Academic journal article Ethical Human Psychology and Psychiatry

Psychiatry, Psychology, and Human Sterilization Then and Now: "Therapeutic" or in the Social Interest?

Academic journal article Ethical Human Psychology and Psychiatry

Psychiatry, Psychology, and Human Sterilization Then and Now: "Therapeutic" or in the Social Interest?

Article excerpt

Practitioners of psychiatry and psychology have played an important role in the sterilization of tens of thousands of Americans throughout the past century. This article examines a number of questions relating to the origin and continuation of sterilization as a treatment and preventive. What social and medical beliefs lead to the use of sterilization as a treatment and preventive for both the individual and society? What ills are being treated and prevented? Who becomes a candidate for sterilization? To what degree are ethical concerns raised, and what is the response to these concerns? And finally, Who is the client-the individual, potential children, or society?-and how do practitioners distinguish the interest of the individuals from that of their potential children and society?

Keywords: eugenics; sterilization; ethics; 19th-21st centuries

Due to their involvement in mental health, mental illness, and intellectual assessment, practitioners of psychiatry and psychology have played an important role in the sterilization of tens of thousands of Americans throughout the past century. In the earlier part of the 20th century, sterilization was performed both therapeutically, in the (supposed) prevention and treatment of mental disorder and handicap, and eugenically, as prevention against what was believed to be genetic transmission of such. In the later 20th and early 21st century, sterilization was still considered a treatment option for mental disorder and handicap, although the biological treatment no longer is based primarily on notions of genetic etiology. While current arguments tend to focus on individual stress and social costs models, vestiges of earlier thinking remain. This article will examine a number of questions relating to the origin and continuation of sterilization as a treatment and preventive. What social and medical beliefs lead to the use of sterilization as a treatment and preventive for both the individual and society? What ills are being treated and prevented? Who becomes a candidate for sterilization? To what degree are ethical concerns raised, and what is the response to these concerns? And finally, Who is the client-the individual, potential children, or society?-and how do practitioners distinguish the interest individuals from that of their potential children and society?

The concept that the modern state or other authority system should concern itself with responsible reproduction originated primarily from the ideas of Galton in Britain (e.g., Galton, 1869, 1883, 1909a, 1909b) and Davenport in the United States (e.g., Davenport, 1911). Galton coined the term eugenics (based on the Greek for good birth) to refer to the idea that society should use education and the power of the state to encourage procreation by the "fit" and to discourage procreation by the "unfit." Eugenics was later popularly defined by Davenport (1911) as "the science of the improvement of the human race by better breeding" (p. 1).

Ideas about genetic determinism and controlled human breeding had spread to the general public during the Progressive Era, often defined as 1890-1913 or 1900-1920. In the United States in particular, the Progressive Era was preceded by a time of unprecedented immigration. Many of these immigrants were economic refugees, poor, uneducated, and in poor health. While Progressive Era reformers were primarily concerned with improving quality of life for the poor, many social workers, physicians, nurses, charities, and police officials had also adopted the popular belief that eugenic remedies such as segregation and sterilization were the solutions to the societal problems in which they were immersed. It wasn't lack of opportunity, low wages, and inadequate housing and sanitation that drove these immigrants to America and left them in lives of poverty, disease, and crime once there-it was hereditary genetic defect. If one could prevent such defective beings from reproducing, one could eventually eliminate poverty, disease, and crime. …

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