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Eugenics and Forced Sterilization: The Infamous Case of Buck v. Bell (1927)

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Conteúdo fornecido por Devan Stahl and Tyler Gibb. Todo o conteúdo do podcast, incluindo episódios, gráficos e descrições de podcast, é carregado e fornecido diretamente por Devan Stahl and Tyler Gibb ou por seu parceiro de plataforma de podcast. Se você acredita que alguém está usando seu trabalho protegido por direitos autorais sem sua permissão, siga o processo descrito aqui https://pt.player.fm/legal.

Tyler and Devan walk through the infamous US Supreme Court Case of Buck v Bell (1927) in this episode. Buck v Bell has a dark legacy that includes forced sterilization, eugenics, disability, and violence against women.

Further Reading:

Transcript

0:03

Come to another episode of Bioethics for the People.I'm joined by my Co host Doctor Devin Stahl, who according to her student reviews should be cloned and teach all of the bioethics.And he's Tyler Gibb, who, according to his students, is best described as the GOAT of bioethics.

0:28

All right, Devin, I've got a case for you.OK.Well, that's kind of the theme of the whole season.So I I would hope so.Yeah, so this is, this is a tough one.I mean not that any of our cases are really like sunshines and roses and feel good stories, but this one is particularly gross.

0:48

Can we say gross?Yes, it are there any like?Warnings you want to give to listeners before we start, then I guess.I I mean, it's kind of always a good idea to to warn people what they're getting into, but this case involves for sterilization and eugenics and also some really terrible mistreatment of people with disabilities and people without disabilities.

1:14

OK.If it's the case I'm thinking of, given what you've just said, is there also?An account of rape.Yes.Yep.All right.So with that caveat, what do you know about the case of Buck versus Bell?

1:35

Yeah, I know a little about this case because I do work in disability and this is kind of this Seminole case, I suppose.I don't know kind of the intimate details.I know the broad strokes of the case of a.A woman with an intellectual disability who was kind of seen as the the case that made its way to into the courts to allow for sterilization of people in the early 20th century.

2:04

So this is kind of that case, right?Yeah.So all of that what you said is right.So let's let's just kind of walk through the case.So this is the case of Carrie Buck versus Bell.And so we're talking about Virginia in the 1920s mostly.

2:25

So this case, I think it was decided in 1927 was when the Supreme Court case was actually published.But kind of the things going on in this case are early 1900s moving into the 1920s.Ish.OK.So get that time frame in your mind.

2:43

I'm getting wait, wait, let me put myself.OK, short haircut.OK, Yep.Yeah, I got it.Yep, Roaring 20s.The The Roaring 20s of the Gatsby's do not make their way into the the lives of the the poor, disadvantaged individuals living in rural Virginia in the 1920s.

3:03

So.Right.So different frame of mind.Different frame of mind.Yep.We're not doing.We're not dancing and drinking martinis here.OK All right.So this case centers around a particular law.And this law was, I think, probably controversial even at the time.

3:24

But it was a law that a lot of people were really jazzed about, So and so much so.And we've talked about in other in other podcasts where people, particular lawyers who or individuals who want a particular law on the books or a law taken off the books, we'll use this idea of targeted litigation.

3:53

And so the idea is that we have this law we want to make either get it proven unconstitutional and and canceled thrown out and or we want it to be like given the the thumbs up, green light by the Supreme Court or whoever.And we are going to look around and try to find the best case we possibly can to sue on behalf of and then actually move it through the court system.

4:17

So it's.What some people call like activist legislation.Litigation.Yeah, activist litigation.And yeah, so targeted activist litigation.And it is this strategy has been really successful in I think overturning a lot of Supreme Court precedents that were really problematic.

4:39

And so if you think of like Brown versus the Board of Education, the the case which threw out this concept of separate but equal education, right.So Thoroughgood Marshall was actually one of the lawyers involved ended up on the Supreme Court.

4:55

And so they they went around and tried to find the exact case in order to make their point about this particular.Yeah, like the perfect case that's going to, you know, prompt us to say, yeah, this is a bad law, right.And it happens really commonly in a lot of the cases that we know about, like for example, Loving versus Virginia, the case that overturned or got rid of or changed interracial marriage outlawed in some states.

5:24

So it it can be really beneficial, I think, to society to do this, but sometimes it's not so great, right?So there's activists on both sides, right?And we don't always agree with them.Yeah.Yeah.If everyone agreed on what public policy should be, then what would lawyers do with their free time?

5:42

All right, so this law that we'll talk about in just a minute called the Virginia Sterilization Act, bit of an ominous name.I think legislators have gotten better about hiding the intent behind laws through like fancy names and acronyms, acronyms of of laws that they passed.

6:03

So yeah, but this?Cut right to the point.We want to yeah, we want to show Sterilization Act of 1924.OK, so the folks involved in this movement behind this were in favor of this idea of eugenics.

6:20

OK, I know you are a very well, well read, well read expert on all things dealing with bioethics.So eugenics tell us what that is.Yeah, well, I did write a book on this, so I should know a little bit about it.So eugenics, this idea.

6:37

So there's positive eugenics and negative eugenics.So early 20th century.We're really Americans in particular, really excited.Hitler will take this up in a really aggressive way, but he got his ideas from American policy.So the idea was that we want to perfect our society through scientific means, so improve the human species.

6:58

Two ways of going about it.You can encourage the right kind of people, quote UN quote, to reproduce so that they will pass on.I mean, I think that they're not.This is way before, like the Human Genome Project.We don't totally understand heritability, but we do understand that kids tend to be like their parents.

7:17

And so and we're not quite sure like what traits are passed on.We're pretty sure, like intelligence and even like poverty could be passed on.These are.We would be very cautious about saying those things these days, but criminality is another one, right?Criminality.Yeah, sure.

7:33

So you know, these things are potentially heritable.So let's get like, and of course it's the exact people you imagine good, wealthy Protestant white people to reproduce.Let's encourage that, and let's discourage the wrong kinds of people from reproducing.

7:50

So poor people and black people and people with disabilities, like, let's, let's.Encourage them not to reproduce or forcibly sterilize them so they can't reproduce.Yeah, so this is there's a number of policies and laws that are being formulated by A and people today would say, oh, this is a pseudoscience, eugenics.

8:12

But at the time it was thought of as good science, right?This was not some like fringy science.This was the mainstream science of its day.I think that one thing that's really interesting about the topic of eugenics is exactly what you just said is that we often associate this with, you know, the Third Reich and Nazi, you know, purification of the the Aryan race type of evil, bad Nazi stereotypes, right.

8:39

But like you said, a lot of these ideas were originating in the United States.And we really actively, as a collective national consciousness, try to forget that a lot of those ideas came from the United States.So in this case, we've got Carrie Buck, who is an A woman from a really poor family who finds herself pregnant in 1924.

9:09

Carrie is from what we would describe as, you know, a broken home.Her mother is actually institutionalized, and it's a little bit unclear why she was institutionalized except for she was, quote UN quote promiscuous.

9:28

So.Yeah, well, and at this time, I've been reading some stuff recently, like not uncommon to institutionalized people too.So there's like this horrible history of institutionalizing people who, you know, had quote UN quote mental disorders.It was really easy to institutionalized women.Even married women, like husbands, could put their wives in asylums for almost no reason at all.

9:50

Just if they went before a judge and said, like, she seems crazy, please, you know, keep her here.And so there were lots of people institutionalized against their will who were not being benefited by being in institutions.So the fact that she was, quote, UN quote promiscuous, who knows what that means?

10:06

It could have just been some guy who was like, I don't want to deal with this woman, please take her away.And she had like, no autonomy.Over that situation exactly, and in a nearby area in Virginia, there was an institution that was known as the Virginia State Colony for Epileptics and the Feeble Minded.

10:27

So, oh, a colony.That's always like a great way to start.Yeah, there's there's at least half of the words in the the title of this that cause a little bit of a emotional reaction.Cringy.Little cringy.So the inner, the guy in charge of this, so Doctor Pretty Albert Sidney Pretty was a Superintendent of this colony and he was a hardcore proponent of eugenics and particularly the negative eugenics, meaning like we're going to sterilize people who he believes for whatever reason to should not be able to procreate in the gene pool.

11:06

And so his entire colony, this institution was built up around kind of as this with this idea in kind of the foundation of it.And so a couple things, interesting quotes from him.And so he was all in favor of institutionalizing women and then sterilizing them against their will.

11:27

And he was a childhood friend of the individual who, in Virginia, helped pass, write, and pass the legislation that legalized this.So the Virginia Sterilization Act author was a friend of this dude?Yeah, So they're in cahoots.

11:42

They're in cahoots.Well, they clearly have a similar view about about eugenics.And so he is quoted as saying that he would choose women or accept women into his organization, his institution, if they were, quote, immoral, if they were, if they had a unnatural fondness for men.

12:02

That's another quote.So promiscuity we've talked about.Natural fondness.Like, I just like the men too much.Too much.Yeah.And then actually there's a quote about a 16 year old who is institutionalized and end up involuntarily sterilized because of her habit of quote talking to little boys.

12:26

Talking to little boys, yeah.Oh no, as as a 16 year old.So, like, is there an implication that she was a pedophile?I think that that is one level of justification beyond what these guys felt like they had to justify.

12:44

She just talked to little boys too much.I I think that they wanted to sterilize this woman and for whatever reason.And so, I mean we talked about the gross history of American medicine, right?So involuntary sterilization is at the top of the list.OK, So Carrie Buck woman from a very poor family, very poor area of Virginia and she, her mom is actually institutionalized in this Virginia colony for the epileptic and feeble minded and and she gets admitted as well.

13:19

And so mother and daughter are both involved, institutionalized together.And there's actually a couple of pictures online of the two of them sitting next to each other like on this call.It's kind of a haunting image of these two.And at the time Carrie Buck was pregnant.

13:35

OK, unmarried.It's pretty clear and I think I think probably on uncontroversial, the father of the child was actually a family member who raped her while she was living in in the same home or in the home of another family member, so.

13:53

This is always what I thought is that the family that was fostering her when her mother was sent away, it was their son who raped her and got her pregnant and they didn't want to deal with her and blamed her right?

14:09

And so sent her away, right?I think it was actually a nephew of this family, a foster family, but definitely a family member.And she was definitely raped and definitely impregnated, and definitely then sent away.The tragic right.

14:25

So she is pregnant in this in this institution with her mother and gives birth to a child.And as part of the rationale for the sterilization that actually occurred to her later, they started doing intelligence tests, IQ tests, type kind of evaluations of the baby almost right away, which is.

14:51

Interesting.I already have such big issues with IQ tests and giving them to babies just seems like.Out of control.There are reports of them holding up like a coin to this child who's only a few months old and like moving it back and forth.

15:06

And whether the chat the baby like tracked it or not was then used as justification for whether the child was going to have a normal intelligence or not.Gross.Pretty gross.So unsurprisingly, Doctor, pretty at the at the Colony, thinks that Carrie Buck is a prime not just example, but a prime candidate for sterilization.

15:32

And not because of any reason that would benefit her, but purely for the benefit of the collective gene pool.Yeah, she's her offspring would be bad for society.So we must sterilize her.For the good of the whole.For the good of the whole.

15:47

Yeah.Yeah.I mean, I think we're compounding cringy upon cringy as we get deeper into this case, right?Yeah, not off to a great start.Yeah, it doesn't, it doesn't get better if we're being quite honest.

16:02

So in in a lot of ways, in some of these cases, particularly kind of from this era, the individual themselves really gets de prioritized throughout the entire process.She's so and she's like 16 at this point, 18. 18 OK, so she has just become an adult.

16:20

They probably did.They wait until that happened.I don't.I don't think that.They didn't care.They didn't care about that.Yeah.OK, so this works its way up through the the Virginia court system and eventually gets it all the way up to the Supreme Court.

16:37

And there's a couple of notable characters on the Supreme Court at this time.As somebody who kind of geeks out on the law, I really like the the makeup conversation of the Supreme Court as being important in the decisions that they make.

16:52

But a couple of folks on this Supreme Court you may have heard of, like, I don't know, Oliver Wendell Holmes.I've heard of him, yeah.Learn at hand is another justice who you may have heard of.And the chief justices this time was an individual named William Howard Taft.

17:13

President William Taft is the only former president to then serve on the Supreme Court.Interesting.Notoriously great president that everyone's definitely heard of Yeah that everyone is super excited is now making is now the Chief Justice of the Supreme Court.

17:29

Yeah, that isn't I.You know, I I don't think I really ever put that together that he would be the only one.Interesting because yeah he's often labeled as like one of the worst presidents of all time.Yeah not not shining example of presidential effectiveness or but he was also kind of a big proponent of eugenics and it I think it's easy to think that you this idea of purifying the the gene pool and and promoting certain characteristics is fringy that not a lot of people have that perspective but it really was really common a lot especially at the the more educated the more wealthy the more powerful quote UN quote folks in kind of society at that time it was a really common perspective really common view.

18:21

Yeah, I'll just add, just because I read a book about it, they're like 2 notable groups that are not eugenics proponents and it would be Catholics who are, you know?Very much a marginalized group in America in the early 20th century, in part because it for sterilization goes against their belief in you know that that this would violate their sort of moral sexual code of you know, not prohibiting children.

18:51

So there there's the Pope has said some things about this and it's and and there was actually some initially some interest from American Catholic Bishops.But, but when you add forced sterilization to the mix, you can't abide that as a Catholic, so good on them.

19:08

Although it's yeah, I will say there's some other things that Catholics are saying at this point where it's like, well, the idea is really good.You just the means are bad.So it's not like they're totally against eugenics on principle.You can read about more about that in my book and then I love it when you promote your book.

19:24

On Yeah, yeah, yeah.I got somebody's got it right and then fundamentalist.So right around this time we also get this liberal fundamentalist divide in American Protestantism.So whereas the Liberals are trying to keep up with like contemporary science and and like kind of the latest.Cultural things.

19:41

The fundamentalists are, you know, retracting and becoming more conservative and saying, you know, we can't, we can't believe this, like these new scientific advances and and a huge part of that too is just like.Are we going to go along with Darwinism?So I'll say that their reasons aren't actually necessarily all that great either for not promoting eugenics.

20:01

It's not very few people have, like, a principled There are some, for sure people were like, I don't think we should be sterilizing poor people.Those people exist.It's not like a principled stance by, like, a notable group.Yet at this point, so yeah.

20:19

Common perspective like so bringing up eugenics like in a cocktail party would not be frowned upon, right?People are talking about it and.Yeah, yeah.It's the science of the day, right?It'd be like today, talking about, I don't know, whatever, gene editing or something like that.

20:35

Sure.Like, well, I'd I'd say I I bet gene editing today is more controversial than eugenics was in the 1920s.Yeah, Interesting.Another interesting wrinkle to this case.Is that it?By some accounts the doctor Pretty, who is the the director of the executive of this colony actually heard about Carrie Buck through her mother who was already, like I said, already institutionalized there and basically solicited her to become an inmate so he could sterilize and use as as the example.

21:09

So at about 14 different levels, Carrie Buck, the person really gets subsumed into other people's.She's just this pawn in this bigger game of eugenics.So what do you think the Supreme Court decided is it is the Virginia Sterilization Act of 1924?

21:30

Does it violate the US Constitution?It doesn't.I do know there's this quote and I you probably have it.At hand better than I do.Something about 3 generations of imbeciles is enough.Oh, yes.All right, so I'm going to text.I'm going to text you this quote.

21:46

So this is from the Decision published in 1927.Buck versus Bell.This is Associate Justice Oliver Wendell Holmes Junior.OK, all right.So we have seen more than once that the public welfare may call upon the best citizens for their lives.

22:01

It would be strange if it could not call upon those who already SAP the strength of the state for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence.Oof, it is better for all the world if instead of waiting to execute degenerate offspring for crime, whoa, yeah.

22:26

Or to let them starve for their imbecility.Woof.Society can prevent those who are manifestly unfit from continuing their kind.The principle that sustains compulsory vaccination is broad enough to cover cutting the fallopian tubes. 3 generations of imbeciles are enough.

22:44

Wow, that is worse than I remember.So I remember that line about 3 generations of imbeciles is enough.But these other lines about sapping the strength?About executing them for crimes or letting them starve.So these are the options, right?

22:59

So either prevent them from being born or obviously we'll execute them for their crimes or they will starve from imbecility, right?Like as if the state has no interest in either of those things.Not happening.Yeah, bonkers.

23:17

That is wild.There are a couple cases that get cited kind of in law school and constitutional law classes.I was like, here's a really, really ugly quote from the Supreme Court, right.So there's a case called Plessy versus Ferguson, which is about the property interests of slaveholders, and it's it's really problematic.

23:36

But this one?It's hard to find a more disturbing quote from a Supreme Court opinion than this one.That is that's brutal.And am I right to think that we haven't like overturned this is this Duke, We don't have any states that still forcibly sterilize that ended way back in the 70s.

23:57

Yikes.But I don't think that it was ever overturned at the Supreme Court level, right, Right.So there's a subsequent case called Skinner versus Oklahoma that actually it doesn't directly overturn Buck versus Bell.But what it does is it basically renders it ineffective and it says that for sterilizations do actually violate.

24:17

Although let me I don't always say my opinion on this podcast about these cases, but it was wrong.I'm going to go out on a limb and just say, like, I think that this ruling was wrong.What was the most wrong about it, do you think?Let's start in the what are, What are some parts of the thing that you just read that are?

24:39

I mean, you had to stop a couple times and take a deep breath as you were reading it, so.Yeah, okay.So I mean, so let's set a little bit of context.So this is right after.I mean, this is the generation most of this generation had seen World War One and the the horrors of World War One and the number of friends and family members and countrymen who died in a brutal war, right.

25:05

So when they're, when they're talking about like the best citizens giving their lives, that's the context that they're talking about.And also so that that one other point of, yeah, the principle that sustains compulsory vaccination is broad enough to, you know, and then the quote goes on.That issue had actually just recently been litigated in the Supreme Court as well.

25:24

So that was actually also fresh on their minds.And so the idea is like, if we're asking someone to do something like vaccination, maybe we can ask them to do other things with their body.So.Right, right.There's there.Like the state has an interest.And I don't think this is wrong on principle the state, because I think there are times in cases of like epidemics when maybe the state really does have an interest in.

25:45

Forcing people to do things to their bodies they wouldn't otherwise want to do for the sake of keeping everyone else safe is like you make a small sacrifice, and with vaccinations you're not even doing that, but you might be asked to make a sacrifice on behalf of the whole to keep everybody else safe.

26:02

So I don't know that that's wrong in principle.Like where that falls, right?Like how what exactly things you're being asked to sacrifice and who gets to decide is?Of course, going to be controversial, but in principle, yeah, I think like most people would say that yes, we can ask people to sacrifice some things, even some of their bodily autonomy for the sake of everybody else around them.

26:23

So that's not wrong on principle.I mean, So what is wrong on principle?The idea that we're like, that America was being swamped with incompetence because of like people's genetic makeup that we just like cannot abide.Some people's intelligence not being as great as other people's is.

26:41

Really gross and and probably inaccurate, right?That some of these things that like poverty being inherited is of course not true.Some people still seem to think that, but not something you pass down genetically.Even if we have systems that keep people in poverty, the idea that, like, the only alternatives to sterilization are executing people or letting them starve to death seems like pretty extreme, yeah?

27:10

And then that they were imbeciles.I mean that's a word obviously we don't use anymore.It was, I think the technical, like medical term at the time, but Yikes.It just comes across as so, like such a gross way to talk about people.Yeah.And I think what's troubling for me about this case, I mean there's obviously a lot of things, but this idea that eugenics is so good and so scientific and such a benefit for society that we're going to use whatever means we can in order to achieve that.

27:42

And the people who kind of at the, the, the, the butt end of that are really vulnerable people also, people who maybe, I don't know.So we talked about this a little bit earlier that it's unclear and maybe it is a little bit clearer.

27:59

And it's not the case that Carrie Buck really wasn't mentally impaired in any way that she was actually, you know, just a a poor woman in a bad situation and got caught up in this other movement, this other the interests of somebody else.

28:16

Yeah, she was just incredibly vulnerable, right?She couldn't.Nobody cared what she had to say as as far as I remember, of this case, like she did.She didn't take the stand.She nobody asked.I mean, how is this true?I'm remembering this and maybe you'll get to this, but like some of the doctors who testified that she was.

28:35

You know, mentally impaired.Never met her.Yep.They relied upon reports.And there's this famous eugenicist at the time kind of the, the one of the people who were really was really advocating in this.His name was Harry Laughlin and so he submitted testimony to the written testimony to the court in this and afterwards so arguing for the the virtues of this law.

28:58

And afterwards he was reflecting upon his his motivations and kind of this Buck versus Bell being the importance of it.And he said that the decision in Buck versus Bell took negative eugenics out of the experimental phase into the the application stage, which is also pretty gross.

29:17

And after the Supreme Court case came down in 27, many, many other states followed Virginia's model and instituted legislation that permits sterilization against somebody's will.Yeah, like most states, right?

29:35

Most states had some sort of compulsory sterilization law.Yeah.So by 1947, so 20 years after that in the United States, the United States was forcibly sterilizing 10s of thousands of people a year.So I said earlier that Skinner was the case in 1940, forty 2:00-ish, I think 1942.

29:57

And it didn't specifically overturn Buck versus Bell, but kind of discourage those types of laws on the books.And then they kind of fell out of favor and state started to not use them.But some of them were never actually formally taken off the books until the 2000s.

30:13

I think the most recent one was maybe North Carolina.I'd have to double check.That, yeah, I saw that, yeah.Yeah.So even if we weren't doing it, but it were on the books, which is pretty bad.Yeah, when?You think so 1946 like this is like post Holocaust, like so we're really embarrassed.

30:28

So but do you know why we're embarrassed is because of all the crazy stuff we saw the Nazis doing that the world condemned.And then we start looking at ourselves and be like, wait a second, maybe these laws aren't great.Right.So they so all the eugenicists started calling themselves something different.

30:45

So it's not like eugenics totally went away at that point.But like it was like population science, so they all just like all the societies like changed their names.They just changed their names.Oh, it's such a sad part of like, it wasn't that they were all just shamed into shutting down.They just like kind of pivoted a little and change their names.

31:03

Yeah, it's almost like a rebranding, remarketing, right situation.So after about 1947, particularly after all the stuff in the Nuremberg trials, so the trials of the the Nazis post World War 2 and a lot of stuff that Joseph Mangala was doing his experimentations, the fervor for being publicly A eugenicist really kind of faded a little bit during that time.

31:34

Is my understanding.Is that yours as well?Yeah, I think.That's right.So it's not as if all the scientists just stopped doing the science, but like the public sort of support because the churches were all on board, like every everyone was on board.Like I said, there's there's exceptions to that, but people were on board, institutions were on board.

31:52

And I think while the science didn't totally stop, the applications were.Really cut back.And I think the public, like churches had eugenic sermon contests.Like those were less popular after World War 2.Yeah, particularly because we were trying to say look how bad the Nazis were.

32:09

They did all these terrible things were not that terrible.Yeah, plot twist, maybe we kind of were.An interesting little tidbit as well is that one of the lawyers at the Nuremberg trials who was defending the Nazis used Buck versus Bell in his argument.

32:25

Oh, that's embarrassing.Yeah.Yeah, so, but yeah, But if a defense attorney is, you know, defending somebody who's accused of eugenics and you in your Supreme Court have said eugenics is OK, like it's hard to make that kind of moral claim.Right.Yeah, absolutely.

32:41

So as we wrap up this case, so, so eugenics for sterilization, they don't happen much anymore, but I think there's maybe a different side.I would love to believe that it doesn't happen anymore.

32:58

Are you going to pop that bubble of mine?Well, yeah, I mean, there's been not at the scale, right?So there were, like you said, 10s of thousands of people every year.There's estimates around 60,000 in that time period.So for sure not at that scale.

33:13

And now it's the case that, and I'm sure you've dealt with some of these cases as I understand it, in I think every state in the US if you want to.Sterilize a person with an intellectual disability you have.You can't just make that decision between like the parents and the doctor.

33:30

You actually need to bring that before a judge.Is that correct that that's my understanding as well.I of course, we can't speak for every single state, but the the couple in a couple states that I've been living in and and doing this type of work, that has been the case that if there's an extra protection for that type of medical decision that requires court review and I think for good reasons.

33:51

Yeah, yeah, I I think this is probably a good idea.I think there's some who want to push back and say like it's overly burdensome to, you know, to do that.But and I'm not sure how often it's really happening, but I've certainly been part of cases and and and Ashley X, which we'll talk about in the series, was another one where, you know, this is a girl with an intellectual disability, had a hysterectomy.

34:15

And as far as I know, they never went to a judge to ask permission for that.It never comes up, at least in the reporting on the case, which is surprising because that is what most states would require you to do.So I'm surprised about that.But remember these cases and maybe you're going to get to this, but there were, there were some cases that came out recently of a physician who was sterilizing women at the border.

34:38

Yeah, so against their without their knowledge.So definitely against their will.And just not telling them, yeah, there's a really good documentary called Nomas Babies that is about the forced sterilization of migrants, particularly from Latin American countries into the United States.

34:56

And I think focusing kind of, you know, South Southern California area.I think it's kind of based in Los Angeles maybe, But yeah, exactly.Bringing light to that issue of women who are very, very vulnerable, right Maybe they're asylum seekers, refugees, people who are immigrating for a lot of different reasons and don't have anybody to speak on their behalf.

35:22

And so it's it's I I find it profoundly troubling that that I mean up until even I think the most recent reports of kind of use using some of this legislation to justify for sterilization without the knowledge of women.

35:39

I mean it was happening in as late as like the 70s and 80s in some places wrapping up.There's a a really interesting kind of kind of human interest aspect to this case later.So there's a a guy who works a, a professor who works in bioethics quite a bit, but also in law and a kind of medical history named Paul Lombardo at Georgia Tech.

36:00

Yeah does some really interesting work and he one of his fascinations or one of his areas of expertise is this case and he's written a book about it and a lot of articles about it and he actually tracked down and met Carrie Buck who is in her 80s and and he was able to interview her and kind of get her side of the story and and so yeah exactly.

36:28

And it's it's reported or or documented that Professor Lombardo was one of the few people who was able to attend her funeral in Yeah.So she lived until her 80s, remarried I think twice, remarried, obviously never had more children, and by all accounts lived a fairly normal life.

36:51

But for the fact that she couldn't have children.Wow.And how about her daughter?Yeah, so her daughter sadly died in childhood from complication from measles.But also there was somebody examined her later and wrote pretty persuasively that the child had no intellectual deficits, that there was no reason to believe that she wasn't anything other than, you know, a healthy child from the circumstances that she was from.

37:20

Yeah, yeah.So really sad.I had, I had, I don't know if this is true.I think I thought, I remember being at one point she was on the honor roll.Like they're like definitely no indication that she had any intellectual disability at all.Not that that would have made any of this like OK.

37:38

Right.But it's just another sort of like they didn't bother these these physicians did not care about Carrie or her mother or her daughter.And I I think it it kind of goes back to the point that is has been troubling throughout this case is that these individuals were really appropriated for other people's interests in a really gross way.

38:00

Yeah, but we've solved all of that.And sorry, maybe not.A problem Problem not solved, but.But I think like we said, I mean, if we're thinking about implications of this, it has gotten better.There are more rules.You can't just sterilize people against their will most of the time.

38:19

So in that sense, things have gotten better.We don't treat people with intellectual disabilities a whole lot better.We don't institutionalized women for basically no reason most of the time.Yeah.So, like, the systems have gotten a little bit better.

38:35

Institutionalization isn't like as much of a thing today as it was.Which isn't to say we can't involuntarily commit people for reasons that are sometimes suspect, but the sort of mass scale institutionalization of women who just like are immoral, not quite as common.

38:50

Today, the Virginia State Colony for Epileptic and Feeble Minded Individuals is closed.You'll be happy to know.But it closed in 2022 or 2020, yeah, yeah.

39:08

But it, it kind of changed it.It wasn't always the same thing.And the name definitely changed.So it opened in 20 in 1910, but even on the website for you know, announcing the closure of this institution, it doesn't use its name as it existed in carry bucks time.

39:29

So it's referred to as the Virginia State Epileptic Colony.They leave out the feeble minded parts little.That's pretty bad.I mean whitewashing of history.But absolutely.Have you been to this?The town where my husband's from has an institution that they've like reconverted into like a shopping mall.

39:48

No, it it what is it like a state mental hospital that yeah no I the the deinstitutionalization movement in like the 70s and stuff you know closing down mental hospitals has had such an interesting ripple effect throughout so many levels of our society, right.

40:10

So up in Michigan there's there's one kind of up towards what we call the thumb up kind of northeast area that has been almost closed and not closed and it really is like a lifeblood of.Well, I don't know if it's Lifeblood anymore.It was a a big employer in that county and like so.

40:27

So closing it has implications for not only the the patients and the people who work there, but also the communities that support and are kind of part of that broader community as well so.Yeah.At some point, we'll probably talk about Willowbrook and kind of what led to people's being people being kind of horrified by what was really happening in these institutions.

40:48

Yeah.So, all right, that's the case of Buck versus Bell.Thanks.That's a tough one.Yeah, that's a tough one.I don't have a bow to put on this one, Devin.Tough but important lesson in American history.Yeah, let's not whitewash this.We did a bad thing.Yes, it was bad and it was cited by bad people to do bad things and but I I think one thing that maybe is a good point to end on is there's a lot of really interesting scholarship on the eugenics movement in the United States.

41:17

Obviously you've had a little bit to write about, but also websites that have like tracking data and analysis and quotes from this case and and all of that stuff is, I think it's really an interesting part of American Medical history.

41:35

Absolutely.So we'll link to a bunch of that on the website.So check it out.So, all right, Buck versus Bell in the books.Done.Thanks for listening to this episode of Bioethics for the People.We can't do this podcast by ourselves.We've tried and it's not pretty.

41:52

Our team includes our research interns Michaela Kim, Madison Foley and Macy Hutto.Special thanks to Helen Webster for social media and production support.Our theme music was created and performed by the talented Chris Wright, friend to all, dad to two and husband to one.Podcast art was created by Darian Golden Stall.

42:09

You can find more of her work at Darian Golden stall.com.You can find more information about this episode and all of our previous seasons at bioethicsforthepeople.com.We love to connect with our listeners.All of our episodes can be found wherever you listen to podcasts.

42:25

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Tyler and Devan walk through the infamous US Supreme Court Case of Buck v Bell (1927) in this episode. Buck v Bell has a dark legacy that includes forced sterilization, eugenics, disability, and violence against women.

Further Reading:

Transcript

0:03

Come to another episode of Bioethics for the People.I'm joined by my Co host Doctor Devin Stahl, who according to her student reviews should be cloned and teach all of the bioethics.And he's Tyler Gibb, who, according to his students, is best described as the GOAT of bioethics.

0:28

All right, Devin, I've got a case for you.OK.Well, that's kind of the theme of the whole season.So I I would hope so.Yeah, so this is, this is a tough one.I mean not that any of our cases are really like sunshines and roses and feel good stories, but this one is particularly gross.

0:48

Can we say gross?Yes, it are there any like?Warnings you want to give to listeners before we start, then I guess.I I mean, it's kind of always a good idea to to warn people what they're getting into, but this case involves for sterilization and eugenics and also some really terrible mistreatment of people with disabilities and people without disabilities.

1:14

OK.If it's the case I'm thinking of, given what you've just said, is there also?An account of rape.Yes.Yep.All right.So with that caveat, what do you know about the case of Buck versus Bell?

1:35

Yeah, I know a little about this case because I do work in disability and this is kind of this Seminole case, I suppose.I don't know kind of the intimate details.I know the broad strokes of the case of a.A woman with an intellectual disability who was kind of seen as the the case that made its way to into the courts to allow for sterilization of people in the early 20th century.

2:04

So this is kind of that case, right?Yeah.So all of that what you said is right.So let's let's just kind of walk through the case.So this is the case of Carrie Buck versus Bell.And so we're talking about Virginia in the 1920s mostly.

2:25

So this case, I think it was decided in 1927 was when the Supreme Court case was actually published.But kind of the things going on in this case are early 1900s moving into the 1920s.Ish.OK.So get that time frame in your mind.

2:43

I'm getting wait, wait, let me put myself.OK, short haircut.OK, Yep.Yeah, I got it.Yep, Roaring 20s.The The Roaring 20s of the Gatsby's do not make their way into the the lives of the the poor, disadvantaged individuals living in rural Virginia in the 1920s.

3:03

So.Right.So different frame of mind.Different frame of mind.Yep.We're not doing.We're not dancing and drinking martinis here.OK All right.So this case centers around a particular law.And this law was, I think, probably controversial even at the time.

3:24

But it was a law that a lot of people were really jazzed about, So and so much so.And we've talked about in other in other podcasts where people, particular lawyers who or individuals who want a particular law on the books or a law taken off the books, we'll use this idea of targeted litigation.

3:53

And so the idea is that we have this law we want to make either get it proven unconstitutional and and canceled thrown out and or we want it to be like given the the thumbs up, green light by the Supreme Court or whoever.And we are going to look around and try to find the best case we possibly can to sue on behalf of and then actually move it through the court system.

4:17

So it's.What some people call like activist legislation.Litigation.Yeah, activist litigation.And yeah, so targeted activist litigation.And it is this strategy has been really successful in I think overturning a lot of Supreme Court precedents that were really problematic.

4:39

And so if you think of like Brown versus the Board of Education, the the case which threw out this concept of separate but equal education, right.So Thoroughgood Marshall was actually one of the lawyers involved ended up on the Supreme Court.

4:55

And so they they went around and tried to find the exact case in order to make their point about this particular.Yeah, like the perfect case that's going to, you know, prompt us to say, yeah, this is a bad law, right.And it happens really commonly in a lot of the cases that we know about, like for example, Loving versus Virginia, the case that overturned or got rid of or changed interracial marriage outlawed in some states.

5:24

So it it can be really beneficial, I think, to society to do this, but sometimes it's not so great, right?So there's activists on both sides, right?And we don't always agree with them.Yeah.Yeah.If everyone agreed on what public policy should be, then what would lawyers do with their free time?

5:42

All right, so this law that we'll talk about in just a minute called the Virginia Sterilization Act, bit of an ominous name.I think legislators have gotten better about hiding the intent behind laws through like fancy names and acronyms, acronyms of of laws that they passed.

6:03

So yeah, but this?Cut right to the point.We want to yeah, we want to show Sterilization Act of 1924.OK, so the folks involved in this movement behind this were in favor of this idea of eugenics.

6:20

OK, I know you are a very well, well read, well read expert on all things dealing with bioethics.So eugenics tell us what that is.Yeah, well, I did write a book on this, so I should know a little bit about it.So eugenics, this idea.

6:37

So there's positive eugenics and negative eugenics.So early 20th century.We're really Americans in particular, really excited.Hitler will take this up in a really aggressive way, but he got his ideas from American policy.So the idea was that we want to perfect our society through scientific means, so improve the human species.

6:58

Two ways of going about it.You can encourage the right kind of people, quote UN quote, to reproduce so that they will pass on.I mean, I think that they're not.This is way before, like the Human Genome Project.We don't totally understand heritability, but we do understand that kids tend to be like their parents.

7:17

And so and we're not quite sure like what traits are passed on.We're pretty sure, like intelligence and even like poverty could be passed on.These are.We would be very cautious about saying those things these days, but criminality is another one, right?Criminality.Yeah, sure.

7:33

So you know, these things are potentially heritable.So let's get like, and of course it's the exact people you imagine good, wealthy Protestant white people to reproduce.Let's encourage that, and let's discourage the wrong kinds of people from reproducing.

7:50

So poor people and black people and people with disabilities, like, let's, let's.Encourage them not to reproduce or forcibly sterilize them so they can't reproduce.Yeah, so this is there's a number of policies and laws that are being formulated by A and people today would say, oh, this is a pseudoscience, eugenics.

8:12

But at the time it was thought of as good science, right?This was not some like fringy science.This was the mainstream science of its day.I think that one thing that's really interesting about the topic of eugenics is exactly what you just said is that we often associate this with, you know, the Third Reich and Nazi, you know, purification of the the Aryan race type of evil, bad Nazi stereotypes, right.

8:39

But like you said, a lot of these ideas were originating in the United States.And we really actively, as a collective national consciousness, try to forget that a lot of those ideas came from the United States.So in this case, we've got Carrie Buck, who is an A woman from a really poor family who finds herself pregnant in 1924.

9:09

Carrie is from what we would describe as, you know, a broken home.Her mother is actually institutionalized, and it's a little bit unclear why she was institutionalized except for she was, quote UN quote promiscuous.

9:28

So.Yeah, well, and at this time, I've been reading some stuff recently, like not uncommon to institutionalized people too.So there's like this horrible history of institutionalizing people who, you know, had quote UN quote mental disorders.It was really easy to institutionalized women.Even married women, like husbands, could put their wives in asylums for almost no reason at all.

9:50

Just if they went before a judge and said, like, she seems crazy, please, you know, keep her here.And so there were lots of people institutionalized against their will who were not being benefited by being in institutions.So the fact that she was, quote, UN quote promiscuous, who knows what that means?

10:06

It could have just been some guy who was like, I don't want to deal with this woman, please take her away.And she had like, no autonomy.Over that situation exactly, and in a nearby area in Virginia, there was an institution that was known as the Virginia State Colony for Epileptics and the Feeble Minded.

10:27

So, oh, a colony.That's always like a great way to start.Yeah, there's there's at least half of the words in the the title of this that cause a little bit of a emotional reaction.Cringy.Little cringy.So the inner, the guy in charge of this, so Doctor Pretty Albert Sidney Pretty was a Superintendent of this colony and he was a hardcore proponent of eugenics and particularly the negative eugenics, meaning like we're going to sterilize people who he believes for whatever reason to should not be able to procreate in the gene pool.

11:06

And so his entire colony, this institution was built up around kind of as this with this idea in kind of the foundation of it.And so a couple things, interesting quotes from him.And so he was all in favor of institutionalizing women and then sterilizing them against their will.

11:27

And he was a childhood friend of the individual who, in Virginia, helped pass, write, and pass the legislation that legalized this.So the Virginia Sterilization Act author was a friend of this dude?Yeah, So they're in cahoots.

11:42

They're in cahoots.Well, they clearly have a similar view about about eugenics.And so he is quoted as saying that he would choose women or accept women into his organization, his institution, if they were, quote, immoral, if they were, if they had a unnatural fondness for men.

12:02

That's another quote.So promiscuity we've talked about.Natural fondness.Like, I just like the men too much.Too much.Yeah.And then actually there's a quote about a 16 year old who is institutionalized and end up involuntarily sterilized because of her habit of quote talking to little boys.

12:26

Talking to little boys, yeah.Oh no, as as a 16 year old.So, like, is there an implication that she was a pedophile?I think that that is one level of justification beyond what these guys felt like they had to justify.

12:44

She just talked to little boys too much.I I think that they wanted to sterilize this woman and for whatever reason.And so, I mean we talked about the gross history of American medicine, right?So involuntary sterilization is at the top of the list.OK, So Carrie Buck woman from a very poor family, very poor area of Virginia and she, her mom is actually institutionalized in this Virginia colony for the epileptic and feeble minded and and she gets admitted as well.

13:19

And so mother and daughter are both involved, institutionalized together.And there's actually a couple of pictures online of the two of them sitting next to each other like on this call.It's kind of a haunting image of these two.And at the time Carrie Buck was pregnant.

13:35

OK, unmarried.It's pretty clear and I think I think probably on uncontroversial, the father of the child was actually a family member who raped her while she was living in in the same home or in the home of another family member, so.

13:53

This is always what I thought is that the family that was fostering her when her mother was sent away, it was their son who raped her and got her pregnant and they didn't want to deal with her and blamed her right?

14:09

And so sent her away, right?I think it was actually a nephew of this family, a foster family, but definitely a family member.And she was definitely raped and definitely impregnated, and definitely then sent away.The tragic right.

14:25

So she is pregnant in this in this institution with her mother and gives birth to a child.And as part of the rationale for the sterilization that actually occurred to her later, they started doing intelligence tests, IQ tests, type kind of evaluations of the baby almost right away, which is.

14:51

Interesting.I already have such big issues with IQ tests and giving them to babies just seems like.Out of control.There are reports of them holding up like a coin to this child who's only a few months old and like moving it back and forth.

15:06

And whether the chat the baby like tracked it or not was then used as justification for whether the child was going to have a normal intelligence or not.Gross.Pretty gross.So unsurprisingly, Doctor, pretty at the at the Colony, thinks that Carrie Buck is a prime not just example, but a prime candidate for sterilization.

15:32

And not because of any reason that would benefit her, but purely for the benefit of the collective gene pool.Yeah, she's her offspring would be bad for society.So we must sterilize her.For the good of the whole.For the good of the whole.

15:47

Yeah.Yeah.I mean, I think we're compounding cringy upon cringy as we get deeper into this case, right?Yeah, not off to a great start.Yeah, it doesn't, it doesn't get better if we're being quite honest.

16:02

So in in a lot of ways, in some of these cases, particularly kind of from this era, the individual themselves really gets de prioritized throughout the entire process.She's so and she's like 16 at this point, 18. 18 OK, so she has just become an adult.

16:20

They probably did.They wait until that happened.I don't.I don't think that.They didn't care.They didn't care about that.Yeah.OK, so this works its way up through the the Virginia court system and eventually gets it all the way up to the Supreme Court.

16:37

And there's a couple of notable characters on the Supreme Court at this time.As somebody who kind of geeks out on the law, I really like the the makeup conversation of the Supreme Court as being important in the decisions that they make.

16:52

But a couple of folks on this Supreme Court you may have heard of, like, I don't know, Oliver Wendell Holmes.I've heard of him, yeah.Learn at hand is another justice who you may have heard of.And the chief justices this time was an individual named William Howard Taft.

17:13

President William Taft is the only former president to then serve on the Supreme Court.Interesting.Notoriously great president that everyone's definitely heard of Yeah that everyone is super excited is now making is now the Chief Justice of the Supreme Court.

17:29

Yeah, that isn't I.You know, I I don't think I really ever put that together that he would be the only one.Interesting because yeah he's often labeled as like one of the worst presidents of all time.Yeah not not shining example of presidential effectiveness or but he was also kind of a big proponent of eugenics and it I think it's easy to think that you this idea of purifying the the gene pool and and promoting certain characteristics is fringy that not a lot of people have that perspective but it really was really common a lot especially at the the more educated the more wealthy the more powerful quote UN quote folks in kind of society at that time it was a really common perspective really common view.

18:21

Yeah, I'll just add, just because I read a book about it, they're like 2 notable groups that are not eugenics proponents and it would be Catholics who are, you know?Very much a marginalized group in America in the early 20th century, in part because it for sterilization goes against their belief in you know that that this would violate their sort of moral sexual code of you know, not prohibiting children.

18:51

So there there's the Pope has said some things about this and it's and and there was actually some initially some interest from American Catholic Bishops.But, but when you add forced sterilization to the mix, you can't abide that as a Catholic, so good on them.

19:08

Although it's yeah, I will say there's some other things that Catholics are saying at this point where it's like, well, the idea is really good.You just the means are bad.So it's not like they're totally against eugenics on principle.You can read about more about that in my book and then I love it when you promote your book.

19:24

On Yeah, yeah, yeah.I got somebody's got it right and then fundamentalist.So right around this time we also get this liberal fundamentalist divide in American Protestantism.So whereas the Liberals are trying to keep up with like contemporary science and and like kind of the latest.Cultural things.

19:41

The fundamentalists are, you know, retracting and becoming more conservative and saying, you know, we can't, we can't believe this, like these new scientific advances and and a huge part of that too is just like.Are we going to go along with Darwinism?So I'll say that their reasons aren't actually necessarily all that great either for not promoting eugenics.

20:01

It's not very few people have, like, a principled There are some, for sure people were like, I don't think we should be sterilizing poor people.Those people exist.It's not like a principled stance by, like, a notable group.Yet at this point, so yeah.

20:19

Common perspective like so bringing up eugenics like in a cocktail party would not be frowned upon, right?People are talking about it and.Yeah, yeah.It's the science of the day, right?It'd be like today, talking about, I don't know, whatever, gene editing or something like that.

20:35

Sure.Like, well, I'd I'd say I I bet gene editing today is more controversial than eugenics was in the 1920s.Yeah, Interesting.Another interesting wrinkle to this case.Is that it?By some accounts the doctor Pretty, who is the the director of the executive of this colony actually heard about Carrie Buck through her mother who was already, like I said, already institutionalized there and basically solicited her to become an inmate so he could sterilize and use as as the example.

21:09

So at about 14 different levels, Carrie Buck, the person really gets subsumed into other people's.She's just this pawn in this bigger game of eugenics.So what do you think the Supreme Court decided is it is the Virginia Sterilization Act of 1924?

21:30

Does it violate the US Constitution?It doesn't.I do know there's this quote and I you probably have it.At hand better than I do.Something about 3 generations of imbeciles is enough.Oh, yes.All right, so I'm going to text.I'm going to text you this quote.

21:46

So this is from the Decision published in 1927.Buck versus Bell.This is Associate Justice Oliver Wendell Holmes Junior.OK, all right.So we have seen more than once that the public welfare may call upon the best citizens for their lives.

22:01

It would be strange if it could not call upon those who already SAP the strength of the state for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence.Oof, it is better for all the world if instead of waiting to execute degenerate offspring for crime, whoa, yeah.

22:26

Or to let them starve for their imbecility.Woof.Society can prevent those who are manifestly unfit from continuing their kind.The principle that sustains compulsory vaccination is broad enough to cover cutting the fallopian tubes. 3 generations of imbeciles are enough.

22:44

Wow, that is worse than I remember.So I remember that line about 3 generations of imbeciles is enough.But these other lines about sapping the strength?About executing them for crimes or letting them starve.So these are the options, right?

22:59

So either prevent them from being born or obviously we'll execute them for their crimes or they will starve from imbecility, right?Like as if the state has no interest in either of those things.Not happening.Yeah, bonkers.

23:17

That is wild.There are a couple cases that get cited kind of in law school and constitutional law classes.I was like, here's a really, really ugly quote from the Supreme Court, right.So there's a case called Plessy versus Ferguson, which is about the property interests of slaveholders, and it's it's really problematic.

23:36

But this one?It's hard to find a more disturbing quote from a Supreme Court opinion than this one.That is that's brutal.And am I right to think that we haven't like overturned this is this Duke, We don't have any states that still forcibly sterilize that ended way back in the 70s.

23:57

Yikes.But I don't think that it was ever overturned at the Supreme Court level, right, Right.So there's a subsequent case called Skinner versus Oklahoma that actually it doesn't directly overturn Buck versus Bell.But what it does is it basically renders it ineffective and it says that for sterilizations do actually violate.

24:17

Although let me I don't always say my opinion on this podcast about these cases, but it was wrong.I'm going to go out on a limb and just say, like, I think that this ruling was wrong.What was the most wrong about it, do you think?Let's start in the what are, What are some parts of the thing that you just read that are?

24:39

I mean, you had to stop a couple times and take a deep breath as you were reading it, so.Yeah, okay.So I mean, so let's set a little bit of context.So this is right after.I mean, this is the generation most of this generation had seen World War One and the the horrors of World War One and the number of friends and family members and countrymen who died in a brutal war, right.

25:05

So when they're, when they're talking about like the best citizens giving their lives, that's the context that they're talking about.And also so that that one other point of, yeah, the principle that sustains compulsory vaccination is broad enough to, you know, and then the quote goes on.That issue had actually just recently been litigated in the Supreme Court as well.

25:24

So that was actually also fresh on their minds.And so the idea is like, if we're asking someone to do something like vaccination, maybe we can ask them to do other things with their body.So.Right, right.There's there.Like the state has an interest.And I don't think this is wrong on principle the state, because I think there are times in cases of like epidemics when maybe the state really does have an interest in.

25:45

Forcing people to do things to their bodies they wouldn't otherwise want to do for the sake of keeping everyone else safe is like you make a small sacrifice, and with vaccinations you're not even doing that, but you might be asked to make a sacrifice on behalf of the whole to keep everybody else safe.

26:02

So I don't know that that's wrong in principle.Like where that falls, right?Like how what exactly things you're being asked to sacrifice and who gets to decide is?Of course, going to be controversial, but in principle, yeah, I think like most people would say that yes, we can ask people to sacrifice some things, even some of their bodily autonomy for the sake of everybody else around them.

26:23

So that's not wrong on principle.I mean, So what is wrong on principle?The idea that we're like, that America was being swamped with incompetence because of like people's genetic makeup that we just like cannot abide.Some people's intelligence not being as great as other people's is.

26:41

Really gross and and probably inaccurate, right?That some of these things that like poverty being inherited is of course not true.Some people still seem to think that, but not something you pass down genetically.Even if we have systems that keep people in poverty, the idea that, like, the only alternatives to sterilization are executing people or letting them starve to death seems like pretty extreme, yeah?

27:10

And then that they were imbeciles.I mean that's a word obviously we don't use anymore.It was, I think the technical, like medical term at the time, but Yikes.It just comes across as so, like such a gross way to talk about people.Yeah.And I think what's troubling for me about this case, I mean there's obviously a lot of things, but this idea that eugenics is so good and so scientific and such a benefit for society that we're going to use whatever means we can in order to achieve that.

27:42

And the people who kind of at the, the, the, the butt end of that are really vulnerable people also, people who maybe, I don't know.So we talked about this a little bit earlier that it's unclear and maybe it is a little bit clearer.

27:59

And it's not the case that Carrie Buck really wasn't mentally impaired in any way that she was actually, you know, just a a poor woman in a bad situation and got caught up in this other movement, this other the interests of somebody else.

28:16

Yeah, she was just incredibly vulnerable, right?She couldn't.Nobody cared what she had to say as as far as I remember, of this case, like she did.She didn't take the stand.She nobody asked.I mean, how is this true?I'm remembering this and maybe you'll get to this, but like some of the doctors who testified that she was.

28:35

You know, mentally impaired.Never met her.Yep.They relied upon reports.And there's this famous eugenicist at the time kind of the, the one of the people who were really was really advocating in this.His name was Harry Laughlin and so he submitted testimony to the written testimony to the court in this and afterwards so arguing for the the virtues of this law.

28:58

And afterwards he was reflecting upon his his motivations and kind of this Buck versus Bell being the importance of it.And he said that the decision in Buck versus Bell took negative eugenics out of the experimental phase into the the application stage, which is also pretty gross.

29:17

And after the Supreme Court case came down in 27, many, many other states followed Virginia's model and instituted legislation that permits sterilization against somebody's will.Yeah, like most states, right?

29:35

Most states had some sort of compulsory sterilization law.Yeah.So by 1947, so 20 years after that in the United States, the United States was forcibly sterilizing 10s of thousands of people a year.So I said earlier that Skinner was the case in 1940, forty 2:00-ish, I think 1942.

29:57

And it didn't specifically overturn Buck versus Bell, but kind of discourage those types of laws on the books.And then they kind of fell out of favor and state started to not use them.But some of them were never actually formally taken off the books until the 2000s.

30:13

I think the most recent one was maybe North Carolina.I'd have to double check.That, yeah, I saw that, yeah.Yeah.So even if we weren't doing it, but it were on the books, which is pretty bad.Yeah, when?You think so 1946 like this is like post Holocaust, like so we're really embarrassed.

30:28

So but do you know why we're embarrassed is because of all the crazy stuff we saw the Nazis doing that the world condemned.And then we start looking at ourselves and be like, wait a second, maybe these laws aren't great.Right.So they so all the eugenicists started calling themselves something different.

30:45

So it's not like eugenics totally went away at that point.But like it was like population science, so they all just like all the societies like changed their names.They just changed their names.Oh, it's such a sad part of like, it wasn't that they were all just shamed into shutting down.They just like kind of pivoted a little and change their names.

31:03

Yeah, it's almost like a rebranding, remarketing, right situation.So after about 1947, particularly after all the stuff in the Nuremberg trials, so the trials of the the Nazis post World War 2 and a lot of stuff that Joseph Mangala was doing his experimentations, the fervor for being publicly A eugenicist really kind of faded a little bit during that time.

31:34

Is my understanding.Is that yours as well?Yeah, I think.That's right.So it's not as if all the scientists just stopped doing the science, but like the public sort of support because the churches were all on board, like every everyone was on board.Like I said, there's there's exceptions to that, but people were on board, institutions were on board.

31:52

And I think while the science didn't totally stop, the applications were.Really cut back.And I think the public, like churches had eugenic sermon contests.Like those were less popular after World War 2.Yeah, particularly because we were trying to say look how bad the Nazis were.

32:09

They did all these terrible things were not that terrible.Yeah, plot twist, maybe we kind of were.An interesting little tidbit as well is that one of the lawyers at the Nuremberg trials who was defending the Nazis used Buck versus Bell in his argument.

32:25

Oh, that's embarrassing.Yeah.Yeah, so, but yeah, But if a defense attorney is, you know, defending somebody who's accused of eugenics and you in your Supreme Court have said eugenics is OK, like it's hard to make that kind of moral claim.Right.Yeah, absolutely.

32:41

So as we wrap up this case, so, so eugenics for sterilization, they don't happen much anymore, but I think there's maybe a different side.I would love to believe that it doesn't happen anymore.

32:58

Are you going to pop that bubble of mine?Well, yeah, I mean, there's been not at the scale, right?So there were, like you said, 10s of thousands of people every year.There's estimates around 60,000 in that time period.So for sure not at that scale.

33:13

And now it's the case that, and I'm sure you've dealt with some of these cases as I understand it, in I think every state in the US if you want to.Sterilize a person with an intellectual disability you have.You can't just make that decision between like the parents and the doctor.

33:30

You actually need to bring that before a judge.Is that correct that that's my understanding as well.I of course, we can't speak for every single state, but the the couple in a couple states that I've been living in and and doing this type of work, that has been the case that if there's an extra protection for that type of medical decision that requires court review and I think for good reasons.

33:51

Yeah, yeah, I I think this is probably a good idea.I think there's some who want to push back and say like it's overly burdensome to, you know, to do that.But and I'm not sure how often it's really happening, but I've certainly been part of cases and and and Ashley X, which we'll talk about in the series, was another one where, you know, this is a girl with an intellectual disability, had a hysterectomy.

34:15

And as far as I know, they never went to a judge to ask permission for that.It never comes up, at least in the reporting on the case, which is surprising because that is what most states would require you to do.So I'm surprised about that.But remember these cases and maybe you're going to get to this, but there were, there were some cases that came out recently of a physician who was sterilizing women at the border.

34:38

Yeah, so against their without their knowledge.So definitely against their will.And just not telling them, yeah, there's a really good documentary called Nomas Babies that is about the forced sterilization of migrants, particularly from Latin American countries into the United States.

34:56

And I think focusing kind of, you know, South Southern California area.I think it's kind of based in Los Angeles maybe, But yeah, exactly.Bringing light to that issue of women who are very, very vulnerable, right Maybe they're asylum seekers, refugees, people who are immigrating for a lot of different reasons and don't have anybody to speak on their behalf.

35:22

And so it's it's I I find it profoundly troubling that that I mean up until even I think the most recent reports of kind of use using some of this legislation to justify for sterilization without the knowledge of women.

35:39

I mean it was happening in as late as like the 70s and 80s in some places wrapping up.There's a a really interesting kind of kind of human interest aspect to this case later.So there's a a guy who works a, a professor who works in bioethics quite a bit, but also in law and a kind of medical history named Paul Lombardo at Georgia Tech.

36:00

Yeah does some really interesting work and he one of his fascinations or one of his areas of expertise is this case and he's written a book about it and a lot of articles about it and he actually tracked down and met Carrie Buck who is in her 80s and and he was able to interview her and kind of get her side of the story and and so yeah exactly.

36:28

And it's it's reported or or documented that Professor Lombardo was one of the few people who was able to attend her funeral in Yeah.So she lived until her 80s, remarried I think twice, remarried, obviously never had more children, and by all accounts lived a fairly normal life.

36:51

But for the fact that she couldn't have children.Wow.And how about her daughter?Yeah, so her daughter sadly died in childhood from complication from measles.But also there was somebody examined her later and wrote pretty persuasively that the child had no intellectual deficits, that there was no reason to believe that she wasn't anything other than, you know, a healthy child from the circumstances that she was from.

37:20

Yeah, yeah.So really sad.I had, I had, I don't know if this is true.I think I thought, I remember being at one point she was on the honor roll.Like they're like definitely no indication that she had any intellectual disability at all.Not that that would have made any of this like OK.

37:38

Right.But it's just another sort of like they didn't bother these these physicians did not care about Carrie or her mother or her daughter.And I I think it it kind of goes back to the point that is has been troubling throughout this case is that these individuals were really appropriated for other people's interests in a really gross way.

38:00

Yeah, but we've solved all of that.And sorry, maybe not.A problem Problem not solved, but.But I think like we said, I mean, if we're thinking about implications of this, it has gotten better.There are more rules.You can't just sterilize people against their will most of the time.

38:19

So in that sense, things have gotten better.We don't treat people with intellectual disabilities a whole lot better.We don't institutionalized women for basically no reason most of the time.Yeah.So, like, the systems have gotten a little bit better.

38:35

Institutionalization isn't like as much of a thing today as it was.Which isn't to say we can't involuntarily commit people for reasons that are sometimes suspect, but the sort of mass scale institutionalization of women who just like are immoral, not quite as common.

38:50

Today, the Virginia State Colony for Epileptic and Feeble Minded Individuals is closed.You'll be happy to know.But it closed in 2022 or 2020, yeah, yeah.

39:08

But it, it kind of changed it.It wasn't always the same thing.And the name definitely changed.So it opened in 20 in 1910, but even on the website for you know, announcing the closure of this institution, it doesn't use its name as it existed in carry bucks time.

39:29

So it's referred to as the Virginia State Epileptic Colony.They leave out the feeble minded parts little.That's pretty bad.I mean whitewashing of history.But absolutely.Have you been to this?The town where my husband's from has an institution that they've like reconverted into like a shopping mall.

39:48

No, it it what is it like a state mental hospital that yeah no I the the deinstitutionalization movement in like the 70s and stuff you know closing down mental hospitals has had such an interesting ripple effect throughout so many levels of our society, right.

40:10

So up in Michigan there's there's one kind of up towards what we call the thumb up kind of northeast area that has been almost closed and not closed and it really is like a lifeblood of.Well, I don't know if it's Lifeblood anymore.It was a a big employer in that county and like so.

40:27

So closing it has implications for not only the the patients and the people who work there, but also the communities that support and are kind of part of that broader community as well so.Yeah.At some point, we'll probably talk about Willowbrook and kind of what led to people's being people being kind of horrified by what was really happening in these institutions.

40:48

Yeah.So, all right, that's the case of Buck versus Bell.Thanks.That's a tough one.Yeah, that's a tough one.I don't have a bow to put on this one, Devin.Tough but important lesson in American history.Yeah, let's not whitewash this.We did a bad thing.Yes, it was bad and it was cited by bad people to do bad things and but I I think one thing that maybe is a good point to end on is there's a lot of really interesting scholarship on the eugenics movement in the United States.

41:17

Obviously you've had a little bit to write about, but also websites that have like tracking data and analysis and quotes from this case and and all of that stuff is, I think it's really an interesting part of American Medical history.

41:35

Absolutely.So we'll link to a bunch of that on the website.So check it out.So, all right, Buck versus Bell in the books.Done.Thanks for listening to this episode of Bioethics for the People.We can't do this podcast by ourselves.We've tried and it's not pretty.

41:52

Our team includes our research interns Michaela Kim, Madison Foley and Macy Hutto.Special thanks to Helen Webster for social media and production support.Our theme music was created and performed by the talented Chris Wright, friend to all, dad to two and husband to one.Podcast art was created by Darian Golden Stall.

42:09

You can find more of her work at Darian Golden stall.com.You can find more information about this episode and all of our previous seasons at bioethicsforthepeople.com.We love to connect with our listeners.All of our episodes can be found wherever you listen to podcasts.

42:25

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