Sure. I can start it.
First of all, let's acknowledge that I think we are speaking to a degree in hypotheticals here. But I doubt that the kind of situations you are speaking of—situations where a women has had an ongoing interaction with one or several health care providers over the course of a pregnancy and has either a planned date for delivery or at least a time frame in which the birth will take place—are the cases where women are being induced into a sterilization procedure that they subsequently either deny agreeing to or feeling was the right decision.
I think the cases we're talking about are more likely instances where, if you can imagine, a person for all practical purposes is homeless, and maybe they've had an interaction with a public health professional wherever they are spending their days and nights in whatever somewhat indigent kind of living situation they have. I think it's more likely that it's that kind of person who has no established relationship with the health care system, and certainly is not dealing on any kind of equal footing with the provider. I think just speaking to these issues of consent, there's a huge difference when there's even a certain amount of cultural awareness or sensitivity to the fact that someone is of very modest economic means or really almost destitute. One can understand that.
We also need to understand that any conversation between a health care professional and a person in those circumstances is such a power imbalance that one can't take at absolute normal face value the exchange that occurs between those two people.
Again, one has to use some imagination, but you can sort of see how a circumstance could evolve in the kind of situation that I'm describing. It's further compounded by mental illness or an addiction—and I want to be clear I'm not making an accusation against health care providers, but it wouldn't be shocking to imagine that some providers without adequate training who encounter a person who's got a whole array of social and economic and psychological circumstances might well be more inclined to ask that person, if it's at the time of delivery, if they'd like to avoid this situation in future, and to have a conversation that is not adequately taking account of the real circumstances of that individual, and therefore what the exchange between the patient and the provider really means and how it should be managed properly.