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Ethical dilemmas and legal aspects in contraceptive counselling for women with intellectual disability—Focus group interviews among midwives in Sweden
Author(s) -
Höglund Berit,
Larsson Margareta
Publication year - 2019
Publication title -
journal of applied research in intellectual disabilities
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 63
eISSN - 1468-3148
pISSN - 1360-2322
DOI - 10.1111/jar.12651
Subject(s) - ambivalence , autonomy , focus group , intellectual disability , teamwork , psychology , medicine , nursing , social psychology , psychiatry , sociology , political science , anthropology , law
Abstract Background Few studies have explored ethical and legal issues in contraceptive counselling among women with intellectual disability (ID). This study aimed to gain a deeper understanding of these issues during midwifery contraceptive counselling. Method The present authors interviewed 19 midwives in five focus groups in Sweden 2016 – 2017 and analysed data with content analysis. Results The participants expressed that women with intellectual disability have equal right to relationships and sexual expressions, but feared exposure to sexual exploitation/abuse. They experienced ethical dilemmas related to principles of fairness and autonomy, but strived to provide assistance in spite of the women's cognitive impairment, presence of supporting persons and uncertainty of optimal counselling. Organizational support was insufficient. Conclusions The midwives experienced ambivalence, uncertainty and ethical dilemmas in their counselling. They were, however, aware of legal aspects and strived for the women's best interest, right to self‐determination and autonomous choices. The participants wanted better professional teamwork and support.