The Need for Strong Legal Protections for Patients’ Rights

An important lesson that emerges from the history of forced sterilization of women in Puerto Rico is the necessity of strong legal protections for patients’ rights to insure that patients, and not doctors, determine what medical procedures patients do and don’t have. As with the eugenic program in Nazi Germany, the policy of forced sterilization in Puerto Rico could not have been carried out without the complicity of the medical profession. Unfortunately, history has repeatedly demonstrated that the medical profession cannot be relied upon to protect patients against government policies that intrude upon bodily integrity and self-determination. Whether by actively persuading women to agree to sterilization in exchange for longer stays in the hospital after childbirth, making it appear that sterilization was medically necessary, telling women that sterilization was their only choice for birth control, or failing to tell women that sterilization involved a surgical procedure that it was irreversible, too many doctors were more than willing to be the instruments of and mouthpieces for the policy of forced sterilization in their everyday interactions with patients and take advantage of the power imbalance that is inherent in the doctor-patient relationship. The deeply troubling history of the involuntary sterilization of women in Puerto Rico reminds us once again of the crucial role that patients’ right to bodily integrity and the law of informed consent play in preventing the medical profession from becoming an instrument of intrusive and repressive governmental policies.