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
Recommended Citation
Ramakrishnan, P. (2025). 1.2 Legal, Ethical, and Multidisciplinary Approaches to Reproductive Health in Adolescents with Intellectual Developmental Disorder and ASD. Journal of the American Academy of Child and Adolescent Psychiatry, 64 (10 Supplement), S3-S3. https://doi.org/https://doi.org/10.1016/j.jaac.2025.07.178
Comments
Journal of the American Academy of Child and Adolescent Psychiatry Conference held 2025-10-20 to 2025-10-25 in Chicago, IL, USA.