That said, the available evidence suggests that Rosemary was not informed of what was going to happen to her in any meaningful way. No source examined for this article describes a conversation in which a physician or family member explained the procedure, its risks, and its likely outcomes to Rosemary and asked for her agreement. The accounts that exist describe the decision being made by Joe Kennedy and, presumably, communicated to medical staff, with Rosemary as the subject rather than the participant.
Given her intellectual disability, the question of what meaningful consent would have looked like is genuinely complicated. Intellectual disability exists on a spectrum and affects different people differently; some individuals with intellectual disability are entirely capable of understanding and agreeing to medical procedures, while others have limited capacity to do so. The accounts of Rosemary’s functioning in 1941 suggest that she had significant limitations in her ability to process complex abstract information — the kind of information that informed consent requires. Whether she could have understood a clear explanation of the procedure and its risks, and made a meaningful choice about whether to proceed, is a question the available evidence does not allow to be answered.
What can be said is that the question was apparently not asked. The decision was made for her, not with her. And the outcome of the decision destroyed capabilities she had spent twenty-three years developing.
The question of consent also encompasses what Rosemary was told about what was happening on the day of the surgery. Was she told she was going to a hospital? Was she told she was having a medical procedure? Did she understand that what was about to happen was irreversible? Again, the available accounts do not describe this conversation, which may mean it did not happen in any meaningful form, or may mean it happened but was not recorded in any source that has survived.