What Is Mississippi Appendectomy

Mississippi Appendectomy
By: Kevin Cortez
February 10th, 2015

Perhaps what is most disturbing about the "Mississippi appendectomy" is that there are very few documents that have recorded these events which were indicative of unethical human rights violations. However, the few documents that have been found are disturbingly descriptive. Fannie Lou Hamer is often regarded as the individual who coined the term Mississippi appendectomy after she went into the Sunflower City Hospital to have a small uterine tumor removed and came out having a complete hysterectomy performed on her. This unnecessary operation was performed in 1961 without her consent under the authority of her attending surgeon. Years later as she rose as a leader in the black
activist community in Mississippi, she provided information indicating that these procedures were being done not only in Mississippi but in other states. Fannie Lou Hamer went into the Sunflower City Hospital in 1961 to have a previously diagnosed small uterine tumor removed.
However, she left the hospital barren without knowing what happened. Her physician decided to perform a complete hysterectomy without getting her consent or telling her about the operation. By definition, a hysterectomy involves the removal of the uterus but may also include removing the ovaries, fallopian tubes, cervix, and other nearby structures. Eventually becoming a leader of the Mississippi Freedom Democratic Party, it wasn't until three years later that Hamer elaborated about the events that took place that day. She spoke out to an audience in Washington, DC describing to them that many black women in her area of residence had fallen victims to a Mississippi Appendectomy. She elaborated that a Mississippi appendectomy is a hysterectomy performed on poor black women who had received no indication that they were going to receive this type of surgery and did not ask for the procedure to be done. Based on the research she provided, 60% of black women in Sunflower County, Mississippi were subjected to some form of sterilization without giving their consent. However, other nonconsensual procedures were also occurring in other southern
states. During the 1960's and 1970's, government funded welfare programs in the southern states actively implemented the sterilization of thousands of black women mostly from poor economic backgrounds.
Many black women were put under pressure by being told that if they did not consent to the sterilization procedure, they would lose their welfare benefits along with any medical and dental care they were eligible to receive. This common form of unnecessary and non-consensual form of sterilization became known as "Mississippi appendectomy(ies)" among the southern black communities. Particularly in the 1970's, this form of sterilization was growing at an increasing rate and in a span of ten years (1970-1980) the number of cases grew from 200,000 cases to over 700,000 cases. (Mississippi Eugenics) In Mississippi alone, there were a total of 683 sterilizations resulting from the eugenics project. Although most sterilizations were performed on females (523), males were also victims (160) of these procedures. Mississippi passed a sterilization law in 1928 resulting in a small increase of operations. However, sterilizations greatly increased towards the end of the 1930's. Cases involving sterilization was also on the rise in other
states. Elaine Riddick was a black teenager who became the victim of molestation and rape leading to her pregnancy. In 1968 she went into a North Carolina hospital to give birth to her son but also received an unnecessary operation which would take many years for her to find out. She had become a victim of a five person state panel known as the North Carolina Eugenics board who were in charge of the sterilizations of thousands of people who were deemed unfit for society based on their "mental health" status. Within the hospital, a social worker had reported that Elaine was "promiscuous" and "feebleminded" and recommended that she become sterilized. Elaine's grandmother who was illiterate, was told that they were going to perform an operation that would benefit 14 year old Elaine. Without Elaine's consent or knowledge and with papers signed with an "X" by her grandmother, the state paid for the sterilization of Elaine and shortly after giving birth she was sterilized. In an interview with Elaine years later she uses this striking phrase to describe what happened to her, "I was raped twice, once by the perpetrator and once by the state of North Carolina". North Carolina and other states involved in the Eugenics project are currently determining forms of compensation for the victims of these programs. The United States of America has often had an unhealthy addiction for sterilization of a percent of the general population. All of the victims were minorities who had very little say over what would happen to their own bodies.It is for this reason that it is important to understand why many minorities find it hard to trust the science community even to this day. In terms of birth control, minorities are often hesitant to use hormonal birth control methods such as the birth control pill. Shortly after the 1960's, many black individuals were hesitant to trust government sponsored birth control clinics in fear that it was an effort to decrease the black population. This fear was well expressed considering that black reproduction was often controlled by whites, particularly in the southern states. Rumors regarding the birth control pill also spread which often carried the connotation that two different types of birth control were made. One type would be given to white women which would just temporarily prevent ovulation while the second type would permanently sterilize black women. Although a substantial amount of time has passed since the days of the first Mississippi Appendectomies, the question as to if this type of human violation has ended is still in question. Recently, an investigation pushed by California democratic state Senator Ted Lieu and the center for investigative reporting (CIR) recently uncovered that there were various systemic violations in terms of female inmates receiving sterilization at the Central California Women's Facility, Folsom Women's Facility, Valley State Prison for women, and the California Institution for women. The investigation discovered that a third of the inmates that had a bilateral tubal ligation received it unlawfully. In 27 instances, the inmate's attending physician did not sign the consent form which indicated that the inmate was properly informed about the operation and fully understood what the procedure entailed. In another 18 cases, the mandatory waiting periods between the time that the inmate confirmed they wanted the operation and when the procedure actually took place may have been violated since California law mandates that sterilization may only be performed between 30 and 180 days from the time a woman gives consent to the surgery so that the patient has enough time to fully make sure that they still want to become sterilized. In certain instances, physicians were found guilty of manipulating consent forms so that it would appear that the mandatory waiting period was met even though it had not. Although the term Mississippi Appendectomy was mostly used in the mid 1900's, it is disturbing to realize that there are still instances where very similar unethical events are still taking place in present day. Several ethical issues were broken during these time periods based on the American Medical Association's (AMA) guidelines which was adopted in 1957. The very first guideline states that physicians need to provide competent care while upholding compassion and respect for human dignity and rights. With the Mississippi Appendectomies, physicians completely took advantage of their patients and treated them as second class citizens while making life changing decisions without their patients consent. Individuals who were once considered property were still regarded as property by several physicians. A separate guideline provided by the AMA states that doctors need to always be honest in all their patient interactions and must not be deceptive when interacting with their patient. However, patients who were sterilized were lied to and their attending physician was deceptive and withheld information about what they were actually going to be doing to the patient. Aside from these medical guidelines, it is personally disturbing to think that as a minority, my family could have been in the same shoes that many of these minority families were in. It is important for future physicians like myself to keep in mind that at one point, events like the Mississippi appendectomies and the sterilization of females in California took place because physicians thought it was in their power to do so. Physicians are hugely influential over their patients so it is important to remember to not take advantage of the responsibilities and powers we are given.

Works Cited

"AMA's Code of Medical Ethics." AMA's Code of Medical Ethics. N.p., n.d. Web. 6 Feb.
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"Black Genocide." PBS. PBS, n.d. Web. 3 Feb. 2015.

"Confirmed: 39 Women Illegally Sterilized in California Prisons." - RT USA. N.p., n.d. Web. 1 Feb. 2015.

"Eugenics: America's Sad Long Flirtation with Forced Sterilization." Examiner.com. N.p., n.d. Web. 1 Feb. 2015.

James, Susan Donaldson, and Courtney Hutchison. "N.C. to Compensate Victims of Sterilization in 20th Century Eugenics Program." ABC News. ABC News Network, 10 Jan. 2012. Web. 5 Feb. 2015.

"Mississippi Eugenics." Mississippi Eugenics. N.p., n.d. Web. 1 Feb. 2015.

"Sterilization Abuse: A Task for the Women's Movement." Sterilization Abuse: A Task for the Women's Movement. N.p., n.d. Web. 3 Feb. 2015.

"US Eugenics Victim: 'I Didn't Know What They Were Doing to Me'" - RT USA. N.p., n.d. Web. 1 Feb. 2015.