Madrigal v. Quilligan

Madrigal v. Quilligan was a federal class action lawsuit from Los Angeles County, California involving sterilization of Latina women without informed consent, or through coercion. The judge ruled in favor of the doctors, but the case led to better informed consent for patients, especially those who are not native English speakers.

Background

California had one of the highest sterilization rates in the country during the time of Madrigal v. Quilligan. The eugenics movement was part of the sterilization campaign by deeming those unfit of procreating candidates for sterilization. There was also a funding program that was enacted that gave states money based on the amount of sterilization procedures performed. Beginning in 1909, these procedures were supported by federal agencies that began to disburse funds in conjunction with the family planning initiative.^[1] With support from the federal government and an influx of immigrants from Mexico, California saw some of the highest rates of sterilization. Part of the forced sterilization was in part due to the notion that immigrant families would put a strain on fiscal budgets and through sterilization there would be control of the population, as well as lifelong birth control. In the case of Madrigal v. Quilligan unsuspecting women were coerced to sign the paperwork to perform the sterilization and others were told that the process could be reversed. When these various women came together under the new Chicano Movement and meetings and learned they had the same problems and learned of the sterilization in these Los Angeles Area Hospitals, they came together to file a lawsuit against the Los Angeles County Hospital, which was where these procedures took place. The ten women in the lawsuit were employed working class women independent of government assistance yet they were still sterilized.^[1] One of the main arguments for sterilizations as mentioned before was this fiscal concern of these families on the state. Even though birth control was available it was more marketed to middle class women and not many of these poor Mexican women. Dr. Bernard Rosenfeld, who was a resident at County Hospital and witnessed the doctors abusing the system of sterilization, spoke out against these practices and brought them to the public's attention.^[2] As soon as Chicana Feminists heard of the stories from these women they began to take action, and were very proactive in protesting the mistreatment of their fellow Mexicans.

Case

Decided: June 7, 1978 (Central District of California, Docket Number: CV-75-2057-EC) Affirmed by the Court of Appeals for the Ninth Circuit at 639 F.2d 789.

Plaintiff: 10 sterilized women

Defendant: Dr. James Quilligan (County hospital obstetricians)

Charges: The plaintiffs charged that their civil and constitutional rights to bear children had been violated, and that between 1971 and 1974 they had been forcibly sterilized by obstetricians at County Hospital. Specifically, they signed consent forms under duress, hours or minutes before or after labor, or had never been informed, or had been misinformed, that their "tubes would be tied."^[1] Part of the case was that women were forced to sign papers giving the doctors the right to perform these operations under coerced circumstances or under false impressions. One of the women for whom the case gets its name, Dolores Madrigal, signed the sterilization paperwork because they had told her that her husband had already approved and signed the paperwork, when indeed he really hadn't and they had lied to her.^[1]

Women's Representatives: Antonia Hernandez and Charles Nabarrete of the Los Angeles Center for Law and Justice

Important points in the case

1. Only one key witness, Karen Benker, spoke out against the doctors. She testified that Dr. James Quilligan had said such things as "poor minority women in L.A. County were having too many babies; that it was a strain on society; and that it was good to be sterilized."^[1]
2. Anthropologist Carlos Velez-Ibanez discussed in his argument that since motherhood was the essence of Mexican women's identity, they wanted to have many children and thus forced sterilization even after the fifth or sixth child was particularly inappropriate to Mexicans, a kind of "cultural sterilization".^[1] His statement is about the motherhood of Mexican women of the old way of life and before their arrival to the United States. In another part of his testimony he talked of the eugenic ideas within the hospital. He testified that he had found ample evidence of eugenics infused attitudes among area doctors, including some listed on the Medical Center staff."^[3]
3. The case was not subject to a jury as the lawyers declined in favor of a decision from judge Jesse Curtis overseeing the case. The judge recognized the language barrier between the defendants and plaintiffs. Judge Curtis ruled that there was no deliberate intent by the doctors to hurt the women.
4. The women in the case were not welfare beneficiaries but some women that also were forcefully sterilized were persuaded because of threats to cut off their welfare access, which was why some women feared the loss of that income and proceeded with the procedure.^[4]

Ruling

In an unpublished opinion, the Judge sided with County Hospital, citing that the doctors had the intent of the patients in mind when deciding to pursue these procedures and that the doctors didn’t do anything wrong. He conveyed that it was not objectionable if a physician believed that a tubal ligation could improve a perceived overpopulation problem, as long as said physician did not try to "overpower the will of his patients."^[1]

Results from the ruling

• Forms in multiple languages would be made available for the patient to understand the procedures and accept or decline.
• Patients under 21 years of age would have 72 hours to think about this choice.
• Welfare benefits would not be terminated.
• A subsequent appeal was later filed on October 19, 1979, but it was denied and not pursued further because the new practices were being utilized.
• Hispanic women were now more informed of their rights with regard to sterilization.
• The MALDEF CRP was established in 1974.^[5] This was a group that advocated for women’s rights and informed Hispanic women to be aware of what was going on with their doctors and to report any kind of abuse.

References

1. Stern, Alexandra (2005). Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America. Berkeley: University of California. pp. 200, 205, 206, 207, 208.
2. Stern, Alexandra Minna. "STERILIZED in the Name of Public Health Race, Immigration, and Reproductive Control in Modern California". Journal of Public Health. American Journal of Public Health. Retrieved February 4, 2012.
3. Ruiz, Vicki (1998). From out of the Shadows. New York: Oxford UP. p. 113.
4. Gonzalez-Rojas and Lindley, Jessica and Taja. "Latinas and Sterilization in the United States". National Latina Institute for Reproductive Health (NLIRH. Women's Health Activist Newsletter. Retrieved February 4, 2012.
5. Gutiérrez, Elena (2008). Fertile Matters:The Politics of Mexican-origin Women's Reproduction. Austin: University of Texas. pp. 103, 107.

Espino, Virginia. "'Woman Sterilized As Gives Birth': Forced Sterilization and Chicana Resistance in the 1970s". Vicki L. Ruiz ed. Las Obreras: Chicana Politics of Work and Family (Los Angeles: UCLA Chicano Studies Research Center Publications, 2000), 65-82.