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The Secret History of Forced Sterilization and America's Quest for Racial Purity

Written by Harry BruiniusAuthor Alerts:  Random House will alert you to new works by Harry Bruinius


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On Sale: December 18, 2007
Pages: 416 | ISBN: 978-0-307-42496-9
Published by : Vintage Knopf
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A timely and gripping history of the controversial eugenics movement in America–and the scientists, social reformers and progressives who supported it.In Better for All the World, Harry Bruinius charts the little known history of eugenics in America–a movement that began in the early twentieth century and resulted in the forced sterilization of more than 65,000 people. Bruinius tells the stories of Emma and Carrie Buck, two women trapped in poverty who became the test case in the 1927 supreme court decision allowing forced sterilization for those deemed unfit to procreate. From the reformers who turned local charities into government-run welfare systems promoting social and moral purity, to the influence the American policies had on Nazi Germany’s development of “racial hygiene,” Bruinius masterfully exposes the players and legislation behind one of America’s darkest secrets.


A Simple and Painless Procedure

On a cloudy afternoon on October 19, 1927, as a chilly autumn wind swept down off the Blue Ridge Mountains, rattling the windows of the infirmary at the Virginia Colony for Epileptics and Feeble-minded, Dr. John H. Bell jotted a few notes about an operation he had performed earlier that day. He was the superintendent of this sprawling institution, a campus of regimented brick dormitories and rolling farmland set amid the bluffs overlooking Lynchburg, and one of the country’s finest. The morning’s procedure was simple, and dozens of such operations had taken place here over the years. But for this patient he wrote with particular care, since it was a case that might draw a bit of attention.

“Patient sterilized this morning under authority of Act of Assembly in 1926, providing for the sterilization of mental defectives, and as ordered by the Board of Directors of this institution,” he wrote. “She went to the operating room at 9:30 and returned to her bed at 10:30, recovered promptly from the anaesthesia with no untoward after effects anticipated. One inch was removed from each Fallopian tube, the tubes ligated and the ends cauterized by carbolic acid followed by alcohol, and the edges of the broad ligaments brought together with continuous suture. Abdominal wound was united with layer sutures and the approximation of the closure was good.”

The patient lying before him on the operating table that morning was Carrie Buck, a plump, twenty-one-year-old woman who had been under his care at the Colony for over three years. He knew her well. On the day she was admitted, he had been the first to examine her, and he took special note of her dark eyes and slight features, her low, narrow forehead and high cheekbones. He would see her in the Colony’s cafeteria, where she was assigned to work, and his words to her were usually cordial and kind. Yet during most of this time, Dr. Bell and Carrie Buck had been, in name at least, legal adversaries.

So, as he finished his surgical report, he decided to add another formal comment: “This is the first case operated on under the sterilization law, and the case was carried through the courts of the State and the United States Supreme Court to test the constitutionality of the Virginia act, and an appeal before the Supreme Court for a rehearing recently having been denied.”

It was a momentous day. It had taken over three years to test and litigate Carrie’s case, but less than an hour to cut and ligate her Fallopian tubes. But for Dr. Bell, this operation was far more than a legal victory. As a “test case,” it had been a carefully orchestrated lawsuit meant not only to sterilize Carrie against her will, but also to protect a bold but controversial social policy he believed would improve the welfare of the nation. Today was the beginning. It was cold, but outside the window, beyond the white, two-tiered veranda on the front façade of the infirmary, Dr. Bell could look out over the Colony and consider the long battle he and other reformers had been fighting for decades.

Beyond the veranda, the parallel rows of austere brick dormitories made this state-run institution look something like a military camp, its geometric precision imposing order on a vast Virginia wilderness, even as magnolias and elms gave the Colony the gentle, pastoral feel of a Southern plantation, peaceful and decorous, like Jefferson’s Monticello just hours to the north. Dr. Bell, too, had devoted his life, both as a physician and a scientist, to building a more perfect land. Sterilizing Carrie just may have been one of the most important things he had ever done, and as he considered her surgery he may have even dared to think, as a colleague would later tell him, that “a hundred years from now you will still have a place in this history of which your descendents may well be proud.”

Yes, our descendants may well be proud. In the end, real progress in this history, in this quest to battle disease and human suffering, will be found in our descendants, Dr. Bell believed. This was why he had to sterilize Carrie, and this was why he was dedicated to the care of epileptics and feebleminded. To those not familiar with the recent discoveries of “genetics”—a new term in science—Carrie might have seemed a normal girl, if sassy and simple and even a little slow. But Dr. Bell knew she carried within her, like the taint of original sin, the defective “germ-plasm” she would pass on to her children. A defect in her genes made her unusually promiscuous, unable to control herself, and prone to bear a child out of wedlock without shame. It kept her—and her mother Emma before her—from being a productive, law-abiding citizen. And he could say with all confidence, too, that Carrie’s illegitimate daughter Vivian, not quite three years old, would follow the same wanton path.

Yes, our descendants may well be proud. Science was revealing the subtleties of nature, the mysterious, microscopic forces that somehow passed on human traits, the genes that kept generations of families mired in poverty, ignorance, and the cesspool of immoral behavior. These families were a breed afflicted by this low-grade mental deficiency called “feeble-mindedness,” the primary cause, Dr. Bell and other reformers believed, of the social ills weakening the fabric of the nation. These people weren’t insane, exactly. They were not “idiots” or “imbeciles”—terms doctors had long used for people with more noticeable mental defects. No, they were simply a population who behaved like perpetual adolescents—mental dullards without developed moral consciences. To the untrained layperson, someone afflicted with feeblemindedness might even appear normal. So scientists had just devised a new term for these unmasked defectives: “morons.” These people engaged in the unhealthy and antisocial practice of masturbation, which led to sexual impurity and hosts of illegitimate children. These frequented saloons and whorehouses, filled state almshouses and prisons, and worst of all, passed their feebleminded genes to their children.

Biologically speaking, science was revealing perhaps the greatest menace to the future of the human race: fecund, feebleminded females.

This surreptitious menace arose from a strange irony in evolution, Dr. Bell believed. Mankind, the most intelligent and ingenious of creatures, had reached its lofty status through millions of years of toil and struggle. The law of the survival of the fittest had always weeded out the weak and foolish, allowing the best of the race to keep evolving to a higher state. But as this clever species made life less nasty and brutish, as it began to protect the weak of mind and frail of body, the genetic pool began to be polluted. Christian charity and enlightened altruism—and even advances in medical science—had disrupted the natural laws of progress and allowed the weak to live and breed. For Dr. Bell, this irony was made even more ominous as the strong were choosing lives of ease and leisure, shunning large families and the burdens of rearing children. The fitter families of the human race, especially those of the most intelligent Northern European “Nordic” stocks, were reproducing less, while the degenerate stocks were running amok. If nothing were done, the strong might start to lose this battle of genetic survival.

These fears were not simply his own. Many of the world’s leaders, Dr. Bell knew, felt the same. Former president Theodore Roosevelt had called this trend “race suicide,” and had felt that America’s greatness was being threatened not only by rampant poverty but also its cozy affluence. He had once proclaimed, “Some day we will realize that the prime duty, the inescapable duty, of the good citizen of the right type is to leave his or her blood behind him in the world; and that we have no business to permit the perpetuation of citizens of the wrong type.” The inventor Alexander Graham Bell, the social crusader Margaret Sanger, and the administrators of the Harriman, Carnegie, and Rockefeller philanthropic foundations were each calling for state-sanctioned programs of better breeding. The editorial pages of newspapers such as the New York Times, scholars at Harvard, Yale, and Stanford, as well as professional associations of doctors and social workers were each urging the nation’s legislatures to quell the tide of “hereditary defectives.”

In addition, many British leaders supported compulsory sterilization to purify their nation’s genetic pool. When Winston Churchill was home secretary, he had once written to Prime Minister Herbert Asquith urging support for a sterilization bill before Parliament. “The unnatural and increasingly rapid growth of the feeble-minded and insane classes, coupled as it is with a steady restriction among all the thrifty, energetic and superior stocks, constitutes a national and race danger which it is impossible to exaggerate,” he explained. “I feel that the source from which all the streams of madness is fed should be cut off and sealed up before the year has passed. . . . [A] simple surgical operation would allow these individuals to live in the world without causing much inconvenience to others.”

Now, after nearly twenty years of effort, the case of Carrie Buck provided the most resounding legal affirmation of this theory of genetic engineering. In the Supreme Court case that bore Bell’s name, Justice Oliver Wendell Holmes, Jr., feared the United States would be “swamped with incompetence” if women like Carrie continued to have children. “It is better for all the world,” he wrote in the majority decision of Buck v. Bell, “if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. . . . Three generations of imbeciles are enough.”

Yes, our descendants may well be proud. Actually, this idea wasn’t new at all, Dr. Bell would muse. “Racial improvement” was a practice as old as the first great civilizations of the world. Didn’t remarkably heroic races cast their defective infants in the River Tiber or leave them upon the mountainside to starve? “The idea of elimination, by one way or another, of those who were expected to be disqualified for a certain standard of physical and mental perfection, has come down to us through a great space of time,” he would later maintain. “And it persists as strongly in the minds of people today as it did in the minds of the ancient Spartans and Romans. . . . Such efforts to preserve a healthy race, cruel as they may seem, were after all but the pursuit of natural laws: the buds unfit to mature, fall; and the weaklings of the flock must perish.”

Sterilization, by contrast, was humane. It was simple and relatively painless. It took nothing from the patient but the ability to pass on the causes of human misery. Far from cruel, forced sterilization represented science and altruism at their most advanced, with goals heroic and noble. Sterilizing Carrie today marked a return to pursuing those natural laws of “elimination”—not in an arbitrary and brutish way, but in a way ordered by science and guided by reason. If science had revealed the congenital, hereditary nature of human imperfection, it was now revealing a path toward restoration.

“It is not foolish to hitch one’s wagon to a star, for the unbelievable theory of today becomes the proven laboratory fact of tomorrow,” Dr. Bell would explain. “And while perhaps a Utopia may never arise out of our efforts to better our brother’s condition in this world in which we live, nevertheless, much that is practical and useful and elevating to all can be developed and carried to a successful conclusion by the simple formula of all who are interested in these things pulling together towards a common goal: a citizenry purged of mental and physical handicaps.”

This was his faith, a faith in science and progress, and a faith informed by a long-held vision of American destiny. After putting Carrie’s chart in order, Dr. Bell could pick up the day’s newspaper and read about the throngs of people in Baltimore cheering Charles Lindbergh, the great American airman who had flown across the ocean alone and was now making a triumphant tour of all forty-eight states. It was indeed a momentous day. But beyond those cheers, Dr. Bell believed America’s greatness was much more evident here in the calm, quiet infirmary at the Virginia Colony. America, more than any other nation, held the promise of being a land of innocence, free from the defects of the past. This land could be, as so many others had believed, a city upon a hill, a beacon to all civilizations, so long as its citizens remained vigilant, persevered in virtue, and held to their sense of civic duty. Now the Supreme Court had recognized the wisdom gleaned from science and declared this harmless procedure a constitutionally valid means to combat the country’s social ills. Forced sterilization would be effective, Dr. Bell knew, and would help purge from American society those defects found deep within human nature. Today was surely the dawn of a new era, not only for the country, but for all the world.


An Epic Quest in the Modern World

In the early decades of the twentieth century, not long after the technology of surgical sterilization had been devised, state governments throughout the United States began a quest for racial purity that would change the lives of thousands of their citizens. By 1927, before Carrie Buck lay prostrate beneath Dr. Bell’s surgical blade, almost 8,500 American citizens had been forcibly sterilized. This “official” figure, taken from informal surveys by proponents of the procedure and representing only what surgeons chose to report, would reach well over 65,000 in the decades to come.

Ill-educated and poor, these people were operated upon and mostly forgotten. But they were first the subjects of methodical research programs in which scientists tried to trace and then eradicate the gene pool that caused what they casually referred to as “the three D’s”: dependency, delinquency, and mental deficiency. Hundreds of fieldworkers fanned out into the country to visit prisons, mental institutions, and the poor rural hamlets where many of their research subjects dwelled. They collected tens of thousands of pages of data on these subjects’ family pedigrees. Armed with this data, which appeared to show a genetic predisposition toward moral deviance and mental deficiency handed down through generations, scientists persuaded state legislatures—and, in the case of Carrie Buck, the U.S. Supreme Court—to enact laws giving states the power to sterilize these genetically “defective” Americans.

From the Hardcover edition.
Harry Bruinius|Author Q&A

About Harry Bruinius

Harry Bruinius - Better for All the World

Photo © Joyce Ravid

Harry Bruinius was born in Chicago and attended Yale University, where he studied theology, and Columbia University, where he studied journalism. He is a frequent contributor to The Christian Science Monitor, a professor of journalism at Hunter College, and the founder of The Village Quill. He lives in Manhattan.

Author Q&A

Q: How did you get access to the letters, diaries, and public records you did while researching Better For all the World, and where did that research lead you?

A: The research trail for the American eugenics movement led me to a number of archives around the country. The primary repository of documents, photos, and other material is located at the American Philosophical Society Library in Philadelphia. Most all of the papers of Charles Davenport and the Eugenics Record Office, the loci of my story, are housed here. At the Pickler Memorial Library at Truman State University in Missouri, the papers of my other main character, Harry Laughlin, remain available to researchers. Another important repository can be found at the California Institute of Technology Archives in Pasadena, which includes the papers of the Human Betterment Society.

But one of the most exciting collections turned out to be the Cold Spring Harbor Laboratory Archives in New York, where I found a treasure trove of untapped sources on the family life of Charles Davenport, including the diaries of his father and mother. I corrected a long-established understanding of Davenport, which maintained that he had been beset by “conflicting influences” as a child, torn between a severe Puritan father and a skeptical, science-loving mother. Not so. As was made clear in his mother’s diaries, she was just as pious as his father, and far from science-loving. Over the years, Davenport’s memories of his mother evolved, and in his later life he had completely forgotten her, describing her to biographers with the personality of his wife.

When I began my research of Carrie and Emma Buck, their confidential medical records were, by law, sealed from public view. But when the law was changed in early 2002, I was the first researcher to see them. (Others have claimed this, but I am confident that when I observed them at the Central Virginia Training Center in the summer of 2002, only a few months after the law was changed, I was the first non-staff to see them.)

Of course, I read a number of secondary sources, and used information first gleaned by academic historians. In particular, the studies of Allan Chase, Nancy Gallagher, DanielKevles, Wendy Kline, Mark Largent, Paul Lombardo, and David Smith were starting points, and my own research often followed the winding trail of sources they had already laid out in their footnotes.

But one of the most meaningful experiences in the course of researching this book would be my time with Lucille. She not only shared painful parts of her life from over 60 years ago, she also allowed me to spend nearly a week with her and showed me places from her past and present. The story of forced sterilization and America’s quest for racial purity is her story, and my hope, above all else, is that this book will be a record of the wrongs done to her and others like her.

Q: What groups of people led the eugenics movement, and what were their influences?

A: Gabriel Garcia Marquez once described One Hundred Years of Solitude as, in effect, a book about a family who did everything they could to avoid having a child with a pig’s tail, and, precisely as a result of everything they did, ended up having a child with a pig’s tail. As a family saga, Better for All the World traces a similar irony. I pay special attention to the relationship between parents and children and the longings and disappointments that arose out the quest for better breeding. There is a theme of “three generations” throughout the book—an allusion, like the book’s title, to Oliver Wendell Holmes’s decision in Buck v. Bell— so the influences of parents on children, and children on parents, resound in the story.

But I also suggest that the American eugenics movement—which, unlike England, passed actual legislation to breed genetically superior citizens—stemmed in part from a unique American self-understanding. Since the time of the Puritans, Americans have seen themselves as a “city upon a hill,” a nation liberated from the old world and its history. Americans have long seen themselves as a “peculiar people,” chosen by God to come to this land of Edenic lushness, where material abundance, good health, and moral purity can reign free. Americans have often defined their civic and spiritual lives through this Biblical image, and have remained relentlessly optimistic, ever confident that the burdens of history and the evils of the past can be swallowed up in this new Jerusalem, this paradise regained in America. But this promise has always been conditional. A return to innocence requires an effort to maintain that innocence, that moral and spiritual purity, or else the promise will become a curse. Many of the eugenics movement’s leaders were New England Protestants, and, using an evangelical tone which harked back to their Puritan forbearers, they proclaimed that the goal of their scientific program was to keep the “American stock” pure by excising the causes of immoral behavior. They saw eugenics as critical to renewing America, purifying it not only from disease, but from moral impurity as well.

Q: In 2006, the idea of eugenics seems appalling. Why was it so appealing in the late 1800s, early 1900s?

A: We see “eugenics” through the lens of the Holocaust today, and the term is certainly untenable—at least at the moment. However, the same longing for perfection, the same drive for physical “purity,” is hardly an appalling idea today. The premise behind thinkers trumpeting the promises of genetic engineering today remains the same as those promoting eugenics 100 years ago. Then, Mendel’s theory, combined with the stunning, identity shattering ideas of Darwin, led many to believe that human reproduction could be engineered, that human imperfections and ailments could be scientifically eliminated, and that human strengths could be enhanced. I argue that eugenics may have been primitive and misguided, and of course riddled with false premises and shoddy methodologies, but it was not, as many maintain, a “pseudoscience.” Today, many believe that genetic engineering offers the exact same promises as eugenics. And some even dare to suggest we make it a social policy of enhancement in order to move the entire human race to a higher level.

On the one hand, those who found eugenics so appealing in the early 20th century were by no means racists or Nazis (though a great many were, of course). Many influential thinkers and politicians rightly believed that science—and, in particular, the science of eugenics and genetics—could help eliminate diseases and social problems, including alcoholism, cancer, and blindness. A great many were honest and well-meaning, and their optimism about the possibilities of science and technology remain very strong with us today.

And I wonder how appalling the idea of eugenics seems to a great number of honest, well-meaning people today. Yes, Oliver Wendell Holmes’s words seem shocking, but I think they really are logically sound. It’s a Utilitarian argument. When can reproductive choices be regulated by the state, if they are demonstrably dangerous to society as a whole?

Q: How did the American scientists’ work influence Nazi “racial hygiene” and genocide?

A: It would be a mistake to see a simple cause-and-effect nexus at work. Eugenics is, however, an Anglo-American idea, and the United States was indeed the pioneer in state-sanctioned programs of better breeding, which included forced sterilization, antimiscegenation, and immigration restriction. Germany had its own history of eugenic research, which dated back to the late 19th century, and many of its eugenic programs rose out German research. But eugenics had been an international movement with international conferences and collaborations, and global research played the same kind of role it usually does in the scientific community, with innovations being picked up, imitated, and revised by scientists in different countries.

Having said this, in the early 20th century many American eugenicists had already suggested, however subtly, that euthanasia could be one “solution” for the problem of “mental defectives,” while conceding that it was “probably” against current social mores. While a few thinkers did suggest euthanasia as a eugenic solution—and there was a significant castration movement in the late 19th century—few called for actually killing. Forced sterilization, too, was very controversial in the early decades after 1900, reaching a high point in the late 1920s and early 1930s.

When the Nazi regime instituted its comprehensive sterilization program in 1934, it hailed American research and legislation as the model. This was probably for propagandistic purposes as much as anything, since such a program is inherently controversial.

Q: As the states adopted new eugenic laws, when and how did the federal government, including President Theodore Roosevelt, become involved?

A: The federal government was involved in the early period of the eugenics movement. In 1906, President Theodore Roosevelt’s Secretary of Agriculture, William Hayes, appointed Davenport and other prominent scientists to a national “Heredity Commission,” charging them to investigate America’s genetic heritage. Its purpose, Hayes said, should be scientific research, but “with the idea of encouraging the increase of families of good blood, and of discouraging the vicious elements in the cross-bred American civilization.” The Commission should also try to discover whether “a new species of human being may be consciously evolved,” even amid the resistance of traditional culture and mores.

This commission helped organize eugenic research and bring together key scholars in the early 20th century, but no federal legislation rose out of it. The key federal legislation is arguably the 1924 Immigration Act, which severely curtailed the immigration of “non-Nordic” peoples, especially Jews. While not an explicitly eugenics act, the arguments in Congress centered around the idea of racial purity. And Calvin Coolidge, who signed the bill into law, had said, “America must be kept American. Biological laws show that Nordics deteriorate when mixed with other races.” But in this pre-New Deal era, most eugenic legislation was passed on the state level.

From the Hardcover edition.



“A powerful and engrossing read, as well as a poignant argument for humility, a plea that resonates in these hubristic times.” —San Francisco Chronicle“Remarkable. . . . A model of the best sort of journalism of ideas, being an impressively researched and well-thought-out cultural history of the horrible crimes committed in the name of an idea–eugenics–that fraudulently posed as a science.” —Ron Rosenbaum, The New York Observer“A comprehensive new history of the American eugenics movement . . . Compelling.” —Salon “Bruinius takes us into the minds of the thought leaders of the time, showing us how otherwise well-respected people could countenance the now-unthinkable act of forced sterilization. . . . Chilling.” —The Christian Science Monitor

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