The Iowa Supreme Court on vasectomies and due process

by Ryan Koopmans | April 18, 2014

By Ryan Koopmans

Must a mother who serves as a guardian for her intellectually disabled adult son get court approval before arranging his vasectomy?  Yes, ruled a unanimous Iowa Supreme Court this morning.

In February 2013, Maria Kennedy took her intellectually handicapped son, Stuart, to get a vasectomy.  Stuart was 21 at the time, but because of his disability, Maria was serving as his guardian.  The month before, Stuart had asked a court to terminate that guardianship because he thought Maria was too controlling.  Stuart had recently told his mom that he’d been having sex with his girlfriend.  That concerned her; hence the vasectomy.

The problem, for Stuart at least, was that the court didn’t get to his termination request until after the medical procedure had been done.  So, through his attorney, he amended the petition to claim that his mom had violated Iowa law by arranging for the vasectomy without court approval. Iowa law requires that guardians get court approval before subjecting their wards  to “major elective surgery” or a “nonemergency major medical procedure.”  Stuart argued that a vasectomy falls into at least one of those categories.

The probate court disagreed, ruling that a vasectomy isn’t major elective surgery or a major medical procedure because it takes just 20-minutes, doesn’t require anesthesia, can be done in the doctor’s office (as opposed to an operating room), and is reversible.

Staurt appealed.  Sterilization, he argued, is a pretty major thing, and doing it without any court oversight would violate his constitutional rights.  The ACLU and Disability Rights Iowa agreed, filing a an amicus brief that made similar arguments.  The groups also disputed the probate court’s finding that a vasectomy is  reversible, arguing instead that a “significant percent of the time” it’s permanent.  (So be certain before scheduling that March Madness appointment.)

The Iowa Supreme Court unanimously agreed with Stuart.  The justices didn’t decide who was right and who was wrong on the permanent vs. reversible debate, because they didn’t need to.  Even when considered in context, the terms “major elective surgery” and “major medical procedure” are ambiguous, Justice Mansfield wrote for the Court.  And because there are constitutional problems with sterilizing someone against their will, the Court interpreted those ambiguous terms to include a vasectomy:

[W]e have serious doubts about the constitutionality of a statute that allowed a guardian to arrange for a ward to undergo a vasectomy without any court involvement.  Accordingly, applying the principle of constitutional avoidance, we hold that a vasectomy is “a major elective surgery” and a “nonemergency major medical procedure” for which prior court approval is required.

In other words, parents must get a court’s okay before sterilizing their intellectually handicapped children.




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