Sterilization, like any other surgical procedure, must be carried out under the general ethical principles of respect for autonomy, beneficence, and justice. Women requesting sterilization should be encouraged to discuss their decision and associated issues with their husbands or other appropriate intimate partners. The physician who objects to a patient's request for sterilization solely as a matter of conscience has the obligation to inform the patient that sterilization services may be available elsewhere and should refer the patient to another caregiver. The presence of mental capacity does not, in itself, justify either sterilization or its denial. When a patient's mental capacity is limited and sterilization is considered, the physician must consult with the patient's family, agents, and other caregivers in an effort to adopt a plan that protects what the consulted group believes to be the patient's best interests while, at the same time, preserving, to the maximum extent possible, the patient's autonomy.