The horrid consequences of the eugenics movement.
I heard a story recently from one of our family practice residents. Seems that a friend of hers was sterilized without knowledge or consent, at the age of 19(!!!!!!) by a doctor who told her after the fact that he had 'taken care of her problem' during her cesarean.
I remember hearing stories about what were called "Mississippi appendectomies" - young black women in public hospitals with abdominal pain being told it was their appendix, and as long as he was in there the doctor tied her tubes.
I remember seeing a young woman from Mexico a few years back who was concerned that she was having trouble getting pregnant. As part of a basic workup, we did a pelvic US that showed an IUD in her uterus. She honestly had no clue.
An interesting tidbit - the Federal Family Planning law has for several years required that consent for any sterilizing operation (including a hysterectomy pre-menopause) be consented for at least 30 days in advance. This can be waived to 72 hours only in very specific circumstances. A hospital that ignores this law will not only not get paid for the operation, but for any other bills incurred duing that hospital stay. But private insurance has no such safety clause.
Call it eugenics or Americanization . . . a number of Hispanic women use birth control in the form of IUD's and have no idea of the ill effects they can have even if they are aware they are there. I know a woman who has for many years suffered from crippling pain as a result of endometriosis. Our county doctors here (either due to expediancy or the language barrier) would not remove her IUD nor commit to a hysterectomy, but instead put her on a birth control pills. I've never understood why this was done. I can only assume that it was that important to her (even in her forties) to not get pregnant or what . . .
It is, in my opinion, a real weakness (at least in our county) that for $15 a year you can get "insurance" from the county hospital and any subsequent visits are "free" (if you qualify), when the treatment that they get is so below an acceptable standard. It would serve the community, the hospital, the doctors, and even the patients to pay a sliding scale (a tiny fraction) per visit and procedure than to simply pay this $15 a get shuffled from one place to another with no real solutions or even reasonable treatment.