To its critics, Project Prevention or Crack - an American organisation which pays drug addicts and alcoholics to be sterilised - is a terrifying throwback to the neutering of "defectives" during the 20th Century.
By Clare Murphy
BBC News Online
But the woman who runs this not-for-profit programme believes she is offering a service to everyone: the drug addict, the taxpayer, the child who has not yet been born, and if she has her way - will never be born.
As the programme - which offers both sterilisation and long term birth control - reaches its fifth anniversary, Barbara Harris also believes she has cause to celebrate.
Some 1,050 addicts have taken up the offer as part of her programme over the past five years.
It may not seem a considerable number, but, Ms Harris stresses, the number of clients has more than doubled over the past 12 months compared with the year before.
"Basically, despite the initial controversy over the programme, people are starting to accept that it's a good idea. Probation officers, social workers and those who work on drug treatment programmes are increasingly referring their clients to us," she says.
There is no way of independently verifying the figures given by Project Prevention, nor will the group divulge the names of institutes whose counsellors allegedly refer their clients to the programme - arguing that those people could fall foul of the authorities if their identities were revealed.
Some prisons - such as the Bernalillo County Detention Center in Albuquerque - have apparently allowed the group to host information sessions for their female inmates, but have stressed that this is not tantamount to a referral.
Volunteers are asked to distribute flyers in their areas
But what is undisputed is that the programme has expanded significantly over the past five years - growing from a small establishment in California to a nationwide programme with a presence in most major cities.
As it has expanded, the tone of the group has also shifted. Ms Harris, who was quoted in one of her first interviews as saying "We don't allow dogs to breed. We spay them. We neuter them. We try to keep them from having unwanted puppies, and yet these women are literally having litters of children," has since toned down her language.
Her project was initially referred to simply as Crack (Children Requiring A Caring Community). Now it frequently uses the warmer term Project Prevention.
But the essence of her project remains the same. It offers drug addicts and alcoholics a sum of $200 for opting for a long-term form of birth control, such as sterilisation or a contraceptive implant.
Those interested are asked to submit documents proving that they have been arrested on narcotic offences, or provide a doctor's letter as evidence that they use drugs.
After she or he has been accepted on the programme, fresh documents are then required to show that the procedure has indeed taken place. The money is then despatched.
"Our principal aim is to stop children winding up in foster care or with long-term health problems, whose care puts an enormous burden on the taxpayer," says Ms Harris.
"If they spend the $200 on drugs, they spend it on drugs. It's none of our business what they do with the money we give them."
Organisations like the National Advocates for Pregnant Women do not deny that there can be problems with children born of addicted parents but stress that many drug addicts become loving mothers and that their children in many cases do not suffer life-long health problems.
The programme diverts efforts away from helping addicts to become clean, they argue.
Project Prevention's statistics
1050 paid clients
78 other ethnicity
"Barbara Harris couldn't care less about the addicts themselves and what might be best for them. And while it may be dressed up in the language of choice, for them to argue that these people come to them entirely of their own free will is totally disingenuous," says Wyndi Anderson, co-ordinator for NAPW.
"The project targets poor women - and you tell me what sort of choice it is when its made by someone living in poverty and desperate for money. The whole project is eugenist, it recalls what went on in the 1930s in America, or even in Nazi Germany."
Laws authorising coerced sterilisations were passed in more than half of US states in the 1930s after lobbying from the American eugenics movement, which sought to further the existence of what it deemed to be the "genetically superior" and prevent reproduction among those it saw as inferior: "the licentious" and "the indolent".
America's legislation served as a model for the Nazis' programme of eugenics, which led to the extermination of Jews and the murder of many gypsies, the mentally ill, and homosexuals.
Ms Harris rejects any comparison.
"It's just nonsense. Nobody is forcing these people to do anything - it's their own decision. What infuriates me is that if my critics don't think these people are capable of making their mind up on an issue like this, why on earth do they think they are capable of bringing up a child?"
Time and reason
Ms Harris also has some influential, and wealthy, people on her side.
Dr Laura Schlessinger, one of the nation's most popular radio talk-show hosts, has made hefty donations and has frequently plugged the project.
Richard Scaife, heir to the Mellon fortune in Pittsburgh, is also reported to have donated, along with Jim Woodhill, a right-wing venture capitalist from Texas.
African-American writers favourable to the programme have also helped to rebuff criticism that the programme targets black people.
Despite these luminaries, the group continues to attract negative coverage in the media and it raises hackles whenever it opens a new branch.
And while it is acknowledged that the group is making progress, the treatment of 1,050 drug addicts in five years remains a relatively inconsiderable number.
This, however, appears to provide little solace to the critics.
"It doesn't seem a lot, but the fact is that the group hasn't disappeared or faded away, and people are now starting to get used to it," says Ms Anderson of NAPW.
"As the saying goes: Time makes more converts than reason."