本文探討一名青春前期中度智能障礙女生，其母親擔心女兒即將面臨青春期會有月經處理問題，亦擔心智障女兒一旦懷孕後可能造成身心困擾，甚至面臨墮胎等傷害，因而希望智障女兒能切除子宮以絕育；然而子宮為女性重要器官，智障兒對其身體之自主權亦應受到重視。本文藉由文獻查證，從智能障礙的定義和分類以及性議題、性教育現況和相關案例、法律著手，並釐清護理人員之角色功能進行討論和分析，且運用Silva倫理決策模式進行資料收集、評估、確立問題，以及最後做出倫理決策，希望能作為相關人員進行倫理決策時的借鏡及參考，進而提供妥善之因應措施，給予智障兒童身心靈最佳的保障。

This article was to explore the problems of a pre-puberty female child with moderate intellectual disability. The client's mother was worried about that her daughter could not deal with menstruation problems when she is puberty, and also considered that she had to face the physical and mental injuries from abortion. Consequently, the client's mother would like the client excised her uterus to be sterilized. However, the uterus is an important organ to every female. As a result, the principle of autonomy of the intellectual disability children should be taking considerately. With consulting the references, we not only identified the definition and classification of intellectual disability but also researched gender issues, sexual education, and relative existing cases. Moreover, we clarified the roles and functions of nurses to carry on discussion and analysis. Furthermore, we used Silva ethics strategic model to collect and assess relating causes, to establish problems, and to make the ethics decision in the end. Hoping this article could be a consulation with people to go on a relative ethics decisions. In conclusion, we sincerely hope that we could provide appropriate measures for intellectual disability children the best guarantee to achieve physically, mentally, and spiritually harmony.