Forced sterilization is possibly one of the greatest affronts to individual autonomy, as the permanent impairment of one’s ability to reproduce not only robs the individual of their natural ability to procreate, but denies them a future genetic lineage as well. In one of the most ethically suspect social policies of the 20th century, the Eugenics Movement was responsible for the forced sterilization of more than 60,000 American citizens. Condoned by leading members of society who shared the public’s desire to eliminate criminals and those with impaired mental capabilities from future populations, the movement was captured in President Theodore Roosevelt’s supportive pronouncement “…Criminals should be sterilised and feeble-minded persons forbidden to leave offspring behind them.” (Stanley, History Today, 2012).
While cleansing society of particular populations is clearly a sinister motivation and no longer accepted public policy, forced sterilizations, continue in a handful of controversial cases, inviting discussion as to whether more benevolent rationales support such a practice. Your reading introduces you to the case of Ashley X, a severely mentally and physically disabled 14-year old girl, lovingly referred to as Pillow Angel by her parents. The case inspired heated debate five-years ago, when Ashley’s parents posted a blog detailing their efforts to have Ashley sterilized and her growth chemically attenuated in an effort to make caring for her easier in years to come. While it is generally recognized that Ashley’s parents and her doctor all believed they were acting in Ashley’s best interests, the ethical implications continue to raise concern, as other similar cases have since emerged. Fueling the debate are fears that the practice represents a form of eugenics, which could lead to technological advancements designed to impair the reproductive capabilities of vulnerable populations.

Read the following and then participate in the discussion activity:
•Module notes
•Textbook pages
•Articles:
?Gann, C. (2012, June 22). North Carolina senate denies funds for sterilization victims.
?Severson, K. (2009, December 9). Thousands sterilized, a state weighs restitution. New York Times.
?Liao, S., Savulescu, J., & Sheehan, M. (2007). The Ashley Treatment: Best Interests, Convenience, and Parental Decision-Making. Hastings Center Report, 37(2), 16-20.
?Shannon, S. E., & Savage, T. A. (2007). The Ashley Treatment: Two Viewpoints. Pediatric Nursing, 33(2), 175-178.
You are a distinguished member of your hospital’s ethics Committee. The Hospital Administrator, Dr. Unsure has requested that you attend the upcoming Board meeting and share with Board your thoughts on the ethical permissibility (or impermissibility) of the Ashley case. Apparently, the Board is concerned that the demands of caring for such children, coupled with the continued cuts in public funding may encourage other parents to request similar procedures for their severely disabled children. The Board is wondering if such a practice could be ethically defended, or if a moratorium on such a drastic procedure should be instituted. Discuss with Dr. Unsure your view on the ethical implications and justifications for or against the “Ashley” treatment. Remember to include the ethical theories and principles that support your position.
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M7D2: Babies First - Forced C-Sections Module 7
In the case of abortion, the intent to terminate the pregnancy and rid the body of the embryo is clear. In the forced c-section cases, which you will read for this activity, the motivation for refusing a C-Section is not nearly as obvious and typically centers around the mother’s right to her own bodily integrity, rather than a desire to harm the fetus. While many believe the welfare of the child must take precedence in the critical hours of delivery, critics argue that the practice goes too far in interfering with a person’s autonomy and sets a dangerous precedent for other oversights that might infringe upon and criminalize a woman’s choices and behaviors throughout her pregnancy.
The following, adapted from an actual case scenario (Pemberton v. Tallahassee Memorial Regional Medical Center, Inc) demonstrates how far society is willing to go to protect a fetus:
Molly Case:Having undergone a prior C-section two years ago with the birth of her son, Molly and her husband were excited about welcoming their new daughter. Molly suffered emotionally after the C-Section. The recovery was difficult, which kept Molly from caring for her son for the first few weeks. Also, as a self-professed ‘naturalist,’ Molly felt she had somehow failed to meet her responsibilities as a woman and a mother by foregoing natural delivery. This time, she was determined that she and her husband would experience a natural birth. Since none of the Obstetricians she contacted would agree to the natural delivery, citing the potential for a uterine rupture that would be harmful to both Molly and her baby, Molly and her husband decided to have the baby at home, with the assistance of a licensed mid-wife.
A day after Molly went into labor the mid-wife was concerned that Molly was getting dehydrated. Upon her suggestion, Molly agreed to go to the ER for some IV fluids and have the baby delivered through natural birth there. Upon being admitted into the ER, one of the obstetricians she had consulted regarding the vaginal birth recognized her. The Obstetrician insisted again that she undergo a C-Section, claiming that there was a 90% risk that the baby would suffer from a vaginal birth, and only a 50% risk that Molly would be unduly harmed by a C-Section. Molly refused and left the hospital, determined to have her baby at home via a vaginal delivery. After she left, the hospital sought and secured a court order to compel Molly to undergo the C-Section to protect the life of the fetus. Shortly thereafter, a sheriff arrived at Molly’s home, arrested her, held her legs together and forced her into his squad car and back to the hospital, where the forced c-section was performed.
Read the following and then proceed to the activity discussion:
•Module notes •Text pages
•Haak, S. (2009, January 23). The rights and responsibilities of pregnant women. Center for Bioethics & Human Dignity
•Lusero, I., & paltrow, L. (2008, September 25). Amendment 48: It’s dangerous to women. DenverPost.com.
•Utah woman in C-section case pleads innocent to murder charge: Woman allegedly refused procedure, twin dies. (March, 15, 2004) MSN.com.
Discuss the following:You are a respected Ethics professor in BigBro, USA. Based on the Molly scenario, your state legislature is considering instituting “Babies First,” a mandatory protection program. Among other provisions, the bill requires that pregnant women follow the delivery recommendation of their obstetrician. If the mother disagrees with the obstetrician’s advice, the mother may seek a consult with an independent obstetrician, and if there is agreement amongst the two doctors, she must adhere to their decision. A failure to comply with any of the requirements may subject the woman to criminal charges related to harm incurred by the baby, including murder should the infant fail to survive delivery due to the mother's refusal to follow the doctor's advice.
Discuss your position on whether the proposed “Babies First” bill is ethically justified in its attempt to protect the interests of an un-born fetus by restricting and mandating the mother’s delivery options. You must justify your response using the ethical theories and principles we’ve learned thus far. You cannot just give an opinion.