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March 6, 2000
Eugenics:
The Impulse Never Dies
In Monroe, Louisiana, Kathy Looney, 29, convicted
of abusing three of her eight children, was ordered at the end
of February to undergo medical sterilization or face lengthy
jail time. District Judge Carl V. Sharp issued a 10-year suspended
sentence and placed Looney on five years of probation. "I
don't want to have to lock you up to keep you from having any
more children, so some kind of medical procedure is needed to
make sure you don't." Looney's lawyer asked the judge to
reconsider.
The eugenic impulse is always
lurking. These days it's surfacing once again, not only in old-fashioned
coercive sterilization such as that imposed by the Louisiana
judge but in programs of genetic improvement, using all the new
splicing technologies. Know-how, as so often in medicine, sprints
ahead of moral considerations. In this context the Annals of
Internal Medicine has just published an interesting comparison
by Drs André N. Sofair and Lauris C. Kaldjian. of German
and US sterilization policies from 1930 to 1945.
During the years when Americans
were being involuntarily sterilized as part of a multi-state
eugenics program dating back to l907, what did the leading medical
journals here have to say on the topic in their editorials? The
authors reviewed the relevant periodicals only in the 1930s.
Even in this narrow time frame, against the backdrop of Nazi
eugenic programs (themselves deriving in part from the theories
of US eugenicists) the facts are instructive.
The American Journal of Medicine,
the Annals of Internal Medicine and the American Journal of Psychiatry
had nothing to say. The American Journal of Public Health had
one anonymous editorial on mental health that Sofair and Kaldjian
describe as "relevant" probably because it suggested
that rising rates of hospitalization for the mentally infirm
didn't necessarily mean that American's mental IQ was falling,
a widely held belief that was exploited by the advocates of eugenic
sterilization. This was the most important conclusion of a influential
report on eugenic sterilization put out by the American Neurological
Association in 1935, which recommended that sterilization be
voluntary.
But the special committee convened by the Neurological
Association did not contest the widely held view that mentally
defective people were a drain on national resources. The committee
took a positive view of "feeble-mindedness" on the
grounds that it breeds "servile, useful people who do the
dirty work of the race." The committee also pointed out
that an involuntary program such as that lawful in many American
states would have sterilized the fathers of both Mozart and Tolstoy
who are "worth more to [society] than the cost of maintenance
of all state institutions put together." The committee reviewed
the Germany sterilization law of 1933 and praised it for precision
and scientific grounding.
The editorial record of the New
England Journal in the early l930s was awful. Editorials lamented
the supposed increase in the rate of American feeble-mindedness
as dangerous and the economic burden of supporting the mentally
feeble as "appalling". In 1934 The Journal's editor,
Morris Fishbein, wrote that "Germany is perhaps the most
progressive nation in restricting fecundity among the unfit",
and argued that the "individual must give way to the greater
good".
But by the mid-1930s, particularly
after the report from the Neurological Association and energetic
interventions by the chairman of its special committee, Abraham
Myerson, the New England Journal had a change of heart and declared
that sterilization laws to prevent propagation were "unwise"
and sterilization should not be mandatory. The Journal of the
American Medical Association followed the same curve.
The authors calculate the number of people neutered
here was a little over 60,000 and that the practice stopped in
the early l960s. Wrong. In l974 US District Court Judge Gerhard
Gesell said that "Over the last few years, an estimated
l00,000 to 150,000 low-income persons have been sterilized annually
in federally funded programs." The late Allan Chase quoted
this in his great book The Legacy of Malthus, and noted that
the US rate equalled that of Nazi Germany where the 12-year career
of the Third Reich after the German Sterilization Act of l933
(in part inspired by US laws) saw 2 million Germans sterilized
as social inadequates.
Gesell pointed out that though
Congress had decreed that family planning programs function on
a voluntary basis "an indefinite number of poor people have
been improperly coerced into accepting a sterilization operation
under the threat that various federally funded benefits would
be withdrawn Patients receiving Medicaid assistance at childbirth
are evidently the most frequent targets of this pressure."
Starting in the early 1990s poor women were allowed
Medicaid funding to have Norplant inserted into their arms, then
when they complained of pain and other unwelcome side effects
they were told no funding was available to have the Norplant
rods taken out. Here, therefore was involuntary sterilization
in a later guise. As the Louisiana report makes clear, the eugenic
impulse is never far away. Don't rely on the medical profession
to safeguard the targets of this "improving" zeal.
CP
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