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Jill has been blogging for Feministe since 2005.
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172 Responses

  1. duck-billed placelot
    duck-billed placelot December 4, 2011 at 4:43 pm |

    Good lord, what a horrific indictment. Can we write some letters? I’d really like for him to not be a ‘senior clinical advisor’ to the Clinton Foundation. At the least.

  2. Vigée
    Vigée December 4, 2011 at 5:22 pm |

    That was utterly chilling.

  3. Brittany-Ann
    Brittany-Ann December 4, 2011 at 5:32 pm |

    Chilling, indeed. I shivered when I finished reading. What a smug asshole.

  4. librarygoose
    librarygoose December 4, 2011 at 5:34 pm |

    Fucking hell.

  5. PrettyAmiable
    PrettyAmiable December 4, 2011 at 5:46 pm |

    WHAT THE FUCKING FUCK.

    What can we do?

  6. Lisa A.
    Lisa A. December 4, 2011 at 5:47 pm |

    librarygoose:
    Fucking hell.

    Seconded.

  7. Femonomics on forced sterilization | Life of refinement

    [...] an Tanzanian woman while saving her life during childbirth.  I first read about  it on Feministe, but followed the original authors back to a new intellectual hotspot: Femonomics. Check out my [...]

  8. Politicalguineapig
    Politicalguineapig December 4, 2011 at 5:53 pm |

    PrettyAmiable: I’d suggest a petition and a google bomb.
    I am pretty horrified by this, but, ya know, doctors. Can’t really expect them to have sympathy.

  9. Tori
    Tori December 4, 2011 at 5:54 pm |

    Ew.

    I do not get what is so difficult about NOT performing medical procedures on patients without their consent?

  10. SDOS
    SDOS December 4, 2011 at 6:39 pm |

    It can’t really be illegal or immoral if Dr. Tom Coburn does it, right?

  11. ferd
    ferd December 4, 2011 at 6:40 pm |

    Where do doctors go to get their egos super-mega-inflated?

  12. Chally
    Chally December 4, 2011 at 6:42 pm |

    PrettyAmiable:

    What can we do?

    I think we can try and find out the organisations he’s still working for and write to them.

  13. BabyRaptor
    BabyRaptor December 4, 2011 at 7:06 pm |

    I cannot being to understand the sheer level of arrogance it would take to do something like that. Even the idea of making that kind of decision for another person makes my skin crawl.

  14. g
    g December 4, 2011 at 7:19 pm |

    So when do we start sterilizing men without their consent while they’re under anesthesia, “for their own good”?

  15. William
    William December 4, 2011 at 7:20 pm |

    I cannot being to understand the sheer level of arrogance it would take to do something like that. Even the idea of making that kind of decision for another person makes my skin crawl.

    Its not a lot of arrogance, its just a little thing. It starts out little, and continues little, and for a doctor like Fleischman remains little. He’s already in a position to influence the lives of others, he’s already paid to do so, he is lauded by society and is the pride of his family for it. Holding a life in his hands becomes commonplace, it becomes a little thing. Its so small it doesn’t even feel like arrogance because, much of the time, he does know better than his patients. He knows what makes them ill, he knows how to cure the pain or make their hearts beat again as they die on the table. He grumbles to himself as he goes home when patients ignore his advice and thinks “if only they had listened” when they suffer and die.

    Its not arrogance that makes men like Dr. Fleischman, it isn’t that he thinks he’s better, its that he cannot imagine that they wouldn’t want what he wants. He cannot imagine that they wouldn’t thank him because, really, he’s a hero. Just like the other doctor. Everyone else is just a little thing, imprecise and poorly defined outside of their relation to him.

    The truly terrifying part is, once you’ve been in the medical industry for a little while, you find out that whats special about Fleischman isn’t so much the lack of insight and empathy, but the honesty with which he expresses what so many health care providers feel. Its why I got the fuck out of hospital settings as soon as I could.

  16. Brian Schlosser
    Brian Schlosser December 4, 2011 at 8:17 pm |

    Wait… a white American doctor who is helping sterilize African women against their will is calling someone who criticizes him COLONIALIST?

    I’m not Buddhist, so I’ll intentionally say “Jesus H Jumped up Christ on a Chariot Driven Sidecar, this guy is a fucking asshole!”

    The arrogance displayed by him and the Tanzanian doctor that actually committed the crime is breathtaking. A doctor performing a tubal ligation on a non-consenting woman in America would soon find themselvs on the express train to Malpracticeville with a continuation on to Lostlicensetown, AND RIGHTFULLY SO. Furthermore, if Dr Erik had witnessed such an act committed in an American hospital against an American woman, I can not imagine he would call the surgeon a “hero”.

    Remember that asshole doctor a few years ago who burned the initials of his favorite college team onto his patient’s cervix? THAT was a horrific abuse of his power, and he was rightfully punished for it… but even that terrible action PALES into comparison with forced sterilization!

    “What I saw was a caring doctor who knew his patient was at the cultural whim of a male driven society that demands their wives keep producing children as their primary directive in life.”

    Clearly, the correct, caring solution was for another man to make the decision NOT to have kids for her. Presumably this doctor would do the same thing to Michelle Duggar, I guess…

  17. matlun
    matlun December 4, 2011 at 8:29 pm |

    William: He knows what makes them ill, he knows how to cure the pain or make their hearts beat again as they die on the table. He grumbles to himself as he goes home when patients ignore his advice and thinks “if only they had listened” when they suffer and die.

    I think this is the core of his motivation and justification for this. In his response to the post he claimed “If this woman got pregnant again, there was a greater than 50% chance she would die during or before childbirth”.

    Accepting the patients’ autonomy when you know that they are killing themselves can not be an easy thing, but that is what you are supposed to do.

    I find the analogy with forced sterilization programs a bit of a stretch, though. This is hardly eugenic sterilization of “undesirables”.

  18. Brian Schlosser
    Brian Schlosser December 4, 2011 at 8:33 pm |

    matlun: I find the analogy with forced sterilization programs a bit of a stretch, though. This is hardly eugenic sterilization of “undesirables”.

    If I went in for a colonoscopy and found out when I woke up that I had been given a vasectomy as well, it would be cold comfort that the doctor did it for his own reasons and not because of eugenics.

  19. matlun
    matlun December 4, 2011 at 8:50 pm |

    Brian Schlosser: If I went in for a colonoscopy and found out when I woke up that I had been given a vasectomy as well, it would be cold comfort that the doctor did it for his own reasons and not because of eugenics.

    Cold comfort indeed, but I might still judge the doctor in question as more or less of a scumbag depending on his reasons.

  20. Jen R
    Jen R December 4, 2011 at 9:39 pm |

    His LinkedIn profile lists these as his current positions:

    Medical Advisor at Newmont Mining Corporation in Indonesia
    Senior Clinical Advisor/Physician at Clinton Foundation
    Consulting Doctor at International SOS

  21. Angel H.
    Angel H. December 4, 2011 at 9:56 pm |

    Jen R: His LinkedIn profile lists these as his current positions:
    Medical Advisor at Newmont Mining Corporation in Indonesia
    Senior Clinical Advisor/Physician at Clinton Foundation
    Consulting Doctor at International SOS

    The Clinton Foundation can be contacted through this link:
    http://clintonfoundation.org/contactus/

  22. Not So Sure
    Not So Sure December 4, 2011 at 9:58 pm |

    Secret sterilizations are obviously insane, but I think people are ignoring a lot of the moral ambiguity.

    First, the doctor that actually sterilized the woman was Tanzanian. That doesn’t make it ok, but it does eliminate the implication that this was some sort of colonial eugenics program.

    Second, as others have mentioned, the woman had a half dozen kids and another pregnancy likely would have killed her. But here’s the interesting part, the doctor in the comments:

    “I’m neither bragging, nor complaining….only reporting how it happens in these remote locations. What I saw was a caring doctor who knew his patient was at the cultural whim of a male driven society that demands their wives keep producing children as their primary directive in life. She would have been at about a 50% risk of dying during her next pregnancy. The guy is a hero.”

    So a Tanzanian doctor thinking that this woman will be forced to have more children, likely killing her, performs a sterilization procedure that she would likely refuse (remember, her social value is defined by her fecundity).

    I don’t like the idea of non-consensual procedures, but in the midst of patriarchy, that woman was going to have her choices destroyed one way or another. Either she’s sterilized in secret or told about the problem, refuses the treatment, then dies 10 months later when she’s forced to carry a child to term by the men that control her.

    There’s a lot more going on here. Again, not arguing that the sterilization was “good,” but I would be curious if someone could diagram a “good” option that doesn’t depend on fairy dust and dreams.

  23. L.
    L. December 4, 2011 at 10:06 pm |

    Not to give short shrift to the actual human rights violations, but these 2 sentences really irritated me:

    I even closed the incision on her skin with a neat plastic surgery closure. This point of finesse would ultimately never be noticed through the stretchmarks and redundant skin of five babies, but it was the right thing to do.

    What a self-important asshole.

  24. Angel H.
    Angel H. December 4, 2011 at 10:10 pm |

    OT but…

    Did anyone else notice that young man in the group picture on his blog giving the middle finger?

    I don’t know who he is or why he did it…But I am so proud of him right now.

  25. EG
    EG December 4, 2011 at 10:18 pm |

    Brian Schlosser: A doctor performing a tubal ligation on a non-consenting woman in America would soon find themselvs on the express train to Malpracticeville with a continuation on to Lostlicensetown, AND RIGHTFULLY SO. Furthermore, if Dr Erik had witnessed such an act committed in an American hospital against an American woman, I can not imagine he would call the surgeon a “hero”.

    Well, in the past few decades, maybe. If the woman in question found out about it, and if she had the money, the connections, and the wherewithal to sue. I am not the most cynical person about the medical profession–I have reaped the benefits of their expertise and caring too many times to be–but forced sterilizations in the US weren’t that long ago, and medical professionals in the US have done some horrible things even more recently than that. From what I remember of recent news, North Carolina was performing forced sterilizations up to 1975, and I think Oregon performed its last one in 1981. That’s within my lifetime, that last one.

    I wonder if he would call the surgeon a “hero” here in the US. Say, if she had several kids and was on welfare, or was on street drugs, or was an immigrant coping with a more patriarchal subculture in the US, particularly if she was any of these things and a woman of color. I am not secure he would not.

  26. Sandy
    Sandy December 4, 2011 at 10:24 pm |

    This is so sickening.

    Thank you for the link, Angel H.

  27. Not So Sure
    Not So Sure December 4, 2011 at 10:34 pm |

    I wonder if he would call the surgeon a “hero” here in the US. Say, if she had several kids and was on welfare, or was on street drugs, or was an immigrant coping with a more patriarchal subculture in the US, particularly if she was any of these things and a woman of color. I am not secure he would not.

    I think people are slightly missing the reasoning behind the sterilization. It wasn’t that the woman was poor and couldn’t care for the kids, it was because she had a high risk of death for future pregnancies and lives in a culture where the men don’t give a fuck. Just look at the range of options:

    1) Don’t sterilize, don’t bring it up, it’s irrelevant to the procedure: she’s pregnant again very soon and has a high risk of death.
    2) Ask her if she wants to be sterilized because of her high risk of death from future pregnancies: her social status is based on her ability to have children, she likely declines and takes the risk not fully understanding the implication.
    2a) Inform her husband and other members of the tribe about her condition: the men don’t give a shit, force her to keep having kids whether she wants to or not, she’s likely dead in 10 months. Alternatively, she’s marginalized, ostracized or somehow treated poorly because of her condition.
    3) Just do the sterilization and don’t say anything about it. She just doesn’t get pregnant and never knows why.

    I see a range of very poor options. This is not analogous to, for instance, the sterilization of Native American women that continued well into the 50′s in the US. This is not a concerted effort to destroy a population or attack a class of people. It’s the quick decision of a doctor who works for $150 a month and understands the subtleties of his culture in a way we don’t.

    I don’t approve of the sterilization, but I don’t know enough to condemn the doctor or demand that the doctor who wrote up the story be removed from his various positions. Both of those doctors are providing care under insanely difficult circumstances and we’re “mansplaining” to them (ignoring any subtleties of their unique, subjective experience to tell them what’s right and wrong in black and white terms).

  28. Not So Sure
    Not So Sure December 4, 2011 at 10:37 pm |

    Please read every instance of “tribe” in my post as “village.” I read the post quickly and I’m not sure if it’s a tribal issue or not.

  29. Alison
    Alison December 4, 2011 at 10:53 pm |

    I’m not sure if I’m more disgusted by this doctor and his attitude, or by the people here twisting themselves into morally ambiguous pretzels trying to defend it or make it “not so bad”.

    I DON’T GIVE TWO FUCKS WHAT THE REASONS WERE. It was NOT anyone else’s decision to make but the patient’s. I could go on and on about autonomy and agency and human rights but for the fucking love of crap, I shouldn’t have to.

    It. Was. Not. Their. Decision. To. Make.

    NOT THEIR DECISIONS. HER DECISION. Period. Full stop.

    That this is up for argument is abhorrent. The fuck is wrong with people.

  30. Not So Sure
    Not So Sure December 4, 2011 at 11:07 pm |

    What’s wrong with you? You would just let this woman die because the men in her village don’t care whether she lives or dies, just that she produces more children?

    The doctor didn’t give her a choice to be sterilized, the men in her village won’t give her the choice of having more children, even if it kills her.

    Freedom of choice doesn’t mean much when you’re six feet under.

  31. LeftSidePositive
    LeftSidePositive December 4, 2011 at 11:26 pm |

    Not So Sure, I really don’t have time or energy to refute every one of your inane points, and anyway most of them were pretty well-refuted by the article itself and other comments, so I’ll just say that you’re a total self-important asshole who confuses lots of words for deep thinking, and that apologizing for or looking for “nuance” in life-altering medical procedures being performed without consent is totally and in all possible ways unacceptable.

    Yeah, but it’s totally more complicated because the doctor who violated her is Tanzanian. Because everyone from the same country must totally have the same cultural experience and no one has ever exploited anyone from their same country of origin. What a load of fucking bullshit.

    Oh, and one more thing–you don’t get to use any of your unique, special-snowflake, subjective experience on SOMEONE ELSE’S FUCKING BODY. That is a pretty damned black-and-white thing, and if she wants to take the risk to her life to have another baby THAT IS HER CHOICE. Work to change the culture she lives in, offer her an IUD if she wants one, offer education and support about birth control or any other economic opportunities, but further constraining her life is utterly unacceptable.

  32. theDAWG
    theDAWG December 4, 2011 at 11:26 pm |

    So if the Tanzanian Dr. hadn’t done this, then she would likely be dead by now. If the next pregnancy didn’t kill her, then it might have been the one after that.

    Who would bear agency for her fully preventable death? The mother? The husband? The doctor? The culture?

    The perfect (informed, uncoerced choices made by the individual) is the enemy of the good (one less dead mother). To say that it was HER decision to make ignores the facts on the ground: that she would either not be permitted to make that decision by the patriarchy or her decision would be coerced either directly or indirectly.

    I can’t condemn the Tanzanian doctor for picking the better of two evils. He has presumably seen this story before where it unfolds the other way, where children never meet their mother and are neglected by a new stepmother. That story sucks too.

  33. Kristen J.
    Kristen J. December 4, 2011 at 11:26 pm |

    You know, I’m as willing to rip up troll logic for shits and giggles as the next angry feminist, but I’m asking for a banhammer on this one. Someone justifying a eugenics program on the grounds that they really, really do know better just makes me want to vomit.

  34. LeftSidePositive
    LeftSidePositive December 4, 2011 at 11:28 pm |

    Another thing–did anyone stop to think about what the consequences for this woman might be if she is ostracized by her village when she is inexplicably infertile? She might seriously have her whole life thrown out from under her, possibly even being separated from her children and disowned by her husband.

  35. librarygoose
    librarygoose December 4, 2011 at 11:31 pm |

    We can argue the implications of oppressive patriarchy versus paternalism, and turn that into a discussion on the merit of cultural relativism. BUT what won’t change is the fact that what that doctor did was abhorrent. just because it can be viewed as the lesser of two evils doesn’t change the fact that it is an evil. The fact that a woman (any woman) is viewed as a baby machine is disgusting and so is the idea that a doctor she trusts would inflict on her a procedure that she was unaware of and most likely would have objected.

  36. Politicalguineapig
    Politicalguineapig December 4, 2011 at 11:32 pm |

    EG: I’ve been helped many times by the medical system- and I’m thinking of going in tomorrow because I have a possible ear infection that I want out of my system- which doesn’t change the fact that I’m cynical as fuck about them. Most of them think they know better than the patient, a lot of them cop an attitude if the patient isn’t het, white, skinny and neurotypical.

    Ob/gyns in particular shouldn’t be trusted as far as one can throw them- a lot of them are pro-life, and most would do exactly what this doctor did if they thought they could get away with it. (I’m not even going into the skeeze-factor with male ob/gyns. For the record, I’ve never gone to a gynecologist, male or female, and I hope to keep avoiding them.)

  37. Kat
    Kat December 4, 2011 at 11:36 pm |

    For everyone saying “it should have been her decision!”, you’re absolutely right. However, step back and think a moment, would it really have been her decision to keep on grunting out kids until her body literally gave out and died? The answer is no, not at all. It would have been the decision of the men who controlled her life from beginning to end and didn’t give a shit if she died or not, beause they’re assholes. My point is, it wouldn’t have been her decision anyway. God, how I wish it could have been.

  38. thebewilderness
    thebewilderness December 4, 2011 at 11:38 pm |

    Interesting the way he blows right by the fact that they screwed up the epidural and stopped her heart. I guess that wouldn’t make him look quite so heroic.

  39. William
    William December 4, 2011 at 11:39 pm |

    Matlun

    Cold comfort indeed, but I might still judge the doctor in question as more or less of a scumbag depending on his reasons.

    Nope, sorry, once a doctor has fucked with someone’s bodily autonomy their motivations cease to matter.

    Why?

    Because it isn’t about the doctor, it’s about the person who they have victimized. Ain’t no good intentions or future good works in the world gonna dig him outta that hole.

    Not So Sure:

    Secret sterilizations are obviously insane, but I think people are ignoring a lot of the moral ambiguity.

    No, they are not “insane” you ableist bag of rancid horse semen, its oppressive. See how easy it is to express what you mean rather than shit in the punchbowl with lazy, thoughtless speech? Not everything you dislike is the province of madness.

    Also, there is no moral ambiguity in ignoring the bodily autonomy of others, so fuck you twice.

    First, the doctor that actually sterilized the woman was Tanzanian. That doesn’t make it ok, but it does eliminate the implication that this was some sort of colonial eugenics program.

    No, no it doesn’t. See, eugenics was never quite so much about keeping brown people from breeding as it was about keeping the wrong people from breeding. That can come down to race, or disability, or class, or personal choices, pretty much any value you can come up with to determine who is undesirable and ought to be excluded from the gene pool. A wealthy Tanzanian doctor surreptitiously sterilizing a poor young woman on her fifth child fits neatly into the eugenics narrative. Because its not about color, its about power. Everything else is just a fig leaf.

    Second, as others have mentioned, the woman had a half dozen kids and another pregnancy likely would have killed her.

    Not your body, not your call, not your place to judge. It really isn’t that tough a concept.

    I mean…unless you’re the kind of person who thinks your (re)sentiments and values ought to trump the silly superstitions of stupid savages.

    I don’t like the idea of non-consensual procedures, but in the midst of patriarchy, that woman was going to have her choices destroyed one way or another.

    One can disagree without transgression. One can even judge. The thing is, once you’ve decided you’re going to decide for others you’ve taken a spot next to the rest of the monsters. You can dress it up with all the purple prose and perfumed bullshit in the world but oppression is oppression.

    You’re arguing that, given her rights are going to be ignored regardless, your brand of infringement was better. Thats creepy on a lot of levels and, I’d argue, flows from the same stream of patriarchy that gets us Good Guy™ Rapists.

    I don’t approve of the sterilization, but I don’t know enough to condemn the doctor or demand that the doctor who wrote up the story be removed from his various positions.

    Which counts as approval because silence, or well-intentioned hand wringing, mean the continuation of the status quo. Standing by is a choice. Keeping your mouth shut is a tacit approval. Waiting until you forget is the same as sitting on your ass. You’re taking cowardice (in this case either of standing up and saying “no” or standing up and saying “yes”) and turning it into the same self-congratulatory bullshit as the plastic surgeon’s sutures.

    What’s wrong with you?

    I got this thing about people’s bodies being their own and it always being wrong to infringe on that. I know, I’m a monster.

    You would just let this woman die because the men in her village don’t care whether she lives or dies, just that she produces more children?

    No, I’d give her a choice and than accept that she’s a human being who has the right to make it. Because, you know, I think she’s a human being and that she gets the final call on what to do with her body even if I disagree with her choice or think she’s wrong. Weird, right?

    Freedom of choice doesn’t mean much when you’re six feet under.

    Would you rather liberty or security? Asking her gives her a fighting chance, not asking her assumes she’s a child.

    Dress it up all you want, you’re arguing for people in positions of power to alter the bodies of people without power in the complete absence of not only consent but even basic knowledge. People do not cover up their victories, they cover up their crimes. The deceit betrays these doctors.

  40. Alison
    Alison December 4, 2011 at 11:41 pm |

    What’s wrong with you? You would just let this woman die because the men in her village don’t care whether she lives or dies, just that she produces more children?

    Yeah, that’s it. You got me. I’m disgusted by this doctor’s actions because I was just totally looking forward to her death so I could gleefully dance on her grave.

    Fuck off with that bullshit. I don’t know if you’re being deliberately obtuse and offensive or if you are really this stupid, but NO, I did not want her to die. And here’s the thing – if a doctor performs a procedure without consent because the patient’s life is DEFINITELY at risk in THAT VERY MOMENT and will in fact die on the table if they don’t perform a procedure, that would be one thing.

    But making a huge life choice like this for someone else without their consent or knowledge based on a POSSIBLE risk to her life, on conjecture and hypothetical scenarios, is totally fucking different.

    I am able to think women being forced to bear children when it puts their health and lives at risk AND that a doctor sterilizing said woman without her knowledge or consent are BOTH BAD THINGS. The former being a horrible way for a woman to live does NOT mitigate the latter in my opinion. And that does not fucking mean I want this woman, or any woman, to die because of a fucked up patriarchy that says bearing children is the most important thing ever. It means that I think you do not compensate for a woman’s agency being taken from her in one way by DOING THE SAME FUCKING THING IN ANOTHER WAY. Loss of autonomy is loss of autonomy, and when it’s done under the guise of Man Knows Best, is fucked up and bullshit no matter how noble that person’s motives might seem to certain people outside the situation.

    IMO there is nothing noble in treating a human being like an animal, whether your desired outcome is a “good” one or a “bad” one.

  41. librarygoose
    librarygoose December 4, 2011 at 11:57 pm |

    William: People do not cover up their victories, they cover up their crimes.

    Perfect.

  42. EG
    EG December 5, 2011 at 12:16 am |

    Not So Sure: I think people are slightly missing the reasoning behind the sterilization. It wasn’t that the woman was poor and couldn’t care for the kids, it was because she had a high risk of death for future pregnancies and lives in a culture where the men don’t give a fuck.

    No. No, I understand the reasoning very well: the doctor thought that what he was doing was for the best. Coincidentally, that’s what every single doctor who has ever done a forced sterilization has thought. And yet…oddly enough, when the women who have been sterilized without their consent are later made aware of what the doctors did to them, they’re never, ever grateful. In fact, they’re heartbroken and furious. Weird. I guess they just don’t know what’s good for them.

    Not So Sure: Ask her if she wants to be sterilized because of her high risk of death from future pregnancies: her social status is based on her ability to have children, she likely declines and takes the risk not fully understanding the implication.

    OK, so because she might make a decision different from the one you want her to make, she doesn’t get to make it at all? That’s so…what’s the word I’m looking for…not “feminist”…ah, yes. Disgusting. Disgusting of you. And just so I know, what’s your reference for saying that her social status is based on her ability to have children? It may be; that kind of thing isn’t unheard of in global human history. But I just read the entire blog post and I didn’t see anything in that indicating that it’s the case here. So your source is…?

    Not So Sure: What’s wrong with you? You would just let this woman die because the men in her village don’t care whether she lives or dies, just that she produces more children?

    It’s true; men who impregnate women never ever care whether those women live or die. Just a fact of life. The women’s brothers and fathers never care either. It is factually impossible for a woman’s life to be valued in any culture that is not Western European.

    Personally, I would ask her what she wants, because it is her decision to make, and hey, she might have some insight into what would happen to her if her entire worth is based on baby-making and she can no longer do it for some unexplained reason. Or, hey, she might happen to know that her husband loves her and would rather she be sterilized than put her life at risk. Or she might think to herself, if it’s on offer, “I could get an IUD for three or four years, and then reconsider whether or not I want to risk another pregnancy.” It is absolutely amazing what people who are not you will come up with when you allow them to think for themselves.

    LeftSidePositive: but it’s totally more complicated because the doctor who violated her is Tanzanian. Because everyone from the same country must totally have the same cultural experience and no one has ever exploited anyone from their same country of origin. What a load of fucking bullshit.

    Yep. And also, everybody knows that a male doctor would never make the wrong decision for a female patient from his same culture because he thinks that he knows better than she does. Never ever ever. Ever.

    I am curious, though, to know Not So Sure’s justification for not telling the woman about the anesthesia fuck-up that almost killed her or the CPR that saved her life or the resulting broken rib.

  43. Mandolin
    Mandolin December 5, 2011 at 12:29 am |

    “Ask her if she wants to be sterilized because of her high risk of death from future pregnancies: her social status is based on her ability to have children, she likely declines and takes the risk not fully understanding the implication.”

    So, why do we assume she doesn’t fully understand the implication?

  44. EG
    EG December 5, 2011 at 12:36 am |

    Mandolin: So, why do we assume she doesn’t fully understand the implication?

    Because there’s a chance that she might not make the same decision that the male doctors made. That could only be due to ignorance. Duh!

  45. Jen R
    Jen R December 5, 2011 at 12:47 am |

    Speaking of “People do not cover up their victories, they cover up their crimes,” Dr. Fleischman has taken his blog post down.

  46. librarygoose
    librarygoose December 5, 2011 at 12:48 am |

    EG: Because there’s a chance that she might not make the same decision that the male doctors made. That could only be due to ignorance. Duh!

    I know right? Like how ladies just pretend to understand that pregnancy is where babies come from, so some superior doctor has to show them so they know that abortions are MURDER. (caps is for the sheer evil of the lady folk)

  47. Alison
    Alison December 5, 2011 at 12:54 am |

    Jen R: Speaking of “People do not cover up their victories, they cover up their crimes,” Dr. Fleischman has taken his blog post down.

    And not even a replacement post explaining the disappearance. God, what an asshole.

  48. LeftSidePositive
    LeftSidePositive December 5, 2011 at 12:57 am |

    Jen R: Speaking of “People do not cover up their victories, they cover up their crimes,” Dr. Fleischman has taken his blog post down.

    Oh, that is just too fucking perfect!

  49. Alison
    Alison December 5, 2011 at 12:58 am |

    I <3 you, Jill.

  50. chava
    chava December 5, 2011 at 1:13 am |

    Fuck. Every time I think the medical community has gotten through its head that this shit is Wrong, another case like this pops up.

    I did want to comment that not telling the patient that they almost died during the procedure is still totally common, even in the U.S., and (generally) not seen as unethical by the medical community. You’re alive, and what you don’t know you can’t sue about.

  51. Brian Schlosser
    Brian Schlosser December 5, 2011 at 1:15 am |

    Stepped away for a few hours, and look at all the justifications of this obscenity I see… good lord…

    EG: Yeah, I should have said “today”, no doubt. Forced sterilization is an all too recent specter haunting American medicine.

    SO… to all those people arguing “he chose the lesser of two evils”, answer me this: If Michelle Duggar’s doctor decided during her next delivery that 20 kids was enough, and the 21st was a threat to her life, and decided on the spur of the moment to sterilize her, would you say that was the lesser of two evils?

  52. DonnaL
    DonnaL December 5, 2011 at 1:20 am |

    I simply cannot believe that anyone here is defending this. I’m horrified. And not only to deprive her of choice, but then not even to tell her what was done, thereby potentially putting her in a position where her failure to be able to get pregnant in the future could lead to her blaming herself, or others blaming her, with all sorts of unknown consequences? The whole thing is repulsive.

  53. Brian Schlosser
    Brian Schlosser December 5, 2011 at 1:24 am |

    chava: I did want to comment that not telling the patient that they almost died during the procedure is still totally common, even in the U.S., and (generally) not seen as unethical by the medical community.

    Likewise, I’m not overly upset by the broken rib. Lifesaving techniques are often injurious in themselves (consider open heart surgery, a procedure that is absolutely horrifying). THAT is a real case of “the lesser of two evils”.

    Very nice that the good Doctor has taken down the post. How will people learn of the heroism now??

  54. librarygoose
    librarygoose December 5, 2011 at 1:28 am |

    Brian Schlosser: Very nice that the good Doctor has taken down the post. How will people learn of the heroism now??

    I’m sure he knows that the internet is the proverbial elephant. It never forgets.

  55. EG
    EG December 5, 2011 at 1:42 am |

    Brian Schlosser: Likewise, I’m not overly upset by the broken rib. Lifesaving techniques are often injurious in themselves (consider open heart surgery, a procedure that is absolutely horrifying).

    Oh, yes, I didn’t mean to imply that the broken rib was a heinous thing; CPR often causes broken ribs and it’s worth it because you don’t die if it works. I was just appalled that they didn’t tell her that she had a broken rib even when she asked about the pain in her chest! I mean, if I had a broken rib, that is something I would like to know about, just so I could be a bit careful.

    Of course, I would like to know and be consulted about any consideration of sterilizing me as well, so I guess I’m just a total idealist.

  56. Brian Schlosser
    Brian Schlosser December 5, 2011 at 1:45 am |

    Also, here is a shortened link to the cached copy of the page Jill provided above. The Clinton foundation contact form is limited to 900 characters, I think the google cache url is about 450 itself…

    http://goo.gl/PwMVJ

  57. superior olive
    superior olive December 5, 2011 at 2:05 am |

    2) Ask her if she wants to be sterilized because of her high risk of death from future pregnancies: her social status is based on her ability to have children, she likely declines and takes the risk not fully understanding the implication.

    Is that likely? And if it is likely, why is that because she does not fully understand the implication? Really, how is this not supported by the underlying assumption that she is profoundly stupid? Because every woman I know, and especially those who’ve had children, understands fertility, and they understand that women sometimes die from childbirth/pregnancy. This is not some esoteric physics theory about quantum mechanics, it’s pregnancy and childbirth. All you have to say is that another pregnancy has a high chance of killing you, we can stop your ability to get pregnant permanently or temporarily, and you can tell whomever you want about your choice, but we won’t say anything so nobody need know. It’s actually pretty simple.

  58. synna
    synna December 5, 2011 at 2:22 am |

    Streisand effect ftw – the more he tries to hide his post, the more who will link it/post it.

    And this whole thing just stinks. The paternalism is just palpable – they don’t even explain why her chest is sore. A broken rib can be extremely painful, and she has a right to know what happened to her when she was unconscious.

    Others have said it more articulate than I regarding the forced sterilisation stuff – its just completely fucked.

  59. EG
    EG December 5, 2011 at 2:43 am |

    superior olive: Really, how is this not supported by the underlying assumption that she is profoundly stupid?

    Well, she is a young woman. I mean, what else could educated men be expected to think?

  60. deb
    deb December 5, 2011 at 2:58 am |

    SO… to all those people arguing “he chose the lesser of two evils”, answer me this: If Michelle Duggar’s doctor decided during her next delivery that 20 kids was enough, and the 21st was a threat to her life, and decided on the spur of the moment to sterilize her, would you say that was the lesser of two evils?

    In that case I’d say it’s the only moral choice.

    The mother has rights. But she also has responsibilities. One of those responsibilities is not to bring a child into the world if she can’t provide a good life for the child. And this isn’t just about money either; my parents were very well off when they had their girls, but they were both clinically insane (at least that’s what the doctors said during the hospitalization) and had both grown up in abusive households without ever getting treatment. Don’t get me wrong, I like existing, but my parents were not fit to be parents and all their kids have grown up to be miserable, broken people because of it. The only reason we’re all still breathing is none of our suicide attempts worked. Having a child in the middle of extreme poverty, extreme mental illness, etc. is morally wrong. Full stop. I applaud anyone who stops that from happening to another child. That includes a doctor stopping Momma Duggar from letting Jesus take the wheel when it comes to her reproduction. And by the way, we still live on a single planet with finite resources. Want to have as many kids as you want? Go colonize space. Until then put a cork in it.

    In my view too many parents get a free pass because of all the nonsense tacked onto parenthood. Anyone who elects to procreate without trying adoption first? Immoral. Anyone who can’t be bothered to ensure a safe space before starting the baby machine? Irresponsible. Childbirth is not a right – it’s a privilege distributed randomly, based purely on biology. There is no correlation between functioning plumbing and the capacity to properly raise a human being, so I do not give a damn what someone thinks they have a right to do with their uterus. I care about the well being of everyone – the potential parents included – and that means sometimes mommy doesn’t get what mommy wants.

    Don’t get me wrong, this guy was a grade A douche and the doctor who was farting around with tying tubes while the mom was DYING needs a good punch in the face. But let’s dispense with this sanctity of the womb nonsense, because that’s pretty fucked up too.

  61. librarygoose
    librarygoose December 5, 2011 at 3:43 am |

    deb: Having a child in the middle of extreme poverty, extreme mental illness, etc. is morally wrong.

    But this just stops certain segments of humanity from breeding. It is morally wrong to assume that poor people have to live a lesser life because they are stupid enough to be poor. This is exactly the shit that eugenics was about. Poor people, crazy people, stupid people, etc. shouldn’t have babies because they have a moral obligation to not bring people into that. And guess who got to decide who was too poor or too crazy to lose their right to have kids? Certainly not the people it affected. It was affluent white people. This is just social fucking Darwinism. You have no right to tell that woman she cannot have kids, you have no right to invade her and violate her, you have no right to say who has “earned” having a fucking kid.

  62. Iany
    Iany December 5, 2011 at 4:45 am |

    You don’t get to make reproductive choices for other people, jesus christ, first thou shalt do no harm.
    It makes me feel almost physically ill.
    You don’t have the right to make other people live the lives you’d force on them. What a monstrous doctor.

  63. Li
    Li December 5, 2011 at 4:50 am |

    deb: Anyone who elects to procreate without trying adoption first?

    As much as I would like to engage your broader eugenicist argument, I just don’t have the energy, so I’m just going to jump on this point and say that adoption is not some fucking trial run for whether you want kids. That shit is nearly as toxic as your argument that only the affluent and the abled should have kids.

  64. Question...
    Question... December 5, 2011 at 8:41 am |

    Did anyone else notice the little detail that the tubal ligation was performed supposedly one-handed in the midst of trying to restart the patient’s heart?

    Seriously?

    I’m calling bullshit on that one, this did not actually happen.

    If it did, that’s even more reason it’s evil: do one has the right to ignore a person’s bodily autonomy, period. But anyone who claims that this doctor was saving her life from some potential future pregnancy’s chance of killing her maybe by badly performing surgery on her is full of it.

    I mean, wouldn’t you freak out if a doctor who had already identified himself as too injured to perform surgery on you then went and performed surgery on you when there was another uninjured surgeon present and you didn’t ask for that surgery anyway?

  65. Question...
    Question... December 5, 2011 at 8:44 am |

    Edit: no one has the right to ignore a person’s bodily autonomy. Go go gadget typing.

  66. Tyler
    Tyler December 5, 2011 at 8:57 am |

    I’ve encountered praise and justification for forced sterilization before. Particularly from my fellow secularists, actually. I’m horrified by this news, but unfortunately not surprised.

  67. jumptoconclusion
    jumptoconclusion December 5, 2011 at 9:09 am |
  68. Alara Rogers
    Alara Rogers December 5, 2011 at 9:09 am |

    Anyone who elects to procreate without trying adoption first?

    Yeah, because the world totally needs more pressure on developing nation women to give up their kids so that white women in the West can feel morally superior.

    There isn’t really a worldwide surplus of orphans with no families or children whose mothers are willingly abandoning them. There are a lot of special needs kids and kids in the foster system, but the difference between adopting a special needs/foster child and birthing a baby is the difference between getting a cute little puppy and adopting a full-grown Great Dane who may or may not have been abused. You’re undertaking a completely different challenge when you take on an older child or a child with special needs, and I’m sorry, but this kind of bullshit sounds just like the NiceGuy entitlement complex. Why are only women ever the ones told “You *have* to love people who have no one to love them, because they *deserve* to be loved. You’re selfish for wanting to love those that you feel love for; you need to love these other people who deserve it more because they have no one else!”

    In general, women want to raise their own children. There are exceptions, but in the majority of cases, it is better to provide a woman financial assistance so she can care for her own infant than to take that infant away from her. There are *already* so many Westerners who want to adopt because they are infertile that it’s putting pressure on the women in the developing world to give up their children for financial reasons, and putting them at risk of having their babies stolen. In a world where that happens, choosing to adopt when you are fertile and *could* have your own children is morally suspect. Advising women (it’s always women) that they should not procreate their own genetic code because there are deserving children out there who need a home is simply bullshit — the deserving children who need a home are almost never healthy infants, and the desire to procreate is, generally speaking, strongly linked to the desire to have a healthy infant. People who are willing to open their hearts and homes to children who are not healthy infants are heroes, but castigating normal people because they’re not heroes totally misses the fucking point of having a hero; people who do something that’s special and above the call of what’s expected of humans are doing something special and above the call of what’s expected of humans, and demanding that every human behave that way or they’re morally inferior is wrong.

    However, because that is true, telling women that they are morally superior to pregnant women because they chose to take some other woman’s healthy infant baby is just all kind of fucked up. You’re not a hero for adopting; you’re a hero for adopting a kid from the foster system whose parents have completely checked out of the picture and who has no relatives who could do better, and you’re a hero for adopting a kid whose health problems or disability led their parents to abandon them or who is an orphan whose relatives don’t want them, but if you adopt a healthy infant, in such a way that the infant’s parents have no contact with them ever again, odds are, you’re not a hero. You’re likely a patsy for the villain.

    And yeah. There are a lot of people who shouldn’t procreate. Because they’re child molesters. Or they’re abusers. Or they’re malignant narcissists. However, the category of “people who shouldn’t procreate” does not include “poor people” and “people in bad health”, because you can be a wonderful parent who raises a good and noble child if you’re poor or sick, and you can be a horrible parent who raises a miserable, screwed up kid if you’re rich and healthy, so it’s just fucking evil to tell people “you can’t have kids because you’re poor/in bad health”, as those are not generally conditions that go away, not conditions that are the person’s fault, and not conditions that preclude them raising a happy kid.

  69. William
    William December 5, 2011 at 9:28 am |

    Having a child in the middle of extreme poverty, extreme mental illness, etc. is morally wrong.

    Lets wave through the obfuscatory cloud of flies and get to the steaming heart of bullshit here.

    I kind of agree with you here. Under my ethical and moral values having a child under those circumstances would be morally wrong. Still, that doesn’t lead to eugenics because…and I know its a tough thing to grasp for handwringing public health assholes and arrogant eugenicists alike…my morals and values do not extend onto the bodies of others.

    People do all sorts of things I disapprove of. I’ve got good reasons to disapprove of some of those things and terribly shitty, personal, foolish, petty reasons to disapprove of others. I spend a lot of time trying to sort between the two, trying to hone my values and sentiments down to what I truly believe and pare away that which is defensive and symptomatic, but its a lifelong process and I’ll die before I’ve completed the task. At the same time, I do all sorts of things other people disapprove of as well. Thats life in a society. You can’t get around human beings being judgmental assholes, its in our nature. All you can do is draw a bright line which limits the impact of our imperfection, and that line is liberty and dignity.

    Ultimately, my opinion on someone else’s reproductive decisions is just that: opinion. It has no weight, it is insignificant. It sure as hell doesn’t justify invasive, destructive, deceitful, deeply oppressive interventions because someone can make an argument that I know better. Fuck that, we’ve seen where that road leads.

  70. wriggles
    wriggles December 5, 2011 at 10:01 am |

    Funnily enough, contempt for things like autonomy, consent and an absurd sense of ownership over people because you’re trained to work on their bodies doesn’t sound particularly outlandish for the medical profession, anywhere. I had to remind myself consciously that it is supposed to be.

    Its some of the comments that have been surprisingly unsavoury projecting much cut price heart of darkness, under the guise of patriarchy, nice try! Yet when I think about it, I ask myself why and I just can’t answer.

    I suppose on a progressive site I still expect better somehow. I get some feel there’s a case to be made for Dr. M’s actions, but those on this thread have not made it-I’m being generous in assuming that someone could make the case without the zomg, if the sainted doctor didn’t violate her person-hood she’d die I tells ya, DIEEEEEEEEEEE; theatrics.

    Yes I know, trolls, but these ones strike me as on side.

  71. segirl
    segirl December 5, 2011 at 10:19 am |

    Why was the epidural even given? They pose risk without reducing risk. Why are men even attempting to manage childbirth? Chances are, there would have been no problem to her heart without the epidural.

  72. wriggles
    wriggles December 5, 2011 at 10:23 am |

    “extreme poverty” relative to what or whom? Would it be “morally wrong” to give birth if everyone is also extremely poor? i can’t believe millions of people around the world shouldn’t exist because somebody had a bad time.

    As money was not the issue surely things like being well balanced, loving and practical count for more than material wealth?

  73. matlun
    matlun December 5, 2011 at 10:32 am |

    Wow. What happened to this thread?

    William: Matlun
    Cold comfort indeed, but I might still judge the doctor in question as more or less of a scumbag depending on his reasons.

    Nope, sorry, once a doctor has fucked with someone’s bodily autonomy their motivations cease to matter.

    Do you really think so? Normally when we do a moral judgement the motivations and not only the actions of the person is seen as relevant, but I guess that is more of a philosophical question. We are in agreement that the action is wrong, which is probably more relevant.

    EG: Because there’s a chance that she might not make the same decision that the male doctors made. That could only be due to ignorance. Duh!

    I think that we must face the fact that it might very well be due to ignorance or stupidity. As I see it, the critical principle here is that even if the patient’s decision would be unwise, it is still her decision to make.

    This type of discussion is relevant for many other situations up to a patient refusing life saving medicinal care (and explicitly choosing to die). The choice must still be accepted (after attempts to convince the patient has failed).

  74. Ledasmom
    Ledasmom December 5, 2011 at 10:52 am |

    Actually, I did sort of wonder about the epidural. It doesn’t take effect that fast, necessarily (I had one for my first child; it was administered before I hit the pushing stage, and didn’t take effect until after I delivered. Heh, bad timing), and can be tricky to administer. On rereading the cached post, I notice that they did have a gas anaesthesia machine, which nobody was trained on, so I’m not sure what other options they had.

  75. Lauren
    Lauren December 5, 2011 at 11:08 am |

    Alara Rogers: Or they’re malignant narcissists. However, the category of “people who shouldn’t procreate” does not include “poor people” and “people in bad health”, because you can be a wonderful parent who raises a good and noble child if you’re poor or sick, and you can be a horrible parent who raises a miserable, screwed up kid if you’re rich and healthy, so it’s just fucking evil to tell people “you can’t have kids because you’re poor/in bad health”, as those are not generally conditions that go away, not conditions that are the person’s fault, and not conditions that preclude them raising a happy kid.

    We really have to get away from forcing women to defend their desire for parenthood.

    deb: Anyone who elects to procreate without trying adoption first? Immoral. Anyone who can’t be bothered to ensure a safe space before starting the baby machine? Irresponsible. Childbirth is not a right – it’s a privilege distributed randomly, based purely on biology. There is no correlation between functioning plumbing and the capacity to properly raise a human being, so I do not give a damn what someone thinks they have a right to do with their uterus.

    I do empathize with your experience, and it’s not far from what I grew up with, but my uterus is not a place for you to work out your childhood traumas.

    You’re correct, childbirth is not a choice. Childbirth is, if you’re straight and the plumbing does what it was designed to do, and don’t have the ways, means, or desire to prevent pregnancy, an inevitability. Why you attach moral judgement to that inevitability is a mystery to me, but your own personal experience does not a) apply to others, and b) justify breaking up families based on arbitrary feelings of morality as applied to poverty and ability.

    What you’re promoting here has been done already: we call it eugenics. Please let us know whether you’ve come to these conclusions through logic and research or if you’re just shooting from the hip. It will help the moderators decide whether or not to ban you for being insolent or just dumb.

  76. Andie
    Andie December 5, 2011 at 11:39 am |

    deb: But let’s dispense with this sanctity of the womb nonsense, because that’s pretty fucked up too.

    It’s not the sanctity of the womb.. it’s sanctity of the WHOLE FUCKING BODY. Unless the patient is unable to consent and their survival in THAT VERY MOMENT is threatened NO DOCTOR SHOULD BE PERFORMING ANY PROCEDURES WITHOUT THE PATIENT’S CONSENT.

    Jesus Mary and Motherfucking Joseph how is that so hard to understand?

  77. Helen Huntingdon
    Helen Huntingdon December 5, 2011 at 11:52 am |

    Did anyone else catch this from Dr. Tool’s cached blog post?

    but in reality it had been twenty years since I’d had my hand inside someone’s belly (in a surgical manner).

    I nearly threw up. He just had to work some pointless squick in there, didn’t he?

  78. Helen Huntingdon
    Helen Huntingdon December 5, 2011 at 11:56 am |

    I’m wondering how Dr. Squick comes up with the “hero” rationale — the other doctor continued to cut into the patient while she was dying on the table, and not as a part of returning her to a stable condition. WTF?

  79. Anonymouse
    Anonymouse December 5, 2011 at 12:18 pm |

    Wow, that is just repulsive. Also repulsive: deb and the rest of the merry band of eugenics proponents defending this guy. Women’s absolute right to control their reproductive decisions is up for debate now? on a feminist blog? You have got to be fucking kidding me.

  80. Politicalguineapig
    Politicalguineapig December 5, 2011 at 12:19 pm |

    Wriggles: Yeah, I agree. I think the only reason doctors don’t pull that kind of shit here is that they know they’d get sued if they got caught. Otherwise, they really don’t have a problem with sterilizing patients left and right, as most of the last century proved.

    Deb: The thing is ‘mental illness’ is a pretty flexible term, and, in the eugenics era, was used to edge a lot of people out of the parenting sweepstakes. Epilepsy was considered a mental illness back then, as was ‘hysteria’ (which doesn’t really exist.) There was also the term ‘feeble-minded’ which was all too often used to define those who simply liked the opposite sex too much and wanted to get married in a leisurely fashion.

    It’s one thing to look at your genetic history or your personal history and decide reproduction isn’t for you- that’s fine. But it’s quite another thing to call for sterilization of everybody who has brains that run on a different wavelength, who doesn’t have enough money right now, who’s in poor health or physically disabled, or is a carrier of a recessive lethal who had the misfortune of marrying another carrier.
    They should be allowed to make their own decisions, and deserve to be supported even if their decision isn’t what you’d like it to be. Also, please stop pretending that adoptive parents are saints. Some of them are, but I can provide links to several stories earlier this year proving that they’re not all saintly people.

  81. Politicalguineapig
    Politicalguineapig December 5, 2011 at 12:26 pm |

    One thing: A recessive lethal is a non-active gene, usually linked to several other chromosomes. Examples of recessive lethals are: Tay-sach’s Disease, hemophilia,* Huntington’s, etc.
    *I am aware that hemophilia is no longer lethal. It used to be.

  82. Ledasmom
    Ledasmom December 5, 2011 at 12:57 pm |

    Minor correction: Huntington’s is dominant.
    I think cystic fibrosis is the most common nasty recessive, though I am basing that entirely on a bar-trivia game I was at.

  83. William
    William December 5, 2011 at 1:25 pm |

    Do you really think so? Normally when we do a moral judgement the motivations and not only the actions of the person is seen as relevant, but I guess that is more of a philosophical question. We are in agreement that the action is wrong, which is probably more relevant.

    Motivations are important to me only so far as the underlying act is not intrinsically immoral. The only real exception would be situations of duress, but the doctor here wasn’t really under any kind of duress. Would it have been more monstrous if he was cackling about shutting off the font of black babies? Sure, I guess, but when the central act of forced sterilization is pretty monstrous to begin with I don’t see the point of looking for nuance.

    Heres the question. Under the rosiest of circumstances, if the patient here was your daughter, or sister, or wife, or you and you had the chance to stop the doctor before the procedure would you for even a second hesitate to use lethal force? The level of violation we’re talking about is so severe that I’m not sure what value there is in ruminating over what degree of monster we’re talking about. The best case scenarios people here are describing are still beyond the pale.

  84. Harald
    Harald December 5, 2011 at 1:38 pm |

    Not the same as this story, but definitely related: The BBC recently had a really interesting three-part documentary about the often appalling history of the modern population control movement. You can get the podcast here

  85. Amelia ze lurker
    Amelia ze lurker December 5, 2011 at 1:48 pm |

    I hope this doctor, and the one who performed the tubal ligation, are exposed, and that the woman is offered a reversal (by an ETHICAL surgeon) free of charge. That is all.

  86. EG
    EG December 5, 2011 at 2:11 pm |

    deb: Anyone who elects to procreate without trying adoption first? Immoral.

    Oh, here we go. You make decisions different from deb’s? You’re immoral. You have a yearning to experience pregnancy and childbirth? You’re immoral. You have emotionally and culturally resonant reasons to want a child biologically related to you? You’re immoral. You have moral qualms about adoption? Too bad, deb has spoken. You don’t have the tens of thousands of dollars necessary for private adoption? Fuck you. You don’t feel that adopting a teenager from foster care is the same thing as having a baby? Who cares what you want? Since when have women’s desires ever fucking mattered when it comes to childbearing?

    deb: Anyone who can’t be bothered to ensure a safe space before starting the baby machine? Irresponsible.

    You’re poor and can’t afford to move to a good neighborhood? Too bad for you; having children is a privilege for the wealthy. You have different ideas about what constitutes “safe” than deb does? You’re irresponsible.

    deb: Childbirth is not a right – it’s a privilege distributed randomly, based purely on biology. There is no correlation between functioning plumbing and the capacity to properly raise a human being, so I do not give a damn what someone thinks they have a right to do with their uterus.

    So true. That’s why good, responsible women living in safe environments should be forced to bear children by the age of 35. Oh, that’s not what you mean? Some uteruses are more equal than others, in other words?

    Again, in the whole long history of forced sterilization and eugenics, it is amazing, given that it is such a good idea and good for so many people, including the potentially child-bearing woman herself, that whenever it is subsequently revealed to the woman what was done to her, she is never, ever grateful. She is always heartbroken and furious. I guess that’s just more evidence of her mental illness and therefore her inability to properly raise children.

    deb: But let’s dispense with this sanctity of the womb nonsense, because that’s pretty fucked up too.

    You know what else is pretty fucked up? Taking bodily autonomy away from women.

    Or, in other words, every single thing librarygoose said in comment #64. And every single thing William said in #72.

    matlun: I think that we must face the fact that it might very well be due to ignorance or stupidity. As I see it, the critical principle here is that even if the patient’s decision would be unwise, it is still her decision to make.

    I agree, but I also still maintain that assuming her choice would be made out of ignorance when neither of these doctors ever met her before the moment of the epidural is nothing but patriarchal bullshit. Their choice might very well have been made out of ignorance as well, ignorance of circumstances of her life that she is very familiar with.

    Ledasmom: Actually, I did sort of wonder about the epidural. It doesn’t take effect that fast, necessarily (I had one for my first child; it was administered before I hit the pushing stage, and didn’t take effect until after I delivered. Heh, bad timing), and can be tricky to administer.

    Really? My best friend had one during her labor, and it took effect within ten minutes. I guess it must vary from woman to woman.

  87. matlun
    matlun December 5, 2011 at 2:12 pm |

    @William: As I said in my posts above, I agree that accepting patient autonomy is an extremely important requirement for any kind of acceptable medical ethics and in this case the behaviour was clearly morally wrong.

    But I do consider the situation where the doctor did it since it would save the life of the patient (according to the doctor’s best judgement) as clearly morally superior than someone who did it for reasons of eugenic ideals of racial purity.

    It should be noted that there are some situations where we do accept overriding patient autonomy. Involuntary commitment has been discussed on this blog before.

  88. Ledasmom
    Ledasmom December 5, 2011 at 2:27 pm |

    Really? My best friend had one during her labor, and it took effect within ten minutes. I guess it must vary from woman to woman

    Well, it may have been within ten minutes with me. That was a weird birth. I suspect it does vary depending on the exact protocol used. But I meant more that ten minutes can be an awfully long time if a woman’s already having problems, and gas is faster. But this particular hospital didn’t have anyone trained to use the gas anaesthesia machine, which explains that.

  89. When Overseas Volunteering Goes Awry: An Involuntary Sterilization in Tanzania « TheMoralMindfield

    [...] failure to disclose to the patient she had a broken rib and had been sterilized. Several feminist blogs have picked it up and run with it because of its outrageous medical [...]

  90. SeteSois
    SeteSois December 5, 2011 at 2:57 pm |

    Brian Schlosser:
    Rememberthatassholedoctorafewyearsagowhoburnedtheinitialsofhisfavoritecollegeteamontohispatient’scervix?THATwasahorrificabuseofhispower,andhewasrightfullypunishedforit…buteventhatterribleactionPALESintocomparisonwithforcedsterilization!

    Holy hell. Can you link this? Google’s not being useful.
    (Not as bad as what Fleischman has done but it’s like comparing… two really really terrible things…)

  91. Mike Crichton
    Mike Crichton December 5, 2011 at 3:15 pm |

    g: So when do we start sterilizing men without their consent while they’re under anesthesia, “for their own good”?

    Do you really think that’s NOT happening? It’s just that childbirth offers the sort of easy, plausibly deniable opportunity to do involuntary abdominal surgery that simply doesn’t occur as often with male patients.

  92. William
    William December 5, 2011 at 3:41 pm |

    But I do consider the situation where the doctor did it since it would save the life of the patient (according to the doctor’s best judgement) as clearly morally superior than someone who did it for reasons of eugenic ideals of racial purity.

    Not all eugenics was about racial purity. A lot of it came down to well intentioned rich white people deciding that this person or that could not handle a child and that all involved would be better off if they just didn’t reproduce. So consider the moral superiority of this doctor’s motives all you want, but at the end of the day know that what you’re doing is arguing that one kind of rape is more benevolent than other. You’re arguing that one kind of sexual coercion and violence is somehow less heinous because of what was going on in the mind of the aggressor at the time. Ultimately you’re arguing that one idea has more of a right to do something which no one has the right to do than another idea. And I do not hold to that.

    A forced sterilization is always wrong in all cases unless there is a clear and immediate threat to the life of the mother. Even then, the bare minimum requirement after the fact is to inform the patient. You’re looking for nuance where I don’t think any can be found and I think the drive to find it is downright suspect.

    It should be noted that there are some situations where we do accept overriding patient autonomy. Involuntary commitment has been discussed on this blog before.

    And I’m pretty sure I’ve made my feelings, and my clinical practice, rather clear on that matter. I think we commit too easily, for too little, and with a depressingly low evidentiary standard. I think the standard is far too large. I don’t think we ought to be involuntarily committing suicidal patients at all because I take autonomy seriously enough that I believe people have a right to decide when its all too much and bow out on their own terms.

    Even with involuntary commitment, though, we’re talking about apples and oranges. A person committed is incarcerated (we use more gentle words, but a locked door is a locked door) for generally 72 hours. Its short and reversible. As bad as a psych ward is, its not surgery. You’re stretching for cover, but what is already exposed is quite disturbing.

  93. TooManyJens
    TooManyJens December 5, 2011 at 3:44 pm |

    But I do consider the situation where the doctor did it since it would save the life of the patient (according to the doctor’s best judgement) as clearly morally superior than someone who did it for reasons of eugenic ideals of racial purity.

    It wouldn’t save the life of the patient. The patient’s life was not in danger at that moment from having intact fallopian tubes. The doctor believed, because the woman was having a difficult birth (further complicated by the medical staff’s actions), that “she does not need another baby after this.” He further believed that the patient lacked the right to decide for herself whether or not to use birth control or be sterilized if pregnancy really did pose an undue risk to her health.

  94. Rob in CT
    Rob in CT December 5, 2011 at 4:36 pm |

    You gotta love how it all starts with their own fuckup.

    1: fuck up epidural, stop patient’s heart
    2: tubal ligation
    3: ???
    4: HERO.

    Anyway, I’m with those who have a major problem with this. The reasons are so obvious there is no need to get into them.

  95. Helen Huntingdon
    Helen Huntingdon December 5, 2011 at 4:39 pm |

    You know, it’s interesting how Doctors Squick who did this express disapproval of waiting to “benefit” from their help:

    The Traditional Healer. Say no more. Straight away I knew this was not going to go well. Each village had a Traditional Healer/Witch Doctor who practiced ancient arts of medicine. These techniques included ritual skin cutting, herbs and randomly placed sticks through punctures. I’m sure that many of their methods worked, but the only ones we ever saw were the ones that didn’t. In those cases the patients would be dragged to our hospital as a last resort. They were usually in septic shock, nearly dead or horribly late for treatment like our Sunday night patient.

    Yeah, why would you wait until the last possible moment do go to the people who perform procedures on you without your consent and then pretend they didn’t? People aren’t stupid. They’ll have figured out that these guys do this kind of thing, and that’s why no one wants to go near them.

  96. EG
    EG December 5, 2011 at 4:42 pm |

    Also, let me point that it is shit like this that discourages women and men in need from seeking out the help of doctors when they need it. If your best friend went into the hospital for a c-section and came out mysteriously unable to have more children and with an injured rib, neither of which she was provided with any explanation for, and the first of which she was not even told about, would you feel comfortable going there for help when you had an emergency? Or would you put off seeking medical treatment until the situation was so dire that something that might have been perfectly easily dealt with had you come in sooner was now threatening your life or that of your child?

    These doctors may think that they’ve saved one woman, but when this is their practice, God knows how many lives it’s going to cost in the long run when women and men do not consider them safe and trustworthy and respectful options.

    When it comes to motivation, sometimes it matters and sometimes it doesn’t. If someone does something to me accidentally, or in order to stop me because they have a reasonable belief that I’m threatening them or someone they love (the key word here is “reasonable”: “reasonable” does not include circumstances like “this person is black and talking to me, OMG) then, sure their reasons for harming me matter.

    If someone rapes a woman, though, I don’t give a shit whether he did it because he thought that women don’t mean it when they say “no” so it was what she really wanted, even if she wouldn’t admit it, or that raping her would turn her into a conventional, straight woman who would have a happier life, or that she was a slut so she had no right to say no. There is no excuse that mitigates the disgustingness of what he has done. As far as I’m concerned, forced sterilization, with or without the person’s consent, falls into the same category.

  97. EG
    EG December 5, 2011 at 4:43 pm |

    Heh, Helen. I swear your comment must have posted while I was typing!

  98. Helen Huntingdon
    Helen Huntingdon December 5, 2011 at 4:52 pm |

    EG, I was just laughing about us posting the same thing at the same time.

    Isn’t it hilarious in a horrible that they think the traditional healer can’t diagnose a broken rib? That they think they can just tell the woman not to worry about it, and somehow no one will figure out that they did something to her and lied about it?

    She’ll go home, the broken rib will get diagnosed and treated, and the word will spread — never go to the doctors unless you’re dying. They do things to you and don’t explain them. When this woman suddenly can’t conceive, people will remember that the doctors already did at least one thing to her and covered it up, so why would they not suspect that they did another? And the word will spread — don’t go there. They’ll sterilize you against your will.

  99. Not So Sure
    Not So Sure December 5, 2011 at 5:13 pm |

    superior olive: Is that likely? And if it is likely, why is that because she does not fully understand the implication? Really, how is this not supported by the underlying assumption that she is profoundly stupid? Because every woman I know, and especially those who’ve had children, understands fertility, and they understand that women sometimes die from childbirth/pregnancy.

    I would say it’s unlikely because of the social pressure placed on the woman. She may understand the likelihood of death and forge on ahead because she feels that she has no societal worth absent her ability to have kids. I don’t think abuse victims, for example, are profoundly stupid, but neither do I trust the legitimacy of their choices when it comes to dealing with their abusers.

    Knowing little about the culture, it’s difficult for me to strongly condemn that doctor. All things being equal, procedures without consent are violations of basic human rights, but we’re not the ones that will have to look at that woman’s dead body on our operating table in 10 months and then figure out what to do with a half dozen orphaned kids in an impoverished area. There’s a lot going on here.

  100. Politicalguineapig
    Politicalguineapig December 5, 2011 at 5:16 pm |

    LedasMom: I think you’re right, on both counts. I’ve forgotten most of my paper on eugenics, but in one of my research books, I remember finding a cute little table of genetic diseases, most of the data which I’ve forgotten. One little interesting thing that I found was that due to extensive in-group marrying, Jewish people around the world have a higher than average risk of recessive lethals being expressed.

    Even wilder; the recessive lethal is exclusive to the regional population: for example, Ashkenazi Jews have a high risk of Tay-Sachs, but Iranian Jews do not. However Iranian Jews have an entirely different recessive lethal gene in their population.

    Sorry for the derail. I just find this fascinating.

    Anyway, I do think that it’s still a question of autonomy. Even if it seems like an irresponsible decision to an outsider, a woman should be able to choose whether or not to have kids, no matter what.
    And seriously, what’s so hard about telling the woman when she came round that “Hi, you almost died on the operating table, we had to restart your heart and accidentally broke a rib. Next time you get pregnant, it might kill you. We can offer you an IUD once you heal up, or if you want a permanent fix..well, we can do that too.”

    Doesn’t seem that hard to me, but I guess they had to take their little powertrip.

  101. Li
    Li December 5, 2011 at 5:35 pm |

    Not So Sure: I would say it’s unlikely because of the social pressure placed on the woman. She may understand the likelihood of death and forge on ahead because she feels that she has no societal worth absent her ability to have kids. I don’t think abuse victims, for example, are profoundly stupid, but neither do I trust the legitimacy of their choices when it comes to dealing with their abusers.

    Knowing little about the culture, it’s difficult for me to strongly condemn that doctor. All things being equal, procedures without consent are violations of basic human rights, but we’re not the ones that will have to look at that woman’s dead body on our operating table in 10 months and then figure out what to do with a half dozen orphaned kids in an impoverished area. There’s a lot going on here.

    Siggghhhhh. So, “knowing little about the culture”, you’ve decided that it’s impossible for a woman in it to be able to exert any agency. Women, even in profoundly misogynistic cultures, have agency and the right to express that agency. In fact, I’d argue that it is even more vitalto respect the bodily autonomy of women in such circumstances. And lets not continue with this racist assumption that because we don’t have detailed information on the culture involved that they’re definately super sexist primitives who can’t express any empathy for a woman making decisions relating to her own health.

  102. matlun
    matlun December 5, 2011 at 5:36 pm |

    William: You’re arguing that one kind of sexual coercion and violence is somehow less heinous because of what was going on in the mind of the aggressor at the time.

    Isn’t that the case? The legal definition of rape includes that the aggressor understood the lack of consent (or if he should have reasonably understood it). So what goes on in the aggressors mind matters in how we judge the perpetrator. Even though it probably matters little to the level of suffering of the victim. (Admittedly I have a hard time coming up with any example beyond mens rea since I can not really come up with any kind of theoretically reasonable justification for rape).

    William: A forced sterilization is always wrong in all cases unless there is a clear and immediate threat to the life of the mother. Even then, the bare minimum requirement after the fact is to inform the patient. You’re looking for nuance where I don’t think any can be found and I think the drive to find it is downright suspect.

    When it comes to sterilization, there would always be time to seek consent. In other words, I do not see that you can justify that unless you go for the “I will do it without consent for their own good” line, which we have agreed is a failed argument.

    Generally speaking, I virtually never think it is wrong to look for nuance and to try to understand the motivations of even the worst offenders. Better understanding often makes for more effective action. (On the other hand your original analysis seemed very good, so your attitude does not appear to block your analysis. YMMV.)

  103. Li
    Li December 5, 2011 at 5:45 pm |

    To paraphrase myself from another discussion of on women and colonialism I was having: The line between women whose agency we respect enough to allow to make choices for themselves and women whose agency we do not is almost inevitably constructed on precisely the same lines that underpin the idea of the ‘West’ itself. That shit is colonialist, it is racist, and it is fucked up.

  104. matlun
    matlun December 5, 2011 at 5:47 pm |

    Politicalguineapig: One little interesting thing that I found was that due to extensive in-group marrying, Jewish people around the world have a higher than average risk of recessive lethals being expressed.

    Well, that is indeed interesting when it comes to eugenics in the sense of modern genetics. I believe it is fairly standard to go for genetic testing to avoid these diseases. See for example Dor Yeshorim.

    Anyway, the whole discussion about ethics as relating to genetic counseling and prenatal testing etc is quite a large derail…

  105. Not So Sure
    Not So Sure December 5, 2011 at 5:57 pm |

    There’s no way I can deal with all of the posts, so I will try to respond broadly.

    1) I am in no way advocating the Tanzanian doctor’s actions as “good” or “moral” or even “appropriate” given the circumstances. I think that the doctor has a duty to inform the patient, and if the patient declines the procedure, he has to live with the consequences.

    2) What I am arguing is that the doctor’s motivations (if the post is accurate), were far from the initial assumptions, which were warranted. It was not a eugenics program based on culture or race, nor does it appear to be one of class (though that’s not entirely clear). The story we were given indicates that this Tanzanian doctor sterilized the woman because he thought she would be forced into another pregnancy that would likely result in her death.

    Now, of course the validity of that factual assertion is relevant. If it’s not true and she had no risk of death or she wouldn’t have been forced into a pregnancy, then what we have is a sorry excuse from someone committing a horrible crime.

    3)

    Um what? How do you even know this? No one would “let this woman die.” We would let her wake up from her surgery, we would tell her what actually happened, and then we would give her the facts about her condition and explain that she has a 50% chance of death with the next pregnancy but she can get her tubes tied if she wants. Then we would let her choose.

    The point I was attempting to raise, and perhaps did so poorly, is that the doctor seemed to think this woman had little actual choice in these matters. Again, maybe true, maybe not, but if we’re evaluating the decision of doctor, that cultural context is important.

    If the woman could wake up, make a free choice based on the medical advice offered, and the members of her village would respect that choice, then what we have is a terrible crime committed by the doctor.

    If, however, the woman would refuse the procedure based on the same psychological process that causes victims to defend their abusers, then it’s very likely that the Tanzanian doctor saved her life.

    I don’t think that excuses the inappropriateness of the secretive procedure, but it does radically change my evaluation of the doctor.

    You’re also making a BIG assumption that the men in her village don’t care whether she lives or dies, or that her entire worth in her culture is based on how many children she has. How exactly do you know that?

    Of course, I have no idea. I’m basing it purely on the comment by Fleischman in defense of his post. Maybe he’s full of shit and trying to rationalize a thoughtless statement and toss up smoke around a possible crime, but as of yet I’ve seen nothing confirming or denying his claim.

    4)

    I am able to think women being forced to bear children when it puts their health and lives at risk AND that a doctor sterilizing said woman without her knowledge or consent are BOTH BAD THINGS.

    I agree. I also think that someone choosing between two bad outcomes should be evaluated differently than someone pursuing a horrific course of action absent any compulsion.

    Whether or not that’s the case here depends on the facts of that culture.

    5)

    To everyone who is like, “If the doctor hadn’t done this she would have died”: HOW DO YOU KNOW THAT? Really. How do you know that if offered sterilization she would have refused? How in the world do any of you know what her decision would have been?

    We don’t. We don’t even know that this was what the doctor actually thought when he performed the procedure. There are at least three levels to our evaluation of the doctor based on both the facts of the case and his subjective belief:

    1) The woman’s life isn’t at risk, the doctor knows it: the procedure is a horrific crime and he should be deprived of his ability to practice medicine.
    2) The woman’s life isn’t at risk, but the doctor earnestly believes that a) she will die if pregnant and b) she has no choice in whether or not she becomes pregnant (forced by the patriarcy): Then he’s an incompetent doctor and should be deprived of his ability to practice medicine, but is not the same moral monster we have in #1. Still clearly not a “hero.”
    3) The woman’s life is actually at risk, the doctor knows it, the doctor knows she has no autonomy moving forward: He’s a person faced with a really shitty choice that only has shitty outcomes. He, however, signed up for the job and took (I assume) the relevant oaths. He should have informed her and tried to help her as much as he could. The probably bad consequences to be dealt with.

    I don’t see any scenario where the secret sterilization was the right choice, but studying the event and the society in which it occurs does make me think more of the doctor. I see him as less a criminal or monster than as a person choosing poorly from an array of negative alternatives. That’s not a defense of the sterilization, but it is a defense of the doctor, however mild.

  106. Not So Sure
    Not So Sure December 5, 2011 at 6:01 pm |

    Siggghhhhh. So, “knowing little about the culture”, you’ve decided that it’s impossible for a woman in it to be able to exert any agency. Women, even in profoundly misogynistic cultures, have agency and the right to express that agency. In fact, I’d argue that it is even more vitalto respect the bodily autonomy of women in such circumstances. And lets not continue with this racist assumption that because we don’t have detailed information on the culture involved that they’re definately super sexist primitives who can’t express any empathy for a woman making decisions relating to her own health.

    Oh please. In my line of work I deal quite regularly with abuse victims. They’re white, sometimes they’re even nice rich people. I question the autonomy of the victims in many of those situations.

    And yes, it does matter. This is the 21st century, we should be able to understand that people (men and women) in horrible situations will defend and justify those situations because of fear and other forms of psychological compulsion. It’s always a horribly difficult prospect to figure out which cases involve coercion and which are free choices, which is why the doctor shouldn’t unilaterally impower himself with that ability, but it does matter in our evaluation of the situation.

  107. TooManyJens
    TooManyJens December 5, 2011 at 6:06 pm |

    the doctor seemed to think this woman had little actual choice in these matters

    He was right. She had none; he took it away from her.

    The blog post doesn’t give us any information whatsoever as to whether the doctor thought she would have any choice in family planning if he hadn’t sterilized her. All he was quoted as saying was, “she does not need another baby after this.” He may well have thought that she would be able to make a choice about pregnancy, but would make the “wrong” (according to him) one.

  108. Thomas MacAulay Millar
    Thomas MacAulay Millar December 5, 2011 at 6:07 pm |

    Involuntary sterilization is not actually one of those things that presents close calls. It’s one of those things so historically disastrous, oppressive and abusive that everyone in medicine — and really, everyone (and if you’re insulted by that, I meant you to be) — should know it’s always unacceptable.

  109. William
    William December 5, 2011 at 6:09 pm |

    I would say it’s unlikely because of the social pressure placed on the woman.

    So to protect her from the social pressure placed on her by a society which we consider inferior we will instead subject her to outright physical alteration without her knowledge and consent by guys who look like us and share our values. Brilliant!

    She may understand the likelihood of death and forge on ahead because she feels that she has no societal worth absent her ability to have kids.

    Good thing there are white men with power to take that terrible decision out of her hands. She is saved from the brutal oppression of the patriarchy by the kind hand of the patriarchy. Woo fucking hoo.

    . I don’t think abuse victims, for example, are profoundly stupid, but neither do I trust the legitimacy of their choices when it comes to dealing with their abusers.

    Just so we’re not confused here…you’re saying that abuse victims should have their agency taken away too? Because, and I know I only have a doctorate in clinical psychology and all so my understanding of abuse is only marginally better than that of these filthy savages who won’t stop popping out babies, from my understanding the thing which tends to most help the healing process of abuse victims is reestablishing a sense of empowerment and agency over their own lives. Again, take it with a grain of salt, its not like I’m an expert on the subject or anything…

    Knowing little about the culture,

    has not prevented you from making great judgements.

    it’s difficult for me to strongly condemn that doctor.

    Makes sense. I mean, its clear where your values lie and the man who shares them deserves the benefit of the doubt. Otherwise there’d be darkness, right?

    All things being equal,

    but some being more equal than others,

    procedures without consent are violations of basic human rights,

    I smell a “but” coming…

    but we’re not the ones that will have to look at that woman’s dead body on our operating table in 10 months and then figure out what to do with a half dozen orphaned kids in an impoverished area.

    EQUIVOCATION BINGO!

    Seriously, though, you’re putting a lot of stock in prognostication. Also, not to be obvious or anything, half a dozen orphaned kids in an impoverished area is a tragedy, not a justification for violating their mother’s body.

    There’s a lot going on here.

    You do seem invested in that idea, don’t you. Truthfully, I agree. I just think the “a lot” is less in the story and more in the desperate reactions from people like you.

  110. librarygoose
    librarygoose December 5, 2011 at 6:11 pm |

    @ Not So Sure
    I understand what you’re saying. For some women the chance for schooling isn’t there, the men of the culture don’t respect them. They will end up the abused wives of older men. For these women it is in their best interest if we limit how many kids they can have, and if need be take the kids they have away so they can be properly cared for. They can’t possibly be expected to have the understanding of choice that we have…WAIT A SECOND. I forgot I was posting justifications for eugenics and colonialism…not a fucking cogent argument. This shit is not new. What you are saying is not new. It is still wrong, will always be wrong and is never justifiable. Not even a little.

  111. EG
    EG December 5, 2011 at 6:16 pm |

    Not So Sure: The story we were given indicates that this Tanzanian doctor sterilized the woman because he thought she would be forced into another pregnancy that would likely result in her death.

    No. He sterilized her because he thought she wasn’t qualified to make the decision about whether or not she wanted to risk her life (if his assessment of the risk was accurate) herself. That’s the issue.

    Not So Sure: the doctor seemed to think this woman had little actual choice in these matters.

    The doctor didn’t say this at all. He said “I do not think she needs to have any more children.” That doesn’t indicate that he thinks she had little actual choice. It indicates that he doesn’t give a shit about her choice.

  112. William
    William December 5, 2011 at 6:28 pm |

    Matlun

    Isn’t that the case? The legal definition of rape includes that the aggressor understood the lack of consent (or if he should have reasonably understood it). So what goes on in the aggressors mind matters in how we judge the perpetrator.

    You’re lawyering. I’m not talking about what you would use to convict in a court and we both know theres no convincing argument for the doctor here to be incompetent.

    Still, lets run with this. Say you’ve got a situation where someone is unaware of a lack of consent. That state of mind is utterly irrelevant when it comes to justification for lethal force to prevent the assault. What you’re talking about is how and where we decide to punish someone after the fact, not the importance of justifications. A forced sterilization, by it’s very nature, is too complicated a process to really be possible in the absence of competency. Unless you’re arguing that dangerous narcissism might somehow absolve a doctor or some blame which simple racism would not.

    Admittedly I have a hard time coming up with any example beyond mens rea since I can not really come up with any kind of theoretically reasonable justification for rape

    I feel the same way about forced sterilization. Thats my issue. We can split hairs about whether a Tanzanian doctor with a boatload of arrogance is somehow less evil than a white purity eugenicist but even the rosiest of motivations land someone so far into the monster territory that I have to wonder what the point is. For my part, I kinda hope this story gets out and all the doctors get named. Maybe the doc in Tanzania will run into his victim’s family and stop being a threat, maybe Fleischman will have to stay in the west.

    Generally speaking, I virtually never think it is wrong to look for nuance and to try to understand the motivations of even the worst offenders.

    Understanding motivation is not the same thing as hierarchizing is. Understanding why someone would do something monstrous is almost always valuable. Saying “this monster is less monstrous than that” strikes me as too close to forgiveness.

    Not So Sure

    Oh please. In my line of work I deal quite regularly with abuse victims. They’re white, sometimes they’re even nice rich people. I question the autonomy of the victims in many of those situations.

    And what line of work is that? I work with a lot of abuse victims and questioning their autonomy has almost always ended up being a bad thing because they know things which I do not and they have values which are different from mine. They are not children to be saved (even when they are actually children) but human beings to be supported. Hell, if I were your supervisor you’d be looking at remediation if I ever saw even a whiff of coercion coming from your internal questioning of your clients autonomy. At minimum.

    In the future I’d caution you against trying to whip out your credentials to silence someone else here because I’m far from the only person on feministe equipped to call your bluff.

  113. Not So Sure
    Not So Sure December 5, 2011 at 6:33 pm |

    If you read the comment section to the post, I guess it’s down now, Fleisxhman claims the woman would have little choice in whether or not she became pregnant. He further states that the men in the culture only value women in so far as they are able to produce children.

    Maybe it’s true, maybe it isn’t, but it’s an important claim to the story.

    So to protect her from the social pressure placed on her by a society which we consider inferior we will instead subject her to outright physical alteration without her knowledge and consent by guys who look like us and share our values. Brilliant!

    Good thing there are white men with power to take that terrible decision out of her hands. She is saved from the brutal oppression of the patriarchy by the kind hand of the patriarchy. Woo fucking hoo.

    What are you off on? Recall again which doctor performed the procedure. It’s amusing how alluring it is for you to rail against the idea of racial eugenics even though the story expressly rejects it.

    Unless you think the doctor was such a simple savage that he had no choice but to act at the behest of his colonial master.

    The decision was not immunized from criticism because it was performed by a Tanzanian doctor, but it does mean that it wasn’t an act of a white westerner.

    Just so we’re not confused here…you’re saying that abuse victims should have their agency taken away too? Because, and I know I only have a doctorate in clinical psychology and all so my understanding of abuse is only marginally better than that of these filthy savages who won’t stop popping out babies, from my understanding the thing which tends to most help the healing process of abuse victims is reestablishing a sense of empowerment and agency over their own lives. Again, take it with a grain of salt, its not like I’m an expert on the subject or anything…

    Yes, I am arguing that it was, for example, a good decision to stop relying on victims to press charges in order to pursue abuse crimes. That elimination of agency has had a very positive effect.

    But, of course, you’re running with the analogy because you’re so excited about arguing. With your cool degree surely you understand that there are various forms of psychological coercion, and those forms of coercion can restrict the free choice of parties subject to the negative influence.

    Makes sense. I mean, its clear where your values lie and the man who shares them deserves the benefit of the doubt. Otherwise there’d be darkness, right?

    Right, because a Tanzanian doctor secretly sterilized a Tanzanian woman, therefore…RACISM. Haha, “dark.” In bold, too. That’s good work.

    EQUIVOCATION BINGO!

    I don’t think that word means what you think it means…

    Seriously, though, you’re putting a lot of stock in prognostication. Also, not to be obvious or anything, half a dozen orphaned kids in an impoverished area is a tragedy, not a justification for violating their mother’s body.

    Kindly quote anything I’ve written where I’ve argued that the act was “justified.” I remember your helpful lecture on the specificity of language, so surely such a strong claim can be supported by available evidence.

    To be clear (though you will ignore this as easily as you ignore the race of the doctor that performed the sterilization), I don’t think the act was “justified” or “right,” I think it was the result of a doctor choosing between many negative options. This doesn’t make the action correct, but it does make it less than Hitler-ish.

    I forgot I was posting justifications for eugenics and colonialism…not a fucking cogent argument. This shit is not new. What you are saying is not new. It is still wrong, will always be wrong and is never justifiable. Not even a little.

    You are correct. Eugenics are never justifiable (though it seems like we could use a little selective breeding for reading comprehension skills). That’s not what we’re dealing with, however.

  114. Not So Sure
    Not So Sure December 5, 2011 at 6:35 pm |

    And what line of work is that? I work with a lot of abuse victims and questioning their autonomy has almost always ended up being a bad thing because they know things which I do not and they have values which are different from mine. They are not children to be saved (even when they are actually children) but human beings to be supported. Hell, if I were your supervisor you’d be looking at remediation if I ever saw even a whiff of coercion coming from your internal questioning of your clients autonomy. At minimum.

    So, in order to “question” their autonomy, I have to directly confront them and tell them they’re being irrational? Or can I “question” their autonomy by doubting it?

    There’s a reason we stopped giving people the choice of pressing charges against their abusers, why was that?

  115. Not So Sure
    Not So Sure December 5, 2011 at 6:39 pm |

    Or to be more accurate, stopped solely relying upon the choice of victim when deciding to pursue and prosecute abuse cases.

  116. Shoshie
    Shoshie December 5, 2011 at 6:42 pm |

    Politicalguineapig: Ashkenazi Jews have a high risk of Tay-Sachs

    Actually, I believe that the Ashkenazi population now has about the same incidence of Tay-Sachs as the general population due to extensive genetic testing.

    \derail

    Also, Not Sure and deb made me kind of nauseous.

  117. Brian Schlosser
    Brian Schlosser December 5, 2011 at 6:49 pm |

    Jill: Because having a cracked rib can really hurt, and she could injure herself further, and it’s an important part of her medical history.

    Oh, yeah. They should have told her, of course. But when I was reading it, I didn’t see that they DIDN’T tell her. But yeah, given Das Wunderdoktors cavalier attitude towards the woman overall, they probably didn’t tell her.

    SeteSois: Holy hell. Can you link this? Google’s not being useful.

    Here it is. Warning: the page has a video of the “branding” being performed. Go Wildcats? Disgusting. The doctor also was sued for performing unnecessary hysterectomies.

    Also, I have not yet heard anything back from the Clinton Foundation in response to my email. Has anyone else heard from them or any of Dr Dillweed’s other employers?

  118. superior olive
    superior olive December 5, 2011 at 6:52 pm |

    I don’t think abuse victims, for example, are profoundly stupid, but neither do I trust the legitimacy of their choices when it comes to dealing with their abusers.

    OK, then, I guess profoundly stupid was the right word choice after all…though in a different way than I originally used it. In case you were curious about what abuse looks like fromthe inside, it might be useful to know that women are at highest risk of being killed by their abusers when they are in the process of leaving, or immediately after. So that “choice” that looks like deciding between violence and freedom is actually a choice between living and dying or even greater violence.

  119. EG
    EG December 5, 2011 at 7:02 pm |

    Not So Sure: Fleisxhman claims the woman would have little choice in whether or not she became pregnant. He further states that the men in the culture only value women in so far as they are able to produce children.

    Given that he had never met, let alone spoken to in depth, the woman in question prior to cutting her abdomen open, I’m going to go ahead and guess that he had absolutely no way of knowing whether this was true in her particular case. A human being is not a conglomeration of averages and likelihoods. She is an individual in a particular situation, and her particular situation may vary hugely from Fleischman’s assessment of the typical attitudes, or it may match it perfectly, or it may fall somewhere in the middle. Only she has the inside scoop on what her situation, relationship with the men in her life, position in her community, feeling about her health is, and she wasn’t even consulted about this violation.

    I know it’s hard to believe that even in patriarchal societies that deeply and cruelly disempower women based on their sex, individual women do and have lead lives with men who loved and valued them, but it is nonetheless the case. I can think of several examples from nineteenth- and early twentieth-century England and US, for instance.

    Not So Sure: Yes, I am arguing that it was, for example, a good decision to stop relying on victims to press charges in order to pursue abuse crimes. That elimination of agency has had a very positive effect.

    Oddly enough, pressing charges has nothing to do with those victims’ control over their own bodies. It has to do with the relationship between the state and the violent abuser.

    Not So Sure: Or to be more accurate, stopped solely relying upon the choice of victim when deciding to pursue and prosecute abuse cases.

    Ah, yes. That does make all the difference, doesn’t it? So not only does your analogy have nothing to do with the body of the victim of abuse, but it doesn’t even actually discount her opinion. Great analogy you’ve got there. It’s a shame it doesn’t have much to say to the situation currently under discussion. By the way, how often does the state pursue and prosecute abuse cases not only without the abuse victim’s consent, but also without her knowledge? I’m just curious, here.

    Not So Sure: Eugenics are never justifiable (though it seems like we could use a little selective breeding for reading comprehension skills). That’s not what we’re dealing with, however.

    See, some women aren’t competent to decide for themselves about, or even to be informed of, their fertility. By a remarkable coincidence, those women are of lower social, physical, and financial power than the men making the decisions about sterilizing them without their consent or approval. How could anybody possibly confuse that with eugenics? Why, it’s an entirely different thing! It’s a kindness, really. I mean, doesn’t everybody know that eugenicists rub their hands together while cackling aloud and saying things like “And now I shall do a terrible and invasive thing, all in my quest to destroy people’s happiness!”? If you don’t think you’re doing a bad thing, it can’t possibly be eugenics.

    Don’t make me laugh. Or sick.

  120. EG
    EG December 5, 2011 at 7:04 pm |

    Brian Schlosser: Oh, yeah. They should have told her, of course. But when I was reading it, I didn’t see that they DIDN’T tell her. But yeah, given Das Wunderdoktors cavalier attitude towards the woman overall, they probably didn’t tell her.

    Yeah, when she woke up she asked about the pain in her chest, and the good doctor told her “not to worry about it.” And that was the sum total of the information she was given.

  121. Not So Sure
    Not So Sure December 5, 2011 at 7:08 pm |

    superior olive:
    OK, then, I guess profoundly stupid was the right word choice after all…though in a different way than I originally used it. In case you were curious about what abuse looks like fromthe inside, it might be useful to know that women are at highest risk of being killed by their abusers when they are in the process of leaving, or immediately after. So that “choice” that looks like deciding between violence and freedom is actually a choice between living and dying or even greater violence.

    I suppose I’m failing to express myself well, but that’s a very powerful explanation of the exact point I was attempting to make.

    If a person has evidence or even a good suspicion that a friend, family member, or acquaintance is suffering from abuse, it isn’t sufficient to simply ask that person about it. It isn’t that the victim is too stupid to understand what’s going on, it’s that they’re acting under extreme coercion.

    Likewise, I don’t think the Tanzanian woman was too stupid to understand the implications of a high risk pregnancy, but given what was described by Fleischman in the follow up to the post (that is now gone because it was taken down–the cached version doesn’t have the full comments), it may be the case that when confronted with the reality of the situation and the proposed procedure she would turn it down, not because she honestly didn’t think it was right for her or that she wanted to consciously assume the risk, but because she was operating under social coercion. Furthermore, the doctor seemed to believe that the men in her village only valued her for procreation and would force her into pregnancy even if they knew the risk.

    Once again, that doesn’t justify the secret sterilization or make it the right choice, but it does change my impression of the doctors. I don’t think they’re the world’s greatest villains, I think they’re people who chose poorly from a set of poor outcomes. That is not an excuse, simply an evaluation that they’re guilty of manslaughter, not first degree murder.

  122. Dao
    Dao December 5, 2011 at 7:11 pm |

    I don’t think abuse victims, for example, are profoundly stupid, but neither do I trust the legitimacy of their choices when it comes to dealing with their abusers.

    So much rage. Others have said it already but…as an abuse victim I still cannot respond to this with anything more logically thought out than: “Fuck you!”

  123. Not So Sure
    Not So Sure December 5, 2011 at 7:14 pm |

    So much rage. Others have said it already but…as an abuse victim I still cannot respond to this with anything more logically thought out than: “Fuck you!”

    “Legitimacy” was poor word choice. I sincerely apologize for that, I saw how it sounded re-reading. I’d edit it if I could.

  124. EG
    EG December 5, 2011 at 7:17 pm |

    Not So Sure: If a person has evidence or even a good suspicion that a friend, family member, or acquaintance is suffering from abuse, it isn’t sufficient to simply ask that person about it.

    Really? So the friend, family member, or acquaintance should…do what, precisely? Something that removes autonomy from the person suffering abuse and further wrest control of her body from her?

  125. Not So Sure
    Not So Sure December 5, 2011 at 7:26 pm |

    Given that he had never met, let alone spoken to in depth, the woman in question prior to cutting her abdomen open, I’m going to go ahead and guess that he had absolutely no way of knowing whether this was true in her particular case. A human being is not a conglomeration of averages and likelihoods. She is an individual in a particular situation, and her particular situation may vary hugely from Fleischman’s assessment of the typical attitudes, or it may match it perfectly, or it may fall somewhere in the middle. Only she has the inside scoop on what her situation, relationship with the men in her life, position in her community, feeling about her health is, and she wasn’t even consulted about this violation.

    He also wasn’t the one the performed the procedure. I agree that the correct answer was to obtain consent and if it was denied, not perform the procedure. According to people who have spent a great deal of time more in that culture than I have, this carried a significant risk of 1) a pregnancy generated independently of the will of the woman and 2) death as a result.

    Obviously if that isn’t true, it changes any evaluation of the procedure.

    I know it’s hard to believe that even in patriarchal societies that deeply and cruelly disempower women based on their sex, individual women do and have lead lives with men who loved and valued them, but it is nonetheless the case. I can think of several examples from nineteenth- and early twentieth-century England and US, for instance.

    Ok, that’s a risk worth taking. Again, the point is not to argue that this should be common operating procedure, but you don’t evaluate a doctor differently for thinking that he was saving a life vs. crowd control? I find motive to be important, clearly you disagree, but that’s the argument, not whether such a procedure was justified or should be common, accepted practice.

    Ah, yes. That does make all the difference, doesn’t it? So not only does your analogy have nothing to do with the body of the victim of abuse, but it doesn’t even actually discount her opinion. Great analogy you’ve got there. It’s a shame it doesn’t have much to say to the situation currently under discussion. By the way, how often does the state pursue and prosecute abuse cases not only without the abuse victim’s consent, but also without her knowledge? I’m just curious, here.

    It very well can discount a victims opinion. I’ve watched victims take the stand to defend their abusers. As you point out, that opinion is no longer necessary to the prosecution of an abuser. I think we can all view this as an important step forward, and the basis of that move lies in understanding the nature of coercion.

    Obviously the analogy isn’t a 1:1 comparison. They rarely are. The point is simply that the Tanzanian woman may not be giving a free choice when asked her opinion of sterilization. She may have chosen to forgo the procedure out of fear and been dead in 10 months, certainly that appears to be what the doctor thought.

    This doesn’t make the secret sterilization correct, but it does paint a very different picture of the doctor’s motives.

    See, some women aren’t competent to decide for themselves about, or even to be informed of, their fertility. By a remarkable coincidence, those women are of lower social, physical, and financial power than the men making the decisions about sterilizing them without their consent or approval. How could anybody possibly confuse that with eugenics? Why, it’s an entirely different thing! It’s a kindness, really. I mean, doesn’t everybody know that eugenicists rub their hands together while cackling aloud and saying things like “And now I shall do a terrible and invasive thing, all in my quest to destroy people’s happiness!”? If you don’t think you’re doing a bad thing, it can’t possibly be eugenics.

    If the primary goal of the Tanzanian doctor was population control or to stop that woman from breeding, then we have a seriously wrong act, regardless of the motivation. If the primary goal was to save the woman’s life because the doctor living in that culture understood what would happen, then we have an inappropriate but not evil act.

    That’s the extent of my defense. I see little evidence of eugenics, save we contort the meaning of the word.

  126. Li
    Li December 5, 2011 at 7:27 pm |

    Not So Sure: Oh please. In my line of work I deal quite regularly with abuse victims. They’re white, sometimes they’re even nice rich people. I question the autonomy of the victims in many of those situations.

    And yes, it does matter. This is the 21st century, we should be able to understand that people (men and women) in horrible situations will defend and justify those situations because of fear and other forms of psychological compulsion. It’s always a horribly difficult prospect to figure out which cases involve coercion and which are free choices, which is why the doctor shouldn’t unilaterally impower himself with that ability, but it does matter in our evaluation of the situation.

    Except that you don’t presume, in the absence of evidence, that any given white, western woman is incapable of agency because of social pressure. You appear to be comfortable making that assumption about a subaltern woman though. Which, again, is kindareally racist.

  127. Not So Sure
    Not So Sure December 5, 2011 at 7:33 pm |

    Really? So the friend, family member, or acquaintance should…do what, precisely? Something that removes autonomy from the person suffering abuse and further wrest control of her body from her?

    Is that a serious question?

    Family member shows up with blackened eyes and bruised arms, you ask, “what happened?”
    They say, “Nothing, I fell.”
    You say, “Oh, that makes sense. I guess I don’t have to worry about that any more.”

    From this site:

    If you blame someone for “going back” to a violent situation, you are excusing violence against women.

    http://www.feministe.us/blog/archives/2011/11/25/white-ribbon-day/

    Hey, they chose to go back, I guess any further action I take would be removing their autonomy. Honestly, what are we arguing about right now?

  128. EG
    EG December 5, 2011 at 7:35 pm |

    Not So Sure: If the primary goal of the Tanzanian doctor was population control or to stop that woman from breeding, then we have a seriously wrong act, regardless of the motivation. If the primary goal was to save the woman’s life because the doctor living in that culture understood what would happen, then we have an inappropriate but not evil act.

    He sterilized her without her consent. If the primary goal was not to stop her from breeding, it’s a hell of a side effect. And the doctor’s culture is irrelevant. Plenty of eugenics efforts were directed at people of the same national/ethnic/cultural background as the eugenics advocates. They were just directed at poorer, less valued members of that society. That did not make them any less evil.

    Performing surgery on a woman without her consent or knowledge is an evil act. How the actor justifies it to himself is irrelevant.

  129. lyn
    lyn December 5, 2011 at 7:36 pm |

    OK – so it was a Tanzanian doctor who actually performed the non-consensual sterilisation. One handed because his other hand was injured. While she was dying. And the white doctor there said the guy was a HERO for doing it. That’s fucked. That’s colonialist and racist. Seriously – they were saving her life from future pregnancies by performing surgery on her while she was undergoing CPR, while she’s moving a lot on the table…does that not sound like risking her life in the moment of the surgery in order to save her from maybe-death later on? That’s bullshit. And, the only reason for performing that surgery under those circumstances (while undergoing CPR) would be about taking advantage of her unconscious state and doing it without her knowledge. Like, seriously, he couldn’t have tied her tubes 5 seconds later while she was awake and breathing and still?

  130. Not So Sure
    Not So Sure December 5, 2011 at 7:37 pm |

    Except that you don’t presume, in the absence of evidence, that any given white, western woman is incapable of agency because of social pressure. You appear to be comfortable making that assumption about a subaltern woman though. Which, again, is kindareally racist.

    The claim comes from a Tanzanian doctor as reported by Fleischman. Maybe they’re lying, I don’t know, but my assumptions are not the source.

  131. EG
    EG December 5, 2011 at 7:39 pm |

    Not So Sure: Is that a serious question?

    Yes. It is. What, precisely, do you advocate? I have written, on numerous threads on this website, of what I decided to do when a friend of mine found herself in an abusive relationship. I’m curious to know what you think I should have done? Locked her in my apartment against her will in order to prevent her from going back?

    Not So Sure: Hey, they chose to go back, I guess any further action I take would be removing their autonomy. Honestly, what are we arguing about right now?

    So you see the range of possible actions in such a situation as an easily deflected question or forcibly removing the woman from her situation against her will and holding her?

  132. Not So Sure
    Not So Sure December 5, 2011 at 7:44 pm |

    He sterilized her without her consent. If the primary goal was not to stop her from breeding, it’s a hell of a side effect. And the doctor’s culture is irrelevant. Plenty of eugenics efforts were directed at people of the same national/ethnic/cultural background as the eugenics advocates. They were just directed at poorer, less valued members of that society. That did not make them any less evil.

    Performing surgery on a woman without her consent or knowledge is an evil act. How the actor justifies it to himself is irrelevant.

    You cannot simultaneously argue that the doctor’s motivation justifies a charge of supporting eugenics and argue that you don’t give a shit about his motivation. If you hold him guilty of supporting eugenics, then you’re directly analyzing his justifications and the reasons behind his decision.

    Eugenics is the “applied science or the bio-social movement which advocates the use of practices aimed at improving the genetic composition of a population”

    http://en.wikipedia.org/wiki/Eugenics

    This is how I understand Eugenics. I see no evidence that this doctor’s goal was to improve the genetic composition of the population.

    The lack of consent, alone, is a crime and a civil wrong (depending on the legal system), but that doesn’t necessarily lead to a conclusion of supporting eugenics.

  133. Not So Sure
    Not So Sure December 5, 2011 at 7:54 pm |

    Yes. It is. What, precisely, do you advocate? I have written, on numerous threads on this website, of what I decided to do when a friend of mine found herself in an abusive relationship. I’m curious to know what you think I should have done? Locked her in my apartment against her will in order to prevent her from going back?

    What do I precisely advocate in a situation I know nothing about? Magic. That would probably solve it.

    Different events will have different prescriptions, and sometimes there’s nothing that can be done to resolve the issue. That doesn’t mean nothing should be attempted. But you already know this, probably much better than I do. We’re just doing the Gish Gallop right now.

    So you see the range of possible actions in such a situation as an easily deflected question or forcibly removing the woman from her situation against her will and holding her?

    Huh? The range of “possible” actions is the range of “possible” actions. I assume you meant the range of “acceptable” or “advisable” actions. And no, I do not see the supplanting of a woman’s will as an acceptable solution.

    But notice the difference between these two acts:

    1) A locks B in the closet because B was going home and would likely be severely abused.
    2) A locks B in the closet to abuse B.

    In neither situation is the involuntary imprisonment legal or right or justified, but certainly our evaluation of A as a person changes.

    Likewise, under no circumstances is the secretive sterilization legal or right or justified, but given the doctor’s motivation, we should view him differently as a moral actor.

  134. EG
    EG December 5, 2011 at 7:56 pm |

    Not So Sure: You cannot simultaneously argue that the doctor’s motivation justifies a charge of supporting eugenics and argue that you don’t give a shit about his motivation. If you hold him guilty of supporting eugenics, then you’re directly analyzing his justifications and the reasons behind his decision.

    Actually, I can. I can argue both that as far as I am concerned, that crap on my floor looks, feels, and smells enough like shit for me to classify it as shit, and say that it doesn’t matter whether or not it actually emerged from someone’s rectum, as it is a disgusting thing to leave on the floor nonetheless.

    Similarly, I can, and do argue both that deciding that this particular woman shouldn’t breed any further counts as eugenics as far as I’m concerned, and that whether or not it meets Wikipedia’s definition doesn’t fucking matter, because he has done something inherently evil

  135. William
    William December 5, 2011 at 7:57 pm |

    The decision was not immunized from criticism because it was performed by a Tanzanian doctor, but it does mean that it wasn’t an act of a white westerner.

    Its not the white nor the western which matters so much (although theres an argument to be made about the flow of ideas about forcible sterilization) as the power. An way you slice it you end up with people in positions of relative power deciding that their opinion trumps the agency of someone with less power. Dance all you want, but you can’t really get away from that.

    Yes, I am arguing that it was, for example, a good decision to stop relying on victims to press charges in order to pursue abuse crimes. That elimination of agency has had a very positive effect.

    In my experience a good clinician and a good clinical relationship can generally bring a patient to a place where they choose to press charges, an act which tends to be enormously empowering and healing. Hell, I’ve done that in the last 60 days. What you’re talking about is harm reduction without much of an eye towards recovery.

    I mean, abuse comes down to elimination of agency. It comes down to someone treating you in a given way because they have the power and you cannot stop them. Eliminating agency might suspend the abuse, but it reenacts the fundamental messages which many abuse victims receive that lead you to decide they don’t deserve their agency anymore.

    But, of course, you’re running with the analogy because you’re so excited about arguing. With your cool degree surely you understand that there are various forms of psychological coercion, and those forms of coercion can restrict the free choice of parties subject to the negative influence.

    Someone get Not So Sure some pearls to clutch, it seems I’ve become hysterical and shown some dangerous passion. Better grab the salts too, lest I have an attack of the vapors.

    Sure, coercion can restrict choice. The solution to that generally isn’t better coercion. Given your arguments thus far, though, I suspect you’d have trouble understanding why benevolent oppression isn’t wonderful next to malevolent oppression.

    Kindly quote anything I’ve written where I’ve argued that the act was “justified.” I remember your helpful lecture on the specificity of language, so surely such a strong claim can be supported by available evidence.

    Lets go back to the tape:

    Again, not arguing that the sterilization was “good,” but I would be curious if someone could diagram a “good” option that doesn’t depend on fairy dust and dreams.

    So you say the sterilization wasn’t good, but then frame any good option as being illusory. Sounds like “best of a bad lot” to me. Maybe I’m wrong, maybe Im just reading too much in. I doubt I’ll find another example in the same…

    It’s the quick decision of a doctor who works for $150 a month and understands the subtleties of his culture in a way we don’t.

    Well fuck. Now we’ve got “good” options all being bullshit and people criticizing the sterilization lacking understanding. Which, of course, tends to suggest that people arguing against the sterilization are wrong and the doctors are operating in a gray area. Justification? Not quite, but I suppose its the best of a bad set of options.

    If, however, the woman would refuse the procedure based on the same psychological process that causes victims to defend their abusers, then it’s very likely that the Tanzanian doctor saved her life.

    All this “I don’t support the sterilization but I understand the doctor” shit smells like conservative christians with their “love the sinner hate the sin” trope. When you defend the doctor, however mildly, you’re offering justification in the face of a culture which you find more offensive.

    There’s a reason we stopped giving people the choice of pressing charges against their abusers, why was that?

    Not in my neck of the woods we haven’t. Hell, where I live victims still generally have to fight for their cases to be prosecuted.

  136. EG
    EG December 5, 2011 at 8:05 pm |

    Not So Sure: But notice the difference between these two acts:

    1) A locks B in the closet because B was going home and would likely be severely abused.
    2) A locks B in the closet to abuse B.

    In neither situation is the involuntary imprisonment legal or right or justified, but certainly our evaluation of A as a person changes.

    Actually, there are a few questions that need to be asked here. Has A ever met or spoken to B? Does A know that B is being abused, or is A just basing that opinion on who B is and where she lives? Has A tried anything else to help B, anything that respects B’s agency? What are B’s reasons for going back to the abuser? How can they be addressed?

    If A has never bothered to consider these questions, and the answer to the first three are no, the latter, and no, then A is no better than an abuser no matter what his/her reasons are.

  137. Not So Sure
    Not So Sure December 5, 2011 at 8:07 pm |

    All this “I don’t support the sterilization but I understand the doctor” shit smells like conservative christians with their “love the sinner hate the sin” trope. When you defend the doctor, however mildly, you’re offering justification in the face of a culture which you find more offensive.

    What utter nonsense. Defending is not offering justification. When I argue that, in fact, A did not lie in wait and murder B in cold blood, that instead he was carelessly playing with a firearm, that’s not a justification, it’s an explanation of motive. That’s the extent of my defense of this doctor.

    It was enjoyable to see you strain to piece together some combination of posts to validate your claim that I argued the sterilization was justified. I do have a great deal of sympathy for that doctor (if he was acting out of concern for that woman’s life–if not, fuck him). He was forced to act in a universe of shitty options. I have pointed out multiple times that this doesn’t excuse or make the act correct, but it does mean we’re dealing with something less that a Tanzanian Nazi.

    To be clear, I have more sympathy for the woman. She was wronged. The doctor did not behave appropriately, and she should have some redress. It was battery.

  138. EG
    EG December 5, 2011 at 8:08 pm |

    Oh, and are there any reasons known to B but not A that would militate against locking the closet in a big way, such as claustrophobia? If the answer is “yes” or “maybe” or “I don’t know,” that also makes A nothing more than an abuser.

  139. EG
    EG December 5, 2011 at 8:09 pm |

    Not So Sure: To be clear, I have more sympathy for the woman. She was wronged. The doctor did not behave appropriately, and she should have some redress. It was battery.

    Do you not find it wildly embarrassing that it’s taken you this many posts to clarify your position on this, and that it’s a position you actually need to clarify? Do you not see what that suggests about the rest of your posts?

  140. Not So Sure
    Not So Sure December 5, 2011 at 8:12 pm |

    Actually, there are a few questions that need to be asked here. Has A ever met or spoken to B? Does A know that B is being abused, or is A just basing that opinion on who B is and where she lives? Has A tried anything else to help B, anything that respects B’s agency? What are B’s reasons for going back to the abuser? How can they be addressed?

    If A has never bothered to consider these questions, and the answer to the first three are no, the latter, and no, then A is no better than an abuser no matter what his/her reasons are.

    Sure, obviously the degree to which the doctor’s decision was based on good evidence will directly correlate with his moral responsibility and the wrongness of the act. If he’s full of shit, then that’s that. He’s a monster.

    If, however, the decision was made based on specific knowledge, which they might have had, they clearly knew something of her history, how many kids she had…, then it changes my evaluation of the doctor.

    We have nothing more than the skeleton of the story based on that blog post—by a visiting doctor, by the way. Fleischman knew nothing about that area, we’re getting the story through his eyes. Maybe the doctor knew a lot, maybe he knew nothing. My opinion of him will change based upon the facts. My assessment of him is purely conditional.

  141. Not So Sure
    Not So Sure December 5, 2011 at 8:14 pm |

    Do you not find it wildly embarrassing that it’s taken you this many posts to clarify your position on this, and that it’s a position you actually need to clarify? Do you not see what that suggests about the rest of your posts?

    Sure, you’re welcome to criticize my strategy. That wasn’t the point at issue, so I didn’t raise it. I don’t doubt that this was a poor choice in retrospect.

  142. Not So Sure
    Not So Sure December 5, 2011 at 8:17 pm |

    Similarly, I can, and do argue both that deciding that this particular woman shouldn’t breed any further counts as eugenics as far as I’m concerned, and that whether or not it meets Wikipedia’s definition doesn’t fucking matter, because he has done something inherently evil

    I should have added the word “cogently.”

  143. EG
    EG December 5, 2011 at 8:17 pm |

    Not So Sure: What’s wrong with you? You would just let this woman die because the men in her village don’t care whether she lives or dies, just that she produces more children?

    This sure sounds like a justification and defense of the doctor’s actions to me, by the way.

  144. Not So Sure
    Not So Sure December 5, 2011 at 8:19 pm |

    This sure sounds like a justification and defense of the doctor’s actions to me, by the way.

    Read the post immediately before that one. It will explain the nature of that statement.

    I replied to a strawman with a strawman.

  145. EG
    EG December 5, 2011 at 8:31 pm |

    Not So Sure: If, however, the decision was made based on specific knowledge, which they might have had, they clearly knew something of her history, how many kids she had…, then it changes my evaluation of the doctor.

    So…Fleischman calls this doctor a “hero,” and when called on the disgustingness of what he did, doesn’t say “Oh, but this doctor had been treating this woman for many years, and had spoken to her many times about her life and knew that she was victim of an abusive rapist of a husband who didn’t care whether she lived or died, but that she was too scared to get sterilized.” Instead, he deletes the post. Tell me…why do you think he would do that if the doctor in question had had any contact with the woman before? Why wouldn’t he mention that? Perhaps because it never happened.

    You are giving this doctor massive benefit of the doubt for reasons that are completely unclear. Most of us are not giving him any benefit of the doubt, because at no point in human history has sterilizing people without their consent or knowledge ever turned out well. We have plenty of examples, and not one is positive.

    Not So Sure: I should have added the word “cogently.”

    I don’t think you understand what that means. These are two separate answers to two separate questions.

    Question 1: Does what this doctor did count as “eugencics”?
    Question 2: Does whether or not it counts as eugenics matter when it comes to his moral culpability?

    The answer to #2 is completely indifferent to the answer to #1. There are four possible combinations of answers, and all are perfectly…cogent.

    1) Yes, this counts as eugenics, and yes, it makes a moral difference that it does.
    2) Yes, this counts as eugenics, and no, it doesn’t make a moral difference that it does. (This is my position.)
    3) No, this does not count as eugenics, and yes, it makes a moral difference that it does. (This seems to be your position.)
    4) No, this does not count as eugenics, and no, it does not make a moral difference.

    Similarly, you can ask two questions:

    1) Does this animal have four legs? (Is the act eugenics?)
    2) Does having four legs mean that it is a dog? (Does being eugenics mean that the act is morally worse?)

    One can argue that yes, the animal has four legs, and no, that doesn’t mean it is a dog. Not only is this a cogent argument to make, but it happens to be the correct one.

    If you are still having difficulty understanding that these two questions and thus their answers are not interdependent, please go back and repeat the logic unit in your high-school mathematics class. Or, perhaps more productively, take the one in my old high-school mathematics class.

  146. J
    J December 5, 2011 at 9:08 pm |

    Not So Sure decoded: It’s not that bad! Really! He meant well! Can’t you just stop beating up on the poor doctor who sterilized a woman without her consent and did not tell her about it just wanted to help with his infinite male-doctor wisdom?

    Because intent, you know, is fucking magic, and the precise degree of just how much of a monster the doctor is matters so much more than what he did to the woman and her pain resulting from that deed. I mean, obviously.

    @Not So Sure: you seriously need to step back and ask yourself why people here are not impressed by your increasingly straining efforts to defend a monstrous violation and the man who committed it. Hint: beyond the broad patterns of colonialism and eugenics that the deed fits into (and seriously, why do you want to march back and forth around the borders of defending shit that stinks even remotely like that?), it just might have something to do with the fact that you are expending an enormous amount of energy attempting to center the conversation on the doctor and away from his victim, once again disregarding her situation and suffering in favor of making sure we’re being nice fair to the privileged asshat who violated her. The overwhelming concern you have invested in making sure that this asshat’s reputation is not tarnished one iota past what you deem an acceptable amount, when that iota is so negligible in comparison to just how far you do admit he strayed over the boundary, says something. Perhaps it would not be utterly out of place and fuck-headed in the context of an extended philosophical debate over determining every fine nuance of moral judgment, ever. Perhaps. (Although IMHO it’d still be pretty fuck-headed and wrong.) But in terms of dealing with actual people who were actually hurt, it’s pretty damned heartless. And to repeatedly and consistently recenter this tiny shaving of moral nuance as if it were The Most Important Thing about this case, thereby minimizing and decentering the suffering of the woman who was his victim, well, that says a lot more. Especially considering how very fucking often women like this are decentered and erased in just about every conversation. And it’s really not pretty, what all that effort at recentering the conversation says about you. Do you understand that? Do you comprehend at all the massive inappropriateness of repeatedly attempting to yet again make it all about the men in the midst of a discussion of just how bad the suffering that the judgments of entitled men can inflict upon women really is?

    And no, a little one-sentence disclaimer at the end of your posts saying ‘of course it’s a little bit bad’ does not help, not when you spend paragraphs on making sure we’re being fair to the entitled monster who did the deed. Your focus is clearly on defending the douchecanoe and not on empathizing with the victim. You aren’t his lawyer, a philosophy professor attemping to teach your students some obscure nuance of ethical theory, or God standing in judgment over this guy’s soul. So why are you so much more invested in defending this asshat than in recognizing and centering, for fucking once, the suffering of a poor woman of color? Seriously. Step back, consider the situation, and what message you are sending. Because the only two options I see are that you are 1) utterly fucking clueless on a truly massive scale, or 2) at some level of (un)consciousness invested in maintaining the systems of power and privilege that allowed this fuck-headed doctor to commit this atrocity and support his equally fuck-headed doctor friend to pass it off as heroism. Regardless of whichever it is, you might want to do something about that, so as not to behave like a nauseously close to eugenics-excusing asshat yourself next time.

    I mean, for fuck’s sake.

  147. librarygoose
    librarygoose December 5, 2011 at 9:21 pm |

    Not So Sure: You are correct. Eugenics are never justifiable (though it seems like we could use a little selective breeding for reading comprehension skills). That’s not what we’re dealing with, however.

    So this doctor deciding for her that “she had enough babies” is not selective? Also, how does this not stink of colonialism, in the doctor’s actions and in the asshole’s decision to call him a hero and laud him openly?

  148. Politicalguineapig
    Politicalguineapig December 5, 2011 at 10:12 pm |

    I’d like to point out that a lot of practical eugenics was, very much a class thing. Poverty was assumed to be a genetic condition at the time. So rich doctor vs. poor woman is not a new thing. (I suspect that while a doctor in Tanzania doesn’t earn as much as a doctor in the US, they’d earn a fair bit more than the average Tanzanian.)

  149. thinksnake
    thinksnake December 5, 2011 at 10:57 pm |

    Politicalguineapig:
    I’dliketopointoutthatalotofpracticaleugenicswas,verymuchaclassthing.Povertywasassumedtobeageneticconditionatthetime.Sorichdoctorvs.poorwomanisnotanewthing.(IsuspectthatwhileadoctorinTanzaniadoesn’tearnasmuchasadoctorintheUS,they’dearnafairbitmorethantheaverageTanzanian.)

    Heck, a lot of eugenic programs began before Mendel first described genetic inheritance, let alone before this idea was widely understood. Bell was going around ordering the sterilisation of Deaf people long before there was any understanding of how deafness was inherited.

  150. theDAWG
    theDAWG December 5, 2011 at 11:16 pm |

    If the Tanzanian doctor had not sterilized this woman, then she would likely be dead now. He is obviously a terrible monster.

    Dr. Fleischman used the wrong word to describe his attackers. They’re not colonialist, they’re unrealistic. One commenter compared the mother to Michelle Duggar! A powerful millionaire with her own tv show! The exact opposite of the situation in almost every way.

    If MD had a high risk pregnancy, she could spend 9 months in a well maintained and professionally staffed ICU.
    If MD chose to not have another child through birth control or abstinence, her husband would probably respect her choice.
    If MD’s husband didn’t respect her choice, she could divorce him and maintain custody of her children and enough resources to keep them from being homeless without resorting to prostitution.
    If MD chose not to engage in sex with her husband, he probably would not go get HIV from a prostitute and infect MD when he later raped her.
    If MD challenged the patriarchy and died in a “kitchen fire”, somebody would probably ask some questions about it.

    Commenters who want to be empathetic with the victim should take a realistic look at the situation including the power and privilege imbalances present in this society at large and the range of realistic options for doctor and patient. The proposed ideal solutions described above are fantasies. The population of Tanzania has doubled in the past 20 years. HIV rates for adult women are 6.6%. Does this sound like a culture where women have a lot of agency in making health choices for themselves and their families?

  151. Li
    Li December 5, 2011 at 11:45 pm |

    theDAWG: Does this sound like a culture where women have a lot of agency in making health choices for themselves and their families?

    Not if doctors are routinely sterilising them without their consent, no. Seriously, I don’t get why this is so difficult.

  152. librarygoose
    librarygoose December 5, 2011 at 11:48 pm |

    theDAWG: HIV rates for adult women are 6.6%. Does this sound like a culture where women have a lot of agency in making health choices for themselves and their families?

    First off, sterilization does not stop HIV infection and by your logic her husband will be pissed when she can no longer provide children, go out and fuck someone else, and increase her risk of being infected. This doctor practically gave her HIV (sarcasm). And just because her culture denies her agency means it’s totally cool to violate it further when you decide it’s for the greater good?

  153. Jane
    Jane December 6, 2011 at 12:23 am |

    @J: Applause for your comment.

  154. Politicalguineapig
    Politicalguineapig December 6, 2011 at 1:12 am |

    Thinksnake: Do you mean Alexander Graham Bell? And yeah, it’s fairly obvious that they didn’t understand how genetics worked, or that something could be congenital or caused by childhood illness. For example, I seem to recall that measles or mumps causes deafness, but the affected person could still have offspring that would have their hearing. (If they had offspring at all, because both those diseases can cause sterility.) And a person with, say, cerebral palsy would not have children that inherited that condition.
    Although it seems fairly obvious now that the idea that poverty could be inherited needed to die a quick death, I see it again and again. It’s not just this guy- it’s most of the Republican party.

  155. lyn
    lyn December 6, 2011 at 2:09 am |

    theDAWG: “The proposed ideal solutions described above are fantasies. ”

    The proposed ideal solutions? You mean, asking the woman if she wants her tubes tied? Why is that so difficult again?

  156. EG
    EG December 6, 2011 at 2:16 am |

    lyn: The proposed ideal solutions?

    You know, like according the woman herself some respect and agency. That’s a totally idealistic fantasy.

  157. Roy
    Roy December 6, 2011 at 3:13 am |

    I actually have some professional connection to Newmont Mining, not the most progressive company but they are pretty gun shy about this sort of publicity. I suspect if anyone even tried a letter writing campaign you would see some positive results very quickly.

    http://www.newmont.com/contact-us

    Beyond the Feminism,
    This is not just a racial issue, or a first world-third world parernalism issue, it is a class issue. An African male elite took it upon himself with elite colonialist approval to make irreversable life decisions for a poor woman.

  158. TooManyJens
    TooManyJens December 6, 2011 at 11:32 am |

    If the Tanzanian doctor had not sterilized this woman, then she would likely be dead now.

    I really do not know why so many people are accepting at face value the claim that he had to sterilize her without her consent or she would die. Whose word are we taking for that? Oh yeah — the guy justifying the forced sterilization! Well, then, it must be true.

  159. J
    J December 6, 2011 at 12:03 pm |

    @EG Yep. Because apparently it is very, very difficult to grasp the notion that the solution to a situation where a woman’s agency and reproductive choice might be limited/denied by men is not, surprise, to have other men limit and deny it further! That instead it might involve finding ways to put agency and choice back in her hands! That’s just thinking beyond the range of most mortals, or something.

  160. TooManyJens
    TooManyJens December 6, 2011 at 12:05 pm |

    Jill: And, funnily enough, he didn’t even say that. He said she would have a 50% chance of dying if she got pregnant again and carried the pregnancy to term.

    True, and he didn’t even give a basis for that number. In the post, he never mentioned anything about the woman’s health that indicated there was any reason to believe that future pregnancies would be particularly dangerous for her.

    (I just noticed that I’ve somehow defaulted back to my usual blog handle, even though I had been posting as Jen R earlier in the thread. Sorry about that; not trying to sockpuppet.)

  161. William
    William December 6, 2011 at 12:11 pm |

    That instead it might involve finding ways to put agency and choice back in her hands!

    But but but….thats just fairy dust! It is up to those of use with the power to make decisions, the education to make the right ones, and the Pure Force of Will™ to do what women lesser men would be afraid to do when the chips are down! Don’t you understand whats at stake here?! There is nuance! And gray areas! Where is the benefit of the doubt? Why can’t you see things from the point of view of the poor, oppressed, powerful men in the situation?

  162. Andie
    Andie December 6, 2011 at 12:21 pm |

    The amount of ‘White (or Rich – whatever you prefer) Man’s Burden’ bullshit that is going on in this thread is astounding.

    Yes, it’s totally justified to involuntarily sterilize a woman because you know, those silly, backward, patriarchy-driven africans have no compassion and would gladly see any one of their women birth themselves to death because they’re all so backwards they only see their wimmens as baby-making machines! (cause’ that NEVER happens in North America, where we’re all civilized and enlightened n’ stuff)

    Is this the mentality we’re dealing with?

    I swear someone upthread referred to a country of people as ‘assholes’ and no one even called that out?

    Gross.

    Everyone who is supporting this ‘doctor knows best’ bullshit should be ashamed of themselves. The man acted completely unethically if not monstrously.

  163. Terra
    Terra December 6, 2011 at 6:19 pm |

    Newmont “not the most progressive company”? They’re considered pretty evil here in Indonesia, with their tailings and bribes to local officials. And several cases of local mismanagement (read : worker abuses) and god knows what else.

  164. randiradio
    randiradio December 7, 2011 at 12:55 am |

    What if it was a situation where a pregnant woman was in the hospital for some other reason, and the doctor terminated her pregnancy without her consent because she had a 50% chance of not surviving it if she carried to term? Somehow I doubt the doctor would be getting the benefit of the doubt that he’s getting on this thread.

    If the woman had the risks of a subsequent pregnancy explained to her and still refused sterilization, that’s her right. People refuse life-saving procedures all the time. It may not be a choice that we like or agree with but it’s still the patient’s right to make the choice. It doesn’t matter if they’re from a culture we don’t understand or even like in the West.

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