The Law: Sterilized: Why?

Mary Alice Relf, now twelve, is mentally retarded, has a speech defect, and was born without a right hand. She has a sister named Minnie, 14, and as they grew old enough to attract boys, welfare workers steered them to a federally financed family planning center in Montgomery, Ala., where they received injections every three months of a drug called Depo-Provera, which was being tested as a contraceptive.

Last month, shortly after the drug was banned because of undesirable side effects, two nurses paid a visit to the shabby apartment where the Relfs live on $150 monthly welfare payments. Lonnie Relf, 56, a former field hand who has been unemployed since he was lamed in an auto accident four years ago, was away from home, but his wife Minnie recalls that the nurses told her the girls would have to go to the hospital for more shots. They said she must sign a paper, so she marked a surgical consent form with an X. The girls were taken to the Professional Center Hospital, kept overnight, and then sterilized next day by tubal ligation.

“I didn’t want it done, and I’m still upset,” Lonnie Relf testified last week before a Senate subcommittee, chaired by Edward M. Kennedy, which is pressing for a bill to tighten controls on Government medical experimentation. Relfs wife agreed: “I was mad. I wouldn’t have let them do that.”

The family planning center has insisted that the operation was properly explained to Mrs. Relf, but she denies this. Had she then given a valid, informed consent, and did she have the legal right to do so? Or, more broadly, what right does the Government have to perform such an operation?

When the Office of Economic Opportunity set up its family-planning program in 1967, the regulations stated that “no project funds shall be expended for any surgical procedures intended to result in sterilization or to cause abortions.” To help poor people prevent unwanted births, the ban on funds for voluntary sterilization was quietly dropped in 1971—the OEO financed some 16,000 of them last year—but no rules were ever promulgated. A set of guidelines was drafted and printed, barring sterilization of anyone who did not have “the legal capacity to himself consent to the procedure,” but after an obscure controversy within the Administration, the guidelines were sent to a warehouse. Thus the use of federal funds for sterilization was left in a kind of legal vacuum.

Joseph Levin Jr., an attorney for the Southern Poverty Law Center, first filed a $1,000,000 damage suit for the Relfs against the family planning center and OEO officials. Then he upped it to $5,000,000 and named John W. Dean III and John D. Ehrlichman as co-defendants on the ground that they had been negligent in failing to speed the issuing of guidelines that could have prevented the operations on the girls.

Taking a broader aim, the American Civil Liberties Union filed suit last week on behalf of Nial Ruth Cox, now 26 and a nurse’s aide on Long Island. She was sterilized in North Carolina in 1965 after her mother, who was supporting ten children on welfare, was persuaded that the results of the operation would be temporary. The suit charged that Miss Cox had been unfairly described as “mentally deficient,” then coerced, deprived of due process and made a victim of cruel and unusual punishment. Laws permitting the “forced sterilization” of anyone termed “mentally defective” exist in 22 states, the A.C.L.U. said, and should all be struck down by the Supreme Court as unconstitutional.