An official state report (pdf) released this week confirms news stories from a year ago that doctors in California prisons sterilized more than 140 female inmates over an eight-year period, many without proper approval for what probably amounted to an extreme form of birth control.
The California State Auditor found that 39 of the patients underwent the surgical procedure, known as bilateral tubal ligation, from fiscal year 2005-2006 to 2012-13 and held both the state Department of Corrections and Rehabilitation (CDCR) and the federal court-appointed California Correctional Health Care Services (CCHCS) accountable.
The federal court took control of the state’s woeful prison medical care and put a receiver in charge in 2006. Although this office has wide-ranging authority, Receiver J. Clark Kelso questioned the auditor’s contention that it is “CCHCS’ duty to ensure compliance with the sterilization and consent procedures set forth in . . . the California Code of Regulations.”
Nonetheless, he acknowledged the practices identified by the auditor were serious and pledged to follow the auditor’s recommendation to do better training, record keeping and reviewing. He also signed off on the auditor’s admonition that the Receiver’s Office cease “facilitating an inmate’s consent for sterizlization in the prison and allow the general acute hospital to obtain an inmate’s consent.”
Physicians in 27 of the 39 sterilizations didn’t sign the inmate consent form certifying the inmate’s apparent mental competence and their understanding of the procedure’s finality. Eighteen of the procedures probably violated the 30-day waiting period between assent and surgery designed to protect the inmate from pressure or being rushed. Six had both violations.
Surgeries were performed by 17 doctors at eight hospitals, but one physician, Dr. James Heinrich, was identified last year by the Center for Investigative Reporting (CIR) as being responsible for two-thirds of the 74 surgeries performed at the Valley State Prison for Women between 2006 and 2010.
Heinrich, himself, explained to CIR why prison sterilization made sense (after being told the doctors were paid $147,460 by the state), “Over a 10-year period, that isn’t a huge amount of money compared to what you save in welfare paying for these unwanted children—as they procreated more.”
Indeed, they did. The audit found the sterilized women were all 26 to 40 years old and had been pregnant five or more times. Most of them had less than a high school reading proficiency and one-third tested at less than sixth-grade.
The auditor admitted that its numbers could be on the low side: at least one hospital was found to have disposed of records related to seven of the cases. The audit also didn’t track sterilizations before 2006.
In its report last July, CIR identified 132 women it said were sterilized “in violation of prison rules” from 2006-2010 and speculated that at least 100 more had undergone the procedure since the late 1990s.
Lawmakers are currently considering legislation, Senate Bill 1135, which would effectively ban all prison sterilizations, unless needed to save an inmate’s life or cure a physical illness.
California has a wicked history of forced sterilizations, male and female, dating back to the early 20th century, when the state championed the pseudo science of eugenics years before Hitler embraced it. Under the state’s 1909 sterilization law, at least 20,000 Californians in state hospitals and prisons were involuntarily sterilized by 1964. The state clamped down on forced sterilization in 1979, and in 1994 passed a law that requires a detailed approval process in prisons for “surgery not medically necessary.”
An effective solution is apparently still a work in progress.
–Ken Broder
To Learn More:
Female Prison Inmates Sterilized Illegally, California Audit Finds (by Corey G. Johnson, Center for Investigative Reporting)
Audit Seeks Investigation of Inmate Sterilizations (by Don Thompson, Associated Press)
Audit Faults Lack of Consent for California Inmate Sterilizations (by David Siders, Sacramento Bee)
State Prisons Violated Procedures in Sterilizations, Audit Finds (by Phil Willon, Los Angeles Times)
148 California Female Prison Inmates Were Illegally Sterilized (by Ken Broder, AllGov California)
A Closer Look at Prison Sterilizations and the Doctor Said to Champion Them (by Ken Broder, AllGov California)
Sterilization of Female Inmates (California State Auditor) (pdf)