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CRACKING DOWN | PAGE 1, 2
Yet while Harris may have touched a nerve with the public, critics question whether her solution is effective, much less ethical. So far, CRACK's numbers are sufficiently modest to border on the symbolic. There have been 13 drug-addicted clients, all women, who have chosen sterilization over the less permanent Norplant option. Prior to being sterilized, these 13 women had given birth to 78 children: Six were stillborn, two died after birth and 64 are now in foster care -- "being supported by taxpayers," Harris is quick to note. With about 6 percent of all newborns exposed in utero to illegal drugs (according to the National Institutes of Drug Abuse's estimate for 1992, the last year for which statistics are available), Harris' program has thus made a tiny dent in a big problem. But it is a big enough dent for some to question who Harris is to play God. "To have somebody out there doing these kinds of things that have to do with creation of life or termination of life is way too presumptuous," says Melanie Blum, an Orange County attorney who specializes in reproductive rights and infertility cases. "To sterilize part of the population because you can afford to do so, it is just not her decision ... to make." For Blum, it doesn't make much difference that it is a private citizen and a nonprofit organization -- not the government -- offering the incentive. If paying people not to have children is legal, Blum suggests, perhaps it shouldn't be: "We prevent certain private contracts in this country -- you can't buy and sell children, for example. We prevent certain things because it is against public policy." "The $200 is just a bribe," adds Jon Dunn, the CEO and president of Planned Parenthood of San Bernardino and Orange counties. "Drug-addicted women are effectively being coerced because of their desperation for money for drugs. It is using their circumstances to exploit them." Rocio Cordoba, a staff attorney with the American Civil Liberties Union of Southern California, agrees. "She is targeting a very discrete, vulnerable population of women who have few options." To Harris, however, obsessing too much about women's reproductive rights is what got us here in the first place -- and that singular focus has obscured the needs of the real vulnerable population, children. "We have more compassion for animals than we do for kids," Harris fumes. "What about the babies that are dying? Don't get me wrong, it is nice to live in America, but we are messed up. Our rights are going to be our biggest downfall." Harris makes no bones about her own singular focus, however: Her program is about the children, not women or their rights. This aspect of CRACK strikes many as cynical, both in its conception and execution -- an image that is not redeemed by the unvarnished message on the program's flyers: "Don't Let Pregnancy Ruin Your Drug Habit." The payment is a one-time offering, with no provision for follow-up. "We would be more supportive of a program that would actually address the underlying problems," says Cordoba. Harris readily admits that some of her clients might use the $200 to buy more drugs. But she does not subscribe to the conventional wisdom that addiction is a disease -- a fact that raises the ire of equally outspoken critics on the left and has cost her support from some in medicine and public health. Next to Cordoba, who describes the women Harris is targeting in a way that makes drug addiction seem like a visitation, Harris sounds callous. "If they are drug addicts, they are drug addicts by choice," Harris says. "People say it is a disease, fine. But it is a disease of choice -- however they got there and whatever their background and however screwed up their life is. The babies don't have a choice." Harris' simple -- some would say facile -- solution has also raised charges of racism. Dr. Xylina Bean, chief neonatologist at Martin Luther King Jr./Drew Medical center in Los Angeles, told the L.A. Times that she believes the program focuses on minority communities, feeding "latent racism" -- although about half of CRACK's clients have been white. And while Harris is white, her husband, Smitty, is African-American, as are their adopted children. Harris' critics also warn about the slippery slope. "Today it is targeting and criminalizing drug abuse, but what will it be tomorrow?" asks the ACLU's Cordoba. "If you take it to its logical conclusion, you could have a program or policy that monitors the kind of food a woman eats while she is pregnant, or whether she exercises enough, or whether she has a glass of wine or a cup of coffee." Blum voices similar concerns. "Where does it stop? Next do we start sterilizing people who don't take their multivitamins?" Harris dismisses the naysayers, laughing off the idea that discouraging crack addicts from having babies will inevitably lead to jailing pregnant coffee drinkers. A more valid concern, however, is whether the program really addresses the problem. "Crack moms" may be a convenient and sensational target, says Deborah Mathieu, author of "Preventing Prenatal Harm: Should the State Intervene?" (second edition, 1996), but alcohol probably poses a much worse threat to the fetus. And alcohol and tobacco use during pregnancy are far more widespread -- according to the National Institutes of Drug Abuse, 18 percent of newborns have been exposed to alcohol in utero and 20 percent to tobacco, nearly four times the number exposed to illegal drugs. In addition, says Mathieu, recent research suggests that the impact of in utero drug exposure may not be as dramatic, or as long-term, as was once feared. "Crack itself is not the main danger," says Mathieu. "The main danger is being brought up by an addict." Harris' critics complain that the decision-making capacity of the women her program targets is so impaired by drug use that any consent to undergo sterilization is suspect. Harris' answer is CRACK client Sharon Adams. "I am not ashamed of how many kids I've had," Adams tells me when we talk. "I am not ashamed to tell anyone I was on dope. I hit bottom, rock bottom. I've been raped, I've been shot, I've been to prison. I was close to death." Herself the 14th of 14 children, Adams had given birth to 13 children, all of whom have ended up in foster care, in prison or dead. She is hard pressed to say why the 14th was a charm, but when she became pregnant again, she decided she would try to stop "chasing the rock" and get clean. She did. A nurse at the hospital where she was due to deliver her son encouraged Adams to be sterilized and gave her a CRACK flier. "I didn't care. Money or not, I still wanted my tubes tied," says Adams. She used most of the $200 to buy things for her baby. "I told him, 'Kendall, you're the last button on Gabriel's coat and I'm going to use this on you.'" Although Adams is not exactly the target CRACK client -- she had already made her decision, and the $200 was just a little more incentive -- she has become a veritable poster child for the program, appearing with Harris on radio and TV. And she has no regrets about her decision. "It is possible that you could regret it," she admits, "but I tell women to have a level head and do it for yourself, nobody else."
Ironically, if the law Harris had lobbied for two years ago had passed in California, Adams might now be behind bars instead of raising her son and doing public relations for Harris' program. Yet that solution may not be so far-fetched: In May, the U.S. Supreme Court let stand a 1989
South Carolina
statute that made drug use by pregnant women a crime. With that kind of momentum, Harris is making plans to go national with CRACK, predicting that the nation is ready for her $200 solution. "Nobody should have a problem with it," she says. "Not anyone who has a
heart, anyway."
Jeff Stryker writes frequently for the New York Times and is a commentator for Public Radio International's "Marketplace." What, if anything, should be done about women who take drugs while pregnant? Join the debate in the Headlines area of Table Talk |
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