I (34M) am the primary caregiver for my younger brother, Noah (22M), who is non-verbal and has a severe intellectual disability. He was diagnosed in early childhood and, despite years of therapies and support, his cognitive abilities are similar to those of a toddler. Noah is a kind and gentle person, but he struggles to communicate his needs and experiences severe sensory sensitivities.
One of the biggest challenges we’ve faced is his dental hygiene. Despite our best efforts, brushing his teeth has always been a battle. He doesn’t understand the importance of it, and any attempt to clean his teeth triggers meltdowns. We’ve tried specialized toothbrushes, desensitization therapies, and even sedating toothpaste options—nothing has worked.
Over the past year, his dental health deteriorated to the point where he was in visible discomfort, but because he can’t tell us when he’s in pain, it took a while to realize how bad things had gotten.
After consulting with his dentist and medical team, we decided the best option was to put him under general anesthesia to treat his existing dental issues and, at the same time, perform a procedure to prevent future decay—applying dental sealants and removing a few problematic teeth.
The procedure went smoothly, and since then, Noah has been noticeably happier and calmer. He’s eating more comfortably, and the stress around brushing his teeth has significantly decreased.
The issue arose when my older sister, Emma (38F), found out. Emma has always been somewhat distant from Noah’s day-to-day care, but she’s very vocal about disability rights.
When I told her about the procedure, she was furious. She accused me of violating Noah’s bodily autonomy and making permanent decisions without his consent. I tried to explain that this was about preventing his suffering—he cannot understand dental pain or communicate his distress, and the procedure improved his quality of life.
But she said I was treating him like a child and implied I was taking the "easy way out" instead of working harder on alternatives. Since then, she’s been calling and texting, saying I crossed an ethical line.
She even involved a few extended family members who now think I’m “controlling” Noah’s body without regard for his autonomy. Meanwhile, I’m just trying to do what’s best for him—I see his daily struggles firsthand, and I genuinely believe this was the kindest choice.
I love my brother and want to give him the best quality of life possible. But with my sister’s accusations ringing in my ears, I’m starting to wonder—did I overstep?
AITA?
Your brother does not have autonomy. You legally control his medical and financial decisions.
Agree. Due to Noah’s severe intellectual disability, he lacks the capacity to make informed decisions. This is a legal and medical determination, not a matter of opinion...
I also feel like if Noah was able to make an informed decision, he would've done the same: the smart doctors will make me sleep, and they can fix the pain in my mouth without me noticing it. When I was a toddler I never wanted to take meds when sick so my mother would trick me into taking ibuprofen by hiding it in my food. Sure she "ignored" my bodily autonomy, but she did it to help me and I was better off.
Healthcare professionals are very studious about this stuff, they would not proceed if they did not have the appropriate consent. That your sister thinks she knows more about consent than the professionals who did the procedure is wild.
And you may have saved his life. Dental infections can get severe enough to cause sepsis.
And if anyone gives you grief, OP, strongly suggest to make them the primary carers. Like your sister is being an ass, just say "yeah, I'm not the best for brother, lets move him to your place, so you can properly care for him". Whenever she says anything nasty, specially in public, aggressively push for her to care for brother and see her squirm.
I agree with what you said but it's fake, OP has changed gender and age many times, not even a week ago they were 28M. They are trying to farm karma.
OP needs to make sure of this legally:
OP says they are the a primary caregiver, but does NOT say they have power of attorney or fiduciary power over Brother. This needs to be locked down.
And if Sister is so concerned, Sister can be the one to take ownership of these decisions legally. Otherwise she must yield to OP's decisions, or go to court to gain such power over Brother.
You acted out of love, improving Noah’s life but bypassed his bodily autonomy.
NTA. There is a difference between physical and mental disabilities. Body atonomy always applies to physical disabilities. However, it does not always apply to mental disabilities. Someone with the mental age of a teenager needs to be treated differently than someone with the mental age of a toddler.
Since you have described Noah as having the mental age of a toddler, his bodily atonomy would be very low. When it comes to medical issues, you have to decide what is best for him, as he does not have the mental in capacity to make an informed decision.
Cavities can kill. The infection in the tooth, left untreated, can spread into the brain. Therefore, you made the right decision to prevent this issue from getting worse or reoccurring.
Absolutely not. NTA. The day your sister sees your brother's suffering firsthand is the day she can comment on how best to alleviate it. In order to know what she's talking about, she needs to see him (and you) more often. Enough said.