France to investigate illegal sterilisation of mentally ill patients

BMJ 1997; 315 doi: (Published 20 September 1997) Cite this as: BMJ 1997;315:697
  1. Alexander Dorozynski
  1. Paris

The French government has ordered an investigation into illegal sterilisations carried out on thousands of mentally handicapped people, mostly women, sometimes without their permission and even without their knowledge.

The extent of the practice was made public last week, when Charlie Hebdo, a satirical weekly magazine, claimed that in recent years tubal ligation had been performed on about 15000 mentally handicapped women. The figure was an extrapolation of data from a study by Nicole Diederich, a sociologist from the National Institute for Health and Medical Research, which showed that 35% of 260 mentally handicapped women in institutions in the department of the Gironde had been sterilised.

French law on surgical sterilisation—even when it is voluntary—is unclear. Such surgery is likened to mutilation and is authorised by law only on strong medical grounds. Voluntary tubal ligation and vasectomy for contraception are illegal. Last year the national ethics consultative committee suggested that sterilisation could be carried out on mentally handicapped people as a last resort in exceptional cases, in qualified microsurgery wards, and after the agreement of an independent interdisciplinary committee.

Ms Diederich, who has been studying the care provided to mental patients in institutions for several years, said: “Most of the time, it [sterilisation] is a very subterranean, occult practice. You have to scratch here and there to get information.” She said she had sent a report of her findings to the French parliament in 1991, but she had not had a response.

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