Sunday, August 14, 2005

Bribing Women to be Sterilized

Via feministing, I learned about this group offering drug-addicted women $200 to be sterilized. Project Prevention's stated mission is to "offer(s) cash incentives to women that are addicted to drugs and/or alcohol to use long-term or permanent birth control." The first problem I have with this is that this group does not provide women with funding for drug treatment, but is "currently writing to 40 of our birth control clients on a monthly basis. She sends them cards of encouragement applauding their efforts to get or stay clean. We have referred over 200 men and women to drug treatment programs..." Ooh, letters, good stuff. At least they mention referrals, but it seems that they really are not effectively advising treatment based on the statement, "Our organization has offered to relocate several addicts to drug treatment programs we located for them (none accepted)." The second problem I have is their logic for not funding treatment, that "For every [baby born to an addict] we prevent from being conceived, society saves millions of dollars that can be put towards drug treatment." This doesn't make sense because there is no straight line between the two; nobody is measuring how many children aren't born, figuring out how much it would have cost to care for them, and putting that money into drug treatment. If hospitals don't spend the money in the NICU, they're spending it somewhere else, and they have no idea how this group hypothetically played into the equation, and the money doesn't get re-routed to drug treatment. The third problem is that they're not targeting any education or sterilization to men (where sterilization could possibly be reversed) - they're only targeting women, at least according to their home page.

The main problem I have with this, though, is two-fold. First, they're effectively sending the coercive message to drug-addicted women, "Hey, we've got $200 for you if you get sterilized." Women with drug problems may use this solution in order to have money for drugs, when what they really need is drug treatment, effectively ignoring the women's own health in order to "save the children." The sterilization option, which vulnerable women may be influenced to choose, is permanent, not allowing them to become pregnant if they wish to in the future, even in a clean future. Second, the women can only opt for sterilization or long-term birth control methods such as IUDs or Norplant, which really may not be the best choice for an individual woman. The IUD, for example, carries risks of uterine perforation and pelvic inflammatory disease. Women should be allowed to choose a birth control method based on their individual needs and health risks, not a "cash incentive." EngenderHealth has a nice overview of informed choice and consent, which involves educating women about all of their choices, and not introducing any bias. The ethical and informed consent issues related to what Project Prevention is doing are really overwhelming, and it's hard to imagine how they have been allowed to continue.

  • Article from BBC News

    FYI-This group apparently has chapters in Memphis and Nashville...
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