Abstract
There are many intricate physiological, ethical, legal, and emotional factors to consider while deciding whether to end a pregnancy in a daughter with borderline IQ. It may be difficult for the daughter to completely comprehend and handle the ramifications of pregnancy if she has borderline intelligence, which is characterised as an IQ between 70 and 84. Concerns regarding the physical, mental, and social difficulties she might encounter are raised by this condition, which can affect her capacity to understand the obligations of motherhood and to provide for a child.
The daughter’s health risks during pregnancy, her capacity for emotional handling, and the degree of care she receives from family and experts are important determinants of the choice. Since a girl with borderline IQ might not have the legal competence to make decisions on her own, legal considerations including guardianship and consent regulations must also be considered. It is also necessary to consider ethical issues about autonomy, the daughter’s welfare, and the possible child.
In order to decide on the appropriate course of action, parents and caregivers must first carefully evaluate the circumstances, frequently with the assistance of medical professionals, legal counsel, and mental health specialists. Other options like temporary care or adoption might also be considered. The health and future welfare of the daughter and any future children should be given top priority in this very personal decision.
What is borderline intelligence?
To be inferred is borderline intelligence. Unlike intellectual disability, the borderline individual is believed to possess defectively great capacities but not quite great. It is as if borderline individuals possess lower-than-average complex cognitive powers or are not very good in terms of taking decisions, among others; but they still can maintain an independent life with certain support.
However, with the right support—including support with daily activities, decision-making, and learning new skills—people with borderline intelligence may be able to live independently. With just a little support, these individuals might do work, socialize, and engage in various activities.
It may be difficult for a daughter with borderline IQ to fully comprehend the circumstances or make an informed decision about her pregnancy. This may make it more difficult for her to decide what is best for herself, and it may put a great deal of pressure on her family to assist in making decisions.
What is meant by pregnancy termination?
Termination of pregnancy, or abortion, is defined as the act of ending a pregnancy, whereby the fetus is not capable of living outside the mother’s body. A person decides to terminate a pregnancy for social, medical, personal, or other reasons.
Quite a number of issues come into play as we consider the decision that could be made in the case of terminating the pregnancy where the baby is a daughter with borderline intelligence: whether she has enough support to take care of her child, her mental and physical health, and most importantly, the financial resources. Where the daughter is deemed to be incapable of making this decision, it would be left up to her parents or guardians to evaluate and come to conclusions that would benefit everyone.
What Makes It More Difficult for One to Decide?
Many factors will make the decision to terminate the pregnancy difficult when it is found that there is a borderline IQ:
Little Understandable Information: When dealing with a girl of borderline intelligence, pregnancy, childbirth, and rearing can be intimidating. She may not honestly comprehend the complications and challenges of parenting a child. Due to this, she might find it difficult to arrive at a decision whether to terminate the pregnancy or continue.
Why Is This Choice So Difficult?
The decision-making on whether to end a pregnancy would prove difficult in the case where an expectant girl has borderline IQ. Several factors are playing a part in this.
Potential Misunderstanding: For a girl with borderline intelligence, the whole process of childbirth, delivery, and motherhood can be quite difficult to fully understand. She might not even grasp her hardship and demands in raising a child. That might pose a challenge in making the abortion-or-not decision.
Risk Factors: A daughter with borderline IQ has to fight an increased health risk, and pregnancy and childbirth can be very taxing on women. Factors such as maternal general health, mental state, and support system are put under stress during a pregnancy. Each case should be evaluated further, paying a lot of attention to the general condition of the mother’s physical and mental resources to deal with pregnancy, labor, and obligations at motherhood.
Emotional Impact: It is important to consider the daughter’s emotional and mental well. When confronted with an unexpected pregnancy, a daughter with borderline intelligence may feel confused or distressed. Pregnancy will bring about physical changes that she may not completely
Legal Concerns: People who might not be able to make decisions for themselves are protected by the law in many jurisdictions. Accordingly, a daughter who has borderline intellect could not be legally capable of making her own medical decisions, such as whether to end a pregnancy. In certain situations, the decision-making process may need to engage parents or guardians.
Support Systems: A vital component is the family’s capacity to offer assistance. Should the daughter struggle with self-care or comprehending the circumstances, the parents or guardians must think about how they may help her. Getting assistance from social services, medical professionals, or other family members may fall under this category.
The rights of person with disabilities act-
On December 13, 2006, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) was adopted, signaling a paradigm change in how people with disabilities are viewed and treated. People with disabilities are now viewed as subjects with rights and choices regarding their lifestyle and any therapies they may want to receive, rather than as objects of charity, medical care, or social protection. On October 1, 2007, India ratified and signed the agreement. This paradigm shift was meant to be incorporated into the Rights of Persons with Disabilities Act, 2016 (RPwD Act) [15], which superseded the previous Persons with Disability (PwD) Act 1995. Any individual with long-term physical, mental, intellectual, or sensory impairments that, when combined with other obstacles, prevent them from fully, effectively, and equally participating in society is referred to as a person with a disability (PwD).
Other Indian laws that affect women’s reproductive rights include the Medical Termination of Pregnancy Act (MTP Act), 1971, its Amendment of 2020 (MTP Amendment Act), the Mental Healthcare Act, 2017 (MHCA), the National Commission for Women Act, 1990 (NCW Act), the Protection of Human Rights Act 1993, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002, and the National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act 1999 (NT Act). This is covered in depth, nevertheless, as not all of these Acts acknowledge WID’s reproductive rights.
Case scenario
The patient is a WID, 26 years old, is brought to the obstetrician by the parents for MTP. Upon examination, it is found that the patient is 19 weeks pregnant and possibly of low IQ, and doesn’t seem to know she is pregnant. The obstetrician, in conjunction with a psychiatrist, ascertains whether she can consent to MTP. The psychiatrist much later evaluates her and ends up assessing her to have a mild intellectual disability. She is in need of help with everyday activities. When the baby is mentioned, she responds with her love of playing with little babies. She cannot give any details about the father of the baby. When informed about the pregnancy, she displays happiness. Yet, she does not comprehend what it entails to stand a mother. Hence her parents want MTP and hysterectomy to be performed, because they can hardly look after their daughter in her present state and would like to prevent pregnancies in future. She does not have any knowledge about menstruation, sexuality, and self-care.
Matters arising from the above-stated case
1. How to determine an adult WID’s capacity to give informed consent for termination of pregnancy and/or temporary/permanent sterilization?
2. If a mother is incapable of taking care of her child, who will be responsible for the child’s upbringing?
3. Can guardians or caregivers consent to the termination of a WID’s pregnancy and/or temporary or permanent sterilization?
4. In this circumstance, what are the duties and responsibilities of the psychiatrist?
Sections 10, 13, and 92 of the RPwD Act, 2016 make it abundantly evident that a woman’s right to motherhood is her own, and that no one may restrict it unless doing so would seriously jeopardize the woman’s bodily or mental well-being. The right to “personal liberty” is guaranteed by the Indian Constitution, and legislation passed by its principles forbids ending a pregnancy for a WID. In a landmark Supreme Court judgment regarding the termination of pregnancy in a woman with intellectual disability, the apex court observed that persons with borderline, mild or moderate intellectual disability are capable of being good parents.
According to the ruling, a woman with a low IQ may nevertheless be able to have the social and emotional skills necessary to be a successful mother. The highest court also declared that it could not order a termination without an adult WID’s approval. The aforementioned case and the Supreme Court’s ruling serve as an illustration of how the law protects WID’s reproductive rights. People with disabilities who are unable to make legally binding decisions may be given the assistance of a “limited guardian” to make decisions on their behalf, according to Section 14 of the RPwD Act and the National Trust Act. We go into more detail about this later.
conclusion:
Determining the possibility of terminating a pregnancy for a daughter with borderline intelligence can be one of the most sensitive and intricate ethical, medical, and legal challenges any family may face. Borderline intelligence is generally defined within an IQ range of 70 to 84. Such issues should be presented with developing difficulties that form obstacles to making decisions, particularly for young females about matters of great import such as pregnancy and motherhood. Thus, ascertaining whether or not one chooses to move forward with the termination is a mosaic of considerations meant to ensure that the daughter’s good, as well as the possible child’s and family’s, are considered at all levels of consideration.
The work of a medical expert must carefully address the ethical and legal issues posed by the termination of her pregnancy. In some cases, borderline intelligence may mean that a girl has insufficient mental capacity to give her free and informed consent to terminate her pregnancy with full insight. In such cases, the guardians and the medical personnel must take control. Legal input is also essential for a family of borderline intelligence. In no way should the termination of a girl who is said to have borderline intelligence be made unless her right has been duly protected.