Ethical issues of forced sterilization

Last week, I came across this video of the Chinese ambassador (unconvincingly) denying China’s involvement in the abuse of Uyghurs. In the drone footage, we can see armed policemen leading handcuffed, blindfolded people, likely Uyghurs or other minorities, off a train in Xinjiang, China. I was shocked to see that such a scene is happening in modern times and I went to read up more about the Uyghurs online.

 

Xinjiang Uyghur Autonomous Region

The Uyghurs are a Turkic-speaking minority ethic group from the Central Asia region. Many Uyghurs are native to the Xinjiang Autonomous Region, and form a majority of the population there. Since the time Xinjiang came under Chinese rule in 1949, there have been conflict between the Uyghurs and the Chinese government in the region. This has escalated into what we see today. Uyghurs are being forced into re-education camps by the government, humiliated and brainwashed against their will. The Uyghurs have also been used as forced labour in factories that produce various products for export. This year, new research has found that the Chinese government has been forcefully suppressing birthrates of the Uyghurs through forced sterilizations, involuntary fitting of intrauterine contraceptives, and threats of internment for women who refuse to abort pregnancies that exceed birth quotas.

I imagine the doctors who were tasked to carry out these procedures were faced with the ethical dilemma: To follow orders, or to put the interests of their patients first? In this case, it is clear that there is a moral imperative to respect the autonomy of Uyghur women and their choices regarding their own bodies. This will also bring less harm to the mother and child and upholds the non-maleficence aspect of being a doctor.

However, the situation may not always be that straightforward. Some mothers may wish to have an abortion. Should we then respect her decision, and carry out the abortion, but in the process killing the baby and risking the health of the mother? It appears that autonomy and non-maleficence are in conflict. What should a doctor do in this case?

I would attempt to resolve the ethical dilemma as such. First, ask the mother if she is aware of what abortion entails. Provide statistics about the risks of abortion and provide a way for the mother to find out more information. I would also encourage her to discuss it with her family as an abortion impacts her family as well emotionally and mentally. If after all these, she still wishes to have an abortion, then by all means. But the help and support should not end there. I would check-in with her in future appointments to see how she is doing and ensure that she receives after-care support. I would also recommend her to search for alternative ways to prevent pregnancy in the first place, such as through contraceptives or birth control pills. Hopefully with this, I would be able to prevent a future case of unwanted pregnancy and abortion.