Social Question

nikipedia's avatar

What should be done about a mentally incompetent person who becomes pregnant?

Asked by nikipedia (27327 points ) January 20th, 2012

A case has recently come through appeals court in which a schizophrenic and bipolar woman became pregnant. It was determined that she was not mentally competent to make decisions for herself, and her parents would be given legal authority over her.

A judge initially ruled that her parents should bribe or trick her into having an abortion, at which time she should be forcibly sterilized. The woman herself is opposed to abortion. She has already had one abortion, and given birth to a child that her parents now care for.

Additionally, the medication she takes for her illnesses are considered harmful to developing fetuses. Taking her off the medication would be dangerous to herself and her family; leaving her on the medication would be dangerous to the fetus.

What do you think should be done in this situation?

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39 Answers

muppetish's avatar

I came in here to say that it is the woman’s choice whether or not to have an abortion, but that the woman would probably be ruled incompetent to raise the child and would not be able to keep it herself. But after reading the details… fuck if I know. This situation is incredibly tricky.

talljasperman's avatar

Alberta tried forced sterilizations on those they labeled as defective…in the 1950’s to I belive the 70’s… the courts ruled that forced sterilizations where criminal and a settlement was put in place. Just being ill , or being mistaken for ill, doesn’t mean one should lose one’s rights. I would move the couple to a new jurisdiction that belives that the ill are not to be treated as animals. Everyone should be treated with respect and dignity. As regard to the pills one can consider switching to other’s that are not harmful to the fetus or the mother.

CWOTUS's avatar

If she’s been ruled “mentally incompetent” to care for herself (and presumably, to care for a child as well), then the next step is for the parents to seek and obtain a full power of attorney and make her medical decisions for her. If she’s truly mentally incompetent, then her protestations about not wanting an abortion or sterilization should carry no weight, same as a child’s protestations. I can understand the parents not wishing to go against her stated wishes, but this isn’t a particularly difficult ethical decision.

For a judge to “rule” (inexplicably and in a total miscarriage of justice, IMHO) that she should be “tricked or bribed” into an abortion is abominable. That judge should be removed from the bench forthwith.

I think the appeals court is also wrong in relying upon the sentiment (from an earlier case, obviously) that ”[T]he personal decision whether to bear or beget a child is a right so fundamental that it must be extended to all persons, including those who are incompetent.” Matter of Mary Moe, 31 Mass.App.Ct. 473, 477 (1991). That is a fantasy world where none of us live, outside of a judge’s ivory tower.

judochop's avatar

Move her to the bible belt.

keobooks's avatar

Schizophrenic and bipolar women DO get pregnant and give birth all the time. There ARE medications they can take, which may not be as effective as what they usually take, but can stave off the worst symptoms while they are pregnant. If her symptoms got out of control, she could spend the duration of her pregnancy in a State hospital until she delivered so that she could be safe.

Part of reproductive rights include allowing people you don’t think should get pregnant to keep their fetuses to term if THEY want it. No one should be forced to have an abortion any more than they should be forced to not have one.

This case could hurt the rights of women with diagnosed mental illnesses in the future. I personally know a few women with bipolar disorder and schizophrenia who are able to stay asymptomatic on their medication. You would seriously never know about their condition if you met them. I don’t know exactly what happened on their pregnancy, except I do know that they took different medications that were not as effective and they all managed to have healthy kids. It’s not up to us to decide who is allowed to be pregnant and carry to term. A case like this could jeopardize the freedoms of millions of other American women with similar disabilities.

Whether she can take care of a baby after it is born will be a matter for social services. Even though she may be mentally incompetent, reproductive rights are a right granted to all females in the US. Even if they are underaged. No one can legally force a 13 year old girl to have an abortion or carry a baby to term against her will. The same rights should be granted to an adult even though they are not fully competent.

In many counties and States, women have been compelled to get birth control shots when they are deemed mentally incompetent. This is different than permanent surgical sterilization, but the same effect for the most part. I don’t think anyone should be forced to undergo surgical sterilization—EVER. This was part of the eugenics movement that started in the US in the late 1800s and unfortunately continued as late as the 1970s in many States.

Ron_C's avatar

I have seen women who are totally dependent on hospital care made pregnant by sexual predators. I think, first of all a full investigation should be made to find, then punish the person that got her pregnant. Second, in my opinion, if the woman is mentally incompetent she must be by definition a ward of either her parents or the state. The state and/or parent should determine if the woman should have her tubes tied. Sterilization should be humane and competently performed. Frankly, I believe the guy should also be sterilized. I would like that to be done as painfully as possible.

The chances for a child of a genetically diminished mental patient and a predator are very poor and the public should not be burdened with the child’s upbringing and probable criminal future. I know that this sounds cold and callous but better a sterilization than an execution.

SpatzieLover's avatar

They deal with this quite differently here in Milwaukee County. A judge would take away all parental rights. Then, any children present or future would be turned over to the State for foster care/adoption.

As for the actual matter of what to do or how to handle it: I despise the idea of ever sterilizing or forcing abortion via a Court ruling. Period.

tedd's avatar

I am against forceable sterilization of anyone, even the mentally incompetent.

I would however find out who impregnated her, as such an act is incredibly reprehensible and deserves punishment.

As for the child itself, I would leave the decision of abortion up to the woman, so since she is in the care of her parents I would leave it up to them. If they chose to have it they could place it up for adoption or raise it themselves.

keobooks's avatar

@Ron_C I doubt you know much about schizophrenia. One of the symptoms is that they have trouble staying on their medication. A person with schizophrenia may be completely “normal” acting for the most part when they are on their meds. They can hold a job and they can seem like anyone else. You may never know they ever had the condition.

One of the main reasons people with schizophrenia are deemed incompetent over their own medical choices is because they have stopped taking their meds one too many times. They may have gotten arrested for vagrancy or committing crimes (usually nonviolent ones—indecent exposure is a common one) because they weren’t on their meds. These people basically lose the right to decide whether or not to take their meds. Someone has the right to force them to take their medication when they don’t want to take it. In some cases, a nurse will come visit them daily and give them medication.

I doubt that she is a raving lunatic with no self control all the time. At worst, the bipolar and schizophrenia may be difficult to treat together and she’s not fully asymptomatic. She may have poor impulse control (which may have lead to her pregnancy in the first place) and some substance abuse problems.

When they ARE on the meds, they are not “mentally diminished”. We’re not talking about someone with a sub average IQ. I doubt that she is so feeble minded that she didn’t go into sex willingly.

As for “not being burdened with the child’s upbringing” = I’m not touching that. There are so many cases in which you could throw that into an argument and this country would be a very different place than it is today if we were to judge people and deem whether or not they had the right to reproduce for this reason.

marinelife's avatar

I think that the baby should be aborted and she should be put on the patch for birth control or sterilized.

judochop's avatar

Being Bipolar does not make you incompetent. Being Bipolar does not make you incompetent. Being Bipolar does not make you incompetent. Being Bipolar does not make you incompetent.

creative1's avatar

This is a slippery slope indeed, the parents should have gone and gotten medical power of attorney over her before she became pregnant and not after her 3rd pregnancy if they felt this strongly about her not having children she can’t care for. If they had done that prior a judge would have probably granted it to them if her mental illness was that severe and done the sterilization prior to having to abort an already forming fetus. Unfortunately the states cannot sterilize a woman or man just because they have no capibility of caring for said child/ren. This is why there are so many foster children waiting for homes, they have people that have mulitple children that all get taken away in hopes that the states will let them keep one even though they can’t possibly raise a child. My oldest daughters mother fried her brains from drugs so badly she is the 5th of all her children to be removed even while she was trying to get her back from the system she became pregnant with twins which she miscarried (blessing if you ask me). Now her bio-mom is back doing drugs and prostitution which who knows if any more children will result from.

Blackberry's avatar

Since we’re so consistent and adamant about women’s choice, why is this different? People we deem mentally normal but obviously shouldn’t breed can do what they want, but not her? That’s what it looks like to me, but I am open to explanations.

Blackberry's avatar

I also forgot to add that it’s a bad situation for everyone, but I’d rather be consistent than single out one person. The “damage” is already done.

HungryGuy's avatar

Sometimes, I just want to put some of these “mentally incompetent” people into a big slingshot and hurl them into the sun…

This morning while waiting at the bus stop to go to work, a “mentally challenged” person started talking to me. S’ok. I try to talk to everyone as an adult, and not in a sing-song voice like I’m talking to a child. We were talking about the soon-to-be expected bus we were waiting for, then he shifted the conversation to wireless internet technologies (at first, he seemed surprisingly well-informed about how Wi-Fi and wireless technology works). Then he mentioned how he thinks he can get free wireless internet by connecting a tin can with a wire coil inside it to his USB port. I told him that’s total bull-crap. He asked me if I worked with computers, and I said so. He then accused me of being “the man” suppressing cancer cures and whatnot in the name of protecting my business profits (I’m just a consultant software developer with no vested interest in such things). I wanted to push him under the bus in the worst way as it pulled up to the bus stop just then!

wundayatta's avatar

One thing is clear to me: no forced abortion and no forced sterilization.

I would let someone smart make an evaluation—preferably someone healthy but who had serious bipolar disorder and/or schizophrenia. The question is what would happen if she goes off her meds during the pregnancy. Is she really a risk to kill others? How can we manage her risk of harming herself (which would be high). I think she’d need nearly constant support.

I would want to provide that support, but in this day and age, who has the money? That means the burden would fall on her family, and if they couldn’t handle it, on the police. She’d end up in jail. Might not be the worst place for her. The other options don’t seem that good, either.

She could take the meds, and who knows what would happen to the baby? I’d rather the meds stopped. I wonder whether they have already. I think the whole community should pull together to take care of this woman and her child. I think it’s a great opportunity for people to learn about the humanity of us mentally defective types. I think @HungryGuy should be first in line. Who knows? Maybe she’d like the way he treated her so much, she’d want to be his slave after. [rolls eyes]

HungryGuy's avatar

@wundayatta – I actually treat people well and fair and justly. After all, I said I talk to people as adults and not in a sing-song voice usually reserved for children. But when people treat me badly, I have a slingshot with destination-sun stamped on it, regardless of their mental capacity…

keobooks's avatar

I find it disturbing that many people who believe in reproductive rights are rooting for forced abortion. Reproductive rights are not only the right to have an abortion—women also should have the right NOT to have an abortion and NOT be sterilized.

Yes, she is likely a terrible mother who will get this baby taken away like the others have been. But reproductive rights must be protected for the sake of all women. No one should have to prove that they deserve to carry a child to term—reproductive rights are all about having control over your own body.

The dark side to having liberty and freedom is that people we don’t think deserve those freedoms get to have them along with everyone else. Forcing this woman to have an abortion will give legal precedence for other people to have the validity of their right to carry a fetus to term legally questioned. This isn’t a slippery slope. This will happen. This would be a big step backwards for the rights of physically and mentally disabled Americans.

bkcunningham's avatar

I agree with you @keobooks But this story is an example of issues that go so far beyond reproductive rights to me.

YARNLADY's avatar

If the woman is mentally competent enough to make a choice, the choice should be hers. If she is not, the party responsible for her should make the choice.

To me, it all hinges on her competency. There is no “force” involved if she is not capable of making a choice, and her caretaker makes a reasoned choice on her behalf.

keobooks's avatar

@YARNLADY : It doesn’t apply to reproductive rights. This is why parents who have legal guardianship of their minor daughter don’t have the right to dictate what happens to her fetus. I doubt that there are any 12 year old American girls who are able to competently take care of a baby, but they get the same reproductive rights as an adult. I think this woman is at least as capable of making decisions as a 12 year old girl. (Which isn’t saying much for the woman or most 12 year olds, IMO.) She should get the same protections.

Blondesjon's avatar

I called her Mom.

CWOTUS's avatar

Few people that I’ve ever met have as much respect and desire for “freedom for all” as I have. And as much as I love the US Bill of Rights and its guaranteed freedoms, none of them are absolute. We don’t have an absolute right to free speech, for example, or absolute freedom of religion either. Notwithstanding that there is no explicit “right to reproduce” guaranteed by the US Constitution or Bill of Rights, I consider it one of the implicit rights we guarantee to each other.

However, like the other rights we guarantee, I don’t think that the right to reproduce should be absolute, either, especially when you have to rely on someone else to raise your spawn, or your children have to be protected against you.

I took “schizophrenic” and “bipolar disorder” to be red herrings in this question. What it turns on for me is “incompetent”. Incompetence can come in all kinds of forms. If the woman is incompetent to care for herself (for whatever reason), then her parents or the state need to assume power of attorney and start to limit some of her rights as they affect others, including unborn children.

lynfromnm's avatar

We are talking about a human being here. Even if she has been deemed incompetent she remains a human being, ans her wishes about what happens to her should take precedence over all other considerations.

People who are incompetent due to mental illness today may be fully functional next month—at least, our mental institutions claim they are treating patients to competency.

Rights are inherent. We are born with them regardless of any disabilities. The unique thing about humans is that we have choices. Don’t strip this woman of her humanity after she’s already been brutalized by a disease.

keobooks's avatar

I wonder how opinions would lay out if her parents were forcing her to keep the fetus against her will and refusing to allow her to have an abortion. They knew that when her symptoms were under control that she was a devout Catholic who would be violently opposed to abortion so they were protecting what would be her deep feelings of sinful agony and guilt by forcing her to stay pregnant and raising her child for her.

Honestly.. would you be defending their right to force her to stay pregnant?

Roe v Wade wasn’t just about abortion rights. It was about the right to keep other people from forcing a female to do ANYTHING to her body against her will that involves reproduction. No forced pregnancies no forced sex, no forced abortions, no forced sterilizations. That’s what reproductive rights are.

I fully support it. The only procedure I believe that should be allowed to be done against someone’s will under dire circumstances is mandatory birth control shots and only because they are completely reverseable if at some point the person recovers.

There are people who believe that abortion is murder. I don’t agree with that sentiment. But I certainly don’t agree with forcing ANYONE to go through an assault on their body, which they would consider to be ripping a human being out of their body and murdering it. It doesn’t matter what I think or what you think about abortion—nobody should be forced to endure something that they consider to be barbaric on that level. It’s inumane.

nikipedia's avatar

@keobooks, you have made a very passionate and compelling argument. I agree completely that reproductive rights are very important rights, but one thing still bothers me. When you make a decision about reproduction, the outcome is equally or more important to the future child, who has no ability to influence the decision. And as much as I would want to grant this woman reproductive autonomy, bringing a child into the world with no resources to care for it—not even a safe environment to grow in as a fetus—seems worse to me than violating her rights.

CWOTUS's avatar

@keobooks, if the woman can articulate – maybe even if she can just agree with – the kind of argument that you have articulated above – then she’s not incompetent, is she? So the premise of the question would be false in that case. But if she’s legally incompetent, then by definition she can’t articulate or even hold such deep thoughts and commitments. These are your arguments projected upon someone else’s charge. They’re perfectly valid arguments – for you – but they don’t apply to someone else’s ward.

Another thing to keep in mind here is that if the woman truly is “legally incompetent”, then a rape has been committed upon her. It seems abhorrent to me that the parents – who must already be under considerable financial and emotional stress in support of their daughter and her already born child – must now accept into their family and care for the product of their daughter’s rape as well.

keobooks's avatar

Please answer though—if her parents were forcing her to keep the fetus and preventing her from having an abortion, what would you think?

CWOTUS's avatar

In that case I’d still think that a crime had been committed in the first place to impregnate her, number one. Assuming the parents were blameless in the commission of the crime and not negligent, and if they had power of attorney, then I guess it’s their decision, whether I like it myself or not. I’d question their sanity, I suppose, but that’s a personal reaction.

HungryGuy's avatar

@keobooks – Okay, to answer the question, if she’s not endangering herself or others, or committing a crime, I don’t think anyone should have the power to tell anyone else what to do or not to do.

Of course, if she has the child, and is neglecting the child due to her diminished mental capacity, then perhaps the government should have the power to get involved. But I’m even leery of that because there have been too many instances of the government abusing its power in the name of “protecting children.” Still, children need to be protected from abusive and/or neglectful environments, so there’s a fine line that must be walked.

bkcunningham's avatar

Why do you keep saying a crime has been committed, @CWOTUS? You do realize the person is schizophrenic. By the very nature of the illness she could have been on her meds and living a “normal” life when she got pregnant. People who have schizophrenia don’t have a scarlett “S” on their chest saying don’t have sex with me I’m crazy. Perhaps the man who got her pregnant had no way of knowing she would go off her meds or that she had a mental illness.

CWOTUS's avatar

That’s a good observation, @bkcunningham, if it’s a condition that comes and goes (as I’m sure is the case with much mental illness and disturbance). However, the determination of “competence” isn’t so fickle. If she was judged “incompetent”, then she doesn’t have the legal competence to consent to sex. Sex with an “incompetent” person is an assault.

bkcunningham's avatar

@CWOTUS, can you show me how you know this woman’s competency ruling said she wasn’t competent to consent to sex? What if the guy who got her pregnant was incompetent? It really isn’t the point though, is it? I mean whether or not her getting pregnant involved a crime. I get what you are saying. I don’t think it is the point though. I was just curious why you said what you said. : )

I think one of the many points and an important point in this discussion is that the Massachusetts Appeals Court ruled that “the personal decision whether to bear or beget a child is a right so fundamental that it must be extended to all persons, including those who are incompetent.”

CWOTUS's avatar

Yes. I posted that quote. I think it was wrong, because “reproduction” involves so much more than simply “conceiving and giving birth”. Only a judge residing in an ivory tower can come to such a ludicrous concept of the exercise of “rights”.

By that reasoning, any man can claim an absolute right to impregnate as many women as will lie still for that, without regard to ability or willingness to support them. Ridiculous!

bkcunningham's avatar

@CWOTUS, are you familiar with the case which that quote and this decision is based on?

nikipedia's avatar

I don’t think keeping the fetus would be good for the mother or the baby, so I would not support that decision by the parents.

And since the parents are likely to be responsible for the child for 18+ years, it seems to me their opinion matters more than the mother who will be carrying it for 9 months.

keobooks's avatar

There is a big difference between a man’s right to impregnate every female on the planet and a woman’s reproductive rights. I will write a post on it later. But in a nutshell, pregnancy is something that happens INSIDE OF A WOMAN’S BODY and this is something no man can experience.

#2. Incompetence from mental illness is VERY different from incompetence due to intellectual deficiency. Talking about someone with schizophrenia as if they were someone with Down’s Syndrome is pointless because most people with schizophrenia have at least average intelligence and the capability to understand intellectual concepts that most people of average intelligence can understand.

#3. Even if they were the same thing, you can’t force a woman who is mentally disabled (aka “retarded”) to have an abortion in this country. You can’t force a minor to have an abortion. You can’t even force a woman in a COMA to have an abortion. When people take the coma patients cases to court, they have to argue about what the woman would want if she could make the choice herself—NOT what is currently best for her health. Even if that woman is as gorked as Teri Schiavo and has almost no chance of ever recovering or regaining consciousness, her wishes are supposed to come first.

Honestly, even I think the coma thing is going to far in protections. But those are the laws right now. We don’t force abortions on people in this country—on ANYONE—not even people in comas. Not even people with very low IQs. Even 12 year old girls who aren’t allowed to get their ears pierced without mommy’s permission can get abortions or choose to keep their babies and their parents can’t do anything legally about it. Even women who will be in prison for the rest of their lives and will never be able to take care of their children—they can’t be forced to have abortions either.

Like it or not – this is American law. And it’s not likely to change. And most true feminists likely don’t want it to change.

wundayatta's avatar

Incompetence and mental illness are judgments that people make and they essentially say they don’t like the decisions someone else makes. Generally, those opinions have some power because a lot of people hold them.

Having experienced mental illness and having seen so many people’s judgements about others that I don’t agree with, I simply don’t trust the process. If someone is mentally ill, they need help. We should be empathetic and try to understand the world from their perspective and we should try to help them.

Under no circumstances at any time would I ever say we should take away someone else’s reproductive rights. I think we might try to keep a person from harming themselves or others, but I don’t think forced abortion or sterilization should ever be a part of public policy. We should protect people, including fetuses, as best we can. If a mother is not taking good care of a child, we should intervene to protect the child. Protection of the child should not include putting the child to death.

If there is a risk that the meds the mother is taking will give the child birth defects, that is not an excuse to kill the child. It does not give us an excuse to take away the mother’s meds. We don’t know for sure what the drugs will do to this particular child, so all we can do is wait and see. We do not know for sure how this mother will treat this child, so all we can do is wait and see.

Sure the way she treats her existing child is compelling evidence for what she will do, but it is not certainty and does not give us the right to protect the child by killing it.

The only person who has a right to terminate the pregnancy is the mother. No one else. We (society) don’t know what we’re doing and can’t guarantee the outcome of any action we might take and so we must leave it to the individuals involved. It is up to us, however, to clean up any messes. We do not have a right to prevent messes. We only have a responsibility to clean them up when the individual can’t handle it.

It’s unfair. Too bad. Society is a lot stronger than the individual and we can handle it.

lynfromnm's avatar

People who are lousy parents have babies every day. They haven’t been judged incompetent by a court of law, but they just aren’t great parents. 16-year-olds have babies all the time. These people have made mistakes, they’ve made bad decisions. Why should THEY be allowed to make bad decisions, but a person with a mental illness isn’t allowed to make a bad choice? I have certainly made my share of bad decisions. It’s a freedom we have – to act against our own self-interest, or to be wrong about what’s in our best interest. We have the right to be wrong, even if we are bi-polar.

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