Compulsory sterilization

Compulsory sterilization, also known as forced sterilization (or compulsory sterilisation respectively forced sterilisation – see spelling differences), programs are government policies which attempt to force people to undergo surgical or other sterilization. The reasons governments implement sterilization programs vary in purpose and intent.[1] In the first half of the 20th century, several such programs were instituted in countries around the world, usually as part of eugenics programs intended to prevent the reproduction and multiplication of members of the population considered to be carriers of defective, more often than not different and not inferior in a natural combination racial genetic traits.[2]

Managing population growth; sex discrimination; 'sex-normalizing' surgeries of intersex persons; and Statute of Rome attempted and other genocide acts against ethnic minorities, the HIV positive, and the mentally disabled have also been reasons compulsive sterilization has been used.[1] There are countries where transgender people are required to undergo sterilization before gaining legal recognition of their gender. This is not to be confused with forced sterilization not associated with a likely genocidal (re.: Statute of Rome) government program. However the report of United Nations Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment states that LGBT people often suffer the medical abuses or forced surgeries (including female genital mutilation and male genital mutilation) despite the Principles 17 and 18 of the Yogyakarta Principles.[3]

Contents

  • Affected populations 1
  • Alternatives to compulsory sterilization 2
    • Human population control 2.1
  • By country 3
    • International law 3.1
    • Canada 3.2
    • China 3.3
    • Czechoslovakia and the Czech Republic 3.4
    • Germany 3.5
    • Japan 3.6
    • India 3.7
    • Israel 3.8
    • Peru 3.9
    • Russia 3.10
    • South Africa 3.11
    • Sweden 3.12
    • Switzerland 3.13
    • United States 3.14
      • Puerto Rico 3.14.1
        • 1940s-1950s 3.14.1.1
        • Sterilization Procedures and Coercion 3.14.1.2
          • Controversy and Opposing Viewpoints 3.14.1.2.1
        • Effects 3.14.1.3
    • Uzbekistan 3.15
    • Other countries 3.16
  • See also 4
  • References 5
  • Further reading 6
  • External links 7

Affected populations

In May 2014, the OHCHR, UN Women, UNAIDS, UNDP, UNFPA and UNICEF issued a joint statement on Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement. The report references the involuntary sterilization of a number of specific population groups. They include:

  • Women, especially in relation to coercive population control policies, and particularly including women living with HIV, indigenous and ethnic minority girls and women. Indigenous and ethnic minority women often face "wrongful stereotyping based on gender, race and ethnicity".
  • Disabled people, often perceived as sexually inactive. women with intellectual disabilities are "often treated as if they have no control, or should have no control, over their sexual and reproductive choices". Other rationales include menstrual management for the benefit of carers.
  • Transgender persons, "as a prerequisite to receiving gender- affirmative treatment and gender-marker changes".

The report recommends a range of guiding principles for medical treatment, including ensuring patient autonomy in decision-making, ensuring non-discrimination, accountability and access to remedies.[1]

Alternatives to compulsory sterilization

Human population control

Human population control is the practice of artificially altering the rate of growth of a human population. Historically, human population control has been implemented by limiting the population's birth rate, usually by government mandate, and has been undertaken as a response to factors including high or increasing levels of poverty, environmental concerns, religious reasons, and overpopulation. While population control can involve measures that improve people's lives by giving them greater control of their reproduction, some programs have exposed them to exploitation.[4]

By country

International law

Widespread or systematic forced sterilization has been recognized as a Crime against Humanity by the Rome Statute of the International Criminal Court in the explanatory memorandum. This memorandum defines the jurisdiction of the International Criminal Court.[5][6]

Canada

Two Canadian provinces (Alberta and British Columbia) performed compulsory sterilization programs in the 20th century with eugenic aims. Canadian compulsory sterilization operated via the same overall mechanisms of institutionalization, judgment, and surgery as the American system. However, one notable difference is in the treatment of non-insane criminals. Canadian legislation never allowed for punitive sterilization of inmates.

The Sexual Sterilization Act of Alberta was enacted in 1928 and repealed in 1972. In 1995, Leilani Muir sued the Province of Alberta for forcing her to be sterilized against her will and without her permission in 1959. Since Muir’s case, the Alberta government has apologized for the forced sterilization of over 2,800 people. Nearly 850 Albertans who were sterilized under the Sexual Sterilization Act were awarded C$142 million in damages.[7]

China

China's nominal GDP trend from 1952 to 2005.

In 1978, Chinese authorities became concerned with the possibility of a baby boom that the country could not handle, and they initialized the one-child policy. In order to effectively deal with the complex issues surrounding childbirth, the Chinese government placed great emphasis on family planning. Because this was such an important matter, the government thought it needed to be standardized, and so to this end laws were introduced in 2002.[8] These laws uphold the basic tenets of what was previously put into practice, outlining the rights of the individuals and outlining what the Chinese government can and cannot do to enforce policy.

However, recently accusations have been raised from groups such as Amnesty International, who have claimed that practices of compulsory sterilization have been occurring for people who have already reached their one child quota. These practices run contrary to the stated principles of the law, and seem to differ on a local level. An especially egregious example, according to Amnesty International, has been occurring in Puning City, Guangdong Province. The stated goal of the sterilization drive in this city in China was to meet with family planning targets that were outlined by the government in the Population and Family Planning Law of 2002. This drive, also known as the Iron Fist Campaign, also is said to have used coercive methods in order to ensure that close to 10,000 women were sterilized, including detaining elderly family members. It is unclear whether support of the increase of the now 90% Han Chinese majority here plays a role [8]

The Chinese government does not seem to be unaware of these discrepancies in policy implementation on a local level. For example, The National Population and Family Planning Commission put forth in a statement that, “Some persons concerned in a few counties and townships of Linyi did commit practices that violated law and infringed upon legitimate rights and interests of citizens while conducting family planning work.” This statement comes in reference to some charges of forced sterilization and abortions in Linyi city of Shandong Province.[9] However, it remains unclear to what extent the government has prosecuted or disciplined the officials in charge of family planning in the country.

The policy requires a "social compensation fee" for those who have more than the legal number of children. According to Forbes editor Heng Shao, critics claims this fee is a toll on the poor but not the rich.[10] There are cases registered in the Chinese legal system (cf. Si Bu Tuo Zhe Renmin) which could prove infractions in the field.

Czechoslovakia and the Czech Republic

Czechoslovakia carried out a policy to sterilize some Romani women, starting in 1973. In various cases the sterilization was agreed upon, often in exchange for social welfare benefits or was given by the lack of education.[11] The dissidents of the Charter 77 denounced it in 1977–78 as a "genocide", but the practice continued through the Velvet Revolution of 1989.[12] A 2005 report by the Czech government's independent ombudsman, Otakar Motejl, identified dozens of cases of coercive sterilization between 1979 and 2001, and called for criminal investigations and possible prosecution against several health care workers and administrators, re Law on Atrocities relevant pre-1990, CR (ChR).[13]

Germany

"We do not stand alone": Nazi poster from 1936 with flags of other countries with compulsory sterilization legislation

One of the first acts by Adolf Hitler after achieving total control over the German state was to pass the Law for the Prevention of Hereditarily Diseased Offspring (Gesetz zur Verhütung erbkranken Nachwuchses) in July 1933. The law was signed in by Hitler himself, and over 200 eugenic courts were created specifically as a result of the law. Under the German law, all doctors in the Reich were required to report patients of theirs who were deemed intellectually disabled, characterized mentally ill (including schizophrenia and manic depression), epileptic, blind, deaf, or physically deformed, and a steep monetary penalty was imposed for any patients who were not properly reported. Individuals suffering from alcoholism or Huntington's Disease could also be sterilized. The individual's case was then presented in front of a court of Nazi officials and public health officers who would review their medical records, take testimony from friends and colleagues, and eventually decide whether or not to order a sterilization operation performed on the individual, using force if necessary. Though not explicitly covered by the law, 400 mixed-race "Rhineland Bastards" were also sterilized beginning in 1937.[14] The sterilization program went on until the war started, with about 600,000 people sterilized.[15]

By the end of World War II, over 400,000 individuals were sterilised under the German law and its revisions, most within its first four years of being enacted. When the issue of compulsory sterilisation was brought up at the Nuremberg trials after the war, many Nazis defended their actions on the matter by indicating that it was the United States itself from whom they had taken inspiration. The Nazis had many other eugenics-inspired racial policies, including their "euthanasia" programme in which around 70,000 people institutionalised or suffering from birth defects were killed, including many members it would appear of the fragile Hun-descendant aristocracy and any Kin-refugee descendants within that physique category.[16]

Japan

In the first part of the Showa era, Japanese governments promoted increasing the number of healthy Japanese, while simultaneously decreasing the number of people suffering from deemed mental retardation, disability, genetic disease and other conditions that led to supposed inferiority in the Japanese gene pool.[17][18]

The Leprosy Prevention laws of 1907, 1931 and 1953, permitted the segregation of patients in sanitariums where forced abortions and sterilization were common and authorized punishment of patients "disturbing peace".[19] Under the colonial Korean Leprosy prevention ordinance, Korean patients were also subjected to hard labor.[20]

The Race Eugenic Protection Law was submitted from 1934 to 1938 to the Diet. After four amendments, this draft was promulgated as a National Eugenic Law in 1940 by the Konoe government.[17] According to Matsubara Yoko, from 1940 to 1945, sterilization was done to 454 Japanese persons under this law.[21]

According to the Eugenic Protection Law (1948), sterilization could be enforced on criminals "with genetic predisposition to commit crime", patients with genetic diseases including mild ones such as total color-blindness, hemophilia, albinism and ichthyosis, and mental affections such as schizophrenia, manic-depression possibly deemed occurrent in their opposition and epilepsy, the sickness of Caesar.[22] The mental sicknesses were added in 1952.

The right to legal sex change in case of transsexual has been approved by legislation in 2004. The legislation only allows the person who has no children in addition to having undergone the sex reassignment surgery. The condition is amended in 2008 to "those who has no child under 20 years old", but still sterilization and sex reassignment surgery is compulsory to legal sex change.

India

India's state of emergency between 1975 and 1977 included a family planning initiative that began in April 1976 through which the government hoped to lower India's ever increasing population. This program used propaganda and monetary incentives to, some may construe, inveigle citizens to get sterilized.[23] People who agreed to get sterilized would receive land, housing, and money or loans.[24] Because of this program, thousands of men received vasectomies and even more women received tubal ligations, both possibly reversible. However, the program focused more on sterilizing women than men. An article in The New York Times titled “For Sterilization, Target Is Women” states, “There were 114,426 vasectomies in India in 2002-03, and 4.6 million tubal ligations, the analogous operation on women, though ligation is a more complicated operation.” [25] Son of the Prime Minister at the time Indira Gandhi, Sanjay Gandhi was largely blamed for what turned out to be a failed program.[26] A strong backlash against any initiative associated with family planning followed the highly controversial program, which continues into the 21st century.[27]

Israel

"Israel has admitted for the first time that Ethiopian Jewish immigrants were given birth-control injections, often without their knowledge or consent. The government had previously denied the practice but the Israeli Health Ministry’s director-general has now ordered gynaecologists to stop administering the drugs. According a report in Haaretz, suspicions were first raised by an investigative journalist, Gal Gabbay, who interviewed more than 30 women from Ethiopia in an attempt to discover why birth rates in the community had fallen dramatically."[28]

Peru

In

  • Forced Sterilization
  • "Buck v. Bell"Three Generations, No Imbeciles: Virginia, Eugenics, and (USA)
  • Eugenics Archive (USA)
  • "Deadly Medicine: Creating the Master Race" (United States Holocaust Memorial Museum exhibit) (Germany, USA)
  • Eugenics - A Psychiatric Responsibility (History of Eugenics in Germany)
  • "Sterilization Law in Germany" (includes text of 1933 German law in appendix)
  • "Genocide in Tibet - Children of Despair"(NGO Group for the Convention on the Rights of the Child)
  • “Buck v. Bell (1927)” by N. Antonios and C. Raup at the Embryo Project Encyclopedia

External links

  • Alvarado, Carmen and C. Tietze. "Birth Control in Puerto Rico." Human Fertility 22, no. 1 (March 1947):15-17.
  • Back, K., R. Hill and J.M. Stycos. "The Puerto Rican Field Experience in Population Control." Human Relations (1956):315-334.
  • "B.C. faces forced sterilization lawsuit". CBC News. February 7, 2003. Canadian Broadcasting Corporation. Accessed April 13, 2006.
  • Clarke, Nic. "Sacred Daemons: Exploring British Columbian Society's Perceptions of 'Mentally Deficient' Children, 1870-1930." BC Studies 144 (2004/2005): 61-89.
  • Dowbiggin, Ian Robert. Keeping America Sane: Psychiatry and Eugenics in the United States and Canada 1880-1940. Ithaca: Cornell University Press, 2003.
  • Grekul, Jana., Krahn, H., Odynak, D.. "Sterilizing the 'Feeble-minded': Eugenics in Alberta, Canada, 1929-1972." J. Hist. Sociol. 17:4 (2004): 358-384.
  • Hill, Reuben et al. The family and population control: a Puerto Rican experiment in social change. [Chapel Hill]: University of North Carolina Press, 1959.
  • Manitoba Law Reform Commission. Discussion Paper on Sterilization of Minors and Mentally Incompetent Adults. Winnipeg: 1990.
  • Manitoba Law Reform Commission. Report on Sterilization and Legal Incompetence. Winnipeg: 1993.
  • McLaren, Angus. Our Own Master Race: Eugenics in Canada, 1885-1945. Toronto: McClelland & Stewart, 1990.
  • Rosen, Christine. Preaching Eugenics: Religious Leaders and the American Eugenics Movement. Oxford [England]; New York: Oxford University Press, 2004.
  • Wahlsten, Douglas. "Leilani Muir versus the Philosopher Kings: Eugenics on trial in Alberta." Genetica 99 (1997): 195-198.
  • "Nine women sterilized in B.C. have lawsuits settled for $450,000". The Vancouver Sun'. December 21, 2005.
  • Warren, Charles W., et al. "CONTRACEPTIVE STERILIZATION IN PUERTO RICO." Demography 23, no. 3 (August 1986): 351-366.

Further reading

  1. ^ a b c usually out of a lack of courage for expansive, population control conflicts. Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement, World Health Organization, May 2014.
  2. ^ Webster University, Forced Sterilization. Retrieved on August 30, 2014. http://www2.webster.edu/~woolflm/forcedsterilization.html
  3. ^
  4. ^
  5. ^ As quoted by Guy Horton in Dying Alive - A Legal Assessment of Human Rights Violations in Burma April 2005, co-Funded by The Netherlands Ministry for Development Co-Operation. See section "12.52 Crimes against humanity", Page 201. He references RSICC/C, Vol. 1 p. 360
  6. ^
  7. ^
  8. ^ a b
  9. ^
  10. ^ Enforcement of One-Child Policy Targets 'The Rich and Famous' in Zhangzhou, China, Forbes, September 20, 2013. http://www.forbes.coms/hengshao/2013/09/20/enforcement-of-one-child-policy-targets-the-rich-and-famous-in-zhangzhou-china/
  11. ^ Sterilized Roma accuse Czechs, BBC, March 12, 2007
  12. ^ For Gypsies, Eugenics is a Modern Problem - Czech Practice Dates to Soviet Era, Newsdesk, June 12, 2006
  13. ^ Final Statement of the Public Defender of Rights in the Matter of Sterilisations Performed in Contravention of the Law and Proposed Remedial Measures, Czech government, 2005
  14. ^ Robert Proctor, Racial hygiene: Medicine under the Nazis (Cambridge, MA: Harvard University Press, 1988), and Gisela Bock, "Nazi sterilization and reproductive policies" in Dieter Kuntz, ed., Deadly medicine: creating the master race (Washington, D.C.: United States Holocaust Memorial Museum, 2004).
  15. ^ |"The connection between American eugenics and Nazi Germany" James Watson speaks about Nazi eugenics
  16. ^ Ian Kershaw, Hitler: A Profile in Power, Chapter VI, first section (London, 1991, rev. 2001)
  17. ^ a b
  18. ^
  19. ^ ,
  20. ^
  21. ^ 「優生問題を考える(四)──国民優生法と優生保護法 Matsubara Yoko - Research of Eugenics problem (Professor of Ritsumeikan University, researcher of Gender-blind and Eugenics.)
  22. ^
  23. ^
  24. ^ Relying on Hard and Soft Sells India Pushes Sterilization, New York Times, June 22, 2011.
  25. ^ For Sterilization Target is Women, New York Times, November 7, 2003.
  26. ^
  27. ^
  28. ^
  29. ^ a b
  30. ^ a b c d Stérilisations forcées des Indiennes du Pérou, Le Monde diplomatique, May 2004
  31. ^
  32. ^ Thousands of Forced Sterilization Cases Reopened in Peru Impunity Watch, published November 14, 2011
  33. ^ a b c d
  34. ^
  35. ^ Савенко: «…Необходим более строго выверенный и открытый контроль за практикой предупредительной евгеники, которая сама по себе, в свою очередь, оправданна».
  36. ^
  37. ^ Steriliseringsfrågan i Sverige 1935 - 1975, SOU 2000:20, in Swedish with an English summary.
  38. ^ Eugenics And Its Relevance To Contemporary Health Care, Rachel Iredale, Nursing Ethics 2000 7 (3), 0969-7330(00)NE346OA © 2000 Arnold
  39. ^ Angela Davis, Women, Race and Class (1981) ISBN 0-394-71351-6
  40. ^ Interview with Alexandra Minna Stern, Ph.D. of University of Michigan in Spanish newspaper El País published on 12 Julz 2013 Los mexicanos, principales víctimas de la esterilización forzosa en California
  41. ^ An overview of U.S. eugenics and sterilization is in ..
  42. ^
  43. ^ The Indiana Supreme Court overturned the law in 1921 in
  44. ^
  45. ^ http://www.law.cornell.edu/supremecourt/text/274/200
  46. ^ https://books.google.com/books?id=fbXeTqBPiP8C&pg=PA17&
  47. ^ On the legal history of eugenic sterilization in the U.S., see
  48. ^ Philip Reilly, The surgical solution: a history of involuntary sterilization in the United States (Baltimore: Johns Hopkins University Press, 1991).
  49. ^
  50. ^ a b
  51. ^ Julie Sullivan. (2002). "State will admit sterilization past", Portland Oregonian, November 15, 2002. (Mirrored in Eugene Register-Guard, November 16, 2002, at Google News.)
  52. ^ On California sterilizations and their connection to the Nazi program, see: Stefan Kühl, The Nazi connection: Eugenics, American racism, and German National Socialism (New York: Oxford University Press, 1994); Alexandra Stern, Eugenic nation: faults and frontiers of better breeding in modern America (Berkeley: University of California Press, 2005); and Wendy Kline, Building a better race: gender, sexuality, and eugenics from the turn of the century to the baby boom (Berkeley: University of California Press, 2001).
  53. ^
  54. ^
  55. ^
  56. ^ Sterilization of Women Including Those With Disabilities, ACOG Committee Opinion, Number 371. July 2007. http://www.acog.org/-/media/Committee-Opinions/Committee-on-Ethics/co371.pdf?dmc=1&ts=20141016T1353026506
  57. ^ Involuntary sterilization of persons with mental retardation: An ethical analysis, Mental Retardation and Developmental Disabilities Research Reviews, Volume 9, Issue 1, pages 21-26, 2003. http://onlinelibrary.wiley.com/doi/10.1002/mrdd.10053/abstract
  58. ^ Sterilization of incompetent mentally handicapped persons: a model for decision making, Journal of Medical Ethics, 1999;25:237-241. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC479215/pdf/jmedeth00004-0019.pdf
  59. ^ Ashley Revisited: A Response to the Critics, American Journal of Bioethics, Volume 10, Issue 1, January 2010. http://www.bioethics.net/articles/ashley-revisited-a-response-to-the-critics/
  60. ^ The Ashley Treatment, March 2007. http://pillowangel.org/Ashley%20Treatment.pdf
  61. ^ VA Man Agrees to Get Vasectomy as Part of Plea Deal, Fox News Insider, June 24, 2014. http://insider.foxnews.com/2014/06/24/va-man-required-get-vasectomy-part-plea-deal
  62. ^ 'Stop Having Kids!': Judge Orders Man Owing $100k in Child Support Payment to Stop Procreating, Fox News Insider, February 5, 2013. http://insider.foxnews.com/2013/02/05/stop-having-kids-judge-orders-man-owing-100k-in-child-support-payments-to-quit-procreating
  63. ^ "Sterilization Abuse in State Prisons" News 07/23/2013 author Alex Stern
  64. ^
  65. ^ a b c d e f g h i j k l m n o p q r s t u v w x y
  66. ^ a b c d e f g h i j
  67. ^ a b c d e f g h i
  68. ^ a b c d e f g h i j k
  69. ^ a b c d e f g h
  70. ^ a b
  71. ^ a b c d e f g
  72. ^ a b c BBC News: Uzbekistan's policy of secretly sterilizing women BBC, published 2012-04-12, accessed 2012-04-12
  73. ^ a b Crossing Continents: Forced Sterilization in Uzbekistan BBC, published 2012-04-12, accessed 2012-04-12
  74. ^ a b Uzbeks Face Forced Sterilization The Moscow Times published 2010-03-10, accessed 2012-04-12
  75. ^ Shadow Report: UN Committee Against Torture United Nations, authors Rapid Response Group and OMCT, published November 2007, accessed 2012-04-12
  76. ^ Press Release: Committee Against Torture Hears Response of Uzbekistan United Nations, published 2007-10-12, accessed 2012-04-12
  77. ^ a b c Birth Control by Decree in Uzbekistan IWPR Institute for War & Peace Reporting, published 2005-11-18, accessed 2012-04-12
  78. ^ Uzbek women accuse state of mass sterilizations The Independent, published 2010-07-17, accessed 2012-04-12
  79. ^ Uzbekistan: Presidential Decree on Birth Rate Leads to Increased Sterilization | EurasiaNet.org published 2011-11-14, accessed 2012-04-12
  80. ^ Our Kids: EU Parliamentarians Applaud MCH Project in Uzbekistan, published 2010-10-28, accessed 2012-04-12
  81. ^ a b c
  82. ^
  83. ^ a b c
  84. ^ Gunnar Broberg and Nils Roll-Hansen, eds., Eugenics And the Welfare State: Sterilization Policy in Denmark, Sweden, Norway, and Finland (Michigan State University Press, 2005), it is unclear whether genocide investigations in regard of Hun descendant and pure Aryan types has been undertaken, and if concealment is attempted through the prevalence of cremation and allegation of psychiatric treatment facial mimicry of Mongolian types.
  85. ^ Gilbert, Martin. Churchill and Eugenics
  86. ^ A link to the testimony of such a deportee (in Romanian).
  87. ^

References

See also

In 2015, the Court of Protection of the United Kingdom ruled that a woman with six children and an IQ of 70 should be sterilized for her own safety because another pregnancy would have been a "significantly life-threatening event" for her and the fetus.[87]

According to some testimonies, the Soviet Union allegedly imposed forced sterilisation on female workers deported from Romania to Soviet labour camps. This is said to have occurred after World War II, when Romania was supposed to supply a reconstruction workforce (according to the armistice convention).[86] However, no court decisions or formal investigations of these allegations are known for the moment.

Eugenics programs including forced sterilization existed in most Northern European countries, as well as other more or less Protestant countries. Some programs, such as Canada's and Sweden's, lasted well into the 1970s. Other countries that had notably active sterilisation programmes include Denmark, Norway, Finland,[84] Estonia, Switzerland, Iceland, and some countries in Latin America (including Panama). In the United Kingdom, Home Secretary Winston Churchill was a noted advocate, and his successor Reginald McKenna introduced a bill that included forced sterilisation. Writer G. K. Chesterton led a successful effort to defeat that clause of the 1913 Mental Deficiency Act.[85]

Other countries

Despite international agreement concerning the inhumanity and illegality of forced sterilization, it has been suggested that the Government of Uzbekistan continues to pursue such programs.[72]

On May 15, 2012, during a meeting with the Russian president Vladimir Putin in Moscow the Uzbek president Islam Karimov said: "we are doing everything in our hands to make sure that the population growth rate [in Uzbekistan] does not exceed 1.2-1.3"[83] The Uzbek version of RFE/RL reported that with this statement Karimov indirectly admitted that forced sterilization of women is indeed taking place in Uzbekistan.[83] The main Uzbek television channel, O'zbekiston, cut out Karimov's statement about the population growth rate while broadcasting his conversation with Putin.[83] It is unclear if there is any genocidal conspiracy in regard of the Mongol type involved, in connection with genetic drain of this type through lack of their reproduction.

Based on a report by journalist Natalia Antelava, doctors reported that the Ministry of Health told doctors they must perform surgical sterilizations on women. One doctor reported, “It's ruling number 1098 and it says that after two children, in some areas after three, a woman should be sterilized.”, in a loss of the former surface decency of Central Asian mores in regard of female chastity.[81] In 2010, the Ministry of Health passed a decree stating all clinics in Uzbekistan should have sterilization equipment ready for use. The same report also states that sterilization is to be done on a voluntary basis with the informed consent of the patient.[81] In the 2010 Human Rights Report of Uzbekistan, there were many reports of forced sterilization of women along with allegations of the government pressuring doctors to sterilize women in order to control the population.[82] Doctors also reported to Antelava that there are quotas they must reach every month on how many women they need to sterilize. These orders are passed on to them through their bosses and, allegedly, from the government.[81]

Reports of forced sterilizations, hysterectomies and IUD insertions first emerged in 2005,[72][73][74][77] although it is reported that the practice originated in the late 1990s,[78] with reports of a secret decree dating from 2000.[77] The current policy was allegedly instituted by Islam Karimov under Presidential Decree PP-1096, "on additional measures to protect the health of the mother and child, the formation of a healthy generation"[79] which came into force in 2009.[80] In 2005 Deputy Health Minister Assomidin Ismoilov confirmed that doctors in Uzbekistan were being held responsible for increased birth rates.[77]

According to reports, as of 2012, un-Islamic forced and coerced sterilization are current Government policy in [75] in response to which the Uzbek delegation to the associated conference was "puzzled by the suggestion of forced sterilization, and could not see how this could be enforced."[76]

Uzbekistan


A survey by a team of Americans in 1975 confirmed Presser's assessment that nearly 1/3 of Puerto Rican women of childbearing age had been sterilized.[65] As of 1977, Puerto Rico had the highest proportion of childbearing-aged persons sterilized in the world.[65] In 1993, ethnographic work done in New York by anthropologist Iris Lopez [67] showed that the history of sterilization continued to effect the lives of Puerto Rican women even after they immigrated to the United States and lived there for generations.[67] The history of the popularity of sterilization in Puerto Rico meant that Puerto Rican women living in America had high rates of female family members who had undergone sterilization, and it remained a highly popular form of birth control among Puerto Rican women living in New York.[67]

Presser’s analysis also found that 46.7% of women who reported they were sterilized were between the ages of 34 and 39.[71] Of the sample of women sterilized, 46.6% had been married 15 to 19 years, 43.9% had been married for 10 to 14 years, and 42.7% had been married for 20 to 24 years.[71] Nearly 50% of women sterilized had three or four births.[71] Over 1/3 of women who reported being sterilized were sterilized in their twenties, with the average age of sterilization being 26.[71]

In 1969, sociologist Harriet Presser analyzed the 1965 Master Sample Survey of Health and Welfare in Puerto Rico.[71] She specifically analyzed data from the survey for women ages 20 to 49 who had at least one birth, resulting in an overall sample size of 1,071 women.[71] She found that over 34% of women aged 20–49 had been sterilized in Puerto Rico in 1965.[71]

When the United States took census of Puerto Rico in 1899 the birth rate was 40 births per one thousand people.[66] By 1961 the birth rate had dropped to 30.8 per thousand.[65] In 1955, 16.5% of Puerto Rican women of childbearing age had been sterilized, this jumped to 34% in 1965.[65]

Effects

On the other side of the debate, scholars like Laura Briggs [68] have argued that evidence does not substantiate claims of a mass sterilization program.[68] She further argues that reducing the popularity of sterilization in Puerto Rico to a state initiative ignores the legacy of Puerto Rican feminist activism in favor or birth control legalization and the individual agency of Puerto Rican women in making decisions about family planning.[68]

Some scholars, such as Bonnie Mass [65] and Iris Lopez,[67] have argued that the history and popularity of mass sterilization in Puerto Rico represents a government-led eugenics initiative for population control.,[65][67][69][70] They cite the private and government funding of sterilization, coercive practices, and the eugenics ideology of Puerto Rican and American governments and physicians as evidence of a mass sterilization campaign.[67][69][70]

There has been much debate and scholarly analysis concerning the legitimacy of choice given to Puerto Rican women with regards to sterilization, reproduction, and birth control, as well as with the ethics of economically-motivated mass sterilization programs.

Controversy and Opposing Viewpoints

By 1949 a survey of Puerto Rican women found that 21% of women interviewed had been sterilized, with sterilizations being performed in 18% of all hospital births statewide as a routine post-partum procedure, with the sterilization operation performed before women left the hospitals after giving birth.[65] As for the birth control clinic’s founded by Sunnen, the Puerto Rican Family Planning Association reported that around 8,000 women and 3,000 men had been sterilized in Sunnen's privately funded clinics.[65] At one point, the levels of sterilization in Puerto Rico were so high that they alarmed the Joint Committee for Hospital Accreditation, who then demanded that Puerto Rican hospitals limit sterilizations to ten percent of all hospital deliveries in order to receive accreditation.[65] The high popularity of sterilization continued into the 60s and 70s, during which the Puerto Rican government made the procedures available for free and reduced fees.[68] The effects of the sterilization and contraception campaigns of the 1900s in Puerto Rico are still felt in Puerto Rican cultural history today.[67]

The legalization of sterilization was followed by a steady increase in the popularity of the procedure, both among the Puerto Rican population and among physicians working in Puerto Rico.[68][69] Though sterilization could be performed on men and women, women were most likely to undergo the procedure.[65][66][68][69] Sterilization was most frequently recommended by physicians because of a pervasive belief that Puerto Ricans and the poor were not intelligent enough to use other forms of contraception.[68][69] Physicians and hospitals alike also implemented hospital policy to encourage sterilization, with some hospitals refusing to admit healthy pregnant women for delivery unless they consented to be sterilized.[68][69] This has been best documented at Presbyterian Hospital, where the unofficial policy for a time was to refuse admittance for delivery to women who already had three living children unless she consented to sterilization.[68][69] There is additional evidence that true informed consent was not obtained from patients before they underwent sterilization, if consent was solicited at all.[69]

From beginning of the 1900s, U.S. and Puerto Rican governments espoused rhetoric connecting the poverty of Puerto Rico with overpopulation and the “hyper-fertility” of Puerto Ricans.[67] Such rhetoric combined with eugenics ideology of reducing “population growth among a particular class or ethnic group because they are considered…a social burden,” was the philosophical basis for the 1937 birth control legislation enacted in Puerto Rico.[67][68] A Puerto Rican Eugenics Board, modeled after a similar board in the United States, was created as part of the bill, and officially ordered ninety-seven involuntary sterilizations.[68]

Sterilization Procedures and Coercion

Unemployment and widespread poverty would continue to grow in Puerto Rico in the 40s, threatening both U.S. private investment in Puerto Rico and acting as a deterrent for future investment.[65] In an attempt to attract additional U.S. private investment in Puerto Rico, another round of liberalizing trade policies were implemented and referred to as “Operation Bootstrap.”[65] Despite these policies and their relative success, unemployment and poverty in Puerto Rico remained high, high enough to prompt an increase in emigration from Puerto Rico to the United States between 1950 and 1955.[65] The issues of immigration, Puerto Rican poverty, and threats to U.S. private investment made population control concerns a prime political and social issue for the United States.[65] The 50s also saw the production of social science research supporting sterilization procedures in Puerto Rico.[65] Princeton’s Office of Population Research, in collaboration with the Social Research Department at the University of Puerto Rico, conducted interviews with couples regarding sterilization and other birth control.[65] Their studies concluded that there was a significant need and desire for permanent birth control among Puerto Ricans.[65] In response, Puerto Rico’s governor and Commissioner of health opened 160 private, temporary birth control clinics with the specific purpose of sterilization.[65] Also during this era, private birth control clinics were established in Puerto Rico with funds provided by wealthy Americans.[65][66] Joseph Sunnen, a wealthy American Republican and industrialist, established the Sunnen Foundation in 1957.[65][66] The foundation funded new birth control clinics under the title “La Asociación Puertorriqueña el Biensestar de la Familia” and spent hundreds of thousands of dollars in an experimental project to determine if a formulaic program could be used to control population growth in Puerto Rico and beyond.[65]

1940s-1950s

[65] The government cited a growing population of the poor and unemployed as motivators for the law.[66][65] law that allowed the dissemination of information regarding birth control methods as well as legalized the practice of birth control.sterilization and eugenic birth control On May 13 of that same year, the Governor of Puerto Rico, Menendez Ramos, signed and implemented a [66] Puerto Rican physician, Dr. Lanauze Rolón, founded the League for Birth Control in Ponce, Puerto Rico in 1925, but the League was quickly squashed by opposition from the

A political map of Puerto Rico

Puerto Rico


Discussions have yet to begin regarding compensation for victims of forced sterilization in other states.

148 female prisoners in two California institutions were sterilized between 2006 and 2010 in a supposedly voluntary program, but it was determined that the prisoners did not give consent to the procedures.[63] In September 2014, California enacted Bill SB 1135 that bans sterilization in correctional facilities, unless the procedure shall be required in a medical emergency to preserve inmate's life.[64]

The inability to pay for the cost of raising children has been a reason courts have ordered coercive or compulsory sterilization. In June 2014, a Virginia judge ruled that a man on probation for child endangerment must be able to pay for his seven children before having more children; the man agreed to get a vasectomy as part of his plea deal.[61] In 2013, an Ohio judge ordered a man owing nearly $100,000 in unpaid child support to "make all reasonable efforts to avoid impregnating a woman" as a condition of his probation.[62]

The Congress of Obstetricians and Gynecologist (ACOG) believes that mental disability is not a reason to deny sterilization. The opinion of ACOG is that "the physician must consult with the patient’s family, agents, and other caregivers" if sterilization is desired for a mentally limited patient.[56] In 2003, Douglas Diekema wrote in Volume 9 of the journal Mental Retardation and Developmental Disabilities Research Reviews that "involuntary sterilization ought not be performed on mentally retarded persons who retain the capacity for reproductive decision-making, the ability to raise a child, or the capacity to provide valid consent to marriage." [57] The Journal of Medical Ethics claimed, in a 1999 article, that doctors are regularly confronted with request to sterilize mentally limited people who cannot give consent for themselves. The article recommend that sterilization should only occur when there is a "situation of necessity" and the "benefits of sterilization outweigh the drawbacks." [58] The American Journal of Bioethics published an article, in 2010, that concluded the interventions used in the Ashley treatment may benefit future patients.[59] These interventions, at the request of the parents and guidance from the physicians, included a hysterectomy and surgical removal of the breast buds of the mentally and physically disabled child.[60]

As of January 2011, discussions were underway regarding compensation for the victims of forced sterilization under the authorization of the Eugenics Board of North Carolina. Governor Bev Perdue formed the NC Justice for Sterilization Victims Foundation in 2010 in order "to provide justice and compensate victims who were forcibly sterilized by the State of North Carolina".[54] In 2013 North Carolina announced that it would spend $10 million beginning in June 2015 to compensate men and women who were sterilized in the state's eugenics program; North Carolina sterilized 7,600 people from 1929 to 1974 who were deemed socially or mentally unfit.[55]

The 27 states where sterilization laws remained on the books (though not all were still in use) in 1956 were: Idaho, Indiana, Iowa, Kansas, Maine, Michigan, Minnesota, Mississippi, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Utah, Vermont, Virginia, West Virginia, Wisconsin.[53]

After World War II, public opinion towards eugenics and sterilization programs became more negative in the light of the connection with the genocidal policies of Nazi Germany, though a significant number of sterilizations continued in a few states through the 1970s. The Oregon Board of Eugenics, later renamed the Board of Social Protection, existed until 1983,[50] with the last forcible sterilization occurring in 1981.[51] The U.S. commonwealth Puerto Rico had a sterilization program as well. Some states continued to have sterilization laws on the books for much longer after that, though they were rarely if ever used. California sterilized more than any other state by a wide margin, and was responsible for over a third of all sterilization operations. Information about the California sterilization program was produced into book form and widely disseminated by eugenicists E.S. Gosney and Paul B. Popenoe, which was said by the government of Adolf Hitler to be of key importance in proving that large-scale compulsory sterilization programs were feasible.[52] In recent years, the governors of many states have made public apologies for their past programs beginning with Virginia and followed by Oregon[50] and California. Few have offered to compensate those sterilized, however, citing that few are likely still living (and would of course have no affected offspring) and that inadequate records remain by which to verify them. At least one compensation case, Poe v. Lynchburg Training School & Hospital (1981), was filed in the courts on the grounds that the sterilization law was unconstitutional. It was rejected because the law was no longer in effect at the time of the filing. However, the petitioners were granted some compensation because the stipulations of the law itself, which required informing the patients about their operations, had not been carried out in many cases.

Most sterilization laws could be divided into three main categories of motivations: eugenic (concerned with heredity), therapeutic (based on the idea that sterilization could cure one of sexual traits such as masturbation or pedophilia), or punitive (as a punishment for criminals), though of course these motivations could be combined in practice and theory (sterilization of criminals could be both punitive and eugenic, for example). Buck v. Bell asserted only that eugenic sterilization was constitutional, whereas Skinner v. Oklahoma ruled specifically against punitive sterilization. Most operations only worked to prevent reproduction (such as severing the vas deferens in males), though some states (Oregon and North Dakota in particular) had laws which called for the use of castration. In general, most sterilizations were performed under eugenic statutes, in state-run psychiatric hospitals and homes for the mentally disabled.[48] There was never a federal sterilization statute, though eugenicist Harry H. Laughlin, whose state-level "Model Eugenical Sterilization Law" was the basis of the statute affirmed in Buck v. Bell, proposed the structure of one in 1922.[49]

The first state to introduce a compulsory sterilization bill was Michigan, in 1897, but the proposed law failed to pass. Eight years later Pennsylvania's state legislators passed a sterilization bill that was vetoed by the governor. Indiana became the first state to enact sterilization legislation in 1907,[43] followed closely by California and Washington in 1909. Several other states followed, but such legislation remained controversial enough to be defeated in some cases, as in Wyoming in 1934.[44] Sterilization rates across the country were relatively low, with the sole exception of California, until the 1927 U.S. Supreme Court decision in Buck v. Bell which legitimized the forced sterilization of patients at a Virginia home for the intellectually disabled.[45] In the wake of that decision, over 62,000 people in the United States, most of them women, were sterilized.[46] The number of sterilizations performed per year increased until another Supreme Court case, Skinner v. Oklahoma, 1942, complicated the legal situation by ruling against sterilization of criminals if the equal protection clause of the constitution was violated. That is, if sterilization was to be performed, then it could not exempt white-collar criminals.[47]

Some sterilizations took place in prisons and other penal institutions, targeting criminality, but they were in the relative minority.[40] In the end, over 65,000 individuals were sterilized in 33 states under state compulsory sterilization programs in the United States in all likelihood without due multi-ethnic and ethnic minority perspective.[41][42]

The United States was the first country to concertedly undertake compulsory sterilization programs for the purpose of eugenics.[38] The heads of the program were avid believers in eugenics and frequently argued for their program. It was shut down due to ethical problems. The principal targets of the American program were the intellectually disabled and the mentally ill, but also targeted under many state laws were the deaf, the blind, people with epilepsy, and the physically deformed. While the claim was that the focus was mainly the mentally ill and disabled, the definition of this during that time was much different than today's. At this time, there were many women that were sent to institutions under the guise of being “feeble-minded" because they were promiscuous or became pregnant while unmarried. According to the activist Angela Davis, women of predominantly ethnic minorities (such as Native Americans, as well as African-American women)[39] were sterilized against their will in many states, often without their knowledge while they were in a hospital for other reasons (e.g. childbirth). For example, in Sunflower County Mississippi, 60% of black women living there were sterilized at Sunflower City Hospital without their permission.

A map from a 1929 Swedish royal commission report displays the U.S. states that had implemented sterilization legislation by then

United States

Switzerland refused, however, to vote a reparations Act.

in the form of a general proposal to adopt legal regulations that would enable reparation for persons sterilized against their will. According to the proposal, reparation was to be provided to persons who had undergone the intervention without their consent or who had consented to sterilization under coercion. According to Margrith von Felten: National Council of SwitzerlandIn October 1999, Margrith von Felten suggested to the

Switzerland

The eugenistic legislation was enacted in 1934 and was formally abolished in 1976. According to the 2000 governmental report, 21,000 were estimated to have been forcibly sterilized, 6,000 were coerced into a 'voluntary' sterilization possibly in the backdrop of admiration with lack of proper comprehension of German National Socialism while the nature of a further 4,000 cases could not be determined.[37] However, the 40,000 or so socio-medical cases are contested, and Zaremba and others argue that they were more in the interest of society than individual women. The Swedish state subsequently paid out damages to victims who contacted the authorities and asked for compensation. The majority of the sterilised were women (according to some sources).

Jan Guillou brought up eugenics in the TV-program Rekordmagazinet in the 1980s, at which time this was still a topic largely unknown to the people, but it wasn't until 1997, following the publication of articles by Maciej Zaremba in the Dagens Nyheter daily, widespread attention was given to the fact that Sweden once operated a strong sterilization program, which was active primarily from the mid-1930s until the 1970s. A governmental commission was set up, and finished its inquiry in 2000.

Sweden

In South Africa, there have been multiple reports of HIV-positive women sterilized without their informed consent and sometimes without their knowledge.[36]

South Africa

In 2008, the Perm Krai ombudswoman Tatyana Margolina reported that 14 women with disabilities were subjected to compulsory medical sterilization in Ozyorskiy psychoneurological nursing home whose director was Grigory Bannikov.[33] The sterilizations were performed not on the basis mandatory court decision appropriate for them, but only on the basis of the application by the guardian Bannikov.[34] On 2 December 2010, the court has not found corpus delicti in the compulsory medical sterilizations performed by his consent.[33] The order by the health minister of the Russian Federation that issued in 1993 and neatly determined the procedure of forced abortion and sterilization of women with disabilities was repealed by the head of Ministry of Health and Social Development of the Russian Federation Tatyana Golikova in 2009.[33] Therefore, now women can be subjected to compulsory sterilization without court decision, according to Tatyana Margolina, which may place some types of humanity within their nation at risk.[33] In Russia, one of the supporters of preventive eugenics is the president of the Independent Psychiatric Association of Russia Yuri Savenko, who justifies forced sterilization of women, which is practiced in Moscow psychoneurological nursing homes, and states that “one needs a more strictly adjusted and open control for the practice of preventive eugenics, which, in itself, is, in its turn, justifiable.”[35]

Russia

On October 21, 2011, Peru’s Attorney General José Bardales decided to reopen an investigation into the cases, which had been halted in 2009 under the statute of limitations, after the Inter-American Commission on Human Rights ruled that President Fujimori’s sterilization program involved crimes against humanity, which are not time-limited.[32] It is unclear as to any progress in matter of the execution (debido ejécucion sumária) of the suspect in the course of any proof of their relevant accusations in the legal sphere of the constituted people in vindication of the rights of the people of South America (en el foro legal o del pueblo debido en reivindicácion del derecho del pueblo sul-americano). It may carry a parallel to any suspect cases for international investigation in any other continent, and be in the sphere of Medical Genocide.

In September 2001, Minister of Health Luis Solari launched a special commission into the activities of the Voluntary Surgical Contraception, initiating a Parliamentary commission tasked with inquiring into the "irregularities" of the program, and to put it on an acceptable footing. In July 2002, its Final Report ordered by the Minister of Health revealed that between 1995 and 2000, 331,600 women were sterilized, while 25,590 men submitted to vasectomies.[30] The plan, which had the objective of diminishing the number of births in areas of poverty within Peru, was essentially directed at the indigenous people living in deprived areas (areas often involved in internal conflicts with the Peruvian government, as with the pueblos jóvenes (in English: shantytowns). In 1996 there were, according to official statistics, 81,762 tubal ligations performed on women, with a peak being reached the following year, with 109,689 ligatures, then only 25,995 in 1998.[29]

  • Discontinue their campaigns in tubal ligations and vasectomies.
  • Make clear to health workers that there are no provider targets for voluntary surgical contraception or any other method of contraception.
  • Implement a comprehensive monitoring program to ensure compliance with family planning norms and informed consent procedures.
  • Welcome Ombudsman Office investigations of complaints received and respond to any additional complaints that are submitted as a result of the public request for any additional concerns.
  • Implement a 72-hour "waiting period" for people who choose tubal ligation or vasectomy. This waiting period will occur between the second counseling session and surgery.
  • Require health facilities to be certified as appropriate for performing surgical contraception as a means to ensure that no operations are done in makeshift or substandard facilities.[31]

On February 25, 1998, a representative for USAID testified before the U.S. government's House International Relations Committee, to address controversy surrounding Peru's program. He indicated that the government of Peru was making important changes to the program, in order to:

[30]

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