Necessary Lies is Diane Chamberlain's novel about a North Carolina sterilization program during the majority of the twentieth century. She begins the book with a note detailing the program and its effects upon the local population. The body of the narrative, however, explores how such a program could be instituted in the first place and why it harmed people. As the story of fifteen-year-old Ivy Hart unfolds, it shows how class prejudice and assumptions made by lawmakers led to generations of trauma and oppression in the lower class.
Chamberlain tells the story from two different perspectives. On the one hand, Jane Forrester is a recent grad eager to begin her social work in a place which really needs it -- Raleigh. She is inundated by the needs of the locals, Ivy being her first case. As the two girls get to know one another, they start to bond and develop trust. From Ivy's perspective, then, the shock of Jane's being required to issue an order for her own involuntary sterilization is a betrayal. She lumps Jane in with all the other government officials who promise one thing and then serve their bottom line.
Jane is not a heartless automaton and faces a crisis of ethics when she learns about Ivy's case. Not eager to lose her job, she is required to submit the order. At the same time, she has come to understand Ivy and the other members of her community better and sees that this is not something which anyone wants to happen. More significantly, Jane observes firsthand how the same procedure on Ivy's sister, Mary Ella, has left her permanently traumatized. Jane cannot bring herself to take away someone's crucial autonomy like that, so she makes a gutsy call. Chamberlain ends with the people winning because ultimately, they did in real life. The state sterilization program was shut down.
