Paying drug addicts cash to be sterilized - Coercive eugenics or freedom to choose?

[astro]

This fascinating article in Salon looks at some of the arguments surrounding the “CRACK” program. It seems like a pretty good idea to me given the flipside consequences. Is this coercive “Hitleresque eugenics” or simply a drug addict making a reasonable and socially prudent choice for cash?

Some pieces of long article

[sub]

Cathy Mayne was devastated when she heard that her 27-year-old daughter, Nicole, would be having another baby. In fact, she prayed it would be Nicole’s last.

That’s because Mayne, a 48-year-old former data entry clerk from Anaheim, Calif., already had custody of Nicole’s first three children, all of whom suffer from medical and developmental problems caused by their mother’s prenatal drug use. A chronic heroin and methamphetamine addict who lives on the street, Nicole had her first child at 17, has gotten pregnant by four different men, and has never had enough money to regularly use birth control. It seemed to Mayne like a “bad cycle that could go on forever.”

But thanks to a controversial program called CRACK (Children Requiring a Caring Kommunity), which pays drug addicts to get sterilized or to use long-term birth control, that cycle has finally ended.

After Cathy Mayne saw a flyer near her grandson’s elementary school that read, “If you’re addicted to drugs, get birth control – get cash!” she called CRACK on Nicole’s behalf. The organization’s premise is radical, if dizzyingly simple: CRACK gives addicts $200 (they’ll throw in an extra $50 if a participant recommends a friend) and sets up the medical procedures at a public hospital or clinic. All Nicole had to do was sign a release form, and two weeks later she had her tubes tied at a local hospital. She received a check the following month.
…

Other critics, such as Planned Parenthood and the ACLU, argue that CRACK preys on minorities and the drug-addicted poor who often live rock to rock and probably use the cash for just another fix. They argue that public money should be funneled toward a larger and more deleterious problem facing addicts – the dearth of affordable drug treatment programs.
…

“Poor women have fewer and fewer options to help them deal with their substance abuse dependencies,” says Gwen Rubenstein, director of policy research for the Legal Action Center, a public interest firm in Washington, which represents individuals with drug and alcohol problems. For this reason, Rubenstein believes that CRACK 's money would be better spent developing viable treatment options for the women they serve. Harris has a simple response to that suggestion: “That’s not what we do.”

The NAPW’s Paltrow, whose voice sometimes strains to contain anger while discussing CRACK, compares the group’s cash-for-birth-control concept to “Hitleresque eugenics.” She argues that historically, many privately funded efforts that purported to help disenfranchised groups eventually revealed other motives. “It’s hard not to think that some of the people who support this just think it’s a good way to get those they don’t like to stop reproducing,” she says.

Harris says that the claim that she and others involved with CRACK are practicing social engineering is ludicrous. “We are not picking on the poor,” she says. “We’re just helping people who need our help but have nowhere else to go.” She pauses and then adds: “Paltrow should adopt some of these children and then try and criticize me.” Harris, who is white, also points out that her husband is black, as are the four children she adopted. “I know what a racist is and I am not a racist. My father disowned me when I married my husband. We have been denied apartments because he is black and my children are biracial. People should know what they are taking about before they call me a racist.”
…

So far, 907 people have signed on with CRACK. Of those, 329 were permanently sterilized and the rest opted for long-term birth control like Norplant or Depo-Provera. Despite critics’ assertions, the majority of participants have not been racial minorities, although there is a greater percentage of minorities than in the general population: 463 have been white, 392 black, and 52 nonwhite Hispanic.

A recent CRACK survey shows that before entering the program, the group as a whole accounted for more than 4,000 pregnancies: 3,003 children; 1,342 abortions; 189 stillborn babies; and 1,603 children living in foster care. “People can criticize us all they want, but there is nothing good about women having six or eight babies taken away from them,” says Harris.

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[lissener]

Coercive eugenics.

[Palo_Verde]

Nah, freedom to choose.

[deball]

Freedom to choose for this particular program. Tubes tied is not the only option. They can choose Norplant or Depo-provera. Thus, they get some cash (for drugs possibly, but also a hot meal, or a room), and free BC. The person couldn’t afford BC before, thus kept getting pregnant, a likely hinderance to the mother’s lifestyle, and a burden on the system.

Affordable drug treatment and education is an even better option. But, that’s like pie in the sky for most of the country.

[TVAA]

Offering someone money to do something isn’t the same as forcing them to do so.

(Unless you’re some weird radical crypto-Marxist, in which case you probably do think money is slavery.)

[lissener]

Or . . . unless you understand that one’s freedom to choose can be limited by one’s situation.

The women who are being targeted by this program are those whose available choices are severely limited. Any freedom of choice in this situation is purely illusory and simply to alleviate the concscience of those “offering” such choices.

Pointing a gun at someone and asking them: “You want it in the head, or in the gut?” Coercion, or freedom of choice?

[robertliguori]

That would be coercion, because there is no none-of-the-above choice. There is one here: don’t go to CRACK. TVAA nailed it.
Q:Why is this not a private business transaction between CRACK and their clientele?

[lissener]

Must be a libertarian, or Nancy Reagan, or Marie Antoinette: “Just say no–here, have some cake!”

The reason that naive quip of Marie Antoinette’s has survived the ages is because of the social blindness it exhibited: that she understood the choice to be that simple: bread or cake.

Life is a lot more complicated than these artificial choices acknowledge.

[Scylla]

Normally I would say freedom to choose.

People addicted to highly addictive drugs do not really have this freedom though.

It’s been well demonstrated, particularly through morphine addiction, that otherwise extremely strong-willed, intelligent, and free-thinking people lose their ability to self-determination and choice as regards their drug addiction.

Drug addiction places an almost unbeleivable level of coercion upon one addicted.

It is not reasonable to think that a person in such a situation can make an informed choice, particularly when what is offered is $.

Why not just be honest and offer them another fix if they do it? That’s what it amounts to.

It’s an interesting moral question. On the hand we have the fact that it is coercive eugenics. On the other hand we have the horror of drug-induced birth defects.

Do the ends justify the means?

[Stoid]

A truly outstanding idea.

[Dissonance]

Long term birth control is one thing, but I can’t help but find sterilization a tad disturbing.

What I find to be really, really, really whacked is that this organization has chosen to call itself CRACK. What, was HEROIN already taken or something?

[Palo_Verde]

What if there were an orgnization that offered free abortions to pregnant crack addicted women?

Is this freedom of choice or forced abortion?

Why is long term or permanent birth control different?

[Odesio]

*Originally posted by lissener *
**
The reason that naive quip of Marie Antoinette’s has survived the ages is because of the social blindness it exhibited: that she understood the choice to be that simple: bread or cake.

**

Isn’t the “cake” she refers to actually that stuff that builds up on the side of baking ovens over the years? If so, she wasn’t naive she was a cold hearted bitch.

**
Life is a lot more complicated than these artificial choices acknowledge. **

The choices have real consequences so I don’t see how they’re artificial. If we are to say that drug addicts have no ability to say no then how can we convict them for crimes? How can we convict them for driving under the influence? Either they’re responsible for their own actions or they aren’t.

Marc

[even_sven]

Why not spend the money on rehab? I know rehab programs in my city have a long waiting list, and there are countless addicts that just have to keep on being addicted, despite wanting to get off of drugs, because they don’t have access to the medical and psychological services they need. Then we’d have productive citizens who could make their own reproductive choices responsibly, not addicts with a couple more bucks in their pockets and a pair of tied tubes.

[Odesio]

*Originally posted by even sven *
**Why not spend the money on rehab? I know rehab programs in my city have a long waiting list, and there are countless addicts that just have to keep on being addicted, despite wanting to get off of drugs, because they don’t have access to the medical and psychological services they need. Then we’d have productive citizens who could make their own reproductive choices responsibly, not addicts with a couple more bucks in their pockets and a pair of tied tubes. **

Can you tell me the success rate of rehab on crack and heroin addicts? Really, I have no idea but I never got the impression that they had a high rate of success.

Marc

[Moirai]

I like what Scylla posted. As a former cocaine addict, I can tell you that if offered cash, I might have done it too.

I consider it coercive eugenics because I understand the addict’s impaired ability to make seemingly simple decisions. Imagine a young girl’s anguish when, after struggling to get and stay clean, she still can never have children because of a stupid decision made when she was incoherant and desperate. Addicts must face up to past mistakes, of course, but this is hardly a “mistake.” They wouldn’t actively seek sterilization if it wasn’t offered with a cash reward.

And Marc, it is true that heroin addicts have a very tough time staying clean, cocaine addicts fare a little better (this post is totally anecdotal, of course- having been there and done that, I think most statistics lie). But do you think they shouldn’t be given the chance?

[Dissonance]

*Originally posted by autz *
**Why is long term or permanent birth control different? **

Because Norplant or Depo-Provera provide reliable long term birth control without requiring the user to remember or care about popping a pill every day, while tubal ligation could turn out to be permanent. The procedure is reversible, but the reversal procedure isn’t always successful.

My problem with sterilization rather than long term birth control is that people addicted to hard drugs don’t think or act rationally. No doubt most patients will spend the $200 on their next score. I have a problem with offering something as potentially permanent as sterilization because it’s being offered to someone with diminished capacity would could in the future break their addiction and be left permanently unable to have children.

[Palo_Verde]

If the addict in question wants money, but not the permanence of sterilization, then she is able to choose long term birth control.

Let’s think of the possible consequences of a woman getting this or not:

When an addict is paid to get sterilized, the possible bad consequences are that she uses the money to buy more drugs and that she may regret the decision at a later date. (I can’t think of any more)

If this addict does not get sterilized, the possible bad consequences are much more severe. She could have children who are at a high risk of physical damage in the womb from their mother’s drug use. And these children are also at a high risk of abuse and neglect once born. This is terrible on the children and a huge drain on our societal resources.

So if an addicted woman chooses to be sterilized and then regrets it, she is paying a price for her own bad choices.

But if she never gets sterilized because no one offers her that opportunity, it is her children and our society who will pay the price.

[even_sven]

It is pretty hard to get accurate data on how effective treatment is. Organizations like Narcanon claim a 75% sucess rate, which I think we can take with a grain of salt. Government sources tend not to really define “sucess”, but instead focus on how many people complete treatment. They say that people who compete treatment are more likely to hold a full-time job, and display other signs of sucess, but do not say how likely they are to be permanently off of drugs.

Here are some stats on people who needed treatment but did not recieve any.

This page claims that around 43% of opiate abusers who enter treatment compete it. Short term residential settings seem to be best (73% of all drug abusers complete the program)

It is hard to tell what a world where comprehensive treatment is readily availible would be like- one where addicts would not simply be sent right back out out on the streets after treatment, but given help out of poverty and access to things like education, medical and physciatric treatment and follow-up care.

[wonky]

My god. I’m jealous of drug addicts. That’s sad.

I’d be delighted if someone were to pay me $200 to be sterilized. As it stands, I can’t find a doctor who would let me pay him or her to do the procedure.

Julie