Tennessee Judge Sam Benningfield thinks he’s come up with a brilliant solution to the opioid crisis: Offer drug offenders 30 days off their jail sentences, if they agree to vasectomies or long-acting reversible contraceptives. Over 70 inmates have already “agreed” to the terms of the deal — and the ACLU, among civil rights groups, is not impressed.
Benningfield argues that having children can complicate recovery for people struggling with drug addiction. But there are a lot of problems with his coerced sterilization program, starting with just that: It’s coerced.
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For centuries, people in power have tried to limit the reproductive freedom of various social groups in the name of eugenics — breeding a “better” class of humans. The efforts came to full flower in the United States in the 20th century, when sterilization procedures got safer and more efficient, and access to nonsurgical birth control expanded. Tens of thousands of Americans across 32 states — from California to South Carolina — were forcibly sterilized.
Such programs primarily targeted people of color, low-income people and disabled people. An up-and-coming German politician was so impressed with American eugenics programs that he successfully instituted them in his own nation — including not just forced sterilization, but also “euthanasia” of people deemed undesirable. His name might be familiar: Adolf Hitler.
Today, these programs are recognized as deeply harmful, and many states have strict rules surrounding sterilization. The medical establishment has also changed the way it handles cases when patients request permanent and potentially irreversible sterilization procedures.
Now, the expectation is that patients should be queried to confirm they’re freely choosing the procedure, in addition to being able to exercise informed consent. Patients receive a detailed explanation of the procedure, the risks and the benefits explained — and must reaffirm at multiple points that this is an elective procedure.
But this isn’t to say that forced or coerced sterilization is a thing of the past.
In 2014, California Governor Jerry Brown signed a bill specifically barring forced sterilization in prisons after an investigation revealed that over 20 women in California prisons were forced into “consenting” to sterilization.
Another organization pays people with substance abuse issues to get sterilized, using financial coercion to pressure vulnerable people into a life-altering procedure. In 2015, a Tennessee inmate was “offered” sterilization as part of a plea deal. And in the 1990s, Norplant was pushed on women in the prison system as a way of controlling their reproductive autonomy.
Apparently, Benningfield is comfortable with promoting sterilization in situations where people can’t really exercise choice, even though it’s unconstitutional — and the Tennessee Department of Health opposes the program.
The case highlights the fact that Tennessee is no stranger to such controversies. In courts across the country, judges offer unusual and sometimes coercive “deals” to people in the name of giving them better opportunities in life. In some cases these offers include acts like community service, but others times, they’re more sinister.
The situation also underscores the severity of the opioid epidemic. Drug offenders who are struggling with substance abuse issues must endure a flawed legal system when they really need psychiatric support. This includes access to addiction treatment programs suited to their needs and long-term supports to help them get and stay clean — like job placement, housing assistance and other social programs.
Many of these programs, notably, are under threat thanks to the proposed funding priorities on a federal level, along with the Republican attempts at altering the health care system. Tennessee is one of the states that opted to refuse Medicaid expansion, depriving low and moderate-income residents of access to drug treatment programs that might help them stay out of the legal system.