Sterilization Offer to Addicts Reopens Ethics Issue

A group called Children Requiring a Caring Kommunity, or “Crack,” is offering male and female addicts $200 to to be sterilized or put on long-term birth control. “Get birth control, get cash,” their flier reads. “If you are addicted to drugs and/or alcohol then this offer is for you.” Crack, contends that the program is a humane effort to keep children from being born to women ill-equipped to raise them.

Critics counter that it is little more than a bribe to women to make an irreversible decision, and argue that counseling is the best method for both ending drug use and promoting responsible parenthood. The New York Civil Liberties Union seems to have their own definition of the word “choose”

Maybe they see a present choice that eliminates future choice to be anti-choice. Or, maybe they don’t like the $200 remuneration.

Some opponents have made even greater rhetorical leaps:

So, is this a sensible program to promote drug treatment and avoid the birth of children who are likely to be raised badly, or is unethical, fascistic, anti-choice, and racist?

Closer to the latter, I think. It’s the $200 payment that bugs me; a sterilisation decision should not be made for money, and offering money to addicts who may be desparate for cash and whose drug dependency, to put it no higher, may impair their ability to make decisions in their own best interests or in society’s best interests disturbs me greatly. I would have fewer concerns if the agency concerned offered counselling rather than cash.

Don’t know who the Mrs Harris referred to in your third quote is or what connection she has with the agency offering the program, but if she speaks for the agency in any way it would reinforce my concerns.

Mrs. Harris is THE “Mrs. Harris”, the Barbara Harris who started the whole thing. She sounds like a hopelessly idealistic do-gooder to me, not like a racist.


They adopted four crack babies, offspring of the same woman who eventually had eight all together.

I don’t like the money offer either. To a junkie, money is the same thing as drugs.

I heard about this on the news yesterday. On the face it seems like a good idea. Junkies SHOULDN’T be having kids, and unfortunately many of them are not in the right minds to worry about contraception and drug-related birth defects. Also, it isn’t fair to society if you keep having damaged children that you cannot care for. However, being a junkie isn’t necessarily a permanent condition, whereas getting your tubes tied generally is. Even Depo-Provera has been known to have long-lasting side effects. So I would worry that many people–especially the most desperate and uneducated–would jump into this without being properly informed about the risks.

Hmph. I would posit that the kind of person who would go on birth control without learning about it is not fit to be a parent.

Hey! Do they pay non-junkies to go on birth control, too?

I’ll add that being born with a disabling condition because of mother’s drug abuse is certainly a “permanent condition.” Isn’t there one party more guilty than the other here? The burden should be on the person who is causing the harm – No. So, if junkies “shouldn’t have kids” I wonder where the other safe alternatives are.

I have really mixed feelings about it.

On the con side, it seems to violate medical ethics all to hell. You don’t pay people for undergoing a medical treatment in general – and in the one normal exception to this ethic (medical experimentation), you do not pay people so much money that it becomes coercive. I remember working at a clinical research center at UNC-Chapel Hill, and one study proposal was turned down by the human-rights-evaluating Institutional Review Board (IRB) because the researchers were offering too much money to the research subjects. The IRB argued that offering that much money was essentially coercive to impoverished people, turned poor people into wealthy people’s guinea pigs.

I worry that the same dynamic applies here: by offering so much money to someone in dire straits, a coercive element appears.

On the other hand, there’s a new element with CRACK that doesn’t appear in medical experimentation: whereas the beenficiaries of medical research comprise society in general, CRACK’s procedures have very specific beneficiaries – the children who aren’t born. Perhaps economic coercion on behalf of these theoretical children is justified.

On the third hand, is coercion of a real person ever justified on behalf of a theoretical person?

On the fourth hand, is this really economic coercion? I’ve never quite understood the Institutional Review Board’s decision in the case of that study.

My feelings are mixed.

“theoretical person” - please. It’s not “theoretical babies” they’re trying to help.

I have no problem with it whatsoever. Anyone who would take $200 for sterilization in order to buy drugs probably isn’t repsonsible enough to have a child in the first place. I suppose the point could be made that the person could later rehabilitate and become a responsible parent… in that case, adoption always remains open.

This is a fascinating area. My wife, who served on her school’s IRB, would probably agree with the UNC IRB.

A related question is whether one should be allowed to sell one’s organ. My wife would consider that unethical.

OTOH, why shouldn’t an individual be able to sell her own organ or her own child-bearing ability? Doesn’t she own her body? Roe v. Wade established that she even owns a fetus living within her body. She is free to donate an organ or to voluntarily choose sterilization. So, why shouldn’t she be free to accept payment for those actions?


In fact, as an under 30-year-old woman, I’d have a hell of a time trying to convince a doctor to take cash to sterilize me.

Among the things I don’t like about the program are first, the cash incentive and second, the advertising practices. I have no idea how it is working in NY, but when it came to Seattle, the advertising was not distributed equally about the city, nor was it simply more concentrated in areas that were known for drug use - the people working with the agency targeted only some neighborhoods, the ones with certain racial demographics. Their actions there were highly questionable.

Hmm…I wonder if this is related to the fact that we don’t allow people to sell themselves into slavery. We seem to consider ownership of one’s body to be different from any other sort of ownership, inasmuch as it’s nontransferable: I’m not allowed to sell my physical body to you either through slavery or through organ transplant.

I can sell you my labor, but that’s different: when I sell you my labor, it’s a continuous process, and I can end the process whenever I feel like it. Selling oneself into slavery, or selling an organ, or “selling” one’s ability to reproduce, is irreversible. And we as a society don’t allow people to make such contracts.

If that’s the ethic we go by, then it seems like CRACK would be unethical. I don’t know that we’d make exceptions to the general rule (you can’t sell your body or any part of your body in an irreversible transaction) in order to help out another being (a theoretical child): to do so smacks of utilitarianism, a philosophy we usually reject as a society.


Er, is there a ‘junkie test’ they administer, or can you just walk in with a baggie full of equal?

Not fit to be a parent ever? I don’t think life-long sterility is justifiable punishment for youthful, possibly drug-induced ignorance.

As a child raised by an alcoholic father & a drug addict mother, I think that what CRACK is doing is long overdue. My childhood neglect was mild compared to many children’s but I still would not wish it on anyone.

Every couple months or so there’s a child abuse/neglect story that gets national attention. Usually these are children dying from parental neglect. How many more do you think happen that go underreported, where the children survive? How many of these tragedies are directly related to the parents’ drug/alcohol problems?

Can you think of a better way to allow the worst candidates for parenthood to self-select out? Any woman (or man) who would sell their reproductive capacities for $200.00 really doesn’t want to become a parent. If they change their mind later, maybe they can adopt. I think their privelege to reproduce is secondary to a child’s right to be raised by caring loving parents.

As to the pamphlets being distributed to black neighborhoods, I can’t really speak on that matter. I would hope that junkies of all colors be given equal opportunity to bow out of the reproductive lottery.

They can adopt if they become responsible, just like other sterile people.

So I assume that if the advertising was concentrated in areas of known drug abuse you would be for the program? If not, what is it about the program itself that you have a problem with? I’ve noticed many times on this board that some will interject race into an issue when the issues are really separate and can be dealt with in that manner. The idea is not a bad one because it is misused no more than cars are bad because people drive them when drunk. This is not an issue about someone’s skin color - it’s an issue about babies being born addited to crack, babies being born and living their lives disabled.

we have too many people breeding. The dumbest among our society are procreating the most. Anything we can do to cut down on the birth rate is a good thing. Even if it is “selective breeding” as long as one race is not overtly preferred there is nothing wrong with it. There is no law banning drug users (or anyone for that matter) from procreating here. I think it’s wonderful.

If you’re for a woman’s right to choose, as I am… then you believe in the “it’s your body you can do what you want with it” philosophy (as I do). That means you have the right to decide to get yourself sterilized if you so desire. “Oh, but the money influences that decision.” So what? Money influences all decisions.

Thank-you, Kalt.

Who cares if these desperate people jump on the chance to get a quick fix? They deserve what they get. If at some future time they want kids, they can adopt.