Application of the do no-harm approach to informed consent among women with intellectual disabilities in Colombia

Abstract

This article analyzes the relevance of the “Action No Harm Approach” (ANHA; in Spanish, Enfoque de Acción sin Daño, EASD) in obtaining informed consent in reproductive decisions of women with intellectual disabilities, who also face multiple forms of vulnerability. From a bioethical perspective, it raises the need to guarantee respect for the autonomy and dignity of these women, avoiding paternalistic practices or interventions that, although well-intentioned, may have adverse effects. The methodological proposal is qualitative and structured around the categories of ANHA, informed consent, reproductive decisions, intellectual disability, and vulnerability. Through a review of literature and case law, the study seeks to identify the models used in practice to obtain consent, noting the need for reasonable adjustments. The ANHA allows for a rethinking of interventions so that they are context-sensitive and promote truly informed decisions, without imposing undue burdens or substituting the will of the women involved.