Healthcare for Native American Women: Moving from Human Rights Violations to Advancing Justice

Overview: This presentation examines the role of social workers in health services for Native Americans, highlighting our complicity in human rights violations, our opportunities to advance human rights, and our responsibility to incorporate this information in the curriculum, thus, providing future generations of social workers with essential knowledge and skills.Proposal text: Social work educators have a responsibility to teach about practices, policies, and structures that hinder or advance human rights. For Native Americans, healthcare is not only a human right, but also a legal right affirmed in the trust responsibility of the federal government, articulated in the Constitution, and guaranteed by numerous treaties, laws, Supreme Court decisions, and Executive Orders (Indian Health Service, 2021).

While health services should focus on well-being, the US colonial legacy and push for assimilation manifested in programs that emphasized eugenics and sterilization. It is estimated that between 1970-1976, 25-42% of Native American women of childbearing age were sterilized (Theobald, 2019). Recent coercive sterilizations have also been documented in Canada (Ryan, Ali & Shawana, 2021). Social workers pressured Native women to undergo sterilization procedures to keep their welfare benefits or prevent their children from being removed (Kennedy, 2008; Lawrence, 2000; Petchesky, 1990, Torpy, 2000; University of Vermont, 2011). There are many documented examples of Indigenous women having no recollection of signing sterilization consent forms, being coerced to sign while medicated or having just given birth (Torpy, 2000). Assessments noting “mental illness,” “mental deficiency,” “degenerate family conditions,” and “bad heredity” led to increased chances of sterilization (University of Vermont, 2011; University of Vermont, n.d.). The profession’s role in normalizing eugenic discourse gave it the veneer of legitimacy, further supporting the sterilization of Indigenous women. Social workers’ involvement in coercive sterilizations is a human rights violation that meets the United Nations definition of genocide (United Nations, 1948). Indigenous organizations, such as Women of All Red Nations (WARN) have raised awareness about forced sterilizations and removal of children, leading to federal regulations requiring informed consent prior to sterilization (Lakota People’s Law Project, 2020).

Educators have opportunities and obligations to teach about past and on-going injustice while cultivating students’ awareness and skills, including the ability to recognize violations of informed consent and when interactions with clients are coercive. Social workers must be aware of the legal responsibilities the federal government has for the health and well-being of Native Americans and advocate for the government to fulfill treaty obligations, including adequate funding and support for health programs, preventive care, mental health parity, and culturally appropriate services. As a basic human right, Native Americans should have access to clean water, adequate sanitation, nutritious food, and not be exposed to environmental toxins.

As we educate about social workers’ roles in human rights violations, we can also teach about opportunities for securing human rights and building a more equitable society. This presentation describes activities to help students understand the federal trust responsibility for provision of healthcare, social workers’ roles in the sterilization of Indigenous women, and opportunities to advocate for health care as a human right. By incorporating this content in our classrooms, we create inclusive learning environments and skilled social workers who can build a more just society. As educators, we have a responsibility to prepare future generations of social workers to advance human rights, confront disparities, and support Indigenous health.