Bioethics and No Mas Bebes

Madrigal v. Quilligan:Forced Sterilization of Hispanic Women at LA County Hospital

Lack of appropriate informed consent is historically the most common bioethical violation in medical, research and other settings. The history of bioethics is replete with such examples.  Among those examples is the forced sterilization of Hispanic, Black and other vulnerable women. 

Given the recent events where the United States Immigration and Custom Enforcement service separated Hispanic parents from their children at the USA-Mexico border, the film, No Mas Bebes is particularly poignant. This theft of children showed complete disregard for the Declaration of Human Rights and the Declaration of the Rights of the Child. It seems appropriate to recall the depths of disregard for Hispanic women and children that has been shown at other times in recent USA history. Listening to the rationalizations of men empowered by medicine for the heinous acts describe in No Mas Bebes is chilling -- but so very familiar with events in our current times

In the 1970s, at Los Angeles-County Hospital, the University of Southern California Obstetrics and Gynecology services systematically sterilized Latina and Black women. Film director Renee Tajima-Peña and producer Virginia Espino have created the definitive documentation of major medical sterilization of those women under the guise of therapeutic privilege. The 2015 award winning film No Más Bebés  tells the story of a little-known but landmark event in reproductive justice. 

A small group of Mexican American immigrant women, on behalf of a much larger class, sued the state of California, and the US federal government after they were sterilized while giving birth at Los Angeles County–USC Medical Center. The violations occurred during the late 1960s and early 1970s where such events had become common. The filmmakers’ statement explains, “Marginalized and fearful, many of these mothers spoke no English, and charged that they had been coerced into tubal ligation.,” during the late stages of labor.

The No Más Bebés production spent five years tracking down sterilized mothers and witnesses of the bioethical violations at Los Angeles County Hospital. Those violations occurred under the direction of the University of Southern California division of Obstetrics and Gyneocology. 

Most of the women abused were reluctant at first to come forward, but ultimately agreed to tell their painful stories. Set against a debate over the impact of Latino immigration and perceived overpopulation by university physicians, and the birth of a movement for Chicana rights and reproductive choice, No Más Bebés revisits a powerful story racism and sexism that still resonates today.

The forced sterilization of Hispanic Women at USC-LA County Hospital coincided with the book the 'Population Bomb'.  The footage of several physicians involved in the 1970s lawsuit was chilling and referenced that book. In the film, shot 40 years later, some clinicians interviewed  maintained that they were "helping the Hispanic women by sterilizing them." Most of the women plaintiffs in the law suit were unaware that they had undergone tubal ligations unlit the legal challenge was mounted. These Latina mothers had only known that they were no longer able to have additional babies. Many became depressed and felt inadequate. 

The wronged Latina mothers’ cause was taken up by a then recently admitted to the California Bar, attorney Antonia Hernandez. She was armed with hospital records secretly gathered by the whistle-blowing Dr. Bernard Rosenfeld. Rosenfeld’s moral intuition was peaked by eyebrow raising events witnessed while on Obsterics & Gynecology rotation at Los Angeles County Hospital. In their landmark 1975 civil rights lawsuit, Madrigal v. Quilligan,  the women argued that a woman’s right to bear a child, as well as not to, is guaranteed under the Supreme Court decision of Roe v. Wade.

The Madrigal v. Quilligan case was lost by the women who had been sterilized. However, when the United States Public Health Service Syphilis Study case—Pollard v. the United States—was settled in favor of the plaintiffs, the state of California immediately passed legislation upholding the doctrine of informed consent.

No Maas Bebe's http://www.pbs.org/independentlens/films/no-mas-bebes/ 

Stern, Alexandra, M. Sterilized in the Name of Public Health. Race, Immigration, and Reproductive Control in Modern California. Am J Public Health. 2005 July; 95(7): 1128–1138. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449330/

The Universal Declaration of Human Rights http://www.un.org/en/universal-declaration-human-rights/

The declaration of the Rights of a Childhttps://www.unicef.org/malaysia/1959-Declaration-of-the-Rights-of-the-Child.

Parts of this article are found in the book by Williams, S. and Mothers' Milk Bank San Jose, The Elephant in the Room: Bioethical Concerns in Human Milk Banking  available
 09 /2018.