I am appreciative of the thoughtful engagement given to a doctor who brags about sterilizing an Tanzanian woman while saving her life during childbirth. I first read about it on Feministe, but followed the original authors back to a new intellectual hotspot: Femonomics. Check out my favorite two paragraphs:
No matter how benign this paternalism masquerading as benevolence might sound, forced sterilization is a crime that is committed against women (and sometimes men, such as in Indira Ghandi’s India), stripping them of free agency and human dignity. Patients get to decide what medical procedures are performed on them for a variety of reasons. They get to decide because there is no medical procedure that does not have risks as well as benefits, no matter how enormous the benefits or how small the risks. They get to decide because lots of things that doctors used to think were really good (e.g., hormone replacement therapy) are sometimes really bad. They get to decide because what makes sense for one person may not make sense for someone else. Fully informed consent, where someone is told of the risks and benefits of a procedure, and allowed to make their own, non-coerced, lucid decision, is one of the hallmarks of ethical medical care.
In the case of sterilization specifically, the stakes can be incredibly high. For some women, being able to produce children may be their guarantee of economic security. If they stop producing, their husband may seek another wife, and cut off spousal support. In Zambia, infertile women have told of being divorced and treated as a burden by their community. In South Asia, failure to produce children has been offered up as one predicator of bride burning. In an environment where women lack access to many conventional forms of capital, their ability to produce something valued by society in the form of children may be vital to their physical and economic security.