E (Mrs) v Eve

Last updated
E (Mrs) v Eve
Supreme court of Canada in summer.jpg
Hearing: June 4–5, 1985
Judgment: October 23, 1986
Full case nameEve, by her Guardian ad litem, Milton B. Fitzpatrick, Official Trustee v. Mrs. E.
Citations [1986] 2 S.C.R. 388
Docket No. 16654
Prior historyJudgment for Mrs. E. in the Court of Appeal for Prince Edward Island.
Rulingappeal allowed
Holding
A proxy decision-maker cannot consent to the non-therapeutic sterilization of a mentally incompetent person.
Court membership
Reasons given
Unanimous reasons byLa Forest J.

E (Mrs) v Eve, [1986] 2 S.C.R. 388 is a judgment by the Supreme Court of Canada regarding a mother's request for the consent of the court to have her disabled daughter sterilized. This was a landmark case which is influential in Canadian legal decisions involving proxy-consented, non-therapeutic medical procedures performed on people of diminished mental capacity.

Contents

Background

Case

Eve was a 24-year-old woman suffering from "extreme expressive aphasia" and was at least "mildly to moderately developmentally delayed" with learning skills at a limited level. [1] She spent the week at a school for adults with mental disabilities, and went back to her mother's home on the weekends. Administrators at Eve's care facility noticed that she was developing a close relationship with a male resident, also disabled, and became concerned. Mrs. E, also, was concerned that Eve might innocently become pregnant. Her disability prevented her from understanding the concept of marriage or the "consequential relationship between intercourse, pregnancy and birth," and she would be unable to carry out the necessary duties of motherhood. [1]

In order to ensure she had the right, as Eve's substitute decision-maker, to consent to the sterilization procedure, Mrs. E requested that:

A major concern of the court was the fact that tubal ligation, in this instance, was non-therapeutic (i.e. not necessary for medical reasons) and that a hysterectomy, which was "authorized by the Appeal Division", was major surgery. [1]

One of the arguments made against Mrs. E. was that the Canadian Charter of Rights and Freedoms was that a court-ordered sterilization of this person of diminished capacity was depriving that person of her right to procreate, infringing on Eve's right to liberty and security.

Previous rulings

In the Family Division of the Supreme Court of Prince Edward Island, Mrs. E.'s requests were denied. Although the judge had no issue with the first two petitions (i.e. the appointment of Mrs. E. as Eve's formal guardian), he rejected the third, on the basis that substitute decision makers cannot consent to non-therapeutic surgical procedures. [1]

On appeal, the original ruling was overturned. The majority of the three judge panel stated that there was sufficient evidence to warrant the sterilization of Eve, and that the parens patriae powers of the court allowed it to consent, on behalf of the incompetent individual, to therapeutic surgical procedures. That court stated that the parens patriae powers of the court were to be used for the benefit of the incompetent individual, and that sufficient evidence had been presented to convince them that sterilization was in Eve's best interest. [1] [2]

Ruling

The Supreme Court of Canada, however, ruled in favour of Eve, and unanimously rejected Mrs. E.'s request for authorization to perform a sterilization procedure. [1] The opinion of the Supreme Court of Canada was that "barring emergency situations, a surgical procedure without consent ordinarily constitutes battery, [and] it will be obvious that the onus of proving the need for the procedure is on those who seek to have it performed...In conducting these procedures, it is obvious that a court must proceed with extreme caution; otherwise...it would open the way for abuse of the mentally incompetent, ...[they] would allow the appeal and restore the decision" of the original court, which had rejected the petition. [1]

See also

Related Research Articles

Sterilization is any of a number of medical methods of birth control that intentionally leaves a person unable to reproduce. Sterilization methods include both surgical and non-surgical, and exist for both males and females. Sterilization procedures are intended to be permanent; reversal is generally difficult or impossible.

<span class="mw-page-title-main">Tubal ligation</span> Surgical clipping,removal or blocking of the fallopian tubes

Tubal ligation is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus the implantation of a fertilized egg. Tubal ligation is considered a permanent method of sterilization and birth control.

Parens patriae is Latin for "parent of the nation". In law, it refers to the public policy power of the state to intervene against an abusive or negligent parent, legal guardian, or informal caretaker, and to act as the parent of any child, individual or animal who is in need of protection. For example, some children, incapacitated individuals, and disabled individuals lack parents who are able and willing to render adequate care, thus requiring state intervention.

Skinner v. State of Oklahoma, ex rel. Williamson, 316 U.S. 535 (1942), is a unanimous United States Supreme Court ruling that held that laws permitting the compulsory sterilization of criminals are unconstitutional as it violates a person's rights given under the 14th Amendment of the United States Constitution, specifically the Equal Protection Clause and the Due Process Clause. The relevant Oklahoma law applied to "habitual criminals" but excluded white-collar crimes from carrying sterilization penalties.

<span class="mw-page-title-main">Compulsory sterilization</span> Government policies which force people to undergo surgical sterilization

Compulsory sterilization, also known as forced or coerced sterilization, is a government-mandated program to involuntarily sterilize a specific group of people. Sterilization removes a person's capacity to reproduce, and is usually done through surgical procedures. Several countries implemented sterilization programs in the early 20th century. Although such programs have been made illegal in most countries of the world, instances of forced or coerced sterilizations persist.

<i>Stump v. Sparkman</i> 1978 U.S. Supreme Court case on judicial immunity

Stump v. Sparkman, 435 U.S. 349 (1978), is the leading United States Supreme Court decision on judicial immunity. It involved an Indiana judge who was sued by a young woman who had been sterilized without her knowledge as a minor in accordance with the judge's order. The Supreme Court held that the judge was immune from being sued for issuing the order because it was issued as a judicial function. The case has been called one of the most controversial in recent Supreme Court history.

<span class="mw-page-title-main">Salpingectomy</span> Surgical removal of Fallopian tube

Salpingectomy refers to the surgical removal of a fallopian tube. This may be done to treat an ectopic pregnancy or cancer, to prevent cancer, or as a form of contraception.

In law, a ward is a minor or incapacitated adult placed under the protection of a legal guardian or government entity, such as a court. Such a person may be referenced as a "ward of the court".

Involuntary treatment refers to medical treatment undertaken without the consent of the person being treated. Involuntary treatment is permitted by law in some countries when overseen by the judiciary through court orders; other countries defer directly to the medical opinions of doctors.

<span class="mw-page-title-main">Essure</span> Permanent birth control method for women

Essure was a device for female sterilization. It is a metal coil which when placed into each fallopian tube induces fibrosis and blockage. Essure was designed as an alternative to tubal ligation. However, it was recalled by Bayer in 2018, and the device is no longer sold due to complications secondary to its implantation. The company has reported that several patients implanted with the Essure System for Permanent Birth Control have experienced and/or reported adverse effects, including: perforation of the uterus and/or fallopian tubes, identification of inserts in the abdominal or pelvic cavity, persistent pain, and suspected allergic or hypersensitivity reaction. Although designed to remain in place for a lifetime, it was approved based on short-term safety studies. Of the 745 women with implants in the original premarket studies, 92% were followed up at one year, and 25% for two years, for safety outcomes. A 2009 review concluded that Essure appeared safe and effective based on short-term studies, that it was less invasive and could be cheaper than laparoscopic bilateral tubal ligation. About 750,000 women have received the device worldwide.

The Alberta Eugenics Board was an agency created by the Alberta government in 1928 that attempted to impose sterilization on a disabled subset of its population, in accordance with the principles of eugenics. It remained active until 1972, when it was dissolved.

<i>Secretary of the Department of Health and Community Services v JWB</i>

Secretary of the Department of Health and Community Services v JWB and SMB, commonly known as Marion's Case, is a leading decision of the High Court of Australia, concerning whether a child has the capacity to make decisions for themselves, and when this is not possible, who may make decisions for them regarding major medical procedures. It largely adopts the views in Gillick v West Norfolk Area Health Authority, a decision of the House of Lords in England and Wales.

Tubal reversal, also called tubal sterilization reversal, tubal ligation reversal, or microsurgical tubal reanastomosis, is a surgical procedure that can restore fertility to women after a tubal ligation. By rejoining the separated segments of the fallopian tube, tubal reversal can give women the chance to become pregnant again. In some cases, however, the separated segments cannot actually be reattached to each other. In some cases the remaining segment of tube needs to be re-implanted into the uterus. In other cases, when the end of the tube has been removed, a procedure called a neofimbrioplasty must be performed to recreate a functional end of the tube which can then act like the missing fimbria and retrieve the egg that has been released during ovulation.

Compulsory sterilization in Canada has a documented history in the provinces of Alberta, Saskatchewan, and British Columbia. In 2017, sixty indigenous women in Saskatchewan sued the provincial government, claiming they had been forced to accept sterilization before seeing their newborn babies.

This disability rights timeline lists events relating to the civil rights of people with disabilities in the United States of America, including court decisions, the passage of legislation, activists' actions, significant abuses of people with disabilities, and the founding of various organizations. Although the disability rights movement itself began in the 1960s, advocacy for the rights of people with disabilities started much earlier and continues to the present.

Madrigal v. Quilligan was a federal class action lawsuit from Los Angeles County, California involving sterilization of Latina women that occurred either without informed consent, or through coercion. Although the judge ruled in favor of the doctors, the case led to better informed consent for patients, especially those who are not native English speakers.

Sterilization law is the area of law, within reproductive rights, that gives a person the right to choose or refuse reproductive sterilization and governs when the government may limit this fundamental right. Sterilization law includes federal and state constitutional law, statutory law, administrative law, and common law. This article primarily focuses on laws concerning compulsory sterilization that have not been repealed or abrogated and are still good laws, in whole or in part, in each jurisdiction.

<i>Doe ex. rel. Tarlow v. District of Columbia</i>

Doe ex. rel. Tarlow v. District of Columbia, 489 F.3d 376, is a unanimous decision of the United States Court of Appeals for the District of Columbia Circuit, written by Circuit Judge Brett Kavanaugh, in which the Court upheld a 2003 District of Columbia statute that stated the conditions for authorizing a non-emergency surgical procedure on a mentally incompetent person. This case developed out of an appeal to a district court decision that was brought on behalf of a mentally incompetent patient who was subjected to an abortion without her consent and another patient who was subjected to an eye surgery without the patient's consent. Under the appellate court's interpretation of the statute, a court located in the District of Columbia must apply the "best interest of the patient" standard to a person who was never competent, and the court must apply the "known wishes of the patient" standard to a person who was once competent. The appellate decision was remanded to the District Court.

The Relf Sisters, Minnie Lee and Mary Alice Relf, are two African-American sisters who were involuntarily sterilized by tubal ligation by a federally funded family planning clinic in Montgomery, Alabama in 1973. News coverage of a class-action lawsuit filed by the Southern Poverty Law Center brought the fact of U.S. government-funded sterilization abuse to the national spotlight.

Sterilization of Latinas has been practiced in the United States on women of different Latin American identities, including those from Puerto Rico and Mexico. There is a significant history of such sterilization practices being conducted involuntarily, in a coerced or forced manner, as well as in more subtle forms such as that of constrained choice. Forced sterilization was permissible by multiple states throughout various periods in the 20th century. Issues of state sterilization have persisted as recently as September 2020. Some sources credit the practice to theories of racial eugenics.

References

  1. 1 2 3 4 5 6 7 8 [E. (Mrs.) v. Eve, Eve v. Mrs. E. [1987], 3D.L.R. (4th) S.C.C. 388 (S.C.C.)
  2. Kluge EHW. After 'Eve': Whither proxy decision making? Can Med Assoc J 1987; 137(8):715b-720.