In the British Medical Journal (# 7108, September 6, 1997, p. 563) there’s an article entitled “Thousands of women sterilized in Sweden without consent.” The Swedish government is investigating why thousands of women were forcibly sterilized on eugenic grounds from the 1930s to the 1970s. There are similar allegations about forced sterilizations in Switzerland, Austria and Finland. Is this the kind of thing you support?
This conjures up shocking images: a young woman – selected for no good reason – is dragged from her home, kicking and screaming, pinned to the operating table, and sterilized against her will. But it’s really hard to imagine that such things happen in Sweden. Sweden certainly appears to be a highly civilized country. Could it be the case that in every imaginable respect it’s a highly civilized country, except for these isolated, totally atypical acts of barbarism? Or is it possible there’s a higher ethical principle operating here that we can see only if we probe beneath the surface? The sad fact is that there are women in this world who are mentally incompetent (either severely retarded or mentally ill) who are also fertile. They present a serious ethical dilemma. It’s easy to condemn Sweden’s actions, but it’s difficult to find alternatives that are demonstrably better.
There’s a very real danger that if such women aren’t sterilized, they’ll get pregnant, because history has shown that there are plenty of unscrupulous men ready to take advantage of them. In mental institutions, women are sometimes impregnated (“raped” is probably more accurate) by attendants or janitors. Then, the infant is taken away from the mother (is this a good thing?) and given up for adoption. In many cases, the adoptive parents are never informed that the biological mother is a schizophrenic who was raped by an employee of the institution (is this fair to the adopting parents?). Most of the children born of such unions will be alright, but as a group, they are far more likely to develop psychopathologies of various sorts, causing them and their families much unhappiness.
And what, precisely, does the phrase “without consent” mean when talking about mentally incompetent people? By definition, mentally incompetent people cannot make rational decisions on their own. And what if they were to give their consent? What would such consent even mean if they were incapable of understanding what they were consenting to? Maybe the authorities in Sweden realized they’d have to decide the issue of reproduction for these women, just as they must decide many other issues for them. Maybe they didn’t bother to ask permission because they knew it would be meaningless.
Furthermore, it might be asked, “Did these women give their consent to get pregnant, give birth, and have their babies taken away from them?” The answer is “No.”
At the risk of stating the obvious, pregnancy and childbirth, in and of themselves, are not terrific experiences! They involve nausea, depression, mood swings, bladder problems, severe discomfort towards the end (just from being so fat), to say nothing of pain. Surrogate mothers are paid considerable sums of money by infertile couples, presumably because there aren’t lots of women volunteering to do it for free. If, after being pregnant for nine months, a woman delivers a baby and then has it forcibly taken away from her, this is a wrenching experience which is far more traumatic than having a simple operation to prevent pregnancy in the first place, a procedure that many thousands of normal women choose to have each year.
One crucial point must be emphasized: By sterilizing these women, Sweden is not depriving them of the joys of motherhood – they are already denied that by the fact that they would be unfit mothers as a consequence of their severe mental impairment. Rather, society is depriving them of the dubious joys of pregnancy and childbirth, which, as the majority of women would attest, is doing them a big favor. In addition, it’s preventing altogether the heartbreak of having babies taken from their mothers at birth, never to be seen again. (It should be noted parenthetically that the problem of fertility among mentally incompetent men is not nearly as serious because they are rarely able to find sexual partners.)
It’s inappropriate to use words like “coercion” in such a situation because there’s no way of knowing what the women would want if they were rational and could see things clearly. The only sensible and compassionate solution is for the authorities to do for them what most women would want in their position, and most women would much rather not risk getting pregnant if they couldn’t keep the baby.
The mentally incompetent must have decisions made by others for their own good, and for the good of everyone involved, in the area of reproduction, just as in all other facets of their lives. Clearly, it’s in their best interest, and in the best interest of society, if these people do not procreate.