Uninformed Consent and the Idealized Myth of the Four-Person-Family

Throughout the 20th century, American medical procedures and experimentation were forced upon the economically poor and "unfit." There are multiple examples of such exploitation in communities widely considered inferior to Americans, but the medical mistreatment of Alaska Natives in the 1930s and Puerto Ricans in the 1960s were emphasized in this week's agenda.

The use of these communities as guinea pigs stems directly from the lack of information provided by the medical practictioners. The idea of informed consent is briefly mentioned in both Andrea Smith's "Natural Laboratories" Medical Experimentation in Native Communities and Ana Maria Garcia's film La Operacion, but in both instances the way such consent was protrayed left me awestruck. In the film, I thought it was interesting that in most cases the husband was the one signing the consent forms for his wife's sterilization (though it seems that the majority of the males would not consent to the male sterilization equivalent). Furthermore, one particular line struck me as particularly odd. In discussion about the consent forms for the sterilization procedure, one individual said "when they sign the consent form" (emphasis added) making it sound as if everyone does consent to the operation whether their consent requires force or not. The scene with the clinic representative walking from house to house asking women why they have yet to get sterilized furthers the implication that the procedure was (too) heavily encouraged. The circumstances in this case are slightly different from those in Alaska, however. In Puerto Rico the operation was not so much an individual right, but a civil obligation in the fight against over-population. In Alaska, the experimentation was much more widescale and even less information was disclosed to the "patients." Claims were made stating that no hazards existed for the patients and that most patients could not accurately remember if they had given their informed consent months later. So, because of this common inability of patients to remember, the practitioners erroneously figured that their consent was not really necessary. They tended to forget granting it anyway. In reality, the fact that patients were not sure whether they were really truly "informed" in their consent does not speak of the apathy of the patients but rather the lack of information provided.

Returning to the film, I drew an interesting parallel between the idealized myth of the four-person-family and other myths we have addressed in class including that of the perpetual male sex drive and the necessity of individuals to fit within our own classifications of "normal."
Puerto Ricans were bombarded with this institutionalized ideal of the well-off family with one boy and one girl and they began to buy into the myth and felt that they needed to emulate this family formula. To me this seemed to be one of the primary reasons why the Puerto Rican women were so open to the idea of sterilization. It was a way that they could escape poverty and live like the white women depicted in the media.