Philosophers in all fields often resort to thought experiments in order to highlight paradoxes and throw light on particularly knotty questions. Well-known examples in the field of ethics include the Prisoner’s Dilemma and the Trolley Problem. Less often, a real-life example throws up issues which run even deeper than a made-up thought experiment.
A recent example is the case of Barbara Harris and Project Prevention, reported in-depth in The Guardian earlier this week. Apparently, Project Prevention offers drug addicts £200 or so if they agree to undergo sterilisation. Harris adopted a number of children born to addicts, and took on the mission of preventing such ‘crack babies’ by any means possible.
And it seems that Project Prevention will adopt any tactic, including doling out flyers with the slogan distributing flyers with slogans such as “DON’T Let a Pregnancy get in the way of your crack habit”. It’s hard to believe Harris and her organisation really do take the stance attributed to them. But let’s assume they do.
Their ‘offer’ is very controversial – almost everyone who reads about it intuitively thinks it is wrong. But what ethical issues does it throw up?
Even if we allow Project Prevention’s major premise, that addicts must, at all costs, be prevented from falling pregnant, Harris’ solution is replete with ethical problems.
Firstly, Project Prevention, in offering addicts a sum which might fund a week or two of drug addiction, is stretching the notion of ‘consent’ impossibly far. Indeed, those who take up Project Prevention’s offer tend not to tell their doctor that they have been offered cash to undergo the procedure (if they did, doctors would be bound to refuse the procedure, as they would see the patient’s consent as prejudiced).
Another ethical problem with Project Prevention is that the inducement they offer (a few hundred pounds) is short-term, but encourages people to undergo a medical procedure with long-term consequences – in essence selling off part of their personal autonomy.
A further alarm bell (should one be needed!) is sounded by the fact that Harris seems to despise addicts – she has said: “we have campaigns to spay cats to prevent them from having unwanted kittens, yet we allow these women to have litters of 14 children”. It seems obvious that, if we hold people in contempt, our ethical motives for intervening in their lives are doubtful at best. In this case, Project Prevention seems to be using the bodily autonomy of crack addicts as low value means in a mission to prevent harm to hypothetical babies.
This leads on to another point. Project Prevention effects an irreversible change in an actual human being, in order to prevent harm to a possible human being. This is a controversial area (see Risking Wretched Lives, a recent paper by Michael Gibb). In any case, in the Harris case there is a massive assumption that the to-be-sterilised addict , if not sterilised, would go on to become pregnant (or make another person pregnant).
Finally, many who have written about Project Prevention have raised the spectre of Eugenics. The Nazis were one famous group who wanted to select an ‘ideal’ society. Sterilising addicts could be the thin end of a wedge, where we ended up sterilising one group after another in an attempt to select out undesirable character traits. My view is that the Eugenics objection, though emotionally compelling, is less important than the points above about autonomy and consent.
Can anyone think of any ethical arguments in favour of Project Prevention?