression or low self-esteem. Next, Medical Aspects and Prognosis is discussed. This shows a basic outline of other impairments the patient might be suffering from such as epilepsy. Lastly, a look at who will help the patient take care of the child financially and emotionally. Another very direct basic reason to consider since child's health depends on it. Overall the journal is very direct in the criteria on the basis of decision making to sterilization of the mental retarded patient. It is focused on deductive premises, mainly with broad ideas to support the claim that the decision, ... comes down to deciding whether the benefits of

4. sterilization outweigh the drawbacks... The right to decide whether an individual should be sterilized is taken in the court's hands in the In Re Grady case. The In Re Grady case is a non criminal case about the claim to whether Lee Ann Grady should be sterilized by request of her parents without her consent. The factual grounds are that Grady is (at the time) a 19-year old individual who was impaired with Down Syndrome. She is capable of doing basic tasks such as small house chores, but unable to make complex decisions such as deciding to become a parent. According to the case, she is unaware of sexual relations or sexual reproduction. She has been on birth control for four years and now parents request a sterilization for her own sake. The case was raised with the denial of sterilization from doctors unless permission was given by court. The court viewed the intention for carrying the procedure. This is important because of the abusive history of mental retarded individuals taken away the right to reproduce for wrong purposes. A list of standards was made to follow on the decision. These standards were different from those of A Model for Decision Making of doctors. The courts standards were focused on permanent sterilization depending if the patient was mentally incapable of procreation. The courts also obliged a guardian to be present during court to state the facts for the reason of sterilization. The political case of Grady is more concerned with the people available to keep the court hearing flowing, rather than a close check up on the patient, like in the doctors' standards. Although the court does not take a close look at the individual, it gets its backing information from other sources, focused on historical cases of mental retardation. The court decided upon these standards that sterilizing Grady outweighs her right to reproduction based on intentions for the procedure. The court justified the case in a moral view. The court decided that it is Grady's best interest to be sterilized if it will permit her to have a rewarding and more active life. Hence, the sterilization was permitted. The majority opinion is convincing in this case because Grady was described as an individual incapable of managing her own life without help, more or less a child of her own. The conflicting interest

5. were through consideration of the many cases where mentally retarded individuals have been abused. An example implied is the North Carolina Association for retarded individuals which discusses the complexity of mental retardation in response to why eugenics has been abandoned. The overall balance of the case makes it clear that the intentions for the procedure are for the best interest of the individual and the case is an example of how sterilization of mental retarded individuals can be for rightful morally through logically accepted reasons. SzeBeny takes a moral stand on the scientific laws and eugenics to promote his viewpoint that the practice of eugenics is unacceptable. He explains that excluding the mentally retarded from their reproductive rights is immoral. Dr. SzeBeny uses a number of scientific approaches through important people. For example he uses scientist's Sir Francis Galton's definition of eugenics in the beginning of his essay to explain what will be his overall thesis. After defining, he gives experimental methods where eugenics have been successfully used. He uses the example of how eugenics have been used in agriculture and animals with great results. He concludes with a modal qualifier to his thesis, saying, Consequently, their survival in changing environment in most precarious (SzeBeny). His modal qualifier can be accepted although it does not explain the basic sciences implied in the implicit premises. These implicit premises are, there is no genetic variation in eugenics since only artificially selected genes are passed down. This can be a problem for many readers since there is confusion of what is stated. With knowledge of basic sciences, one knows that genetic variation is needed for survival according to natural selection in evolution. He continues by explaining the use eugenics. He gives the ground that an individual whose IQ is of 160 would be considered to be the less fittest in survival since biologically speaking an individual who has an IQ of 100 would have the most contributed genes to their offspring. This explanation is relevant to the journal by D M Denekens, H Nys, and H Stuer, A Model For Decision Making, in the considerations when sterilizing a mental retarded individual. As earlier explained, authors state that IQ is

6. not an important factor when sterilizing a mentally retarded individual. Biologically speaking, like Dr. SzeBeny implies, average IQ is more genetically contributing than high IQ, the Journal for Decision Making takes a scientific implicit premise in its standards. Dr. BzeBeny distorts facts by implying his opinions and justifying them with empirical quotes. He states that he ...believes that the best approach to positive eugenics in the human situation is not direct manipulation of the genotype, but as Verle E Headings has stated, it is the optimization of the performance of human genes by providing a rich environment and thus enhancing all developmental opportunities ( Dr. SzeBeny). He makes the fallacy of appealing to authority by a quotation, but his opinions do not gain strength because he does not give evidence to his claim. Neither does the person being quoted give proof of what is said to be applicable. Therefore, his whole statement is complete opinion and of nothing of relevance in his argument of eugenics usage not being the right thing to do to get rid of unwanted genes. Dr. SzeBeny goes on to consider negative eugenics and the theory of elimination of negative eugenics through sterilization of those who carry abnormal mutations of unhealthy genes. Using science to proof that unwanted genes will still be present after many generations of sterilization because abnormal genes could and remain present in many upcoming generations. This is because through laws of science, abnormal genes remain in the heterozygous where genes may not show up in individual, but are carried in recessive genes to future generations. He uses relative frequencies to state calculations of how many generations it will take to get rid of unwanted genes through of the mentally retarded. He says, The average frequency of such defective genes in human gene pool is 0.2 (Dr. SzeBeny), concluding hypothetically a 1,5000 year process to eliminate unwanted genes. His calculations do not tightly support his claims creating a fallacy of composition. This is because his statements do not follow. With his calculations he implies that, ...making the sterilization program regional and voluntary... would considerably slow down the progress... He affirms that forced sterilization is wrong while assuming that it will slow the process of terminating unwanted genes. He is making an assumption to something he

7. is against giving the opponents view more strength than his for the obvious convincing view towards unwanted genes which is a speedy process of 1,500 years. As earlier mentioned Dr. SzeBeny described that there is an unhealthy gene in everyone, he concludes by explaining his moral views on sterilization of negative eugenics. He says that everyone should accept the incapable as part of respect to human life and discrimination should be eliminated. He ties his argument with a factor that all individuals have been fighting since history which is discrimination. This is essential because, like people who have been discriminated and abused on the basis of race, gender, and ethnicity, the mentally retarded have also been victims and should be protected. A child with mentally retarded parents is dangerous for the child's proper care and psychological state. In The Influence of Families on Child Health by Edward L. Schor provides a framework for pediatricians of how a child is affected mentally by a parent in different states of living. He explains that it affects children's health, behaviors and emotional well-being, and social competence. Under the section where L. Schor reviews parental retardation, he uses IQ to explain the mental state of mental retarded individuals. This is relevant since in the medical journal, A Model for Decision Making IQ does not play and important role in the dentition of mental retardation and neither does it play a big role in SzeBeny's essay, Negative Genetics. Continuing on the subject, of IQ, the way L. Schor explains IQ is much tied close to the definition adopted by the American Association on Intellectual Disabilities. L. Schor explains that some mentally retarded parents have difficulty with basic parenting such as mealtimes and bed time. He writes, Some mentally retarded parents have such limited knowledge and skills that their children's health and safety is in jeopardy. On the issue of reproductive rights, SzeBeny claimed there is no need for sterilization of negative eugenics since there is potential in all of us to inherit an unwanted gene. If the mentally retarded are not sterilized like BzeBeny suggests and the belief that there is no need to, since everyone has potential of reproducing a mentally retarded offspring, the mentally retarded will be having

8. children who will not grow up healthy psychologically. The mentally retarded people are incapable of caring for an offspring and the therefore have no safe reason to reproduce. L. Schor uses modal qualifiers to assert his claims. When explaining that mothers with low IQ tend to be less operative on decision making for children, he writes that because of this, Mental retarded mothers may not know either how to or what to reinforce among their children's behaviors. In L. Schor's modal qualifier that mentally retarded mothers may not know how to deal with their children. The deductive premise that mothers with low IQ are less capable of decision making for their children flows properly since there is factual evidence that mentally retarded individuals have low IQs. L. Schor gives a statistical evidence as a backing to the bad influence that the mentally retarded parent has on its offspring. He mentions that about 40% of individuals with mentally retarded parents end up with IQ as low as their parents and in danger of neglect and abuse. L. Schor takes a stand on a logical perspective on how mentally retarded parents affect their offspring. He clearly affirms all physical evidence without any assumptions to political correctness on the judgment of the mentally retarded. He noted all this for the purpose of the safety of the child, not the desire to bear of the mentally retarded individual. His approach is effective since it is of higher value to consider the child's safety and disadvantages it will have throughout his life if it were born to a mentally retarded parent. After all a child who is raised in a healthy family, turn to grow up with healthy lifestyle. as L. Schor says, The quality of interactions between a parent and child is key to optimal child development. Hence, a mentally retarded parent will be incapable of providing all needed mental intellectual support. In the book Equal Treatment for People with Mental Retardation, Field questions the choice for sterilization. She reviews the court case of 37-year old La Vista Earline Romero. Romero was requested to be sterilized with the consent of her guardians and doctors, and her consent was not taking for judgment of the decision. Romero was interviewed, and when asked if she would have another child

9. after knowing her health condition, she responded that she would still want to bear a child even if her life was at fatal risk. According to the court, in response to Romero's answers in the interview, she did not have the capability to to decide for herself because she was unable to understand how her life is at risk. She was first granted by judge to be sterilized without her consent, but later Colorado court respected Romero's wishes, and she was not sterilized without her consent. Field stresses that any other court could have had Romero sterilized without her consent. Although she does not give examples of her assumptions. She writes that mentally retarded individuals can be sterilized without their consent for the fact that they consider them to not be able to make choices for themselves. For example, in Romero's case, she w as asked if she wanted to be sterilized for the sake of her health. She responded no. The courts her reply as irrational and unreliable for preferring to have her life at risk and went against decision. Field write, Often the evaluations give the impression that the decision makers never consider the subject as a real or whole person capable of feeling, understanding, or doing anything 'normal' (Filed 59). Field demonstrates the case of Romero with an emotional approach. She implies that Romero's answers should be taken of higher priority than legal guardians and her doctors' advises. This is because according to her, mental retardation should not be an issue an individual should be judged upon because, they too, have feelings like everyone and therefore their decisions on reproduction should be considered and respected. In a moralistic analysis, Field proposes that it would be immoral to go against someone's will on their right to procreation because they are mentally retarded. Looking at this in a logical perspective, it would not be safe to have a mentally retarded individual make important choices by themselves because it would be contradictory to allow them to do something to keep them happy even though they will die in the process. Similar to SzeBeny, Field excites one's emotions and one can view Romero as being discriminated because of her mental state her right to enjoy the rights other people enjoy. Like BzeBeny,

10. Field rises the view to the reader that all individuals should be treated equally and not seen differently, since we all have life like BzeBeny puts it. They both argue that mentally retarded individuals should not be denied the same rights all others have. Considering their views, it is possible that the mentally retarded can be abused and denied their rights if justice systems continue viewing the mentally retarded as incapable of anything for themselves. According to these critics, the overal convincing point for me is that the mentally retarded should be sterilized when it is requested by parents. Like in Field's case, Romero was unable to see the risk of having a baby under her condition and should not be let to procreate just because she feels is right. While, emotions can take over a person's logic, one has to always think about the rational outcomes of conditions. According L. Schor, bothers with low IQ have a limited ability to guide a child. If so, a mentally retarded parent would be even of more threatening to the child's safety and well-being. The child should come first since it is essential for them to have a proper caring since they are born. It is true that like in Romero's case it may seem as one is not understanding the decision of the patient because they are easily stereotyped to not be able to understand or be understood, but if the patient cannot give a proper explanation to their decisions, they should be treated equally like all, and should be expected to give logical explanations for their decisions. Overall, L. Schor convinced me with logic truthful explanations, after, the "decision-makers" should be reliable.

Works Cited

11. Genetic Engineering. [Date Unknown] SzeBeny. S.J., Dr. Andrew L. 22 May 2011<> http://web.lemoyne.edu/~szebenyi/0201.htm>

In re Grady. 426 A. 2d 467. Supreme Court of New Jersey. 1981. Google Scholar. Web. 1981. --- Cite in text:(In Re Grady)

Denekens, Joke P M, Herman Nys, and Hugo Stuer. "Sterilisation of Incompetent Mentally Handicapped Persons: A Model for Decision Making." Journal of Medical Ethics 25 (1999): 237-241. Print.

Schor, Edward L. The Influence of Families On Child Health. Boston Massachusetts. Number 1. (1995).

Field, Martha A, and Valerie A. Sanchez. Equal Treatment for People with Mental Retardation. Harvard University Press. 2001.

Stein, G., Biological Science and the Roots of Nazism, American Scientists 76 (1): 50-58, 1988