Anita cannot speak or comprehend complex information. At 28, she communicates mostly with facial expressions and baby-like sounds. When excited, she washes her hands. When her periods cause cramping and pain, she moans and agitates, unable to understand.

To eliminate this monthly discomfort and ease the burden of caring for her, caregivers at an assisted-living home in Reykjavik, Iceland, proposed an unusually aggressive step. The home’s manager recommended that Anita undergo a hysterectomy, a major surgical procedure to remove her uterus and end her periods.

Eirikur Smith, an official in Iceland’s disabilities office, discovered this plan last year during a routine visit to the home.