An article on AlterNet today takes issue with a doctor's power to decide whether a woman is ready to get her tubes tied. The piece uses 25-year-old Lauren Green as an example of the obstacles facing almost any woman under 30 in search of sterilization. Green says that since she was little, she has known she never wanted kids, but she has been repeatedly denied tubal ligation.

There isn't an actual law in place that bans doctors from performing the procedure on women under 30, but most refuse. Dr. Daniel Wiener, assistant professor of obstetrics and gynecology at Montreal's McGill University, follows that guideline and says it isn't arbitrary: "It's because of the thirty years of practice in my life. Because of the number of years of experience that we, as physicians, have come to see that twenty-five, twenty-six, twenty-seven year old women have, historically, more often than not, told you they regretted their decision to get their tubes tied."

But, Christine Brooks, who is conducting research on women who have opted out of motherhood, says that's a "paternalistic" approach. "It questions a woman's inner knowing, her own path in life. It also suggests that women don't know what's best for them and that they have to defer to a medical authority to make life decisions."

I'll admit to being torn on this one. It's an issue of reproductive choice and freedom, to be sure. But making medical and ethical judgments like whether to tie a woman's tubes (or whether someone is prepared for a sex change) is a doctor's right and, arguably, an essential part of the job description. On the other hand, when it comes to elective operations, allowing doctors to determine what's really best for a woman is, of course, an incredibly slippery slope. Thoughts?