Respecting the Autonomy of Chronic Mentally Ill Women in Decisions About Contraception

Family Planning and the Scope of the “Reproductive Psychiatry” Curriculum

“…A preventive ethics strategy involves proactively discussing family planning with patients with mental disorders in order to reduce the risk of ethical dilemmas and adverse ethical outcomes [50]. Key components of an ethical framework for preventing unwanted pregnancies in patients with major mental disorders include balancing autonomy and beneficence-based obligations to the patient [51,52]. It has not been shown that coercing or manipulating a patient's decision-making regarding contraception is ethically justified when at risk of unwanted pregnancies, even when the patient has impaired decisionmaking [51,52].…”

“…Key components of an ethical framework for preventing unwanted pregnancies in patients with major mental disorders include balancing autonomy and beneficence-based obligations to the patient [51,52]. It has not been shown that coercing or manipulating a patient's decision-making regarding contraception is ethically justified when at risk of unwanted pregnancies, even when the patient has impaired decisionmaking [51,52]. Although long-acting reversible contraception methods are highly effective and safe for use in almost all women [53], potential ethical problems occur when these are not removed at a patient's request.…”

The Cornell University Experience

“…Our research has therefore addressed a wide range of topics in clinical obstetrics and gynecology including the limits of viability [67], mental health and pregnancy [68][69][70][71][72][73][74][75][76], cesarean delivery [77,78], patient's refusals of medically indicated management [29,35,38], assisted reproductive technology [79,80], obstetric anesthesia [81], cancer during pregnancy [82,83], HIV infection [84], issues in gynecology [85,86], the language that should be used in decision making with patients [87], advance directives [29,82,83] and professional issues [88].…”

Women's Mental Health: Focus on Sexual and Reproductive Issues

“…Clinicians often experience very mixed emotions (3,4). While we want to help both male and female patients to participate fully in life to the extent of their abilities, it may be challenging to include optimal sexual and reproductive functioning in the treatment plan.…”