Scholars such as Nancy Leys Stepan, Alexandra Minna Stern, Marius Turda and Aaron Gillette have all argued that the rejection of coerced sterilization was a defining feature of “Latin” eugenic theory and practice. These studies highlight the influence of neo-Lamarckism in this development not only in Latin America but also in parts of Europe in the first half of the twentieth century. This article builds upon this historiographical framework to examine an often-neglected site of Latin American eugenic knowledge (...) production: Chile. By focusing on Chilean eugenicists’ understandings of environment and coerced sterilization, this article argues that there was no uniquely Latin objection to the practice initially. In fact, Chilean eugenicists echoed concerns of eugenicists from a variety of locations, both “mainstream” and Latin, who felt that sterilization was not the most effective way to ensure the eugenic improvement of national populations. Instead, the article contends that it was not until the implementation of the 1933 German racial purity laws, which included coerced sterilization legislation, that Chilean eugenicists began to define their objections to the practice as explicitly Latin. Using a variety of medical texts which appeared in popular periodicals as well as professional journals, this article reveals the complexity of eugenic thought and practice in Chile in the early twentieth century. (shrink)

Sterilizations sponsored and coerced by the state occurred at the Laconia State School in New Hampshire for decades as part of the American eugenics movement in the early twentieth century. The context of that movement is summarized, the case of the Laconia State School is presented, and arguments are offered to explain the immorality of the affair.

Due to a history of coerced sterilization, a federal Medicaid sterilization policy mandates that a specific consent form be signed by a patient at least thirty days prior to when the patient undergoes sterilization. However, in contemporary obstetrical practice, the Medicaid sterilization policy serves as a policy‐level barrier to autonomously desired care. We review the clinical and ethical implications of the current Medicaid sterilization policy. After discussing the utility and impact of waiting periods for (...) other surgical procedures, we explore the psychology of time required for decision‐making and consider scientific understanding of regret. We argue that the current Medicaid sterilization waiting period is clinically and ethically unjustifiable and that the policy ought to be revised in light of the goals, preferences, and concerns of the people most affected by it. While the need for continued protection against coercion remains, the current mandated waiting period does little to enforce the high‐quality shared decision‐making that is desired for sterilization counseling. (shrink)

Since the early 1970s, despite popular opposition, to control the rapid growth of population the Chinese government has been carrying out the strictest and most comprehensive family planning policy in the world. In addition to contraceptive methods and sterilization, artificial abortionhas been used as an important measure of birth control under the policy. Many women have been required, persuaded, and even forced by the authorities to abort fetuses no matter how much they want to give birth.

In recent years the Australian parliament has been considering the rights to protection from discrimination of intersex and gender identity disorder people. In 2013 such protections were made law in the amendment to the Sex Discrimination Act 1984, which in turn has influenced Senate inquiries into the medical treatment of intersex people. This year’s Australian report describes the purview and the potential ramifications of the inquiry of the Senate Standing Committees on Community Affairs, published in October 2013, into the involuntary (...) or coerced sterilization of intersex people in Australia. (shrink)

To study Judicial determinants of the ordered obstetrical and fertility interventions. Nature, corresponding laws, decisions upon the 37 expounded holdings at the Probate, Trial, District, Appellate, and Supreme Courts are studied in 92 published materials identified through the ACOG, RCOG, SOCG portals, and Legal Scholarship Repository. Hearings are held in the US (83.8 %), Canada (10.8 %) and U.K (5.4 %). Of all the hearings reviewed, 27 % concern mentally impaired, 37.8 %-maternal incompetence, and 21.6 % cases are of criminal (...) nature. The Judicial determinants vary from country to country. In Canada, the ordered medical interventions are effected by the child protection legislation, whereas in the US, by court orders. In majority of cases, orders are obtained by dismissing the patriae petitions for involuntary sterilizations of mentally impaired sui juris adults (57 %); coerced obstetrical interventions (33.3 %), fetal custody (50 %); enforcement of surrogacy contracts (62.5 %) in favor of the Common Humanity Benefit clause; and recognizing the rights to inherit in posthumously conceived children (80 %) pursuant to the Social Security Act, Law of obviousness, Law of inherent anticipation, and Intestacy statute. Current study prioritizes two questions: (1) whether it is justified to override the wishes of a competent patient purportedly in her best interests; and (2) whether the patient’s autonomy and competence is an absolute concept. With the law unsettled as to a woman’s right to assent a treatment and contradict her fetus, parties concerned with fetal rights should consider exercising of screening tools on maternal judgmental fitness jointly developed by medical and legal practitioners. Further, given the advances in gamete conservations, states consider enacting legislation in order to safeguard the orderly administration of estates disrupted by claims from posthumously conceived children. A balance must be struck between the child’s right to inherit, the state’s interest, as well as the interests of prior born children. (shrink)

The ArgumentA survey of 2901 genetics professionals in 36 nations suggests that eugenic thought underlies their perceptions of the goals of genetics and that directiveness in counseling after prenatal diagnosis leads to individual decisions based on pessimistically biaed information, especially in developing nations of Asia and Eastern Europe. The “non-directive counseling” found in English-speaking nations is an aberration from the rest of the world. Most geneticists, except in China, rejected government involvement in premarital testing or sterilization, but most also (...) held a pessimistic view of persons with genetic disabilities. Individual, but not state-coerced, eugenics survives in much modern genetic practice. (shrink)

Approximately 47 percent of women ages fifteen to forty‐four are currently without children, and slightly more than 20 percent of white women in America will never bear children, the highest percentage in modern history. Many fertile women who are childless are voluntarily so. Although any competent person twenty‐one years or older is legally eligible for voluntary sterilization, many doctors refuse to sterilize childfree women. This essay explores various reasons a woman would want to continue in her childfree lifestyle, evaluates (...) the accessibility of sterilization for women who are childfree by examining the reported reasons for denial of sterilization—both from the woman's and the physician's perspective—and assesses the legal status of voluntary sterilization for nonparous women. The essay also urges physicians to follow recommended guidelines for counseling women who, regardless of parity, desire sterilization and to provide this contraception if, after careful consideration, there are no outstanding health or other reasons that the procedure should not be performed. (shrink)

The central contention of this article is that contemporary liberal theory is without an account of what legitimates coercing those who reject liberalism that is consistent with its own stipulations of the conditions of political legitimacy. After exploring the nature of the liberal principle of legitimacy, and in particular how it is intended to function as a way of protecting individuals from domination and oppression by reconciling freedom and public law, the article considers four different possible accounts of what might (...) legitimate coercing non-liberals. While some of them have independent plausibility, the article argues that none of them meets the requirements of liberal legitimacy. The final section of the article considers the implications of this theoretical gap for liberal theory more widely. The argument is made that liberalism must accept that even liberal politics will necessitate the oppressive use of coercive power, i.e. compelling people to live according to wills other than their own, and that insofar as this is a position central to the recent burgeoning literature on political realism, liberalism ought therefore to be more realist. (shrink)

Reproductive coercion encompasses a collection of pregnancy promoting and pregnancy avoiding behaviours. Coercion may vary in severity and be perpetrated by intimate partners or others. Research is complicated by the inclusion of behaviours that do not necessarily involve an intention to influence reproduction, such as contraceptive sabotage. These behaviours are the most common, but are not always included in survey instruments. This may explain why the prevalence of reproductive coercion varies widely. Prevalence also varies when coerced abortion is included (...) in survey instruments. When it is, it seems roughly comparable in prevalence to coercion intended to impregnate. The extent and nature of coerced abortion can also be derived from studies that explore the reasons why women access abortion, the relationship between abortion and intimate partner violence, and online blogs and forums. This narrative review of reproductive coercion examines the evidence and attempts to comprehend why coerced abortion has been neglected. (shrink)

I defend a novel account of the wrong of subjecting people to non-consensual sterilization (NCS), particularly in the context of the state-sponsored eugenics programmes once prevalent in the United States. What makes the eugenic practice of NCS distinctively wrong, I claim, is its dehumanizing core: the fact that it is tantamount to treating people as nonhuman animals, thereby expressing the degrading social meaning that they have the value of animals. The practice of NCS is prima facie seriously wrong partly, (...) but crucially, on these grounds. I consider and reject accounts of the wrong of NCS that make no reference to its animalizing character, such as that it violates victims’ (procreative) autonomy, amounts to treating them merely as a means, inflicts psychological harm on them, or constitutes an affront to their human dignity. My discussion suggests that the critical vocabulary of bioethics should be expanded beyond talk of rights-violations, benefits and harms, and equal treatment—and that the language of dehumanization is indispensable to bioethicists. (shrink)

The moral standing of involuntary sterilization has long been subject to debate but has only recently been looked upon with disfavor. When sterilization of a mentally handicapped minor is entertained, issues of eugenics, medical ethics, and legal precedent specially arise. Ethics consultants and ethics committees have been asked to consider such cases.

A recent Massachusetts bill seeks to incentivize living organ donation among the state’s incarcerated population by offering volunteers reduced sentences. While the incentive has been removed from the bill, the bill remains controversial. This essay argues that insofar as carceral conditions unduly motivate incarcerated people to participate, living organ donation in prison remains a morally hazardous initiative. The essay suggests that the pervasiveness of medical neglect in Massachusetts prisons not only makes organ donation unsafe but it also implicitly renders the (...) lives of those outside of prison more valuable than those inside. This falls short of Catholic teaching on human dignity. Drawing from the history of medical experimentation in US prisons, the essay posits how the state might unduly influence incarcerated people to become living donors by preying on their moral sentiments. In such instances, the self-gift of organ donation can be understood as a kind of exploited or coerced kenosis. (shrink)

Brazilian women rely on sterilization as the main source of birth control. Sterilization has been one of the causes of the steep decline in fertility in Brazil, at least since the second half of 1970. It is hypothesized that understanding couples’ relationships might be key to explaining this high rate of female sterilizations. Possible reasons for the higher level of fertility among women in unstable unions than among women in stable ones could be the less effective use of (...) contraceptive methods, or that women in unstable unions tend to use less effective or reversible contraceptive methods. In this paper discrete time modelling of the timing of sterilization according to union histories is presented. The analysis uses the calendar data of the 1996 Brazilian DHS. It is shown that women in second or higher order unions have a lower risk of sterilization. This result should be taken into account in the analysis of the determinants of female sterilization in Brazil. (shrink)

Is there a duty to do more than one’s fair share of solving collective problems? If there is, can those who do less than their fair share coerce others to do more? These questions arise urgently in relation to the problem of refugee protection. The fact that various states host refugees to a dramatically different extent is due to a range of factors but the most prominent one is that, on the whole, states devote their differential capabilities to the aim (...) of not hosting them. When some states fail to host – or otherwise assist – as many refugees as they should, must other states do more than their fair share in order to solve the problem of providing refugees with an appropriate place to live? I examine what I call the conservative, moderate and responsive answers to this question. I defend the responsive view and argue that there is a duty to do more than one’s fair share here and that such a duty is always enforceable. (shrink)

Fertility levels have dropped substantially in Latin America in recent decades, fuelled by increased contraceptive use and notably a method mix skewed towards female sterilization. This study examined choice of female sterilization in four Latin American countries: Brazil, Colombia, the Dominican Republic and Peru. Data were drawn from national Demographic and Health Surveys conducted in 1995s reproductive histories to consider the effects of a number of sociodemographic and contextual determinants as they pertained to status at the moment of (...) the event. The results revealed that the likelihood of a womans propensity to choose sterilization. (shrink)

SummaryIn contrast to the USA and the UK, vasectomy is less popular than tubal ligation in Australia, and this may reflect differences in husband-wife communication. Using data from the 1979 Canberra Population Survey, it seemed that although a majority of respondents would use sterilization, female sterilization would be preferred, largely because males were more resistant to the idea than females. Respondents born outside Australia, the UK, and Eire were more resistant to the idea of sterilization, but reported (...) higher use of tubal ligation. (shrink)

In this paper I examine some of the significant moral concerns inherent in cases of treatment refusal involving patients with psychotic disorders. In particular, I explore the relevance of the principle of autonomy in such situations. After exploring the concept of autonomy and explaining its current and historical significance in a health care setting, I argue that because autonomous choice depends for its existence upon certain human functions such as the ability to reason, judge, and assess consequences, patients cannot be (...) said to be making free and autonomous decisions if these capacities are compromised. I contend further that because psychotic disorders have the potential to compromise these functions in the future, it is appropriate, in some limited cases, to coerce patients with psychotic disorders to undergo treatment in order to preserve their future decisionmaking capacities and to protect their ability to recognize and respect the autonomy of others. (shrink)

From 1966 to 1990 there was a marked rise in the use of voluntary sterilization in Flanders, followed by a fall in women under the age of 40. In the last three decades a remarkable change has occurred in the choice between male and female sterilization. Compared with many other European countries, sterilization of men and women is widely practised in Flanders. In 1996 40% of 40- to 44-year-old women underwent voluntarily sterilization or had voluntarily sterilized (...) partners. Additionally, another 9% of these women were sterilized for medical reasons. Voluntarily sterilized couples are on average older than non-sterilized couples, and, obviously, consider their families to be complete. For couples with a complete family, parity is the most important predictor in the choice between sterilization and non-sterilization. Regularly practising Catholics undergo sterilization least. Also, highly educated couples are less likely to have a sterilization. Couples who ever experienced a contraceptive failure choose sterilization more. Voluntary sterilization has no substantial effect on the fertility of the population since the effect on the prevented numbers of both wanted and unwanted births appears to be small. However, if voluntary sterilization did not occur, differences in fertility within the population would probably increase. It is presumed that the popularity of voluntary sterilization in Flanders has passed its peak and that its use will decline in the near future. (shrink)

Cowdin and Tuohey argue for a rethinking of Catholic bioethical principles and the Church's moral authority. Citing the Second Vatican council for support, they argue that if the Church were to respect the proper autonomy of medicine, it would allow sterilizations. In this essay I argue against Cowdin and Tuohey's understanding that the Church has derived its moral laws independent of consultation with medicine and that it treats medicine simply as a source of technical expertise. I also argue that they (...) misunderstand the nature of autonomy as well as the Church's position regarding the type of autonomy they request for medicine. I will especially argue against their understanding of the principles of totality and double effect as “dispensations” from the moral order. I conclude that they have provided no grounds to cause the Church to reconsider its condemnation of all sterilizations. (shrink)

Disagreement over the legitimacy of direct sterilization continues within Catholic moral debate, with painful and at times confusing ramifications for Catholic healthcare systems. This paper argues that the medical profession should be construed as a key moral authority in this debate, on two grounds. First, the recent revival of neo-Aristotelianism in moral philosophy as applied to medical ethics has brought out the inherently moral dimensions of the history and current practice of medicine. Second, this recognition can be linked to (...) Catholic morality through Vatican II’s affirmation of the legitimate autonomy of culture, including the sciences. A partial precedent for understanding the moral authority of medicine can be found in the recent history of Catholic medical morality, and we further argue that a full contemporary recognition of that authority would weigh against an absolute prohibition of direct sterilizations. Institutionally, we propose the allowance of direct sterilizations in cases where the clinically perceived biomedical good of the patient is at stake. (shrink)

This paper focuses on the concept of sterility as idealized in the Biblical text and exemplified in the stories of Sarah and Abraham, Rebecca, Leah, Rachel and Jacob. My analysis of these stories leads to the hypothesis that sterility is one of the foundational themes of Israel’s ancient past, by condensing some of the main obstacles inherent to the emergency of a people who believe to be guided by God. This new perspective on sterility was achieved by focusing on the (...) spectrum of meanings of the Hebrew root ‘qr, which includes infertility and uprooting; these, added to famine in the land, are experiences that will shape the religious conscience of Israel. This approach amplifies the perception of sterility in the Hebrew Bible, as it emerges from the text as a liminal state of deprivation , in opposition to the contents of the divine oath to the patriarchs (progeny and land). But even while enclosing lack of productivity, weakness and death, which have a negative value, Biblical sterility is not a closed circle, but a space open to potentiality, where divine revelation occurs. God reveals himself through sterility and in sterility. The originality and the notion of specificity in the biblical idea of sterility lie in this cyclical trait, which breaks the circumscription and negative orientation of sterility. The Bible presents sterility as a transitory state, an area for individual and corporate transformation of status. In an ideological system, such as ancient Israel’s, where contractual relations replace natural relations, sterility functions as a powerful symbol of the relationship among men and between men and God. And this may be the reason why sterile matriarch’s traditions were continually re-interpreted, from the 10th century BCE. until the 1st century CE, and could be adapted to new contexts and make sense to distinct communities, particularly in times of crisis and transition. (shrink)

ABSTRACTBased on the case of Rosa, a nine‐year‐old girl who was denied a therapeutic abortion, this article analyzes the role played by the social in medical practice. For that purpose, it compares the different application of two similar pieces of legislation in Costa Rica, where both the practice of abortion and sterilization are restricted to the protection of health and life by the Penal Code. As a concept subject to interpretation, a broad conception of medical necessity could enable an (...) ample use of the therapeutic exception and a liberal use of both surgeries. The practice of therapeutic sterilization has been generalized in Costa Rica and has become the legitimate way to distribute contraceptive sterilization. In contrast, therapeutic abortion is very rarely practiced. The analysis carried out proposes that it is the difference in social acceptance of abortion and sterilization that explains the different use that doctors, as gatekeepers of social morality, make of medical necessity. (shrink)

Does the contemporary Natural Law position that only heterosexual couples are capable of marriage rest upon an “arbitrary and irrational distinction between same-sex couples and sterile heterosexual couples?” Anderson :759–775, 2013: 759). There are many who think so. In a recent article in these pages, Erik Anderson offers his case that these critics are correct. In what follows I examine Anderson’s argument and conclude that, whether or not one ultimately agrees with the New Natural Law account of marriage, the distinction (...) found there between same sex couples and sterile heterosexual couples is neither arbitrary nor irrational. (shrink)

Philosophy and Phenomenological Research, Volume 103, Issue 2, Page 441-461, September 2021.