Here's the story:
Project Prevention is an organization that pays an incentive of $300 to drug users to get sterilized or go on long-term birth control. The project was started by Barbara Harris, who adopted four babies from the same drug-addicted woman. After watching the newborns go through withdrawal after they were born, she decided to take action....and this is the action she chose to take.
Part of her rationale is that having unwanted, drug-exposed babies is harmful to a woman's self-esteem. Another part of it is that the children are a burden on the system - according to the the Project's website, 80% of newborns whose mothers are illicit drug users go straight from the hospital to foster care.
I think that because this is an extreme case, it forces us to confront all sorts of issues in public health ethics. Sure, this is cost-effective, but is it social engineering? And no doubt many women use the incentive money to pay for drugs. Is the incentive coercive, given their addiction and need for money? But what if it is true (as the organization claims) that this incentive is the "nudge" that people need to do something that they know is the right thing for themselves? And there are many more questions that a program like this raises.
If you want to learn more, google the organization - there are lots of opinions out there.
Controversial enough for you?
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Yes, very controversial:). I shudder to think that this is considered public health. If all we can manage is to prevent a woman from having babies that will irreparably damaged from addiction- aren't we treating symptoms and not the problem? WHAT ABOUT THE WOMAN'S DRUG USE??!!
ReplyDeleteWhy is she using drugs? Does she see no other options? Is she being forced? Does she want children? Does she want a family planning method? Choice is choice, whether we like it or not. All we can do here is try to reconstruct the woman's reality so she can see a path away from drugs.
TOTALLY controversial and coercive! This may sit better with me if the women were not provided a monetary incentive to sterilize themselves. Then, at least, the program just offers this service for free to women who do not want children and who can not get the procedure otherwise. However, the fact that Ms. Harris is "bribing" these women shocks me. This totally reminds me of the beginning chapters of Brave New World.
ReplyDeleteNice one, Santhi! Love the provocative post. I can say that I am 100% opposed to sterilization, because of the permanency of the decision. It insinuates that you're giving up on the women. What if she's 22, but by the time she's 32 she's been clean and sober for 5 years, and now she wants to be mother?
ReplyDeleteI don't necessarily have a problem with the idea of offering a financial incentive. This is done all the time with research projects, for example. The devil is in the details--how much are you giving? The amount is the important part, I think.
I also think Lauren hit the nail on the head--this is a classic downstream approach. How about treating the addiction instead.
Very nice post. Thanks for making me want to debate a little! :)