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"..isn't a huge amount of money compared to what you save in welfare.."
July 7, 2013 3:39 PM   Subscribe

The Center for Investigative Reporting has found that in 2006-2010 nearly 150 female inmates in California were coerced into sterilization without state approval.

Post title quoted from Dr. James Heinrich: “Over a 10-year period, that isn’t a huge amount of money compared to what you save in welfare paying for these unwanted children – as they procreated more.”

tl;abridged in the SacBee.
posted by seanmpuckett (89 comments total) 19 users marked this as a favorite

 
oh good, i think i'll just go turn the bbq off and sit in a dark room for the rest of the day
posted by Stonestock Relentless at 3:45 PM on July 7, 2013 [15 favorites]


I'll be curious to see where the discussion on this focuses: on the fact that the sterilizations happened, that they were "coerced", that they happened without "state approval", or that "state approval" is even a factor in this type of procedure.
posted by HuronBob at 3:45 PM on July 7, 2013 [2 favorites]


For sanity's sake do not under any circumstances read the comments at the SacBee. Even one might be too many.
posted by seanmpuckett at 3:46 PM on July 7, 2013 [1 favorite]


I looked at the comments and it's like 1000 permutations of reblogspam like

Rabid Badger RT @pourmecoffee: “California sterilized nearly 150 female inmates from 2006 to 2010 without permission” http://cironline.org/reports/female-inmates-steril...

Jason Gross RT @pourmecoffee: “California sterilized nearly 150 female inmates from 2006 to 2010 without permission” http://cironline.org/reports/female-inmates-steril...

Remy Julienne RT @pourmecoffee: “California sterilized nearly 150 female inmates from 2006 to 2010 without permission” http://cironline.org/reports/female-inmates-steril...

ugh...
posted by crapmatic at 3:52 PM on July 7, 2013


Yet, Kimberly Jeffrey says she was pressured by a doctor while sedated and strapped to a surgical table for a C-section in 2010, during a stint at Valley State for a parole violation. Jeffrey, 43, was horrified, she said, and resisted.

“He said, ‘So we’re going to be doing this tubal ligation, right?’ ” Jeffrey said. “I’m like, ‘Tubal ligation? What are you talking about? I don’t want any procedure. I just want to have my baby.’ I went into a straight panic.”


I was just having a conversation with someone last night about coercive/dishonest adoption of kids from poor countries by US families, particularly though not exclusively by evangelicals.

Reading this article reminds me of how - whatever you want to call our ruling ideology, capitalism, neoliberalism, greed, mainstream thinking, whatever - the fundamental belief is that everything about poor folks is a resource for the rich and for the state, just like it were a forest to be chopped down. Want children? Steal them via dodgy adoption. Want to "save" money on social services? Cut up the bodies of poor women so they can't have children any more. That's the most brutal end of biopower, where the body is explicitly taken over to serve the state and the wealthy.

The reality of our current ideology is enclosure - is theft, conquest. Whenever there's something that has a scrap of freedom about it, even the freedom to give birth to a child, that thing must be enclosed and made to serve the state and the wealthy.
posted by Frowner at 3:57 PM on July 7, 2013 [89 favorites]


Nah. This kind of thing only happened long, long ago, like ancient history, like in the 1930's and stuff.
posted by telstar at 3:59 PM on July 7, 2013 [1 favorite]


Oh god, telstar, that's just disgusting, on top of this. Particularly for me, as someone who had to fight for ages to get proper birth control since I don't want children due to having multiple disabilities. But surely I wanted kids, right? I was barely 25! Or 30! I'd CHANGE MY MIND!

... turns out all I had to do was get hooked on some drugs other than my pain killers I have to fight to get.
posted by strixus at 4:02 PM on July 7, 2013 [1 favorite]


“They all wanted it done,” he said of the sterilizations. “If they come a year or two later saying, ‘Somebody forced me to have this done,’ that’s a lie. That’s somebody looking for the state to give them a handout.

“My guess is that the only reason you do that is not because you feel wronged, but that you want to stay on the state’s dole somehow.”


I feel sorry for the women who trusted him with their care.
posted by jetlagaddict at 4:02 PM on July 7, 2013 [5 favorites]


For sanity's sake do not under any circumstances read the comments at the SacBee. Even one might be too many.

Boy, you weren't kidding.
posted by Lutoslawski at 4:02 PM on July 7, 2013


Buck v. Bell
posted by Navelgazer at 4:02 PM on July 7, 2013 [4 favorites]


A body might also be reminded of the judicially-required implantation of Norplant for women convicted of certain crimes, not to mention attempts to require women on public assistance to use Norplant as a condition of receiving benefits. That was in the 90s, or at least started then.
posted by immlass at 4:04 PM on July 7, 2013 [7 favorites]


Want to "save" money on social services? Cut up the bodies of poor women so they can't have children any more.

While there are no doubt many people who would get behind such a sentiment, it's not really very plausible to suggest that this story is proof that such a point of view frames the state's approach to these women. The whole point about the "without approval" and "without permission" parts of these stories is that they were acting without the state's approval and permission, which, by law, they are expressly required to seek before performing any tubal ligation on an inmate. So if it is true that the doctor involved was pressuring the women unduly (and it's only fair to note that he denies this strenuously, although he does seem bent on parading all the worst possible attitudes to the inmates in his care) he was very much a rogue actor here.
posted by yoink at 4:04 PM on July 7, 2013 [5 favorites]


I really do need to find a Chrome extension to hide all newspaper site comments.
posted by Tomorrowful at 4:06 PM on July 7, 2013 [8 favorites]


Ugh, ugh ugh. I have zero problem with women receiving tubal ligations if they want them -- although I agree that a Mirena or Paraguard is probably better -- but this seems to be the latest chapter in a book we've been reading for a long, long time.
posted by KathrynT at 4:06 PM on July 7, 2013 [1 favorite]


I thought I came home from China a year ago.
posted by craniac at 4:18 PM on July 7, 2013 [2 favorites]


Tomorrowful, between adblock and noscript, I have to really want to read comments on most newspapers and anyplace that uses disqus in order to even know they're there.
posted by rtha at 4:20 PM on July 7, 2013 [2 favorites]


What the actual fuck?

This the actual fuck, I believe.
posted by yoink at 4:24 PM on July 7, 2013 [1 favorite]


Sorry. It was a reference to Holmes' awful reasoning in Buck v. Bell, in which he famously stated "three generations of imbeciles is enough" as justification for allowing forced sterilization without due process. It was perhaps in poor taste, but I was just making a wry comment on how poorly framed that particular argument was, when it ignored the rights of the prisoners involved.
posted by Navelgazer at 4:24 PM on July 7, 2013 [1 favorite]


[Comment deleted. If you're going to argue in favor of eugenics, you're going to have to spell that right out. ]
posted by restless_nomad at 4:24 PM on July 7, 2013 [4 favorites]


Nah. This kind of thing only happened long, long ago, like ancient history, like in the 1930's and stuff.

It continued in Sweden until 1976, and in Oregon until the 1980s, if I remember correctly. War Against the Weak is a good starter volume on how it began here in the United States.

In fairness, KathrynT, how many generations of imbeciles do you think is enough?

Really, really hoping this is meant ironically somehow.
posted by AdamCSnider at 4:24 PM on July 7, 2013 [3 favorites]


I feel sorry for the women who trusted him with their care.

I don't know that much about prison health care, but did the women really have a choice whether or not to trust him with their care?
posted by The Underpants Monster at 4:24 PM on July 7, 2013 [4 favorites]


OK, so CRACK simply substituted "drug addicts" for "imbeciles" and don't seem to be encountering much censure.
posted by telstar at 4:30 PM on July 7, 2013 [1 favorite]


From the article:
The receiver has overseen medical care in all 33 of the state’s prisons since 2006, when U.S. District Judge Thelton Henderson of the Northern District of California ruled that the system’s health care was so poor that it violated the constitutional ban on cruel and unusual punishment.
These doctors are saying they didn't know they were required to get state permission. Which means the receiver has failed, because coercing someone into an unnecessary medical procedure...looks and smells a lot like cruel and unusual punishment.

And this guy seems to have missed the point of those 2003 hearings:
“While obviously this was a dark chapter in our State’s history, the CDC (California Department of Corrections and Rehabilitation) played a minuscule role,” Alameida wrote in a June 2003 letter. “Thus our participation in your hearing would provide no substantial information on that role and I do not believe our presence would contribute in any way toward your objectives.”
If I had to guess, I'd say part of the point was to not have this happen again.
posted by bilabial at 4:36 PM on July 7, 2013 [2 favorites]


I don't know that much about prison health care, but did the women really have a choice whether or not to trust him with their care?

Oh, sorry, I didn't mean that in the sense that they were free to choose and pick their own medical care at all-- I think there was a reference to shackles at one point-- but they were still entrusted to the care of a licensed doctor.
posted by jetlagaddict at 4:37 PM on July 7, 2013


⌘ + F "medical license"... ⌘ + F "License"

Wait, i don't see anything about this guy losing his license to practice in here. I guess you have to be not behind bars, and have the capitol to hire a lawyer and actually sue to take someone like this down nowadays?
posted by emptythought at 4:41 PM on July 7, 2013


For sanity's sake do not under any circumstances read the comments at the SacBee. Even one might be too many.

Who knew the dregs of society make Sacramento their home?
posted by Blazecock Pileon at 4:41 PM on July 7, 2013


I think there was a reference to shackles at one point-

Related.

In 33 states across the country, pregnant inmates, including women being held exclusively for immigration-related offenses, can be shackled to their hospital beds during the birthing process
posted by emjaybee at 4:50 PM on July 7, 2013 [3 favorites]


Three generations of imbecilic doctors is enough.

Fuck.
posted by anotherpanacea at 4:52 PM on July 7, 2013 [4 favorites]


I can't believe anyone is surprised. I just have a fundamentally darker view of this country, apparently. I'm more surprised that it wasn't being done until yesterday, or really that it came out at all. In fact, if it wasn't so obvious and could be done quickly and without pain, I'd bet dollars to donuts it would still be done on the sly.
posted by nevercalm at 4:55 PM on July 7, 2013 [2 favorites]


And every Republican State Legislator in Texas points at California and says "See? THAT's what happens when abortion is legal!"
posted by evilmidnightbomberwhatbombsatmidnight at 5:01 PM on July 7, 2013 [1 favorite]


California just last year got rid of the abhorrently barbaric practice of shackling incarcerated women during labor and birth. It took years of advocacy to get that bill passed and signed into law. Which really makes you wonder about the people who think it's a good idea.
posted by gingerbeer at 5:17 PM on July 7, 2013 [13 favorites]


The idea that crime began going down 18+ years after abortion was legalized is similar to this. Although this is definitely less pleasant.
posted by Halogenhat at 5:18 PM on July 7, 2013 [1 favorite]


Can anyone explain why the people responsible for this haven't all been thrown in jail?
posted by delmoi at 7:04 PM on July 7, 2013 [1 favorite]


Because sweeping it under the rug is easier than doing anything about the problem. Also, dealing with it would involve admitting you let it happen under your nose.

That, and isn't mistreatment of inmates widely regarded as just like, a thing that happens if not something "to be expected" as part of being incarcerated if not even "part of the punishment" by a large portion of society?

See also: The averages persons view on prison rape, and the amount of jokes surrounding it that are just seen as normal.
posted by emptythought at 7:19 PM on July 7, 2013


This doctor may or may not have gotten informed consent. If he didn't, he should go to jail.

But as a matter of principle, I don't see why we wouldn't want to heavily encourage serious criminals not to have any children. In this case, it was inmates who had served multiple prison terms. To encourage them to have ligations seems like a no-brainer.
posted by shivohum at 7:39 PM on July 7, 2013


I don't see why we wouldn't want to heavily encourage serious criminals not to have any children.
I don't see what this has to do with the crime under discussion.
posted by delmoi at 7:44 PM on July 7, 2013 [1 favorite]


If you're feeling inspired by any of this to take action, Justice Now is the group responsible for getting this story into the news. They do really fantastic and amazing work with a tiny budget on behalf of people like the women interviewed in this story. They are unique even among organizations doing prison advocacy in that most of their Board of Directors are currently incarcerated people (mostly women).

(I don't work for them, although I do work with them sometimes.)
posted by gingerbeer at 7:44 PM on July 7, 2013 [1 favorite]


Who knew the dregs of society make Sacramento their home?

It's the state capital. It's overrun with politicians, lobbyists, and prison healthcare middle managers.
posted by notyou at 7:53 PM on July 7, 2013 [4 favorites]


In this case, it was inmates who had served multiple prison terms. To encourage them to have ligations seems like a no-brainer. shivohum

This is problematic because skin color and socioeconomic factors have as much, if not more, to do with incarceration and conviction than "seriousness" of the crimes. For example, some of these women are in jail for parole violations. Consider that people most likely to have the skills and other resources to advocate for themselves/hire competent and informed advocates tend not to end up in prison. Consider that parole violations may be as simple as inability pay a fine and inability to defend that failure rigorously. Whatever they are in jail for, the state of California decided that tubal ligations are only allowable if they are approved before hand. This approval was not sought in these cases.

People choose to have or not have children for any number of reasons. Because I am pro body autonomy, I am necessarily in favor a woman's right to have children when and how she wants. And to be supported in that decision. I am in favor of a woman being the person who decides whether she does or does not wish to have children, without coercion on either end of the spectrum. Coercion in this area is certainly a no-brainer for me, but perhaps not in the way you meant it.
posted by bilabial at 8:07 PM on July 7, 2013 [4 favorites]


California (along with a few other states) also has huge issues with disciplinary histories of its prison physicians; I can't find current stats, but it look like about 20% of doctors practicing in California prisons have major, major disciplinary actions in their history. So you've got the most incompetent doctors coercing the most vulnerable patients into major irreversible surgeries, without any oversight.
posted by jaguar at 8:45 PM on July 7, 2013 [1 favorite]


CIR is doing the best work out there in investigative journalism.
posted by Ironmouth at 9:10 PM on July 7, 2013


In the previous thread about the woman who was offering incentives for drug addicted women to be sterilized, after much thought I fell into the "consenting adults" camp.

In this case, we are talking about women in prison who, by that very definition, are NOT granted a normal level of agency and freedom to make decisions.

The very locale is (in my opinion) by definition a coercive environment, and I would say that a procedure to permanently alter a person's body that is not undertaken for the immediate health of the person involved should be disallowed under all circumstances.
posted by chimaera at 9:13 PM on July 7, 2013


bilabial: "“While obviously this was a dark chapter in our State’s history, the CDC (California Department of Corrections and Rehabilitation) played a minuscule role,” Alameida wrote in a June 2003 letter. “Thus our participation in your hearing would provide no substantial information on that role and I do not believe our presence would contribute in any way toward your objectives.”"

One of the things that bothers me about that quote is that it's the CDCR, dammit — the California Department of Corrections and Rehabilitation. Not just Corrections. I'm sure many of the people in charge would prefer to forget about the rehabilitation aspect, but that's supposed to be part of it.
posted by Lexica at 9:28 PM on July 7, 2013


Many of the article comments drift down the road of, "We (the country/state/county) will save money in the long term if all these people have to look after is themselves/whoever they've already given birth to and no more".

And I would say that yes, no shit Sherlock, fewer babies will mean fewer costs to society and in more ways than they think. But I don't see, can't see those people actually volunteering to permanently remove their ability to procreate.

They see the problem (local or global) being an unsustainable growth in population, they see the solution being in less conceptions, but they would rather limit someone else's freedom to contribute to the existing problem than to stop contributing to the problem themselves.

And that's really fucking frustrating.
posted by Slackermagee at 9:50 PM on July 7, 2013 [1 favorite]


Blazecock Pileon: For sanity's sake do not under any circumstances read the comments at the SacBee. Even one might be too many.

Who knew the dregs of society make Sacramento their home?
You do realize that Sacramento's internet reaches outside of the city limits, yes?
posted by IAmBroom at 9:55 PM on July 7, 2013 [1 favorite]


Okay. That's it. Stop the world, I want to get off. How's that asteroid coming? Still nothing? Shit. What else have we got?
posted by ob1quixote at 10:01 PM on July 7, 2013 [1 favorite]


Considering the forced sterilization of Native American women in the 70s, the use of the legal system to coerce women into Norplants, and various other ways the government has attempted to sterilize or otherwise control the births of vulnerable women, I'm not at all surprised. We have a long history with eugenics in this country and much of it is very, very recent.
posted by NoraReed at 10:49 PM on July 7, 2013


Given that women in correctional facilities are regularly raped by guards and faculty, it might be that the sterilizations had an element of self-interest.
posted by empath at 10:51 PM on July 7, 2013 [2 favorites]


I usually like to play the contrarian, but this really is the vilest and most disproportionate trespass I've ever heard of on MetaFilter, a breach of every possible moral concept in play. Not the least of which is that doctors haven taken an oath to protect the weak and sick from harm and injustice.

To think that even if you did have the best of intentions, out of all the people that you could affect, that you would coerce an imprisoned woman in her most vulnerable state, that of bringing new life into this world, and make her pay for her sins and society's shortcomings by performing a medical operation like this, in the shadow of civilization, so far inside a woman's body that nobody will ever see it - this is to essentially play God.

Perhaps this story is still breaking, but I am shocked that the linked article did not address the existence of any fallout or apology. These doctors should lose their license and these institutions should lose their accreditation. If there is a grey area here, then the DHHS and AMA should step in and create new regulations along with severe penalties. I hope the people involved in this never get a good night's sleep again, and may God have mercy on their soul.

What a complete and utter travesty.
posted by phaedon at 12:37 AM on July 8, 2013 [6 favorites]


I'm sure there's something somewhere about doing things to the very least of society you also do it to some important dude.
posted by fullerine at 12:39 AM on July 8, 2013 [1 favorite]


“As soon as he found out that I had five kids, he suggested that I look into getting it done. The closer I got to my due date, the more he talked about it,” said Christina Cordero, 34, who spent two years in prison for auto theft. “He made me feel like a bad mother if I didn’t do it.”

Well, 5 kids is a lot. If my friends where intending to have more than 5 kids I'd probably start trying to talk them out of it as well.

In some sense I think this treatment of prisons is totally inline with contemporary attitudes towards the role of imprisonment in modern society and widespread notions of hereditary / nuture influence. That is, "non-productive" adults are locked up and there is a strong belief that the combined influence of genes and upbringing in fact does have a significant impact on your chances as an adult. ie we believe there is a high chance that a prisoners children will also be "non-productive".

Non-productive in the sort of foucaultian sense of not able to contribute to the surpluses of industrial society.

There is also the issue of what exactly is "coercing" someone into a particular action. We coerce people into doing things all the time - like working, going to school, college, not doing drugs.
posted by mary8nne at 4:18 AM on July 8, 2013 [1 favorite]


I can't believe that this is the world I live in. Is there someone somewhere I could give some money to that would MAKE THE WORLD STOP BEING SO FUCKING EVIL?
posted by medusa at 4:42 AM on July 8, 2013


There is also the issue of what exactly is "coercing" someone into a particular action. We coerce people into doing things all the time - like working, going to school, college, not doing drugs.

The "what is coercion" bit is something of a red herring, since, as your list of example shows, coercion occurs differently in different contexts. The other policies you list involve neither the direct violation of another person's bodily integrity nor the inherent perversion of doctor-patient relationships. which pretty much have to be built on consent and mutual trust.

The argument is not about coercion as a Platonic evil, as if circumstances of class, gender, race, and so forth did not exist. It's about situated instances in which a medical procedure has been performed without consent on a particularly vulnerable population, something that has direct or very close historical precedents in the forced sterilization of racially-"othered" women and cognitively impaired persons. And this is without putting this coercion in the context of an ongoing set of attempts to diminish or revoke women's control of their own bodies.

Pursuing the question of coercion-in-general takes us rather abstractly away from these quite concrete and terribly *real* violations. It might be possible to argue about power, knowledge, history, and the social order from these examples; it's hard to see how that would prove helpful rather than trivializing in the context of this story and this discussion.
posted by kewb at 6:11 AM on July 8, 2013 [2 favorites]


And how many male inmates were sterilized, encouraged to be sterilized, or even offered the procedure? Near zero, I'd bet?
posted by mikeh at 6:28 AM on July 8, 2013 [8 favorites]


(In a horrible devils advocate, I cant believe I am actually saying this way)

Mikeh population growth rate is normally only a function of breeding females of a species, provided there is a minimum level of males. In order for the male sterilization to be effective you would need near 100% coverage, while each female that is sterilized would reduce the population growth rate. Population growth is female limited.

(Again only devils advocate and in no way an endorsement for the forced sterilization of anyone. I do think that contraception should be available to everyone on the planet though, completely free of cost and permanent voluntary sterilization has a place in that as yet unobtained utopia.)
posted by koolkat at 6:41 AM on July 8, 2013


And how many male inmates were sterilized, encouraged to be sterilized, or even offered the procedure? Near zero, I'd bet?

Male criminals have historically been just as much a target of punitive sterilization efforts as women -- see Skinner v. Oklahoma. And they should be again. But it should be done in an open, transparent way and subject to public debate: we should simply admit that not everyone should be allowed to have children.

If you repeatedly commit violent crimes, for instance, just as you lose your freedom to move around society and are put in prison, you should lose your freedom to bring human beings into the world. You cannot be trusted to take care of them properly.
posted by shivohum at 7:14 AM on July 8, 2013 [3 favorites]


How does forced sterilization jibe with libertarianism?
posted by MisantropicPainforest at 10:05 AM on July 8, 2013


And they should be again. But it should be done in an open, transparent way and subject to public debate: we should simply admit that not everyone should be allowed to have children.

That's a conversation I don't think we should even think about kicking around as a what-if unless and until we are willing and able to talk about the current realities of our criminal justice system - where something like 70% of inmates are nonwhite - because the outcome would be racial and ethnic eugenics.
posted by rtha at 10:14 AM on July 8, 2013 [4 favorites]


If this is actually about the good of the children, we have an entire branch of social services that already exists to prevent child abuse, ensure minimal levels of parenting and, if necessary, take away children who aren't being cared for properly. Why isn't their oversight good enough?

If, on the other hand, you're suggesting that criminals should be sterilized because they don't deserve to have children, I think that's generally referred to as "cruel and unusual."
posted by ostro at 11:58 AM on July 8, 2013 [1 favorite]


Is this where I can register the opinion that I am not at all okay with eugenics?

Somehow, this opinion seems to be a lot less ubiquitous and implicit than I thought it was before I started reading this thread....
posted by schmod at 12:05 PM on July 8, 2013 [6 favorites]


Feeling about the same way after reading comments on it here and other places, Schmod. I think Frowner really nailed my issues with it upthread. This is ... just not okay.
posted by Archelaus at 12:18 PM on July 8, 2013


It's well established that dollar-for-dollar, money spent on incarceration would be much more effective at reducing crime if it were instead spent on nutrition, education, health and other support services for the poor. Of course, that would upset the smug little morality play enjoyed by so very many people.

It should be source of nation-wide shame that millions of people's lives are being effectively destroyed -- and in many cases, before they've even begun -- just so that millions of others can feel superior about how they've "worked so hard to earn what they deserve" without any thought at all to the various entitlements that made those choices available to them.

I don't mind the money so much; it's the human cost I resent the most.
posted by seanmpuckett at 12:24 PM on July 8, 2013 [3 favorites]


we should simply admit that not everyone should be allowed to have children.

No, not everyone should be allowed to *care* for children. Making a baby is not the same thing as being around one.
posted by Phalene at 12:29 PM on July 8, 2013


How does forced steriization jibe with libertarianism?

I'm not a libertarian, but very easily, depending on the brand of libertarianism; most libertarians believe, after all, in the right of some entity to punish people for criminal offenses.
--
That's a conversation I don't think we should even think about kicking around as a what-if unless and until we are willing and able to talk about the current realities of our criminal justice system - where something like 70% of inmates are nonwhite - because the outcome would be racial and ethnic eugenics.

This is nothing like racial or ethnic eugenics, because only a small percentage of any particular ethnic or racial group has been convicted of violent crime. 70% of inmates may be nonwhite, but only a tiny percentage of nonwhites are violent convicted criminals.
--
Why isn't their oversight good enough?

No, not everyone should be allowed to *care* for children. Making a baby is not the same thing as being around one.

Child protective services is well known to anyone who works with them to be grossly inadequate to the problems of neglect and abuse that millions of children face. Often taking abused kids away from their parents puts them in even worse situations with foster parents, etc.

Once you've made a baby, if you're unable or unwilling to take care of it, you have unconscionably increased the chances of that child facing unacceptable suffering (unless you've carefully sought out adoption at a time when the child is still highly adoptable).
posted by shivohum at 1:03 PM on July 8, 2013


Once you've made a baby, if you're unable or unwilling to take care of it

So we're just preemptively assuming these things of people who have committed completely unrelated crimes, then? And we're so sure that we're willing to stake forced, irreversible bodily modification on it?

Child protective services is well known to anyone who works with them to be grossly inadequate to the problems of neglect and abuse that millions of children face. Often taking abused kids away from their parents puts them in even worse situations with foster parents, etc.

Yes, and the solution to that is to improve that system. When there are two solutions to a problem, one that involves shackling people to a hospital bed for nonconsensual surgery and one that doesn't, I'll take the one that doesn't, thanks.

Anyhow, suffering is far more assured for biological children born of parents with certain genetic conditions, and somehow nobody is lining up to advocate their forced sterilization. I wonder why?
posted by ostro at 1:36 PM on July 8, 2013


You seem to be assuming that people convicted of violent crimes cannot care for children.
posted by MisantropicPainforest at 1:37 PM on July 8, 2013


So we're just preemptively assuming these things of people who have committed completely unrelated crimes, then? And we're so sure that we're willing to stake forced, irreversible bodily modification on it?

You see to be assuming that people convicted of violent crimes cannot care for children.

I'd put it differently. How can we just assume that convicted violent criminals are capable of taking care of children? Are we so sure of that that we are willing to subject children to them? The majority of violent criminals are diagnosable with personality disorders. They have lower impulse control, more substance abuse, and have shown that they are willing to physically harm other people. How much more evidence can there be that they would be unfit parents? Certainly any one of them should have the chance to show that they are different, but the majority...

I wonder why?

Because those people have not committed acts that justify the state to make generally massive intrusions into their lives for the good of society, like putting them in prison. It's a big bright line that is not perfect, but has the merit of simplicity.
posted by shivohum at 1:59 PM on July 8, 2013


How can we just assume that convicted violent criminals are capable of taking care of children? Are we so sure of that that we are willing to subject children to them?

Well I mean if we were handing out kids willy nilly I would have some sort of process so that I wouldn't be giving a kid to a violent person, but that is not what is happening. These people are simply procreating, which is an inviolable human right.
posted by MisantropicPainforest at 2:06 PM on July 8, 2013 [1 favorite]


How can we just assume that convicted violent criminals are capable of taking care of children?

What's your goal, exactly? Is it to protect children? All children, or only these? Is it to punish a certain class of criminal in this one specific way? Why? Is that the most effective punishment? Is it the best way to protect children? What benefit can you demonstrate that would outweigh the very basic encroachment on a fundamental human right?
posted by rtha at 2:26 PM on July 8, 2013


I'd just like to say that i never thought i would be reading this type of "literally hitler" eugenics argument on MeFi. This is absolutely the garbage i'd expect to see on reddit. Complete with the 3/4-assed justifications about how certain people are "less suited" to care for children either overtly or just implying that they'll be taking an "unfair share of the pie" of what they contribute to society Vs what they'd take away or some right wing garbage like that.

Think long and hard about what you're saying here, people who are in favor of this type of thing or "playing devils advocate". Because this is a dark road to even be hypothetically going down, and you're getting an awful lot of mud on yourself while you're trying to bucket it up here.

You also seem to be conveniently ignoring what even landed these women in prison and what the racial and ethnic makeup is, despite lots of people trying to tell you and show you the statistics that it's disproportionately crap like possession and they're mostly not white.

So yea, this is really the best of the web guys. Keep giving 110% to good faith discussion, "arguing for the other side for the sake of debate" always brings us to the highest level of discourse.

I'd like to note that i let this one marinate for a while too. It passed the HALT test, and a proof read after the fact. I'm not angry, just disappointed and bemused. I legitimately thought i'd never see this here
posted by emptythought at 4:29 PM on July 8, 2013 [4 favorites]


So I actually read the article, and I'm wondering if everyone here did, because I'm sitting here thinking WTF?

This whole casei is not as cut and dried, to me, as the consensus in this thread would have it. I realize that it is very easy to read a headline like this and think, "OMG, prison doctors have been forcing helpless women to be sterilized! It's eugenics! Let's go lynch the doctors who did this!

But there really is no evidence whatsoever to support the claim that these women were coerced into having their tubes tied.

Yes, some women claim they were. Actually, one woman claims to have heard other women being pressured, and another woman claims she was pressured as well. But this is not supported by the medical records or other women who were inmates at the time or the doctors. Even the people in charge of the prison, being characterized here as heartless zombies, seem rather to have compassionately considered the limited healthcare options available to the women under their supervision. The fact that one woman in this article refused the procedure when it was offered to her and both the offers and the denials were clearly documented in her chart Strongly suggests that coercion was NOT a common practice. She did not appear to suffer any consequences from denying the procedure, so the idea that women were being forced to consent against their will is not only not backed up anywhere in the article but seems completely unfounded.

Another woman, with seven children, also said that she was asked about a tubal ligation and was surprised she was asked (either she didn't know a tubal was an option or she could not have afforded it outside of prison). This woman, though, decided to have the tubal, was very happy she had done so, and said if given the chance again, she would make the same choice. That does not sound like someone forced into aprocedure against her will.

Now, we do appear to have evidence that "the state" was not approached for permission beforehand for the tubal ligations, which is supposedly the proper procedure. But 1) The doctors did not seem to know this was required, and informing them of that, I should think, is the responsibility of the penal system, and 2) how do we think asking the state for permission would have gone, exactly? Mefites frequently say that birth control and even abortion should be available on demand and free of cost to women who want those services, and we don't even have this for women today, women who aren't imprisoned.

Say these women inmates wanted to have tubal ligations. The most likely outcome is that they would be denied access to this procedure because of the cost to taxpayers, despite, as the doctor rightly states in the article, in the long run these procedures might actually save taxpayers money.

This is important because tubal ligations are invasive procedures, as are C sections, and even today it is not just acceptable practice, but women are in fact encouraged to have both done at once. Opening a woman up again to have her tubes tied later would be subjecting her to another entirely unnecessary surgical procedure.

Even if the women were on the fence about whether to have more children prior to being questioned about having their tubes tied, there is inherent danger in having repeat C-sections, whoch they might not be aware of, and which, as also mentioned in the article, doctors are required to explain to patients at risk. This danger was even greater in the days before laproscopic surgeries were developed. Multiple abdominal surgeries are NOT good for a woman's body, and repeated cutting of the supportive abdominal muscles as well as the scar tissue resulting from each procedure meant that doctors routinely counselled women to have tubal ligations rather than getting pregnant again right up until quite recently (heck, maybe they still do). I know whereof I speak; I was strongly counselled against another pregnancy after two pregnancies resulted in two back-to-back C-sections in two years, and offered a tubal ligation as a matter of ensuring my own health was not put at risk by another pregnancy. Even the potential of a third C-section was considered that dangerous. Heck, my hysterectomy, six years later,was a cause for concern, as I had to have it done abdominally; if the endometriosis had not been so severe we would not have gone through with the surgery. It was news to me that women are not supposed to be asked during labor if they want to be sterilized because the, "pain and discomfort can impair a woman’s ability to weigh the decision." Though I think it is a good general policy for those reasons, that was not my own experience in the late 1990's, when I had my kids.

But again, if a woman inmate did not want the tubal ligation, we already have at least one woman who refused the procedure with no negative consequences as a result. Maybe some women did regret, after the fact, having the tubals done. But that regret is not the fault of the doctors (unless proof that coercion took place is forthcoming).

So the cries in the thread about eugenics and how everyone involved should be in jail is just...well, like I said, I am sitting here going WTF and wondering if we all read the same story.
posted by misha at 5:16 PM on July 8, 2013


These people are simply procreating, which is an inviolable human right.

Why is procreating an inviolable human right while the right not to be kidnapped and locked up for 20 years is not inviolable?
--
What's your goal, exactly? Is it to protect children?

Absolutely. Ideally I'd like to protect any children from being born to abusive and violent parents, but that's not possible. Things could be improved, however, and this is a practical, clear case of where policy could change.
--
well, like I said, I am sitting here going WTF and wondering if we all read the same story.

Probably not. There's a lot of people who see a topic like this and immediately assimilate the headline to their pre-existing view that the System Is Evil and start in with the hysterics.
posted by shivohum at 5:43 PM on July 8, 2013


The fear of consequences can be just as coercive as actual consequences. Similar ideas exist in most definitions of rape, where if a victim reasonably fears she will be harmed if she says no, that's coercion. The article states that several women were asked to give consent for sterilization while they were in active labor, and the article specifically points out that physicians and prison staff abused the idea that such sterilizations were medical emergencies that needed that level of no-time-to-think-about-it decision-making from the prisoner. I find it incredibly hard to perceive a scenario in which prison officials can't find some period of time to give an imprisoned pregnant woman some time to think about an upcoming medical procedure. They know she's pregnant, they know where she is, they know she's not going anywhere.

I'm sure some women did want the procedure and were happy to have the opportunity. That's great for them. It has no bearing on whether other women who did not want the procedure got it anyway.

"The people in charge didn't know how consent was supposed to work" is not a valid defense for... anything, actually. Lack of proper oversight is a HUGE RED FLAG that the system is being abused. As the article mentions, the oversight was indeed specifically instituted because abuse was happening.

And again, see my previous comment about California's ongoing issues with incompetent doctors (as in, their malpractice insurance has been revoked - level problems) working in the prison system. The likelihood of these particular doctors making stupid self-serving choices is much higher than the likelihood of other doctors making bad choices.
posted by jaguar at 5:51 PM on July 8, 2013


If you repeatedly commit violent crimes, for instance, just as you lose your freedom to move around society and are put in prison, you should lose your freedom to bring human beings into the world.

No more Bush dynasty, then? How tempting.

This was obviously quite deliberate, and constitutes a crime against humanity.

The doctors who did these sterilizations should be in the dock at the Hague, along with their enablers.
posted by jamjam at 7:28 PM on July 8, 2013 [1 favorite]


There's a lot of people who see a topic like this and immediately assimilate the headline to their pre-existing view that the System Is Evil and start in with the hysterics

More unfortunately, there are people who have so little knowledge of or respect for history that they can apparently seriously advocate for racist, sexist policies to be perpetrated on people who are incarcerated and not see anything wrong with that.

If I am "hysterical" in your world, then I am happy to be so. The policy you advocate is repugnant to me.
posted by rtha at 7:45 PM on July 8, 2013


How can we just assume that convicted violent criminals are capable of taking care of children?

I used to work with a guy that used to sell coke and went to prison for "aggravated mayhem". At the time I worked with him, he had been clean for 7-8 years, had a high paying IT job, was married, raising a daughter, and was paying child support for a kid from a previous relationship. From what I could tell, he was a great dad, and didn't at all seem to be violent. People can change -- and more particularly -- fatherhood can change people.
posted by empath at 7:48 PM on July 8, 2013 [1 favorite]


If I am "hysterical" in your world, then I am happy to be so. The policy you advocate is repugnant to me.

I actually didn't mean you at all.
posted by shivohum at 7:49 PM on July 8, 2013


Think long and hard about what you're saying here, people who are in favor of this type of thing or "playing devils advocate". Because this is a dark road to even be hypothetically going down,...

This is such an absurd thing to say... pearl clutching over philosophical discussions.

Really I think its these sort of situations that help us understand some of the complexities and hypocrisy at the heart of Modern Society. To me there is something very odd that we find it perfectly logical to lock someone up for X years (and hence irrecoverably alter the physical realities of their life) but for some reason preventing procreation is seen as a worse punishment.

For me if it was a choice of punishment - X years jail or sterilisation.. even for say 5 years jail time - I'd probably give up kids to avoid the jail time. But the ideology of our age has this kind of spirtualized fetishisation of childbearing and parenthood.

on another note yes it seems that Enforced Sterilization has been defined by the ICC as a "Crime Against Humanity" but seriously these sort of definitions are just as arbitrary as any other legal regulations.
http://en.wikipedia.org/wiki/Crimes_against_humanity#International_Criminal_Court
posted by mary8nne at 2:45 AM on July 9, 2013 [1 favorite]


Things could be improved, however, and this is a practical, clear case of where policy could change.

shivohum, giving your point the best possible read, let it first be said that the events described in this link did not occur in, as you put it, an "open, transparent way and subject to public debate." So let's just go ahead and talk about what did happen. This happened behind closed doors and without public debate. Furthermore, if we are to believe that these women were coerced into having tubal ligation, and if we agree that the law does not currently allow for - or inform the public of - this sort of punishment for criminal behavior, then we can at least agree that these women have been denied both life and liberty by representatives of the Government outside the sanction of law. You simply cannot tack on an ad hoc punitive infertility procedure to a person who is already serving a sentence, without prior written notice through for example the formation of a law, a hearing, a defendant of sound mind, legal representation, and the right to appeal. All of these rights were categorically denied in these cases. This discrepancy cannot be overstated enough. So let's not diminish what you're trying to say by forcing it to defend the indefensible.

That leaves the question of whether or not tubal ligation constitutes "cruel and unusual" punishment. I'm going to stop short of writing a thesis here, so let me just say I don't believe the right to have a child can be revoked solely on the basis of a foreseen negative social obligation it may create, because having a child is not nor has it ever been a purely social decision in the United States. But more importantly, giving birth to and raising a child under miserable circumstances is not currently a crime in this country. If it was, then maybe we could start talking about tubal ligation as a retributive form of justice. We might then want to pause for a moment, and marvel at the society we would then be living in, and then address other private failures that have a social impact, such as divorce and poverty, with surgical punishment, just as eagerly.

A much clearer and more practical policy in dealing with violent offenders (that many, as a matter of opinion, find offensive) is the death penalty. Interestingly enough, even life itself is not, as you put it, a totally "inviolable human right." This would seem to support your point. But nonetheless this country does not currently mutilate, dismember, poison or torture its American-born prisoners domestically for crimes such as theft or rape. And death by lethal injection is the last stop in a tremendous appeals process; a process that, notably, for reasons relating to human fallibility, has been suspended in many states.

Also, the death penalty is typically reserved for criminals that have committed aggravated murder. Tubal ligation qua punishment is an extreme and unusual procedure with an effect on the individual that does not in any way stem from, counteract or relate to their crime, nor does your argument seem to care that it doesn't. It also does not rehabilitate the criminal in any way, and in many cases, is totally irreversible.

So one should at least entertain that tubal ligation is not even close to being a self-evident "next step" in situations such as this, nor should we pretend like it is. Your "But it improves things" brand of utilitarianism has to be balanced at the very least with constitutional protections and broader moral considerations, even when it comes to detainees. And it should be noted that pure utilitarianism is a woefully broad, reductionist philosophy that is rather famous for producing ridiculous outcomes, and does not, strictly speaking, form the foundation of any current Western legal system.
posted by phaedon at 3:48 AM on July 9, 2013


For me if it was a choice of punishment - X years jail or sterilisation.. even for say 5 years jail time - I'd probably give up kids to avoid the jail time. But the ideology of our age has this kind of spirtualized fetishisation of childbearing and parenthood.

But then it's your choice, and doesn't resemble the situation here, where you lose the five years *and* are sterilized, and the latter done in a way that treats you and your body as variables in someone else's utilitarian calculus, not your own. The "fetishization" here is not about childbirth, or even reproduction specifically, but rather of personal bodily integrity and personal power over biological capacities.

Imprisonment alters a person's physical realities, yes, but still treats the physical borders of the body itself and its capacities as the limit to state power. Remember, in Foucault you don't get rid of power, you just reconsider its points of application. While he uses examples like the torture and mutilation of Villiers as a way to set up his examination of punitive power, he's not actually making some straightforward argument that torture or forced medical procedures are preferable to imprisonment.

Promoting sterilization as a criminal penalty would seem to be advocacy of exactly the kind of monstrous applications of biopower that Foucault critiques in the Collège de France lectures. You're talking about letting the state decide which forms of life will be reproduced and which will not.

Foucault's notion was eventually to financialize all punishments and desacralize both sexuality and "life," as with his later pronouncements that rape should be treated as a civil tort rather than a crime. Somewhat bizarrely, he deliberately neglected or did not care much about financial powers, which looks increasingly like a colossal blind spot in his thinking. Marx has had his revenge after all.

But whatever your philosophical aims, your hypotheticals seem to ignore the situation we have today, where we have both torture *and* medicalization *and* the panopticon at once. It's five years *and* sterilization, not five years *or* sterilization.
posted by kewb at 5:21 AM on July 9, 2013


phaedon, I don't think I particularly disagree with most of what you wrote. I'm not a simple utilitarian, nor would my advocated policy be chiefly for retributive purposes. The right to have a child would not be revoked because of a "negative social obligation" that might be created but because there have been clear and judicially found facts that render the prisoner presumptively unfit to parent a child.
posted by shivohum at 5:27 AM on July 9, 2013


he's not actually making some straightforward argument that torture or forced medical procedures are preferable to imprisonment.

I"m not either. I was trying to make the point that in this thread there is a kind of hysterical reaction to the notion of sterilization as part of the punishment regime at all. Which seems to totally ignore the kind of violence that is done simply in locking people up. That it ignores the impact of locking people up because it seems less 'bodily' even though in a sense it is even more total. the entire body is acted upon. not just a part - even an internal part.

- its just that we see locking people up for X years as a "normal" thing to do to non-productive members of society.
posted by mary8nne at 5:51 AM on July 9, 2013 [1 favorite]


I was trying to make the point that in this thread there is a kind of hysterical reaction to the notion of sterilization as part of the punishment regime at all.

Oh FFS, the norm for punishment for over 100 years in societies around the globe and nearly all societies has been sequestration. Sterilization is completely unnecessary and moreover, part of a program of eugenics, which people react 'hysterically' for very very good reason.
posted by MisantropicPainforest at 6:02 AM on July 9, 2013 [2 favorites]


Why is procreating an inviolable human right while the right not to be kidnapped and locked up for 20 years is not inviolable?

Imprisonment isn't kidnapping.
posted by MisantropicPainforest at 6:29 AM on July 9, 2013


I"m not either. I was trying to make the point that in this thread there is a kind of hysterical reaction to the notion of sterilization as part of the punishment regime at all.

Right, but the problem here isn't that a particular kind of punishment is "worse than" another, it's that a range of punishments that imprisonment was supposed to displace are coming back in alongside imprisonment. Imprisonment may be a violence against the body, but this adds a new kind of violence that may now be done with impunity to bodies already subject to a somewhat different, carceral order of power.

More generally, imprisonment may be a sort of violence if we look at justice as state retribution or as ways of paying for or precluding "debts/obligations to society," but it's possible to see imprisonment as necessary restraint or as a minimally invasive, relatively remediable form of violence as compared to surgical interventions into bodily capacities.

In the world we have, everything from private property to physical infrastructure already creates a general system of power based around limited, channeling, and guiding the part of bodily capacity that is free movement through space. The prison becomes a nested structure within a much larger order of "violence as restriction" in that case.

This sort of surgical intervention reflects a new point of application for power, one which, left unchallenged, will proliferate and multiply and create a new norm of violence against "criminal life" that will exist in and extend the current order of the power to restrict bodies. It's not necessarily "hysterical" -- and I hope you intended the pun -- or even straightforward hypocrisy to become enraged or upset about that in particular.

You're right, I think, that if we lived in a society where surgical or chemical castration were the usual criminal penalty, we'd be just as angered about someone suddenly adding imprisonment as a penalty. But they do represent two very different applications of power, one of which appears functional in a capitalist state and one of which appears understandably monstrous.

Based on the historical evidence of what happens when you add involuntary medical procedures to imprisonment and indelible labeling, this will not take us to a better alternative nor will it reveal that imprisonment is "just as violent" to those who are labeled/label themselves "good citizens."
posted by kewb at 6:42 AM on July 9, 2013 [3 favorites]


- its just that we see locking people up for X years as a "normal" thing to do to non-productive members of society.

I certainly don't; I think our imprisonment policies and practices are one of the largest current civil rights abuses in the US, and I think future generations will look back on them with appropriate horror and revulsion.

I suspect that many of the "hysterical" commentators here feel at least somewhat similarly, otherwise it would be hard to identify prisoners as a particularly vulnerable and oft-abused group.

But since this thread is not really about imprisonment as an issue, but rather a particular abuse that happened to imprisoned women, people are -- logically -- focusing on the latter. It's illogical to therefore assume we don't care about the former.
posted by jaguar at 10:24 AM on July 9, 2013


where you lose the five years *and* are sterilized, and the latter done in a way that treats you and your body as variables in someone else's utilitarian calculus, not your own.

I don't agree that this was the case, though, and I'd still like to see where the proof is that these procedures were done without the women's consent.

Especially if, as some are arguing here, the tubal ligations were done as some kind of premeditated punishment of these women, because I'm damned if I can see where you are drawing that conclusion from.

The top medical manager at Valley State Prison from 2005 to 2008 characterized the surgeries as an empowerment issue for female inmates, providing them the same options as women on the outside.

Martin told CIR that she and Heinrich began to look for ways around the restrictions. Both believed the rules were unfair to women, she said.


So they are both guilty of trying to get around the restrictions, but I don't see evidence of a "utilitarian calculus" motivating their actions. Also, I'm still not seeing coercion here.

Getting back to that "utilitarian calculus", let's look at the math involved. The numbers here, though intended to shock, are actually pretty low.

We know 148 tubal ligations were performed in five years. That's thirty a year. The Valley prison alone housed more than 3500 women at any given time, sometimes up to nearly 4300. But let's go with the lowest number, 3500. For the entire prison population, that amounts to about 1 percent of of the imprisoned women having tubal ligations.

Let's look at just those women who were giving birth in the prison. Records show that somewhere around 5% of the population arrive at the jail pregnant in any given year. That's at least 175 women every year even going by the 3500 total population. So that amounts to about 17% of the pregnant women had tubal ligations in a given year.

How does that compare to the regular population (where, I just learned, 49% of pregnancies in 2002 were unintended "accidents". Wow.).

In the general population, looking at figures for that time period, 36% of all women using birth control chose to use surgical sterilization by tubal ligation as their preferred method. So the women in the prison, at 17%, are not even at half the rate of the general population.

I'm also curious to know if any of the women in the lawsuit are attempting to reverse the tubal ligations they had?
posted by misha at 3:11 PM on July 9, 2013


In the general population, looking at figures for that time period, 36% of all women using birth control chose to use surgical sterilization by tubal ligation as their preferred method. So the women in the prison, at 17%, are not even at half the rate of the general population.

You're comparing the set of "women using birth control" outside of prison to the set of "all women" inside the prison.
posted by KathrynT at 4:40 PM on July 9, 2013 [1 favorite]


And the article says that it was women with multiple previous births who were targeted.

And you're conflating a couple issues; I actually totally agree that tubal ligation should be offered to women, which is the issue your quoted bit was about (the prison system wanted it to be completely unavailable as an option). Giving women choices about their reproductive health is, I agree, empowering.

But there was a system in place, after the prison system agreed the tubal ligation should be an option for prisoners, for ensuring that medical or prison staff didn't coerce prisoners into sterilization, since doing sterilizations on prisoners without consent was legal and encouraged until 1972 in California. The new system required that every request for tubal ligation had to be approved by the state.

These two prisons ignored that requirement. That's (a) illegal, and (b) as I said earlier, a HUGE RED FLAG that something hinky was going on. In addition, several former prisoners are saying that they did not get appropriate information to make an informed consent about the procedure, others are saying they were pressured at absolutely inappropriate times (like during active labor) to get the procedure.

These are both legal and ethical violations, and they are violations even if the patients end up happy with the outcome.
posted by jaguar at 6:07 PM on July 9, 2013


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