1.2 Legal, Ethical, and Multidisciplinary Approaches to Reproductive Health in Adolescents with Intellectual Developmental Disorder and ASD

Document Type

Abstract

Publication Date

10-1-2025

Abstract

Objectives: Adolescents with intellectual and developmental disabilities (IDDs) and ASD face complex legal, ethical, spiritual, and clinical challenges in reproductive decision-making. This study aims to: 1) examine ethical dilemmas around informed consent, autonomy, and spiritual care in clinical settings; 2) compare legal and guardianship frameworks across countries in relation to autonomy and dignity; and 3) assess the role of multidisciplinary collaboration—including spiritual care—in supporting person-centered reproductive healthcare. Methods: A comparative policy analysis of legal frameworks in South Asia and high-income countries (HICs) was conducted to evaluate their impact on healthcare access for adolescents with IDDs/ASD. Case studies illustrate the ethical and spiritual tensions in consent processes and reproductive decision-making. Additionally, literature from occupational therapy, psychiatry, and disability studies was reviewed to identify evidence-based models integrating medical, psychological, social, educational, and spiritual domains. Results: Legal approaches vary significantly: some jurisdictions emphasize autonomy and supported decision-making, while others rely on protective guardianship. Ethical tensions arise in assessing capacity while honoring familial, cultural, and spiritual values. In many low- and middle-income countries (LMICs), parental attitudes shaped by spiritual or religious beliefs influence perceptions of sexuality, often restricting open discussion or consent. HICs that embed spiritual care (eg, chaplaincy, ethics consults) within interdisciplinary teams offer more inclusive, trust-building environments. Holistic models improve care by addressing identity, emotional resilience, and meaning-making—core concerns for adolescents with IDDs/ASD. Conclusions: Reproductive healthcare for adolescents with IDDs and ASD must integrate legal protections, ethical clarity, and spiritual responsiveness. Including spiritual perspectives in care planning enhances dignity, cultural congruence, and resilience, affirming adolescents as whole persons in their reproductive lives. AC, ID, ASD

Publication Title

Journal of the American Academy of Child and Adolescent Psychiatry

Volume

64

Issue

10 Supplement

First Page

S3

Last Page

S3

Comments

Journal of the American Academy of Child and Adolescent Psychiatry Conference held 2025-10-20 to 2025-10-25 in Chicago, IL, USA.

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