Eugenics: The Impulse Never Dies

by Alexander Cockburn

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. Andre N. Sofair and Lauris C. Kaldjian of German and U.S. sterilization policies from 1930 to 1945.

During the years when Americans were being involuntarily sterilized as part of a multistate eugenics program dating back to 1907, what did the leading medical journals here have to say on the topic in their editorials? The authors reviewed the relevant periodicals only from the 1930s. Even in this narrow time frame, against the backdrop of Nazi eugenic programs (themselves deriving in part from the theories of U.S. 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 Americans' mental IQs were 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 "feeblemindedness," 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 1930s was awful. Editorials lamented the supposed increase in the rate of American feeblemindedness 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 that 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 1960s. Wrong. In 1974, U.S. District Court Judge Gerhard Gesell said that "over the last few years, an estimated 100,000 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 U.S. rate equaled that of Nazi Germany, where the 12-year career of the Third Reich after the German Sterilization Act of 1933 (in part inspired by U.S. 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.