Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Spring 5-10-2019 An Ethical Analysis of Reproductive Justice in the Context of the Egenics Movement in the United States Bernetta Welch Follow this and additional works at: https://dsc.duq.edu/etd Part of the Bioethics and Medical Ethics Commons, Humane Education Commons, Liberal Studies Commons, and the Medical Humanities Commons Recommended Citation Welch, B. (2019). An Ethical Analysis of Reproductive Justice in the Context of the Egenics Movement in the United States (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/1779 This Immediate Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. AN ETHICAL ANALYSIS OF REPRODUCTIVE JUSTICE IN THE CONTEXT OF THE EUGENICS MOVEMENT IN THE UNITED STATES A Dissertation Submitted to the McNulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By B. De Neice Welch May 2019 Copyright by B. De Neice Welch 2019 AN ETHICAL ANALYSIS OF REPRODUCTIVE JUSTICE IN THE CONTEXT OF THE EUGENICS MOVEMENT IN THE UNITED STATES By B. De Neice Welch Approved March 21, 2019 __________________________ _______________________ Henk ten Have, MD., Ph.D. Gerard Magill, Ph.D. Director, Center for Healthcare Ethics The Vernon F. Gallagher Chair Professor of Healthcare Ethics Professor of Healthcare Ethics (Dissertation Director) (Committee Member) __________________________ _____________________________ Joris Gielen, Ph.D. Joris Gielen, Ph.D. McAnulty College and Graduate Director, Center for Healthcare Ethics School of Liberal Arts Professor of Healthcare Ethics Assistant Professor of Healthcare Ethics (Committee Member) ______________________________ James Swindal, Ph.D. Dean, McAnulty College and Graduate School of Liberal Arts iii ABSTRACT AN ETHICAL ANALYSIS OF REPRODUCTIVE JUSTICE IN THE CONTEXT OF THE EUGENICS MOVEMENT IN THE UNITED STATES By B. De Neice Welch May, 2019 Dissertation supervised by Professor Henk ten Have, MD, PhD The history of forced sterilization and the American cultural agreement with this practice robbed women of color of control of their own bodies, destinies, and communities. Negative eugenics as genetic proof of low intelligence, low possibility, and low productivity fed the system of compulsory sterilization even though the science proved faulty and incorrect. As advances in medical technology and genetic science increases, eugenics is making a return into the American psyche. Vulnerable populations which include women of color make reproduction and the subsequent control of their bodies vulnerable once again. The Reproductive Justice Movement is a collaboration of organized women of color who fight for the full range of reproductive rights, health services, and parenting options for women. The movement formed by the group SisterSong, forged partnerships based on an expanded vision of reproductive rights beyond pro-choice or pro-life politics. The Movement produced a “March for Women’s Lives” which is the largest single civil rights march in the history of the iv United States. One major strategic move was the decision to position reproductive rights as “human rights with a connection to the UNESCO Declaration on Human Rights. It is necessary to ethically justify their framework according to traditional health care ethics principles. The framework was also analyzed against the traditional protections for women of color who are medical research subjects and who are vulnerable according to their intersectionality. v DEDICATION I humbly submit this work in dedication to my grandmother Bernice and her loving sisters who provided love and nurture for me, but who were never able to have children of their own. I dedicate this work to my husband, the Rev. Dr. John C. Welch who has always gone before me and lead me through and who carried me when I could go no further. To my gifts called my children: Aja, Jordan, John Christopher, and Ian, who are also my greatest teachers. To my grandchildren: Ayauna, Genesis, and Aiden, may you see this as motivation and proof that you can do anything you set your mind and heart to do. To Florence, Darlene, Phyllis, Mrs. Diggs, and Audrey, and my Bidwell Church family, who fed me, prayed for me, and encouraged me; I dedicate this work as gratitude for all the time you granted me to write. To the countless women of color who were robbed of the ability to have children, because of this project, I consider you all my mothers. To my God whose leading felt at times like holy inspiration, I am eternally grateful. vi ACKNOWLEDGEMENT I want to acknowledge the committed detailed work provided by Dr. Henk ten Have, my dissertation advisor and Dr. Gerard Magill, who encouraged me even beyond the writing of this project. Many thanks to Glory Smith for her keeping me on schedule and kept me on task. I also want to acknowledge retired professor Dr. Moni McIntyre, who challenged me to write on a graduate level and refused to accept any work from me that appeared to be less than that. vii TABLE OF CONTENTS Abstract……………………………………………………………………………………..….....iv Dedication……………………………………………………………………………………...…vi Acknowledgement…………………………………………………………………………….…vii Chapter 1: Introduction…………..….………..…………………………………………….......1 A. The Need for the Ethical Analysis of the Reproductive Justice Movement......1 B. The Reproductive Justice Movement Defined………………………….……..7 C. The Struggle to Form the Movement….…………………...……………….....9 D. The Human Rights Thrust to the Movement ….……..….…………….….…11 E. Applied Ethics as Justification for Analyzing the Reproductive Justice Movement……………………………………………………………………12 F. Conclusion……...……………………………………………………………13 Chapter 2: Why Women of Color Formed the Reproductive Justice Movement……….….21 A. Slavery as an Institutional Foundation of Stereotyping Black Women.……..21 B. The African Woman’s Slave Body…….……………………….…….……...24 C. Jezebel: The Promiscuous Black Woman……………………………………32 D. Sapphire: The Angry Black Woman……...………………………………....38 E. Mammy: The Ideal Black Woman……….…………………………………..39 F. Matriarch: Single Head of Household……………………………………….47 G. Sassy Mammy: The Bridge Character……………………………………….55 H. The Twenty First Century Sapphire………………………………………….56 I. Cassandra: The Lying Black Woman……………………………………..…57 J. The Welfare Queen………………………………………………………......59 K. Colorism and Other Forms of Self Hatred…………………………………...66 L. Conclusion…………………………………………………………...………68 Chapter 3: Combining Eugenics and Genetic Science in Forced Sterilization……………..83 A. The Development of Eugenic Theory……….…………………….…………83 A.1. Positive Eugenics…………………………………………………..88 A. 2. Negative Eugenics…………………………………………………94 A.3. Lais-sez-faire Eugenics…………………………………………….96 B. Genetic Science………………………………………………………………98 C. Sterilization as the Application of Eugenic Thought...……………………..103 C.1. Negative Eugenics Initiatives……………….……………...…..…106 C.2. Margaret Sanger and the Eugenics Alliance………………………108 i. Sanger the Feminist Activist……………………………108 ii. The American Birth Control League………...…………111 iii. Eugenic Alliance………………………….…………….113 iv. The Negro Project………………...………….…………114 v. The Development of the Birth Control Pill…..…………118 viii D. Forced Sterilization………………………………………………..………..121 E. Conclusion……………………………….……….…………………………126 Chapter 4: The Ethical Conflict Disclosed...……..………………...………………………141 A. Do No Harm and the Hippocratic Oath…………………………………….141 B. Ethical Conflicts and the Law………………...…………………………….150 B.1. Buck v. Bell: Sterilizing the Social Unfit vs. Patient Autonomy…..154 B.2. Skinner v. Oklahoma: Sterilization of Hereditary Criminals vs.14th Amendment………………………………………………………..156 B.3. Loving v. Virginia: White Purity and Miscegenation by Law…….159 C. Consequentialism vs. Deontological Ethics…………………………...……162 D. Black Complicity……………………………………………...……………166 E. Religious Ethics and Conflicts……………………………………….…......173 F. Conclusion……………………………………………………………….…179 Chapter 5: The Ethical Analysis of the Reproductive Justice Movement …….……..…193 A. The Principles of Biomedical Ethics..…...…………………….……………193 A.1. Applied Ethics as Justification for Analyzing the Reproductive Justice Movement………………………………………………….194 A.2. Public and Professional Morality………………………….………194 B. The Reproductive Justice Framework……………………..………………195 C. The Analysis by the Biomedical Principles Method…………………….....200 C.1. Respect for Autonomy and Informed Consent…………………….201 C.2. Beneficence………………………………………………………..206 C.3. Non-Maleficence…………………………………………………..207 C.4. Justice…………………………………………………………...…208 C.5. Professionalism……………………………………………………210 D. Reproductive Rights and Reproductive Ethics...…………………………..212 E. An African American Perspective on Bioethics……...……………………217 F. Health Care Ethics and Religion………………………...…………………220 G. Conclusion…………...….………………………………………………....224 Chapter 6: Applying Traditional Ethical Protections to the Reproductive Justice….….237 A. The Case for Protections……………………………………………………238 A.1. Birthright U.S.A. - Deceptive Clinics…………………………….239 A.2. Project Prevention – C.R.A.C.K………………………………….241 A.3. The State of California – Incarcerated Women…………………..244 A.4. Medicaid Postpartum Tubal Ligation…………………………….246 A.5. The Women of North Carolina – Victims of Sterilization….…….247 B. The Nuremberg Code…………………….…………………………………250