Sedating Women With Mental Retardation for Routine Gynecologic Examination: An Ethical Analysis

Abstract

...The socialization of persons with mental retardation carries practical implications for their routine health care. Health-care providers should demonstrate their respect for women with mental retardation by allowing these women access to what is regarded as routine gynecologic care delivered in the safest and most reasonable way....To forgo a pelvic examination for these women or to restrain them physically in order to perform the examination are not acceptable alternatives, because neither shows adequate respect for the patient. Performing the examination under general anesthesia is neither risk-free nor cost-effective. Outpatient ketamine sedation offers a medically defensible alternative. While significantly concerned about sedating patients who cannot give consent in order to perform a routine procedure, providers who have worked with the ketamine program regard this alternative to be ethically justifiable due to the safety, efficacy, and patient respect this sedation program embodies. Their judgment is implicitly based on the principle of beneficence....