Tuesday, 13 April 2010

The need for a Project "Project Prevention" Prevention

There have been a couple of articles in the Herald newspaper recently on the "Project Prevention" charity, most recently this morning under the headline "Social workers urged to refer addicts for sterilisation." http://www.heraldscotland.com/life-style/real-lives/social-workers-urged-to-refer-addicts-for-sterilisation-1.1020204

Barbara Harris, the Founder of the project - which hopes to pay addicts £200 each to go through a sterilisation procedure - appears to be motivated by a genuine concern for the wellbeing of children born with the same addiction as their mother and/or subjected to neglect and other abuse over the course of their childhood.

On the face of it sterilisation would achieve some positive outcomes: Fewer babies born with serious addictions and needing considerable hospital treatment, and fewer babies born into households where the parents' primary motivation is drug-seeking rather than their child's welfare. Many people will find the proposal morally abhorrent. But is this a morally dubious proposal that might just be an answer to some of our society's problems? Could projects such as these produce knock-on effects similar to those highlighted in the book "Freakonomics" following the legalisation of abortion in the US? The economist responsible for the research found that the considerable drop in crime in the US in the early 1990s could be almost entirely explained by the nationwide legalisation of abortion following the Roe vs. Wade Supreme Court ruling in 1973. The implication was that lower numbers of unwanted children being born led to lower numbers of people being brought up in an environment that fostered criminality. Could sterilising addicts not only prevent child suffering, but prevent the future crime that these damaged children might commit?

What then are the objections to this plan that could have such potential benefits? We could liken the procedure to the selling of a kidney in that you would be reducing your fitness for the benefit of others and for financial gain. But with Project Prevention's proposals the "client" might not only be motivated by poverty, but also by the physical pain of withdrawal. Were the procedure to be offered without financial incentive, judgement might still be clouded by the feelings of worthlessness and general low self-esteem that so often occur alongside addiction problems. For these reasons I am not confident that addicts are in a position to make a rational decision on their future suitability or desire to become a parent. This has both moral and legal implications, with it being unclear whether it is possible for informed consent to be given for a sterilisation procedure in the circumstances in which Project Prevention seeks to operate.

The word "eugenics" has been used to describe Project Prevention, but as a man who studied evolution with great interest at undergrad level, I am uncomfortable with this description. The term implies that drug addiction is a genetic trait which can be eliminated from the gene pool. While it is true that there may be a genetic predisposition to addiction and risk-taking behaviours, drug addiction is far more environmental in nature. Perhaps we could invent the term "euenvics" to describe the prevention of reproduction of individuals who would likely provide a poor environment for their children and thus risk those children becoming a greater burden to society than the average child.

Unlike genetic traits, drug addiction is something which need not be permanent. With the right intervention in addicts' lives, it is very possible for them to end their drug use and to become capable of parenting that need not lead to their child's suffering and/or criminality. The thought of sterilising addicts strikes me as jumping straight to plan Z following the failure of plan A.

I would suggest we should try to find a morally, economically and politically viable plan B instead. I believe this should be a plan that recognises that addicts should be able to seek treatment without fear of criminalisation or the removal of their children into care. For there to be positive outcomes for mother and child, the mother needs to feel she can trust the police, social services and health services to be doing everything they can to help her:
a) stabilise her lifestyle without the need to commit acquisitive crime, prostitute herself or deal in drugs to fund her addiction.
b) (if she wishes to have a family) come off drugs in a controlled fashion whilst using contraception that she is comfortable with.
c) raise the child in an environment conducive to a happy, healthy life.

I believe passionately that such conditions are more likely to come about if drug use is decriminalised and addicts have the option of stabilising on prescribed heroin.

To instead pay these women to be sterilised is to reinforce their feelings of worthlessness and low self-esteem and to demonstrate we have given up hope that they can turn their lives around. Sterilisation also deprives these women of a great life-changing event and the responsibility to stay clean not only for their own benefit, but for the benefit of a child that they love dearly and that would be utterly reliant upon their care.

We should be seeking to minimise the number of babies born to addicted mothers. An addicted baby goes through excruciating pain and requires considerable medical attention as they go through withdrawal. But the most humane way to achieve this is to treat addicts as just another patient group with a treatable medical condition. If we fail to assist women to cease drug use, then we need to recognise that addicts can hold down jobs and raise families just as well as the rest of us if they know when and where to get their next fix and they don't have to pay massively inflated prices for an illegal supply.

A facebook group has been started to resist "Project Prevention" in the UK.


And if you agree with me that we need to try a Plan B then why not join Liberal Democrats for Drug Policy Reform at http://act.libdems.org.uk/group/liberaldemocratsfordrugpolicyreform


Anonymous said...

Another blogger mentioned the project was looking to start in the UK. You appear to have confirmed this.

I do not know the size of the problem in the UK, but I am sure it is not on the same scale as it is in the US.

In the UK we do have back up support such as healthcare, social services, housing and care workers, none of which exist in the US. My honest opinion is that Mrs Harris has not yet understood the UK situation. In her interview she was very single-minded and committed, and is probably used to people telling her she is not needed. I suspect if she does launch in the UK, she will change her approach swiftly.

That is not to say she should not expect a reasonable audience. Her ideas should focus us all on the fact that the drug epidemic is a multi-layered cancer in our society that we have not significantly dealt with in any area.

You are painting an unfair picture of project prevention which according to her interview is simply not true. The women offered this treatment do not have to take the permanent solution. They are given the option of a ten-year temporary solution. It isn't pushed, but it is available. They are given councilling, and she says she does not offer the procedure to first time mothers. She also mentioned that there is a world class doctor who has offered any "client" a reversal free of charge if she has cleaned up and has made a conscious decision to have another child.

I am not saying she has all the answers. I don't like her rhetoric. I agree that her campaign is about the sterillisation of women, but I dont think it is out of sexism.

Her original campaign was to counter the rise in pregnant prostitution, she intonated that this was the battle she chose to fight, and it was someone elses problem to deal with everyone else.

I am saying her arguments have a genuine place any of todays societies. Someone should be doing something about these children. We forget that there are unwanted uncared for babies involved here, destined to live a life in underfunded childrens homes.

In our search to protect the rights of people who have had a choice, we find we have created a group of people who have none.

We are not the US, and I cannot see her project being utilised over here. I'm not even sure if it is legal. There are much better options in the UK for a drug addict than having a drastic operation for just £200. Our national state cares for people in the UK much better than the US.

I understand your concern. I know there is a problem with the leaking of morals in our society, but to my mind drugs must supercede many of our political values. The drug addict doesn't hold to our ethical laws. The drugs cartells dont care about our societal borders. We need to find progressive approaches to deal with the problems we face.

Michael said...

"Eugenics" may not be literally coreect but the term was applied to forced sterilzation of peope ith traits whih were not inherited. In my country (Canada) the "Sexual Sterilization Act" (Alberta 1928) forced sterilzation of "mentally deficient" people until the 1970s. This encompassed people with low IQs caused by acquired brain injuries. epilepsy, toxins, infectious disease, malnutrition, fetal and birth traumas, etc. It's an understandable comparison. The "Eugenics Movement" worked in the same manner historically except sterilization didn't require consent.