Quoted and from “The Chequered History of Vasectomy” by M.J. Drake, I.W. Mills and D. Cranston – © British Journal of Urology. References as per the History of Vasectomy page.
In the late 19th century, rising populations in prisons and institutions for the feeble-minded or paupers led to the public perception of a degeneration in society that relentlessly would lead to “race suicide”. The socially inadequate were considered to include44:
(i) the mentally diseased, e.g. maniacs and schizophrenics
(ii) the dependant members of society, e.g. the deaf, deformed and blind
(iii) the delinquents, such as the wayward and criminals; (iv) the mentally deficient, e.g. the morons and idiots
(v) the degenerates, e.g. sadists and drug habitués
(vi) the infectious, such as those with tuberculosis, the syphilitics and lepers
Richard Dugdale, a New York prison visitor published a family tree of the Juke family identifying 709 persons descended in five generations from Ada Juke, “the mother of criminals”. Most of the Jukes at some point in their lives could be found in homes for the feeble-minded, almshouses, brothels and prisons – an enormous expense to the state derived from one individual. Using this information, it was argued that “degenerates” bred “degenerates” and these people were reported to be remarkably fertile.
Francis Galton, a cousin of Charles Darwin, coined the term “Eugenics”, meaning “the science which deals with all influences that improve inborn qualities”. It was adopted by a vociferous section of society, keen to diminish “cacogenic” germplasm by segregating defectives in institutions and removing their ability to reproduce. It was suggested that “the wise philanthropist, seeing the millions of dollars now used for caring for the weak and defective help only one generation, will soon be induced to provide large sums for eugenics, with the idea of preventing the production of the imbecile, the insane, the inebriate and the criminal”45.
G. Frank Lydston, Professor of Genitourinary Surgery at Illinois, advocated the medical scrutiny of applicants for a marriage licence, with sterilization of the unfit, including consumptives, epileptics, insane, incurable inebriates and criminals. He also argued for sealed apartments with a pipe for the admission of deadly gas “to kill promptly the convicted murderer and the drivelling imbecile”. “Sterilization is the only sop that should be thrown to the Cerberus of sentiment”46.
The surgeon of possibly the highest professional standing to speak in favour of eugenic sterilization was Dr William Belfield, Professor of Surgery at Rush Medical College, who listed factors encouraging crime as: “the farcical maladministration of our medieval criminal laws, the notorious partnership between criminals and many public officials and the maudlin sentiment which has infinite compassion for the prisoner but none for those of us who keep out of jail”49.
The Eugenic movement in America
In 1899, Albert Ochsner, future Professor of Surgery at the University of Illinois, published Surgical Treatment of Habitual Criminals48. As he bluntly put it: “If it were possible to eliminate all habitual criminals from having children, there would soon be a very marked decrease in this class”. He stated: “so far as female criminals are concerned, nature usually protects the community because a large proportion acquire a specific endometritis resulting in occlusion of the Fallopian tubes early in their career, hence their sterility is assured. In order to accomplish this in males, a method must be involved which will in itself not be a punishment to the criminal, or interfere with his enjoyment of life should he reform and become a useful member of society”. He listed the advantages of dealing with habitual criminals by vasectomy as follows:
(i) it would dispense with hereditary criminals from the father’s side
(ii) aside from being sterile, the criminal would remain his normal self
(iii) it would protect the community at large without harming the criminal
(iv) the same treatment could reasonably be suggested for chronic inebriates, imbeciles, perverts and paupers
Harry Sharp’s Vasectomy as a Means of Preventing Procreation in Defectives explained hereditary insanity as a failure of moral or intellectual stimuli to reach the cerebral cortex, the centres of self-restraint being most defective50. He advocated vasectomy for multitudinous indications and urged colleagues to lobby the state legislature apparatus for laws authorizing clinicians at state institutions “to render every male sterile who passes its portals, whether it be almshouse, insane asylum, institute of the feeble-minded, reformatory or prison”47. Numerous articles followed, exhorting the sterilization of defectives; of 38 papers published between 1899 and 1912, all were in favour of the practice48. A Eugenics Record Office was set up in 1910 under Dr Harry Laughlin to record progress in the field49.
Some clinicians of eugenicist attitude carried out operations with no legal authority. F. Hoyt Pilcher, superintendent of the Asylum for Idiotic and Imbecile Youth in Kansas, castrated 47 inmates. The superintendent of a leper colony in Cuba stated he would change his plan to sterilize lepers with radiation to the use of vasectomy. In 1907 the state of Indiana introduced a bill authorizing the compulsory sterilization of any confirmed criminal, idiot, rapist or imbecile in a state institution, whose condition was considered unimprovable by a panel of physicians. Eventually 29 states had statutes permitting sterilization of the insane and feeble-minded, of which 12 also covered sterilization of criminals.
The Virginia sterilization statute was tested in the supreme court in 1927 in the case of Buck vs Bell. Carrie Buck was an inmate of the State Colony for Epileptics and the Feeble-minded, with a mentally subnormal mother and daughter. Justice Oliver Wendell Holmes approved the statute as a therapeutic measure: “public welfare may call upon the best citizens for their lives. 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…. Three generations of imbeciles are enough”. Davis vs Walton was a landmark case involving vasectomy. Esau Walton was a Negro, incarcerated at the age of 19 at Utah State Prison, where Davis was warden. When Walton was found committing sodomy with another inmate, Davis petitioned for a sterilization order. The petition was rejected, because the behaviours shown by Walton were considered to be acquired rather than inherited.
Many of the early statutes were quickly overturned following legal challenges. Nevertheless, over 6000 people were sterilized in the USA between 1909 and 1924, more than half of them under the supervision of the secretary of the California State Lunacy Commission, Dr F.W. Hatch. In total, 65 000 sterilizations were undertaken in a 61-year period50, peaking in the 1930s51. Roughly half were undertaken on the basis of insanity and one-sixth on the feeble-minded, with a few criminals and epileptics included for good measure44. By the 1960s, eugenic sterilizations had slowed to a trickle but there were calls for punitive sterilization legislation for people on the “Aid to Families with Dependent Children” programme who had further illegitimate children. While sterilization was not included in final legislation, vasectomy was occasionally made a condition of parole50.
The Eugenic movement in Europe
In Britain, the voluntary sterilization campaign achieved little more than the influencing of committees13. The Eugenics Education Society (later shortened to the Eugenics Society) was founded in 1907 to promote public awareness of eugenics problems and the need to encourage social responsibility about these qualities. It gained a wide membership, including many prominent people of the day, which rose with perception of the “dysgenics of war”52, i.e. the feeling that the First World War was being fought by the best that the country had to offer, while the shirkers and defectives stayed at home to pollute the germplasm53. The Eugenics Society set up the Committee for Legalising Eugenic Sterilization, with membership including Lady Asquith, Jeremy Huxley and C.P. Blacker. In 1931, a member of the committee, Major A.G. Church, tried to introduce a motion to present a bill to Parliament. He failed as a result of opposition from the Labour party, who portrayed the voluntary sterilization movement as fundamentally against the working class. The Roman Catholic Church, for whom sterilization for any nontherapeutic reason was banned, provided a disproportionately significant source of further opposition. The Eugenics Society turned instead to influence the Committee on Sterilization under Sir Lawrence Brock, whose final report recommended sterilization for mental defectives, persons with a transmissible physical disability and persons likely to transmit mental disorder or defect54. Regardless of these recommendations, no legislation was ever introduced in Britain.
Eugenics flourished elsewhere in Europe, particularly in Scandinavia in the 1920s, where Hothar Scharling advocated pelvic irradiation for female and vasectomy for male mental defectives55. Switzerland was also active in this regard; it passed the first European eugenics law in 1928, and the Swiss programme to control the Gypsy population only ended in 197213. The Russian Government sent a delegate to the American Prison Association Conference in 1910 specifically to witness a sterilization procedure; Harry Sharp duly obliged with a “consenting” prison inmate56.
Germany had a Social Darwinist movement from the late 19th century. In 1927, the Kaiser Wilhelm Institute for Anthropology, Human Genetics and Eugenics was established, experimenting to discriminate race on the basis of blood group, shape of tongue and outer ear, and the half-moon at the base of the fingernails13. A Reich Sterilization law was drafted in 1932, before Hitler’s accession to the Chancellorship in January 1933. In July 1933, a law was passed which required certification of fitness to marry, issued by the local health office (“Gesundheitsamt”). Unsuccessful applicants were considered candidates for sterilization and tried in “hereditary health courts”. “Remarkable as it may seem in this age of selfishness and struggle, the German people have accepted wholeheartedly the racial betterment plan devised by their Führer, and are cheerfully and willingly submitting, regardless of sacrifices involved, to the fulfilment of the duties asked of them”57. Eventually, compulsory sterilization of an estimated 320 000 people resulted13, discontinuing only with the Allied victory in Europe.