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 a few 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.
You are a distinguished member of your hospital’s Ethics Committee. The Hospital Administrator, Dr. Matthews 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.
Let’s discuss with Dr. Matthews your view on the ethical implications and justifications for or against the “Ashley” treatment.
- Do parental rights include the right to permanently alter their child’s body?
- How is this like or unlike the forced sterilizations of the early 1970’s?
- How would you go about determining the best interests of Ashley? Remember to include the ethical theories and principles that support your position.
Ashe, A. and Stubblefield, A. (2010). Good intentions: bad decisions (Links to an external site.). American Journal of Bioethics, 10(1), 46-48.
Diekma, D and Fost, N. (2010). Ashley revisited: A response to the critics (Links to an external site.). American Journal of Bioethics, 10 (1), 30-44.
Insogna, I. and Fiester, A. (2015). Sterilization as a last resort in women with intellectual disabilities: protection or disservice (Links to an external site.). American journal of Obstetrics and Gynecology, 212(1), 34-36e1