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Page last updated at 11:33 GMT, Monday, 8 February 2010

Should drug addicts be paid to get sterilised?

Crack smoker

Paying drug addicts to be sterilised is exploitative and wrong, say critics of just such a scheme that runs in the US. Jane Beresford talks to the woman behind Project Prevention.

If you call Project Prevention's helpline it's likely that Barbara Harris, the founder of this US based organisation, will answer the phone. A warm and vivacious grandmother, her aim is to give $300 to as many drug and alcohol addicted women as possible.

The deal? That they receive long term contraception or sterilisation to prevent them having children she believes they are unable or unwilling to care for. Funded through private donations, her organisation is non-profit making.

Project Prevention, started in 1997, says it has paid money out to 3,242 addicts, or clients as it prefers to call them. Most of them were women and 1,226 were permanently sterilised. Thirty-five men have had vasectomies.

Barbara Harris and her family
Barbara Harris and family, including her four adopted children

To get the money people have to show evidence that they have been arrested on narcotic offences, or provide a doctor's letter confirming they use drugs. Fresh documents are then required to show the medical procedure has actually taken place.

Ms Harris is driven by her own experience. She fostered, and then adopted, four children born to the same crack-addicted woman in Los Angeles. Taylor was the second she took in.

"He couldn't keep food down and his eyes looked like they were going to bulge out of his head," she says. "Noise bothered him, light bothered him, he just couldn't sleep.

You can hear Fergal Keane talking to Barbara Harris on Taking a Stand, on Tuesday, February 9, on Radio 4 at 0900 GMT.
Or listen to it BBC iPlayer.

"My husband and I had to take shifts with him. He would sleep 10 minutes, wake up screaming. I was just angry at his mom, I thought how could somebody do this to a baby?"

Her stand has drawn fierce opposition. Critics, such as US group National Advocates for Pregnant Women (NAPW), accuse Ms Harris of spreading "dangerous propaganda".

They say what she does is social engineering, defining one category of people - addicts - as unsuitable to have children. The scheme has been compared to eugenic sterilisation in the US during the 1930s and the Nazis' programme of eugenics, which led to the extermination of Jews and the murder of many gypsies, the mentally ill, and homosexuals.

Such comparisons are rejected by Ms Harris, who says the criticisms do not concern her.

"It doesn't matter," she says. "I'll do anything I have to do to prevent babies from suffering. My heart is with the children. I don't believe that anybody has the right to force their addiction on another human being."

Chance after chance

She has also been accused of being racist, targeting poor black communities with her promotional campaigns. Ms Harris says this is ironic as she is married to a black man.

"I have a large family and I'm the only white face in my family. We have 10 kids and they are all black, some are bi-racial. It's not about race to me."

And according to their own figures, which haven't been independently verified, over half Project Prevention's clients are white.

Offering money to addicts is clearly not a solution to the problem, say critics. Ms Harris herself admits the money she pays out is probably spent on drugs. So why not use her resources to lobby for measures to help stop women turning to drugs in the first place - or better treatment programmes when they do?

Pegnant woman
Critics have accused Ms Harris of exploiting addicts

"I do a survey on every one that comes into the programme," she says. "Most of them started using drugs when they were 11, 12, 13 years old. And all of them have been in and out of drug treatment programmes, in and out, in and out.

"So people tell me that I should be focusing on drug treatment not birth control but drug treatment is just a gamble you know. Women go in there, they get off drugs, they go back on drugs but that doesn't keep them from getting pregnant.

"If they feel so strongly about it then they need to start an organisation that does what they are telling me to do. I am concentrating on women who are addicted to drugs who are getting pregnant over and over again. That is really my focus."

Organisations like NAPW don't deny the problems of mothers and fathers who are addicted, but argue that many do get clean and become loving parents of healthy children.

Also, having a family is one of the most valued parts of many people's lives. By removing that, or the possibility of it, does she not remove a powerful incentive for an addicted person to get clean: the hope of that better life?


"These women have a chance every time they give birth to a child," says Ms Harris. "They are told if they go into drug treatment they can get their child back. They are given chance after chance after chance.

"And drugs are more important, but at the very least we can stop them from giving birth to children whose lives may end up the same as theirs."

She takes an extremely hard line, but says she does feel sympathy for the mothers living in poverty.

"If anybody believes that these women having multiple babies that are taken away is a good thing for these women, they are wrong," she says.

She talks of one woman who had 13 children taken into care before she finally got off drugs. When she was clean she was unable to contact any of them.

"She was heartbroken. She didn't know where they were, they were gone".

Send us your comments using the form below.

None of the men or women who receive the money are forced to approach Project Prevention. The critics seem to have little regard for the children who either live in neglectful homes or are taken into care. Any adult is free to be an addict if they choose but they should not be able to subject their children to addiction and more life outcomes.
Angela Willson, Oxford, UK

Part of me completely agrees that there are some people out there who should not be able to have children, they cannot afford to look after them and some times do not want them either. Personally, I have never wanted kids and have been met with a negative attitude from friends, family and even health professionals when I have asked about sterilisation. Of course I understand that if you are under the influence of any substance you can make decisions that you live to regret. Surely it would be better not to have kids you don't want and then look into adoption later in life than having a child that will end up suffering because you didn't really want it or cannot afford to keep it.
Boris, Ilminster, Somerset

Typical mudslinging by her detractors, I note. I don't remember the nazis giving the subjects of their eugenics policy either the choice or any sort of benefit for being exterminated. If that is the best argument which can be marshalled against this lady, it suggests that she is probably in the right.
Dr J, West Yorkshire UK

No, they should be given help to reform, not be permanently deformed
Keith Waters, Ely

Fully agree. There needs to be an economic incentive to prevent babies being born into what are essentially hopeless conditions. We spend millions on social care after the child is born, paying someone so they can spend the money on cigarettes/alcohol/drugs is fine PROVIDING they in return have no more children. Sounds like a win-win to me.
J Mullins, Brentwood, Essex

We need a sensible debate about this sort of thing. It seems to me that the women who breed the most are often the least suitable people to bring up children. The cycle goes on and society doesn't want and can't afford the results
Richard, Cardiff

People quite rightly call this social engineering, but the current tax and benefit system is a form of social engineering as well. This particular "experiment" states that all people who are biologically able to have children should be allowed to have children. I don't think this argument has any more validity than Project Prevention's one. Let's have a proper discussion about child rearing, rather than slinging the Eugenics accusation at anybody who dares to commit to a solution.
Graham Halsey, London

Reprehensible. This is coming from the right place in her head, but is skewed by her own experience and also the general attitude in the USA that people on drugs are BAD PEOPLE. It's the same with their jail policy which has a 0 percent rehabilitation rate mainly because they don't rehabilitate offenders. It's clearly exploitation and an attempt at social engineering which will clearly fail because it does not solve the underlying socio-economic problems that drug abuse is created by or creates.
Krystan Honour, Leeds

Seven years ago I got clean after finding out I was pregnant with my first daughter. I am the only woman I've ever met that got and stayed clean for a pregnancy. I know that I am an exception to the norm. In my years of using I witnessed much pain and suffering inflicted on children with addict parents, ranging from neglect to emotional, physical and even sexual abuse. Mrs. Harris is nothing short of a hero and the work that she's doing is truly a blessing. Addicts don't abuse substances because they innocently tried them once and became hopeless slaves. Addicts use in an attempt to compensate for a fundamental lacking and the truth is that most of them aren't going to change anytime soon, if at all. Anyone that would criticize Mrs. Harris' work obviously has little to no personal experience to speak from.
Fury K, USA

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