HEALTH :: SEPTEMBER 22, 2004

Overdue in Michigan: An apology for forced sterilization

Part of my job at MSU is teaching medical ethics. I have devoted relatively few columns to that part of my work. But a recent conference we held on disability perspectives on bioethics, alerted me to an issue that deserves much more public discussion.

The state of Michigan owes some people an apology.

We tend today to identify the eugenics movement in the first half of the 20th century with Nazi Germany, and to forget that the Nazis adopted many of their eugenic ideas from the United States. In the first three decades of the century, a number of states passed laws providing for the involuntary sterilization of citizens who suffered from a variety of conditions that were thought then to be hereditary — especially mental retardation. In 1927, the Supreme Court upheld the Virginia sterilization statute in the case of Buck v. Bell. Writing for the majority, Justice Oliver Wendell Holmes Jr. proclaimed in a now infamous phrase, “Three generations of imbeciles are enough.”

Eugenic sterilizations were not exactly ancient history and in fact lasted well beyond the days of the Third Reich; they were being performed as late as the 1970s. In Michigan, an estimated 3,700 such sterilizations were performed, making us the fourthth-highest-ranking state in performing this procedure. It is estimated that in the United States there were a total of 60,000 forced eugenic sterilizations. (For more information, see www.eugenicsarchive.org/eugenics)

When we look back on this episode in history today, we are struck by a number of considerations. First, the so-called science upon which these acts were based turns out in hindsight to be startlingly primitive, despite the fact that the eugenicists of the time prided themselves in being in the scientific vanguard. The majority of the conditions for which people were sterilized turn out not to be hereditary at all; the people were in fact in no risk of passing their “defect” to their offspring. Moreover, the “defects” in many instances were more imaginary than real. Many of the so-called “mental defectives” went on to function as completely productive members of their communities. (Carrie Buck’s daughter in Virginia, who was used as Exhibit A to “prove” that mental retardation was hereditary in the family, actually made the school honor roll later in life.)

Even worse than the scientific transgressions were the ethical violations of basic human rights. In the most egregious cases, individuals and their families were not even told that they were sterilized. They were told that they had needed to have an appendix out or given some other totally false account of the operation. Some of these people later sought medical attention to find out why they could not have children, and were astonished as well as saddened to discover that state agencies and the doctors and nurses employed by them had sterilized them against their will and without their knowledge.

So far three states have issued formal apologies to those citizens who suffered this mistreatment. The state of Michigan has never apologized, even though a number of the victims of forced sterilization are still alive.

One pragmatic, if not highly ethical argument against issuing an apology is that this would be seen as merely a prelude to the victims’ demanding cash reparations. First, it is not exactly clear why cash reparations would necessarily be unsuitable in such a case. The U.S. government eventually made a settlement to all the survivors of the infamous Tuskegee Syphilis Study, who were denied treatment for syphilis so that U.S. Public Health Service physicians could study the late stages of the disease. Second, it is increasingly being recognized (even by a bill recently introduced into the Michigan legislature) that offering an apology is sometimes the humane and decent thing to do and should not be confused with admission of legal liability.

I urge Michigan to move quickly to correct this deficiency and offer a formal apology to all of its citizens who were involuntarily sterilized under state law.

Some think that apologies are today so much in fashion that they have become cheapened. I hope this is not the case as I plan to offer a personal apology in a future column.