Many consider their plight an archetype for genocide. Centuries past, the British suggested the proper response to their presence was “extermination.”1 Their soldiers then proceeded to knowingly decimate them with smallpox—a virus to which Native Americans had no immunity. Many other reprehensible efforts to eradicate their race HMwould follow. There would be a “Trail of Tears,” murderous attacks on Nez Perce men, women, and children to acquire their ancestral homeland, and a massacre at Wounded Knee. There were many more examples, too many in fact to recount. In common, they all were the outcome of misguided governments, widespread greed, and the enforcement thereof HMby a ruthless military. A recent, albeit weakly publicized, continuation of policy entered a Bioethical arena thought to be off limits since Nuremberg. That killing field had already been condemned, hadn’t it? It was once inhabited by the evil of forced sterilization. When she was 20 years old, a Native American woman underwent a total hysterectomy by an Indian Health Service (I.H.S.) physician for unconvincing indications. Her experience came to light when she visited Dr. Connie Pinkerton-Uri, a physician of Native American heritage in the 1970s. Two other young women in Montana needed appendectomies and also received “incidental” tubal ligations. Were these merely aberrations or the first examples of a disturbing pattern? Bureau of Census Reports explicitly documented a steep decline in childbirth for diverse Native American tribes comparing birth numbers from 1980 to 1970. The three examples were, unfortunately, the tip of an iceberg. What may be the most disturbing aspect of discoveries that would follow: it was physicians and healthcare professionals in the I. H. S. who coerced these women. It was they who abandoned their professional responsibility to protect the vulnerable through informed consent. Their coercion included the threat of withdrawing future healthcare provisions, or even custody of their children, if permission for sterilization was withheld. The scandal of this replay of earlier Twentieth Century eugenic programs and genocidal tactics led to a Congressional Hearing (Senator James Abourzek, Democrat, South Dakota), but little else in terms of publicity, justice, or public outcry. But the investigation estimated that the forced sterilization efforts might have targeted more than 3,000 Native American women (likely a conservative estimate). Although the travesty of forced sterilization targeting Native Americans occurred a generation ago, and has apparently ended, this déjà vu in 2009 is critical. First and foremost, it took place in America. The record for such immoral activities here has already been questioned in light of California’s record with forced sterilization from 1909 through 1979, all with Federal funding.6 Approximately 20,000 similar operations were performed there, a significant number of these after Nuremberg and the Geneva Convention. Secondly, if the centuries-long treatment of Native Americans is a protracted genocide, the addition of physicians to the armamentarium, especially now, is ominous. It was observed that the physicians in the I.H.S. at the time were young. Since their generation, additional medical graduates have moved even further from the tenets of “Do no Harm.” Indeed, W.B. Yeats had been right in general, but even more so in a post-Hippocratic Medical Culture. The “falcon cannot hear the falconer” any longer. The center of a noble profession does not seem to be holding.