Many consider the plight of Native Americans an archetypal genocide. Centuries ago, the British suggested the response to their presence should be “extermination.”[i] Their soldiers then proceeded to knowingly decimate them with smallpox—a virus to which Native Americans had no immunity. Additional efforts over centuries to eradicate their population would follow. There would be a “Trail of Tears,” lethal attacks on Nez Perce men, women, and children to acquire their ancestral homeland, and a massacre at Wounded Knee—to name merely a few. The protracted policy directed against the United States of America’s indigenous peoples represented misguided governments, widespread greed, and enforcement by an at times ruthless, undisciplined military. A recent, albeit weakly publicized, continuation of this policy has been played out in a bioethical arena. Indeed, after the Nuremberg Trials and an explicit international consensus, this would be considered anathema. On view is the evil of forced abortions and sterilizations. This two-pronged approach to knowingly limit births in selected populations was emblematic of eugenic policy in the early to mid-twentieth century. Unfortunately, eugenic birth control had been resuscitated as late as the 1970s through voluntary physician complicity with an immoral national eugenic policy.
When she was 20 years old, a Native American woman underwent a total hysterectomy by an Indian Health Service (IHS) physician for unconvincing indications.[ii] Her experience came to light when she visited Dr. Connie Pinkerton-Uri, a physician of Native American heritage in the 1970s. Two other young women in Montana needed appendectomies and also received “incidental” tubal ligations. Were these merely aberrations or the first examples of a disturbing pattern? Bureau of Census Reports explicitly documented a steep decline in childbirth for diverse Native American tribes comparing birth numbers from 1960 through 1980.[iii] The three examples were, unfortunately, merely the tip of the iceberg.