Sterilization Guidlines

  • In 1974, the Department of Health, Education and Welfare (now Health and Human Services) published guidelines for sterilization procedures.  These guidelines established a moratorium on sterilization of women under the age of 21 and on others without the legal ability to provide consent.  A 72-hour waiting period between the signing of a consent form and the procedure was mandated.  A written statement that women would not lose their welfare benefits if they refused the sterilization procedure, and that reserved a woman’s right to change her mind and refuse the procedure anytime up until the surgery, even after granting original consent, served as informed consent.  (Krase 1996)
  • A 1974 survey of 42 large teaching hospitals across the country found that 27, or 64% of them to be in gross violation of the regulations, including two Chicago hospitals who subsequently claimed to be in full compliance. Fourteen of the hospitals were not even aware that such regulations even existed.[McGarrah, Robert. 1975. "Sterilization Without Consent; Teaching Hospital Violations of HEW Regulations." Health Research Group Document 252. (Jan.): Washington, D.C.] (CCESA 1977)
  • [S]tudies conducted by the ACLU and the Center for Disease Control in 1975 showed that noncompliance with the guidelines was widespread.  (Krase 1996)
  • In New York City, after a 9 month battle, the Committee to End Sterilization Abuse (C.E.S.A.) was successful in getting better guidelines adopted by municipal hospitals. The major improvements over the federal guidelines include a 30 day waiting period, a detailed consent form, and counseling in the women’s own language. (CCESA 1977)
  • In early 1975, the HHC called on members of CESA, including Dr. Rodriguez-Trias, and members of other reproductive rights organizations, to serve on an ad hoc Advisory Committee on Sterilization Guidelines.  The goal of the advisory committee was to set guidelines, like the HEW guidelines, for the public hospitals of New York City.  These local guidelines hoped to promote the successful monitoring of sterilization practices.  By identifying the weaknesses of the HEW guidelines, the advisory committee drafted a more effective set of regulations that were aimed at protecting the rights of the women who were mistreated in the past.  The committee’s guidelines required a 30-day waiting period from the signing of the consent to the procedure.  During this time, hospitals were required to offer counseling services.  These services were to be provided in the language that the woman spoke, and would not be given by the doctors themselves, but by a counselor removed from the clinical experience.  As part of the consent, women described their understanding of the procedure and the alternatives available; so that there was no doubt that she understood the permanence of the procedure.  The guidelines suggested by the advisory committee became effective HHC rules on November 1, 1975. (Krase 1996)
  • The guidelines set forth by the HHC could only be applied to the city’s public hospitals.  In response, Public Law #37 was passed by the New York City Council in April of 1977, making the HHC guidelines the law of the city, applicable to both public and private facilities.  Failure to comply with these regulations would result in a penalty.  Public Law #37 was unique in that past guidelines were expanded to include the regulation of the practice of sterilization on men as well as women. (Krase 1996)
  • In response to regional action, the HEW redesigned their national guidelines for sterilization practices to embody the provisions of New York’s Public Law #37 in 1978.  The national guidelines received widespread support from CESA as well as over one hundred other regional and national organizations, but also faced opposition from organizations that saw the guidelines as limiting women’s access to sterilization s a choice for contraception. (Krase 1996)

references:

Chicago Committee to End Sterilization Abuse (CCESA). 1977. “Sterilization Abuse: A Task for the Women’s Movement”(January-1977). Available online: <http://www.cwluherstory.org/CWLUArchive/cesa.html> Accessed: November 20, 2007.

Krase, Katherine. 1996. “Organizing for Change: Sterilization Abuse.” First published in the Jan/Feb 1996 newsletter of the National Women’s Health Network. Available online at the Our Bodies Ourselves Health Resource Center. <http://www.ourbodiesourselves.org/book/companion.asp?id=32&compID=55&page=1&gt; Accessed: November 19, 2007.

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~ by Serena on November 19, 2007.

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