{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:18:08Z","timestamp":1791253088443,"version":"4.1.0"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,1]]},"abstract":"<jats:p>One of the most complicated ethical issues that arises in children\u2019s hospitals today is the issue of whether it is ever permissible to perform a procedure for a minor that will result in permanent sterilization. In most cases, the answer is no. The availability of good, safe, long-acting contraception allows surgical options to be postponed when the primary goal of such surgical options is to prevent pregnancy. But what if a minor has congenital urogenital anomalies or other medical conditions for which the best treatment is a hysterectomy? In those cases, the primary goal of therapy is not to prevent pregnancy. Instead, sterility is an unfortunate side effect of a medically indicated treatment. Should that side effect preclude the provision of a therapy that is otherwise medically appropriate? We present a case that raises these issues, and asked experts in law, bioethics, community advocacy, and gynecology to respond. They discuss whether the best option is to proceed with the surgery or to cautiously delay making a decision to give the teenager more time to carefully consider all of the options.<\/jats:p>","DOI":"10.1542\/peds.2016-3992","type":"journal-article","created":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T09:25:24Z","timestamp":1494581124000},"source":"Crossref","is-referenced-by-count":5,"title":["Ethical Controversy About Hysterectomy for a Minor"],"prefix":"10.1542","volume":"139","author":[{"given":"Alyssa M.","family":"Burgart","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Perioperative, and Pain Medicine,"},{"name":"Stanford Center for Biomedical Ethics, Stanford University, Palo Alto, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Strickland","sequence":"additional","affiliation":[{"name":"Departments of Pediatric and Adolescent Gynecology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dena","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Religious Studies and"},{"name":"Program in Health, Medicine, and Society, Lehigh University, Bethlehem, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlene B.","family":"Baratz","sequence":"additional","affiliation":[{"name":"Androgen Insensitivity Syndrome-Differences of Sex Development Support Group, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Karkazis","sequence":"additional","affiliation":[{"name":"Stanford Center for Biomedical Ethics, Stanford University, Palo Alto, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Lantos","sequence":"additional","affiliation":[{"name":"Pediatrics, Children\u2019s Mercy Hospital, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,6,1]]},"reference":[{"issue":"2","key":"2021120916501655400_B1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1097\/GRF.0b013e3181dbdc61","article-title":"Endometriosis and the adolescent.","volume":"53","author":"Dovey","year":"2010","journal-title":"Clin Obstet Gynecol"},{"key":"2021120916501655400_B2","unstructured":"DSD Teens. Dilations: a step-by-step guide. Available at: www.dsdteens.org\/taking-the-wheel\/dilation-a-step-by-step-guide\/. Accessed April 3, 2017"},{"issue":"2","key":"2021120916501655400_B3","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.contraception.2005.08.006","article-title":"Regret following female sterilization at a young age: a systematic review.","volume":"73","author":"Curtis","year":"2006","journal-title":"Contraception"},{"issue":"9968","key":"2021120916501655400_B4","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S0140-6736(14)61728-1","article-title":"Livebirth after uterus transplantation.","volume":"385","author":"Br\u00e4nnstr\u00f6m","year":"2015","journal-title":"Lancet"},{"key":"2021120916501655400_B5","unstructured":"Tamar-Mattis\u2008A. Sterilization and minors with intersex conditions in California law. California Law Review. April 19, 2012. Available at: www.californialawreview.org\/sterilization-and-minors-with-intersex-conditions-in-california-law\/. Accessed Nov 20, 2016"},{"key":"2021120916501655400_B6","unstructured":"Tamar-Mattis\u2008A. Exploring gray areas in the law about DSD and sterilization: legal rules about parental consent are different when fertility is on the line. Endocrine Today. October 2009. Available at: www.healio.com\/endocrinology\/reproduction-androgen-disorders\/news\/print\/endocrine-today\/{c6029f85-28ac-43f4-9e7e-0fc897f6313f}\/exploring-gray-areas-in-the-law-about-dsd-and-sterilization. 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Sterilization of women, including those with mental disabilities.","volume":"110","author":"Committee on Ethics","year":"2007","journal-title":"Obstet Gynecol"},{"issue":"2","key":"2021120916501655400_B9","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/AOG.0000000000001581","article-title":"Committee opinion no. 668 summary: menstrual manipulation for adolescents with physical and developmental disabilities.","volume":"128","year":"2016","journal-title":"Obstet Gynecol"},{"issue":"6","key":"2021120916501655400_B10","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.jpag.2014.09.001","article-title":"Obstructive reproductive tract anomalies.","volume":"27","author":"Dietrich","year":"2014","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"6","key":"2021120916501655400_B11","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.jpag.2008.11.006","article-title":"Mayer-Rokitansky-K\u00fcster-Hauser syndrome: sexuality, psychological effects, and quality of life.","volume":"22","author":"Bean","year":"2009","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"6","key":"2021120916501655400_B12","first-page":"889","article-title":"Poststerilization regret: findings from the United States Collaborative Review of Sterilization.","volume":"93","author":"Hillis","year":"1999","journal-title":"Obstet Gynecol"},{"key":"2021120916501655400_B13","unstructured":"Emerson\u2008RW. Self-reliance. Available at: https:\/\/math.dartmouth.edu\/\u223cdoyle\/docs\/self\/self.pdf. 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