Region: Americas
Year: 1977
Court: United States Court of Appeals, Fourth Circuit
Health Topics: Health care and health services, Informed consent, Medical malpractice, Poverty, Sexual and reproductive health
Human Rights: Freedom from discrimination, Right to bodily integrity, Right to family life, Right to health, Right to privacy
Tags: Access to health care, Family planning, Indigent, Involuntary sterilization, Low income, Patient choice, Poor, Sterilization
Plaintiff Virgil Walker filed suit against Defendant, Clovis H. Pierce, the attending obstetrician at Aiken County Hospital in South Carolina, seeking damages and declaratory and injunctive relief for a violation of her civil rights under the 1st, 4th, 5th 8th, 9th, 13th, and 14th amendments.
Virgil Walker, an African American woman on Medicaid, went to see Pierce on January 7, 1972 when she was expecting her fourth child. Pierce informed her of his sterilization policy which was that “people who were unable to financially support themselves, whether they be on Medicaid or just unable to pay their own bills, if they were having a third child, to request they voluntarily submit to sterilization following the delivery of the third child.” Walker v. Pierce, 560 F.2d 609, 611 (4th Cir. 1977).
Walker did not consent during her first visit. The issue came up again at a second visit and she again refused. Walker testified that Pierce threatened to have her state assistance terminated unless she cooperated. She attempted to find another doctor, but could not find one willing to take new patients. She returned to Pierce and subsequently signed a consent form for sterilization.
On April 16, 1972, Walker delivered her child with Dr. Burke, who substituted for Pierce on occasion. Dr. Burke discussed tubal ligation with Walker, who affirmed she understood it would be permanent and signed two more consent forms submitting to the procedure. Pierce performed the operation the next day. Walker stated that she only submit because protesting would have been futile.
The Court examined whether Pierce’s sterilization policy was in violation of the plaintiff’s Constitutional rights to privacy, due process of law, equal protection of the law, as well as her statutory privileges against discrimination.
The Court held that there was no reason why the defendant could not establish and pursue a policy of requesting that patients who were having a third child and who were unable to financially support themselves voluntarily submit to sterilization following the delivery of a third child or seek another physician. In reaching this conclusion, the Court gave weight to the fact that the Pierce publicly announced his policy. The Court also interpreted Walker’s decision to sign three consent forms as evidence of voluntary action.
“We perceive no reason why Dr. Pierce could not establish and pursue the policy he has publicly and freely announced.” Walker v. Pierce, 560 F.2d 609, 613 (4th Cir. 1977)
“Particularly is this so when all persons coming to him as patients are seasonably made fully aware of his professional attitude toward the increase in offspring and his determination to see it prevail. At no time is he shown to have forced his view upon any mother. Indeed, quite the opposite appears.” Walker v. Pierce, 560 F.2d 609, 613 (4th Cir. 1977)