From the moment it was introduced, the most remarkable thing about the birth-control device Norplant has not been the medical technology involved but the rapid emergence of a popular consensus on who ought to use it.
Norplant is designed to prevent conception for five years. Its six plastic capsules are surgically inserted into a woman's upper arm. There, they gradually release a synthetic hormone widely used in birth control pills. The price of the capsules and the implant procedure is about $700.
Given the device's rather stiff price and the duration of its utility, one would have thought that it would have appealed principally to affluent members of the convenience-minded upper-middle class. To the contrary, within days of its approval by the Food and Drug Administration, Norplant was hailed variously as at least a partial solution to the problems of teen-age pregnancy, the urban underclass, welfare dependency and crack cocaine.
A Philadelphia Inquirer editorial urged that the implant be made available to African-American women who are members of the so-called underclass of desperately, apparently permanently, poor.
White supremacist David Duke, a Republican member of the Louisiana Legislature, introduced a measure that would have paid a cash bounty to any poor woman who would accept Norplant along with her welfare payments.
A white male judge in Visalia ordered a black woman convicted of child abuse to choose between jail and the contraceptive implant. His ruling is being appealed.
Earlier this month, Gov. Pete Wilson told The Times that he hoped to make Norplant available through state-financed family planning clinics and the Medi-Cal health-care program for the poor. He said he does not believe that dispensation of the implant to teen-age girls would require their parents' consent.
Wilson also said he was considering providing the device to women who had given birth to "crack babies," infants born addicted to cocaine because their mothers used the drug during pregnancy. Asked whether he thought such women ought to be legally compelled to undergo a Norplant implant, Wilson replied, "Frankly, we haven't decided."
According to a Times Poll, the people of California have. More than 60% of them say that Norplant should be mandatory for women who abuse drugs. Moreover, that majority holds across all categories: 64% of all women would approve such coercion, as would seven of every 10 Latinos and six of every 10 blacks and whites. Half of all African-Americans and more than half of Latinos "strongly approve" the concept. Far smaller percentages in each group endorse the idea of giving Norplant to teen-agers without their parents' consent.
Among the 1,679 adult Californians polled by The Times, nearly half listed drug abuse as the most serious problem confronting children in their neighborhoods. Doubtless, frustration with the seeming intractability of this problem accounts for part of this attitude. But, unfortunately, so too does the traditional American attitude that the appropriate responses to poverty are punitive.
After all, the argument goes, it's for their--and our--own good. As Margaret Sanger, patron saint of programmatic contraception, wrote 72 years ago: "More children from the fit, less from the unfit--that is the chief issue of birth control."
When that attitude conjoins with a good-faith effort to tackle a serious and difficult social problem--as it does in this instance--the moment is fraught with peril, as well as with promise. As Wilson told The Times, "To the extent you can prevent the birth of an addicted newborn, who can be terribly and irreversibly damaged, God knows you want to do that."
But do you want to do it enough to put the state of California back into the business of deciding who will have children and who will not?
A return to such practices ought to be proceeded not by a heedless rush but by a broad and profound debate. We ought to hear the views of the Catholic Church, whose leading intellectuals played a prominent role in the fight to roll back America's earlier experiment with coercive eugenics. We ought to hear from medical ethicists and from doctors and nurses who would have to implement such a law. We ought to hear from civil libertarians and, particularly, from organizations representing women and the poor.
We ought to ask ourselves whether the persistence of racism and sexism in our public life somehow commends this solution above others.
Consider this hypothetical example: Children born addicted to cocaine are a serious concern. However, numerically speaking, they are a small problem compared to those children likely to be physically or socially impaired by poverty. An overwhelming number of the latter children are poor because they are being raised by mothers who live alone. Either the men involved never accepted financial responsibility for the child they fathered or they have refused to pay court-ordered support.
