BIOETHICS

Eugenic Statecraft in the Operating Room

An Interview with Paul Lombardo

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In 1924, after Carrie Buck was raped and impregnated, the Commonwealth of Virginia institutionalized her. Having decided that her mother and child were mentally deficient, authorities wanted to use a recently passed eugenic law designed to prevent “defective” people from reproducing to have Buck sterilized. Unfortunately, her lawyer in the resulting court case against the directive was the founder of the Virginia Colony for the Epileptic and the Feeble-Minded, where she was held. When the Supreme Court ruled 8-1 in favor of the state, Justice Oliver Wendel Holmes Jr. wrote in his opinion that “three generations of imbeciles are enough.” Buck was sterilized shortly thereafter.

Georgia State University Law Professor Paul Lombardo’s book, Three Generations, No Imbeciles, explores the harrowing case (which has never been overturned) and the American eugenics movement, which enabled more than 60,000 involuntary sterilizations in the United States. Science Progress Editor-in-Chief Jonathan Moreno talked with Lombardo about the history of eugenics, its misuse of science, and the implications for contemporary progressivism. This interview transcript has been edited and condensed.

Jonathan Moreno: It always seems to me that the case that is the basis of the book, namely the case of Carrie Buck, is in the pantheon of medical ethics and indeed in the history of American culture. But sort of like the Tuskegee Syphilis Study, a lot of people think they know about it and understand it but really don’t. In the case of Carrie Buck, perhaps she’s unfortunately been lost in the mists of time. Could you explain to us who Carrie Buck was, and why her 1927 Supreme Court case about her sterilization was, and continues to be, important.

Paul Lombardo: Well, Carrie Buck was a girl from Charlottesville, Virginia. She was about 17 at the time this case started. She had been chosen as a resident of the Virginia Colony for the Epileptic and the Feeble-Minded in Lynchburg, which is about 50 miles south of Charlottesville. She’d been sent there when she was taken out of her home, because she was pregnant and wasn’t married. She was basically an unwed mother. Many girls like Carrie were sent to the colony because they were supposedly people possessed of hereditary defects, “moral degeneracy” they called it. So Carrie became, unfortunately for her, the subject of very bad timing. The state of Virginia had just passed a law in 1924 that would allow for sexual sterilization of people with hereditary defects. She was at the colony; her mother had already been committed to the colony several years earlier; and she had a baby that people looked at and said there is something strange about the baby too, so this looked like a pattern. It looked like there was some kind of hereditary anomaly that was passed down through the generations.

So Carrie becomes the person chosen to test the Virginia law by the people who wrote it. They wanted to take a case through the courts to demonstrate that the law was constitutional. And Carrie is the person who eventually ends up as the named party in the lawsuit of Buck vs. Bell, Bell being the doctor at the Virginia colony who eventually sterilizes her. And the case becomes famous only after Oliver Wendell Holmes, at that time the most famous judge in the country, maybe in the world, writes an opinion describing Carrie, her mother, and her daughter as three generations of imbeciles. And Holmes says in ending his very brief and pointed opinion, “three generations of imbeciles are enough.”

Moreno: And that was, of course, a majority opinion, with one dissent, with no content to the dissent. Is that right?

Lombardo: Correct, it was an 8-1 decision. The only dissenter was a man named Pierce Butler, a somewhat obscure justice, and he left no opinion, so we’re not exactly sure why he dissented.

Moreno: This case was taking place in the context a social and scientific movement that we know as eugenics. Isn’t that right?

Lombardo: Correct. The eugenics movement had really picked up a lot of steam from about the first decade of the 20^th century, when it was introduced to America by scientists—people like Charles Davenport who ran the Eugenics Record Office in Long Island. Davenport had been a scholar. He studied at Harvard; he taught there and at the University of Chicago; and he was the recipient of a fair amount of what today we would call grant money from the Harriman Foundation and later the Carnegie and the Rockefeller Foundations to set up a place called the Eugenics Record Office, which would study heredity. And it was that office that really brought the whole idea of eugenics as the science of good breeding into the public eye, along with other groups like the Racial Betterment Foundation of Battle Creek, run by Dr. Kellogg, and groups such as that.

Moreno: Of Kellogg’s fame, the Kellogg’s cereal.

Lombardo: Same family, correct.

Moreno: This biological philosophy was also reduced to law in a number of states, including Virginia.

Lombardo: Yes, the first laws were really developed as early as the late 19^th century to prevent marriages among people who were “feeble-minded” or people who had epilepsy. Then the first sterilization law—which was the next step marriages don’t always prevent births—preventing somebody from actually having a child, first occurred in Indiana in 1907, the first sterilization law was passed. Between 1907 and 1924, the time of the law that was tested in the Buck case, there were another dozen or so states that passed laws. But Buck was the one that cast the national and really international light on this process, because it’s the one that the Supreme Court endorsed, again by an 8-1 decision.

Moreno: And we should point out that these diagnoses of “feeble-mindedness,” for example, or the notion of “hereditary drunkenness,” or “heritable excessive sexual pathology” have all been debunked by more recent science. Is that right?

Lombardo: Pretty generally. I think that the length of the list that the people in the Buck case focused on was extraordinary; it included people who were orphans, people who were criminals, people who were in any way possessed of chronic diseases, drunkards, “n’er do wells,” and the poor.

Moreno: So rich drunks and rich n’er do wells probably weren’t sterilized in these systems.

Lombardo: There tended to be a pretty clear class distinction here. People who could afford to hire a lawyer to fight these things didn’t get sterilized, even when the laws were on the books.

Moreno: When we teach about eugenics, we tend to talk about both negative eugenics and positive eugenics. And positive eugenics, actually once in a while it serves as again. Wasn’t it about 20 years ago that the leadership in Singapore advocated that only rich people should marry and have babies?

Lombardo: Yeah, the Singapore law was a tax incentive for giving tax credits to the people who were employed and paying taxes and not giving tax credits to other people. The assumption was that if you got a tax credit for children and you were working, that was a good thing.

Moreno: So in this sort of gross way, this positive eugenics notion is still very contemporary, and of course the darkest results of the eugenics movement in the United States manifested themselves in both positive but also negative eugenics in the Holocaust. I don’t think many Americans really understand the role or the priority that American eugenics had in influencing Nazi biological philosophy. Can you explain that?

Lombardo: Well, deciding which is the chicken and which is the egg is often difficult. But in this case you’ve got two things going on at the same time. The Germans, as far back as the Weimar Republic and even into the 19^th century, were very interested in studying heredity and had some of the first scientists who did so. They were also interested in this new idea of eugenics very early on, the first decade of the 20^th century. They and their American counterparts, scientists with this kind of interest, were in touch from 1900 on. But America led the way in the law.

America passed the first sterilization law, as we said, and passed the stronger laws, also in 1924, prohibiting immigration on the basis of ethnicity, and that was certainly eugenics law as well. And then the United States eventually went on to pass other laws or to change other laws and put a scientific spin on the old anti-miscegenation laws that prohibited people of different races from being married. So in that sense America was first and the Germans paid attention to those laws. Eventually, the Germans actually gave an award, gave an honorary degree, to Harry Laughlin, the man who wrote the model sterilization act which was the basis for the Virginia law. It’s pretty clear that the German scientists who stood at Hitler’s elbow knew all about eugenics— they certainly knew all about genetics as well—but looked to America for precedents that they could rely on and justify some of their own activities.

Moreno: At one point, they were even concerned that the Americans were getting ahead of them with respect to purifying the race.

Lombardo: Yes, well Hitler writes in Mein Kampf that the German law on immigration, for example, is really silly. They let anybody in at all, and that America is leading the way there. So that’s early in the 1920’s, and then later on when sterilization laws are in effect, the Germans print out maps showing how they learned from America this way and they were concerned that they were behind the curve.

Moreno: After the war, the popular thinking is that the eugenics movement, particularly the aspect of the eugenics movement that resulted in the Holocaust and in those pre-WWII sterilizations, was pretty much on the decline but I think your view is that things are little bit more complicated that that after WWII. Isn’t that right?

Lombardo: Well, I think a good deal more complicated. Obviously there was revulsion when the films of the liberation of the death camps came out in the 1940’s. But I don’t think very many people made any direct connection between things like American sterilization laws—or for that matter the immigration or anti-miscegenation laws that stayed on the books in America until the 1960’s—and the idea that those things were somehow reflected in a social policy that was part of Nazism. I think we had a clear revulsion against Hitler’s excesses, but understanding the intellectual foundations for those things is something that didn’t come until much, much later.

Moreno: Many listeners are familiar, for example, with the so-called “Bell Curve” movement. You argue that there is a connection to the pre-WWII beginnings of eugenics in that movement as well—this notion that there are racial differences that are inherent and discernable with respect to IQ.

Lombardo: Yes, the biological determinism that is the basis really of the argument of Bell Curve is in place by the 1920’s. The person who is the first President of the group which advances that perspective even today, the Pioneer Fund, was Harry Laughlin, the same man who got the Nazi honorary degree for his work in what the Nazis called the “science of racial cleansing.” So there are some clear historical connections between these very old ideas and contemporary directions as well.

Moreno: Talk a little bit about contemporary ethics and genetics. It is not as easy to make moral judgments, as you and I know, about what’s going on right now, for example, in pre-natal diagnosis, in family planning, and so forth. Although you write with the careful pen of an historian, nonetheless one senses your outrage, if I might say, in the pages of this book about the Buck case and the consequences of the Buck case. But you’re not as clear about the implications of Buck for all the different work that is going on right now in genetics. Could you talk a little bit about that?

Lombardo: Yes, I think it’s a much more difficult question to address. I try to address what I consider the clear issue of coercive surgery. I mean the Buck case is the first time in the history of the United States in which the Supreme Court says that it’s appropriate to operate on someone who doesn’t need surgery, for purposes of state. This is eugenic statecraft in the operating room. And I think that’s outrageous. It was then. It was then not only because I think it violates some of the most cherished principles of bodily integrity that are imbedded in our law, but also because the case was bogus. Carrie Buck, it turns out, was raped; she wasn’t just another unwed mother. Her lawyer essentially threw the case. So there are a lot of very nasty facts in the Buck case.

It’s, to me, much easier to talk about the ways in which we try to cling to old-fashioned eugenics today by continuing to try to sterilize people who are on welfare, for example. This comes up regularly—judges try to make this declaration to deadbeat dads or to mothers who are on drugs. And that sort of thing goes on even today. That’s not like what happened in Buck. That’s exactly what happened in Buck. So to me to make that parallel is not so hard.

It’s more difficult to say what things are like eugenics, and to try to make an analogy. The notion of pre-natal genetic diagnosis is something that raises the question: “Is this like eugenics?” Some people would say, “Of course this is, it’s choosing in advance who should live and who should not be born.” Others would say it’s not, because there’s no heavy hand of the state here deciding who will be born or who will not be born, it’s an individual choice. So it’s a much more nuanced discussion. It’s no less controversial I think, but as a historian it easier for me to point out the parallels that are exact as opposed to those that are analogies

Moreno: We’ve talked about class as a factor. Obviously an old-fashioned platonic notion of race was more of factor—the idea of race is much more ambiguous now that it was 50 to 60 years ago.

Lombardo: Clearly. Even though we know if we look back at the history of that idea that it morphed over and over and over again. In the 1900’s the things that we would consider ethnicity, like being Slovakian for example, were considered race. So today we have a very different perspective on what race means than what we did then.

Moreno: I want to end by talk for a few minutes about the implications of all this for contemporary progressivism. You and I well know that the Buck case and the eugenics movement are taken by many conservative commentators as a very clear failure and warning for progressive policy. Talk about that for a couple of minutes. What can progressives learn from the story you tell in Three Generations, No Imbeciles? What are the implications for progressives in the 21^st century?

Lombardo: Well I think that people from the conservative side would say that progressivism embodied the worst kind of reliance on science, and reliance on experts, and elite professionals. And I think to a certain extent, they’re right. Buck was sold as the triumph of science—we could clean up the streets, get rid of all those loose women, those drunkards, those poor people—if we just applied science through eugenics. So clearly that’s a cautionary note that sounded, and its not completely wrong. I think it goes overboard. I think it goes overboard significantly when people try to make very facile and sometimes really simple-minded connections between the ideas that fed into eugenics and current social issues.

For example, there is a trend to attempt to link in a very facile way Darwinism, eugenics, and then the current debate over abortion. The Nazi card is played pretty regularly there by people who want to argue against Darwinism, want to argue against eugenics, which they say—I would disagree—is the straightforwardly direct descendent of Darwinism. Eugenics is much more complex than that. And we could spend a lot of time talking about the progressive era and what it meant, but we might as well talk about the industrial movement that made automobiles on the assembly line. The efficiency movement of people like Henry Ford was as much a part of progressivism as was eugenics.

So I think this argument of who gets to claim eugenics and what should it be remembered for sometimes becomes to simplistically an argument about the good guys and the bad guys. There are some bad guys in my book, clearly. But most of the people are trying to do what they think is the right thing. Their motives are not always pure, nobody’s are, but they end up with a result that is terrible. The conclusion that I draw from that is that we need to be most suspicious, as good conservatives usually say they are, of government when government tells us who should have children and who should not.

Moreno: Well said. So we’ve been talking with Paul Lombardo, author of Three Generations, No Imbeciles. Lombardo is a Professor of Law at Georgia State University. The book is published by Johns Hopkins. Paul, thanks very much for joining us today.

Lombardo: Thank you, Jonathan.

Tags: bioethics, eugenics

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