A report emerged recently that at least 148 female inmates in the California penal system had been sterilized without authorization. The outcry justifiably focused on the fact that some women did not give informed consent, that it was against the law without prior authorization, and that in some cases it appeared there had been coercion. But the underlying travesty is why the medical professionals thought it was okay: it would save the taxpayers money.
It is easy to see why the doctor thought just under $150,000 in medical fees over 10 years was not so very much for the state to expend to produce savings on “unwanted children.”
Under President Hollande, France seems poised to broaden medical treatment to include the most untreatment-like of care, physician-assisted suicide. Meanwhile, reports have emerged suggesting that legalized euthanasia undermines psychiatric and palliative care. Once suicide is considered treatment, it is easy to see why insurance companies might prefer it over longer-term, life-prolonging care.
Texas recently passed a new law limiting abortions after 20 weeks. Although undoubtedly a pro-life victory, it contains an exception for severe fetal anomaly, reflective of the high rates of abortion of those diagnosed with disabilities and severe diseases pre-birth. (Id.) Contrary to the bill’s statement that five months was sufficient time to decide to abort a child conceived in rape, opponents railed against any limitation whatsoever on aborting in cases of rape and incest.
Each of these instances highlights a deeply flawed way of assessing human beings, although they do not all err in the same way.
Dr. James Heinrich in California used cost-benefit analysis on human lives and freedom: the children of female convicts often go into state care. If these women have additional children and land back in jail it will indeed cost the state money. And to be honest, preventing recidivism, providing child care and job training, tracking down absentee fathers, providing social support for poor pregnant women, that all costs money, too. The difference is that none of those efforts imply that society is better off with fewer burdensome babies, or analyze women’s fertility economically. There is no practical difference between this practice and its legal parent, Buck v. Bell, in which Justice Holmes opined, “Three generations of idiots is enough.” Is human worth merely the last sum in a ledger of social costs and financial contributions?
Disability advocates have proven stalwart opponents of euthanasia because they see what it says: some lives just aren’t worth having, and “some lives” usually means those without full, able-bodied functions. It is simply not possible to say that disabled persons enjoy full respect and rights when an illness causing the same problems they live with daily is sufficient reason to justify suicide. Similarly, abortion rates are appallingly high in cases of “fetal anomaly,” which can range from certainly lethal conditions to cognitive disabilities which have limited if any effects on health. The story is the same, however: nontypical lives simply cannot be worth the same as “normal” ones, regardless of countless stories from parents and differently-abled people about lives that, though not free from difficulty, are nonetheless lives of joy which they value. It is no favor to human dignity to define it based on physical, cognitive or social abilities, nor to create a society where the atypical is at best foreign and at worst freakish. Is it our characteristics that give human beings value and dignity?
Rape and incest are among the most horrific crimes against a person; all women in such a position deserve medical and psychological care. They can hardly be blamed should they want to avoid all signs of their trauma, including a resulting pregnancy. But ending a pregnancy is not a cure for the trauma of rape. And what does it mean when we carve out an exception based on the circumstances of conception, something over which no child has any control? Is the value of a life predicated on the deeds of his or her parents?
Each of these practices has an internal logic to it, but applying that logic leads to troubling results. If children are to be responsible for the deeds of their parents, should we not sterilize not only inmates but their children as well? If a woman with a criminal record is pregnant when she goes to prison, should she be forced to submit to a “eugenic” abortion? If some physical or mental or social aptitude is the measure of a life’s value, is there any reason not to take this to its ubermensch-eugenicist conclusion, and simply kill individuals as undesirable characteristics manifest? (Surely, it is also cheaper than paying for their care.) And really, is it any surprise that in a culture that makes these arguments, it is very easy to say that some lives don’t matter, because of dependency, or disability, or size? It is every bit as logical to justify infanticide, as some have done.
Shall we repeat the errors of racism in deciding who is human enough, and perpetuate the idea that being human isn’t enough to be a person? Shall we value women’s bodies and fertility as a vehicle for cost saving over their own freedom? Shall we tell the depressed that in some cases life really isn’t worth living? Might it not be better to affirm the value of each person, and leave the arithmetic—the value assessment—in math class where it belongs? Until being human is the only standard for being a life of worth, we shall never achieve a truly just society.
*Nadja Wolfe is a student at William and Mary School of Law and a CLI Contributor.
 Corey Johnson, “Female inmates sterilized in California prisons without approval,” The Center for Investigative Reporting, July 7, 2013 (“‘Over a 10-year period, that isn’t a huge amount of money,’ Heinrich said, ‘compared to what you save in welfare paying for these unwanted children – as they procreated more.’”)
 Buck v. Bell, 274 U.S. 200, 207 (1927).
 It is worth noting that similar cost-benefit analysis can also be applied to the disabled, who may need assistance or special accommodation and state support. It would of course be cheaper not to pay for any of their needs.