To what extent was eugenic science implemented in state medical and health polices during the twentieth century? Essay

The English scientist Francis Galton first used the term ‘eugenics’ in 1883 to refer to the science of ‘improving human stock. 1’ Closely linked with Darwinist Theory and Mendelian Law, of like producing like, the development of eugenics was the development of science to control evolution; ironing out undesirable traits such as criminality and ‘feeblemindedness’ to produce a ‘fitter’ human race. The science was at the peak of its influence in the early twentieth century.

The eugenics movement of this time sought to influence social policy throughout the civilised world, at a time when the numbers of social deviants and undesirables was perceived to be rising, in order to ensure the continuation of the fittest bloodlines. Today traditional eugenics is dead. During the Nazi regime in Germany eugenic science merged with misconceived notions of race and genetics with infamously barbarous results. In the shadow of Nazi Death Camps eugenic science was discredited.

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However, as genetics has emerged as a powerful tool of medicine s modern form of eugenic science still exists. The mapping of the Human Genome and great advancements in technology mean that genetic tailoring is now with us, albeit in a basic form. Mothers and their unborn children undergo unprecedented levels of testing to discover whether the child will be born disabled or with disease and if the tests return positive then the option of abortion is available.

As our knowledge of the Genome increases it will be possible to genetically tailor generations to our needs and expectations, we are only decades away from the world that Aldous Huxley envisaged2. The Eugenics of the early twentieth century has now been discredited, chiefly a result of the uncovering of the full extent of Nazi racially eugenic policy. It is worthwhile charting the development of early eugenics before considering how it is still present in late twentieth century society albeit somewhat ‘hidden’ from view.

Our more comprehensive knowledge of the complexity of human genes makes it difficult to comprehend that complex human behaviour and disease, could be determined by a single gene as eugenics dictated. Genetics does however show that some disorders are indeed a result of a single genetic defect. Whilst we look back on eugenics with distaste it is true that it highlighted that some traits are inherited and modern genetics owes much to early eugenic work. Early eugenics has now been discredited but what seems inhuman today was quite acceptable then.

The later years of the nineteenth century were characterised by increasing levels of intervention in health care by the state, this intervention was backed up by the science of the time3. Eugenics was one science that influenced health policy at this time. By the start of the twentieth century, medicine was increasingly looking towards preventative treatment as a cost-effective and desirable solution to health issues as opposed to treatment of the symptoms of illness – one only needs to cite the widespread pro-vaccination policies across Europe and America as evidence.

The development of eugenics as an ideology followed the pioneering work of Galton in 1883. The sciences of eugenics was aimed at raising the physical and mental level of the human race4 at a time when industrial society was plagued with those deemed ‘unfit’ i. e. those who did not conform to Galton’s middle class ideals of work ethic, intelligence and sexual roles. Scholars of the eugenic ideology soon began to diverge as to how to achieve the goals of a superior generation.

The Galtonian ‘positive’ school favoured the encouragement of breeding between those with desirable hereditary traits whilst a ‘negative’ school campaigned for the prevention of those with ‘undesirable’ hereditary traits from breeding at all be it through sterilization or incarceration5. For both schools there was a real concern that the charitable and humanitarianism of the nineteenth century across Europe and America was preventing the progression of the human race. Welfare initiatives and charity were providing a safety net for the poor, morally reprehensible and ‘feebleminded. ‘

Birth rates amongst the middle and upper classes were far lower than those of the working classes generally. It was the working classes that were most clearly associated with undesirable hereditary traits. Some members of the eugenics movement desired the dismantling of welfare provision along the lines that it interfered with processes of natural selection. Economic problems of the early twentieth century also meant that there was to be more discussion regarding the allocation of resources to sections of society.

Eugenics, particularly negative eugenics suggested that future generations could be saved the expense of caring for the ‘unfit’ if they were never born at all; ‘The superficially sympathetic man flings a coin to the beggar; the more deeply sympathetic man builds an almshouse for him so that he need no longer beg; but perhaps the most radically sympathetic of all is the man who arranges that the beggar shall not be born’7 At the beginning of the twentieth century the notion of competition between nations emerged strongly, particularly in Europe.

Nations had to mobilise their entire populations to their most effective roles in society, as industrial dominance was required to deter foreign nations from warlike policy. Eugenics became more prominent in society as the need for healthy and fit populations became more important. Eugenic ideas were forwarded by groups wishing to change their societal standings, both Socialist and Women’s movements advanced eugenic theories not because of any great belief in the science but because it was a means to achieve their aims.

Socialists used eugenics to campaign for a breaking down of laissez faire policy to create a collective society that currently inhibited the chances of working class people from developing to their full potential. Women found eugenic ideas that they should be allowed to select the ‘fittest’ partners suggested the breaking down of gender positions. The starkest example of negative eugenic science being implemented in medical and health policy is that of Germany. Galton’s work had been disseminated by 1900 by German scholars who were making influential additions to the theories.

Theorists such as Schallmeyer mimicked ideas found in other countries that those of lesser hereditary value should be prevented from reproducing and heavy weight was put in August Weismann’s theory of germ plasm. This essentially ruled out the belief that environmental factors could affect the people afflicted with undesirably hereditary traits. By the outbreak of the First World War negative eugenics was becoming a much discussed and important topic of debate.

As in other countries German eugenics was concerned that the efficiency of the German race was being weakened by the protection of the week8. The First World War momentarily halted the calls for eugenic policy as the emphasis was shifted to quantity of people who could fight or work in factories, however soon after negative eugenics one again took hold. It is a particularly grey distinction between eugenics and racism and German though took on a new tinge of eugenics – racial hygiene.

It seems a small step from conventional eugenics, where people who don’t conform to expected social and moral norms should be prevented from contaminating future generations, to ideas that other races are perhaps not as ‘pure’ and that they should be prevented from contaminating future generations too. Theorists such as Heackel, Schallmayer and Ploetz introduced racial meanings to eugenics. Unlike other countries these views seemed acceptable and to some such as Hitler, desirable. The result of the war was to reaffirm the need for high quality stock in the future and lesser stocks such as the Jews were blamed for Germany’s defeat.

It was revealed in 1923 that doctors in one District were already performing illegal sterilizations on the mentally ill and a law for sterilization was pressed upon the Weimar government, though not implemented. As economic conditions worsened and more questioning of where resources should be directed the more the call for negative eugenics came. Even before the Nazi coming to power the Reich had drafted a law on voluntary sterilization9. Soon after Hitler came to power he introduced anti-Semitic laws but other elements of the ‘lesser race’ also came under attack.

On 1st January 1934 the Prevention of Hereditarily Diseased Progeny Law was implemented that allowed the compulsory castration of those suffering hereditary illness, which was decided by the newly set up Hereditary Health Courts. From 1935 the Law also came to allow the abortion of unborn children if their mothers were deemed to be hereditarily ill. By 1936 women who were deemed of no hereditary value were not allowed state led post-natal care and the mentally and physically handicapped were no longer allowed to claim welfare benefits.

A Euthanasia programme was set up during 1938 following the request of a Reich citizen that his deformed child be killed for his own sake. Children who were born with deformities or serious mental handicap were removed from society and put to death in ‘paediatric clinics. ‘ The children’s euthanasia programme was soon put to use against adults not only to aid the progression of the race but also to free up more hospital beds for the imminent war that Hitler was planning. By September 1939 those suffering illnesses deemed to be incurable would be granted a ‘mercy death’.

Sterilization had existed in the asylums of Germany before the euthanasia programme began but sterilization came to be applied to other sections of society that were seen to be hereditarily poor. A loophole in the Law for the Prevention of Hereditary Diseased Progeny allowed those who were not afflicted by mental illness but were convicted criminals or vagrants to be sterilized under the guise of being socially feebleminded. Following 1936 the police was given the virtual right to incarcerate all vagrants, beggars and habitual criminals.

These social misfits would increasingly be sent to concentration camps, saving penal and welfare resources. There can be no doubt that Hitler’s individual energy and passion for racial eugenics influenced the implementation of sterilization, incarceration and euthanasia but there was also economic reasoning that today seems cold and callous. The Great Depression of 1929 hit Germany the hardest and killed off the Weimar government, Germany had a huge welfare system and a huge population, eugenic policy could cut down on expenditure with a scientific backing and allowed resources to be diverted elsewhere.

One would not equate America in 1945 with Germany in 1945 yet much of the eugenic theory that the Germans acted on was at first employed in America. Here negative eugenics became popular and similar laws to those of the Nazi’s were implemented during the 1920’s and 1930’s. Urbanisation was occurring rapidly in America at the beginning of the twentieth century and as elsewhere the presence of poverty and ‘feeblemindedness’ demanded a response from the state and a move away from Laissez Faire policy.

Eugenic Science provided an acceptable answer, as it didn’t question or demand any fundamental changes in how society was functioning, social undesirables and the mentally ill were merely a product of hereditary law10. Like Germany theorists were more influenced by Weismann’s contention that environmental factors had little impact upon hereditary law rather than Benedict Morel’s ideas that degeneracy was a result of certain agents present in society.

Similarly there was evidence to suggest that the upper classes weren’t reproducing at the correct rate and that over reproduction of degenerates presented a danger for future generations. The First Compulsory Sterilization Law was passed in Indiana in 1907 and other states soon followed suit though truly widespread support for compulsory sterilization didn’t occur until the 1920’s when economic hardship again proved a decisive factor.

Eugenics had become a widespread ideology in America and administrative bodies were put into place to chart the hereditary of American families as well as much publicised immigration laws to prevent the contamination of the American gene pool and to prevent foreign peoples from taking the jobs of Americans that were becoming all the more scarce with repeated economic hardships. Laughlin at the Eugenics Record Office advocated sterilization of the socially inadequate encompassing people who were ‘feebleminded’ to those who were diseased, deformed or work shy.

It came at a time when the public tax burden of increasing asylum and institution populations was at odds with poor economy. Laughlin’s model law was published in 1914, by this time twelve states had already become law. By 1924 some 3000 people had been involuntarily sterilized but sterilization was widely considered a punishment as opposed to a eugenic act. The case of Buck vs Bell in 1927 shifted the emphasis onto sterilization as a right and proper eugenic act11. A court heard the claims that a woman should not be sterilized, only to trace back her hereditary and to deem her ‘feebleminded’ and conduct a sterilization.

By the end of the 1920’s compulsory sterilization was a legal option to twenty-four states across the US. By 1936 thirteen states had the sterilization of convicted criminals on their statutes. The end of Nazi Germany didn’t however end sterilization in the US, though it did reduce it to the most extreme of cases. The sterilization of the mentally ill continued at some level right through to the 1970’s in America. American tests for what constituted feeblemindedness and social misfits have come under much criticism but it was not to the same extent of picking and choose attitude of the Nazi programmes.

Britain to was not untouched by the Eugenics movement, indeed some of the most influential theorists resided in the English administrative bodies such as the Eugenics Education Society. Again in England there was concern over the future health of the nation, particularly accentuated by the national efficiency scare of the Boer War at the turn of the century, though a Parliamentary Report found that this was more to do with poor environment than anything hereditary. Again the humanitarianism and charity of the nineteenth century was criticised for allowing the paupers and feebleminded to exist in society.

As with both Germany and the US there were campaigns for the sterilization and segregation from society of the socially unfit and mentally disabled with particular emphasis on incarceration. 12 It seems that British Health policy was little affected by the calls of eugenics. Whilst eugenic notions did transcend society Britain’s history of public health policy and a professional health service served enough anti-eugenics thought to prevent it ever developing mainstream appeal such as in Germany or the US. Humanitarian and charity goals had developed into a sprawling public health administration in Britain.

British Health provision was deeply entrenched in preventative medicine but it was contested that the growth of pauper classes and the feeble minded in Britain was a result of Parliaments’ unwillingness to implement widespread reform in areas of education and health rather than any hereditary explanations13. There was a deeply imbedded willingness to treat social problems with health measures such as sanitation rather than eugenic practices. The most noticeable health policy that was influenced by eugenics was the Mental Deficiency Act of 1913.

Eugenic campaigners sought greater government influence over the medical care of it’s citizens but the Liberal Governments before the war were reluctant to give in to the collectivist calls and abandon Laissez Faire all together. The Mental Deficiency Act allowed for the voluntary sterilization of the feebleminded and allowed the segregation of social misfits on the certificates of two doctors however it did not go as far as criminalizing procreation or marriage between the feebleminded as had been desired.

It seems government was willing to allow eugenic science influence in health policy however it was not willing to force eugenic science, indeed any science, upon its citizens. Unlike the US and Germany voluntarianism was the order of the day, if eugenics could convince the population then it would be voluntarily implemented. Eugenics could not do this as environmental improvements such as improved nutrition showed that people could be ‘improved’ without such radical measures of sterilization.

Post 1945 eugenics lost the ability to campaign for compulsory measures along the lines of the population being ignorant and science ‘knowing best. ‘ The later half of the twentieth century still sees the existence of voluntary eugenics all be it influenced by social and moral pressures. In Britain, America and Germany and the Western World the use of contraceptives has experienced rapid growth. Contraceptives are made available free of charge through Family Planning Clinics.

The introduction of the Contraceptive Pill has given women the ability to choose when to have a baby and who to procreate with. 14 Throughout the second half of the twentieth century there has been a concern of overpopulation and again issues of quality of ‘stock’ have been raised. Whilst the Contraceptive Pill has made the planning of families easier the legalisation of Abortions in these countries has made it possible to eugenically select which foetuses are allowed to mature and which are disposed of.

In 1971 Bently Glass, the president for the Advancement of Science suggested that as families were to be encouraged to have fewer children there would be a greater demand for those children to be ‘perfect. ‘ Two years later Abortion was legalised in the US and whilst many abortions are carried out simply because of social stigma and attitudes they are also carried out on medical grounds. ‘It became possible, and in many societies acceptable, to terminate pregnancies when undesirable genetic conditions were detected in the foetus. 5’ Medical technology has improved to an extent that from the 1980’s onwards foetuses could be tested for various genetic diseases such as Fragile X Syndrome or Cystic Fibrosis.

Whilst governments in the US, Britain and Germany do not advocate mandatory terminations of foetuses with these diseases the medical profession give mothers the choice of an abortion and more and more of them are taking up the option. Eugenic thought in the three countries is still apparent though it is not legally compulsory but is morally acceptable. A form of ‘negative’ eugenics is still with us.

Sperm banks and IVF treatments in these countries do not use random samples to impregnate women having trouble conceiving but provide only ‘quality’ stock that is unlikely to result in physical defects at birth. In China, the world’s most populous country, there has been a history of state lead population control with the policy of one child per marriage. However more recently eugenic ideas have surfaced in Chinese Law. A Law implemented in 1994 makes it mandatory in some provinces to abort foetuses that are carrying genetic physical defects16.

Whilst civilization has not yet discovered how to measure mental and behavioural genetic defects it is quite plausible that this too will be implemented by law in China and by choice in Western nations. The eugenics of the early twentieth century was formed on the basis of what a few men deemed as undesirable traits. The science that was developed was flawed by simplicity but at a time when science was seen as a cure all was implemented, particularly in America and Germany but it also influenced health policy in Britain all though to a lesser degree.

This traditional eugenics doesn’t exist in these countries today though China has resurrected it during the late twentieth century as an extension of its anti birth-rate policy, if the population is to be reduced then it needs to be healthy and ‘fit’ to make up for fewer numbers. The sifting through and termination of foetuses that don’t conform to what is acceptable is clear evidence of eugenic thought right through into the twenty-first century. Eugenics still exists in America, Britain and Germany. It is no longer in the form of state led legislation backed up by science.

It has become embedded in the thoughts of society. Whilst the debate rages as to the morality of abortion it is an everyday part of Western Society. Abortion and contraception was a result of Women’s Movements demanding the control of women over reproduction but today it can be used to eugenically select which babies get born. Parents want the best for their children and fewer parents are prepared to bring up children with deformities and diseases in the knowledge that it simply doesn’t have to be. The original eugenic doctrines of selective breeding now seem to be apparent.

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