FOREWORD

Guel A. Russell

At the International Summit on Human Gene Editing in Washington, DC, held December 1–3, 2015, scientists advocated caution, declaring that the clinical implementation of gene editing would be “irresponsible” at present. They recommended proceeding with thoughtfulness and care “to assess the many scientific, ethical, and social issues associated with human gene editing” until there would be a broad societal consensus about the appropriateness of any proposed change.¹ This was not surprising with such formidable editing tools of “unprecedented ease and precision” as CRISPR-Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats), which could alter human heredity and affect the germ line. Of particular note was a reference to being “part of a historical process that dates from Darwin and Mendel’s work in the 19th century” and the question that motivated the meeting: “How, if at all, do we as a society want to use this capability?”²

That historical process gave rise to “eugenics”—the devastating social movement of the first half of the twentieth century that emerged in the wake of the rediscovery in 1905 of Bohemian monk and naturalist Gregor Mendel’s (1822–84) genetic discoveries.³ How society manipulated that knowledge to create a pseudo-science sanctioned by medicine and the law embodies cautionary lessons. The present volume, Psychiatry and the Legacies of Eugenics: Historical Studies of Alberta and Beyond, provides a critical analysis of the consequences that resulted when genetics, psychiatry, and deeply embedded societal biases and institutional self-interests converged. This approach contributes to a greater understanding of not only the historical complexity of the mechanisms that underlie eugenics but also the contemporary social issues that may arise from genetics. In the narrative process, the questions raised in the individual chapters and the continuous threads brought out in the introductory overview and conclusions by the editors are most timely. Eugenics is not a closed book of past history. It casts a long shadow over both science and society in the Western world and, in fact, also globally.

Historically, the eugenics movement found in the emerging science of classical Mendelian genetics supportive evidence for the utopian theory of the Victorian polymath Francis Galton (1822–1911) of improving society through “selective breeding” of “hereditary genius.”⁴ In the United States, however, under the influence of Charles Davenport (1866–1944), the first director of the Eugenics Record Office at Cold Spring Harbor, New York, positive eugenics became negative “dysgenics.” The emphasis shifted to prevention of the breeding of those perceived as genetically “defective.” These were not only the inmates of institutions and the physically disabled, but the socially and mentally inadequate, as well as the economically disadvantaged, consisting largely of women and children. Categorized by psychologists and psychiatrists as “unfit” or “degenerate,” ranked on the basis of intelligence quotient (IQ) tests,⁵ and diagnosed by neurologists and psychiatrists as “feeble-minded,” they were perceived as a parasitic burden on society and seen to pose a threat to the germ plasm (gene pool) as a whole.⁶ With heredity as the root cause, systematic control of reproduction through compulsory sterilization became a convenient solution to economic, social, moral, and behavioural problems, yet ignored their complexity.

An important aim of the studies assembled in this book is to draw attention to the key role of psychiatrists and clinical psychologists in the interests of spurious societal and institutional benefit. Historically, they provided the ranking, the labels, and the justification to influence the law as to who would be segregated in institutions, involuntarily sterilized, or prevented entry, in the case of immigrants from eastern and southern Europe. Although the primary focus here is on the application of eugenic ideals to the mental health systems and psychiatric institutions in western Canada, the treatment of the subject balances individual experiences, specific cases, and comprehensive critical analyses place eugenics within a broader context of international links. The studies highlight how German-speaking psychiatrists and neurologists during the Nazi period in Europe developed their eugenics programs based on preceding theories from Victorian Britain and methodologies from North America. The contributors to this edited collection demonstrate how the basic eugenics assumptions, arguments, and forms of implementation (e.g., stigmatizing labels, sexual segregation, compulsory sterilization) were continuous despite geographical, political, and cultural differences.

It is highly significant that geneticists, and even ardent progressive eugenicists like Henry J. Muller (1890–1976), despite their enthusiasm for its utopian ideal, had quickly identified the eugenic fallacy in attributing social behaviour, economic, class, and gender differences to inborn causes and heritability, to the exclusion of environmental influences (such as economic depression), as well as its dependence on the subjective, unreliable evidence of “pedigree charts.”⁷

The increasing criticisms of eugenics views by geneticists and biologists for lack of scientific evidence did not halt the tragic consequences of, first, legalized compulsory sterilization in North America and, then, the elimination of those deemed “unworthy of life” in the euthanasia program of Nazi Germany.⁸ What gave rise to bioethics as a discipline was the need to safeguard against such violations of individual rights, whether those of patients or of experimental subjects, in vulnerable segments of society. The editors did not limit contributions to the first half of the twentieth century, however; chapters cover the postwar period too, when eugenics was discredited and genetics separated itself from this precursor “pathological science.”⁹

This volume leaves no doubt that a view of eugenics as a purely historical phenomenon would miss the insights into its powerful legacy and minimize its fundamental relevance to current parallel problems. The potential danger is not the science of genomics, or gene editing on its own, any more than was the scientific introduction of Mendelian genetics into the fields of agriculture and biology. It is the possible resurgence of a form of “biological determinism,”¹⁰ a societal consensus whereby individuals are reduced to the sum of their genes alone, the complex connectome of genetics and environment is disregarded, and this reduction is extended to similarly account for differences in social groups or populations.¹¹ The focus here is on the relation of eugenics to psychiatry, what Stephen Jay Gould diagnosed in his book The Mismeasure of Man as the intrinsic problem: the “pervasive propensity in society” to “use numbers to rank people in a single series of worthiness, invariably to find that oppressed and disadvantaged groups—races, classes, sexes—are innately inferior and deserve their status.”¹²

In the encounter of genomic science and society, the most important safeguard is a critical account and detailed analysis of what occurred with eugenics. This book goes a long way toward bending the moral arc towards justice.¹³

ACKNOWLEDGMENTS

We are truly indebted to the wonderful contributors to this edited collection. Thank you for submitting your valuable scholarship and for your patience throughout the editorial process of this book. We have very much enjoyed your input, discussions, and collaboration on this project.

During the research period for this book, we have been further inspired, constructively motivated, and supported by various colleagues, students, friends, and to a significant extent by the members of the “Living Archives on Eugenics in Western Canada” group. We are extremely grateful and pleased to have the opportunity here to express our sincere gratitude to all of them, even if many will no longer recollect our earlier exchanges, draft discussions, and exciting conversations that we shared during our workshops and continuous research group meetings. We mention most of them here by name, as an expression of our deep gratitude to them: Erika Dyck (team leader, Archives and Collections), Department of History, University of Saskatchewan, Bruce Uditsky (team leader, Reproductive Choice in an Ableist World), CEO Emeritus, Alberta Inclusion; Anne Hughson, Community Rehabilitation and Disability Studies, University of Calgary; John Dossetor, Health Ethics Centre, University of Alberta; Judy Lytton; Amy Kaler, Department of Sociology, University of Alberta; Christine Ferguson, English Studies, University of Glasgow; Nick Supina III, community visual artist; Dick Sobsey (ret.), Department of Educational Psychology and director of John Dossetor Health Ethics Centre, University of Alberta; Gregor Wolbring (team leader, Post-Eugenics Futures), International Centre for Bioethics, Culture, and Disability, University of Calgary; Geoffrey Reaume, Faculty of Health, York University; Doug Wahlsten (ret.), Department of Psychology, University of Alberta; Natasha Nunn (team leader, Technical Team); Michael Billinger; Glenn Griener, Department of Philosophy, University of Alberta; Kathryn Harvey; Kyle Whitfield, Faculty of Extension, University of Alberta; Raymond Frogner; Colette Leung; Rob Wilson (team leader, Eugenics Frames); Alexandra Minna Stern, Department of Medicine, University of Michigan; Molly Ladd-Taylor, History Department, York University; Paul Weindling, Oxford Brookes University; Lene Koch, Department of Health Services, University of Copenhagen; Paul Lombardo, Faculty of Law, Georgetown University; Heidi Janz; Joanne Faulker, ARC Future Fellow, Macquarie University; John Sutton; Wendy Kline, Department of History, University of Cincinnati; Karen Stote, Women and Gender Studies, Wilfrid Laurier University; Allan Garber, Parlee McLaws LLP; Leilani Muir, sterilization survivor, activist, member of the Living Archives on Eugenics Governing Board; and, certainly, Moyra Lang, who as Living Archives on Eugenics project coordinator facilitated and supported the many steps that have finally led to the publication of this volume.

A substantial part of the book was compiled and written when Frank W. Stahnisch held a visiting scholarship at the Centre for the History of Science, Technology, Medicine, and Society at the University of California at Berkeley. There, some of his colleagues read earlier drafts and graciously supported ongoing research steps toward this volume. The Office for History of Science and Technology at Stephens Hall provided a stimulating working milieu, which has thus far been incomparable. At the University of Calgary, our colleagues—especially in the Hotchkiss Brain Institute, the O’Brien Institute for Public Health, the History and Philosophy of Science program, and the Science, Technology, Environment, and Medicine Studies laboratory—have provided a fertile and enriching context in which to complete this project. It has been our pleasure to work with Donna Weich, Beth Cusitar, Mikkel Dack, Brenan Smith, and Keith Hann, whose editorial advice and meticulous correction of the English in this manuscript fostered the writing process. We are furthermore indebted to the gracious support of a community-based research grant entitled “Living Archives on Eugenics in Western Canada – CURA,” from the Social Sciences and Humanities Research Council of Canada, with Professor Robert A. Wilson at the University of Western Australia (formerly at the University of Alberta), as the principal investigator and project director. This financial support helped greatly at all stages of the research and publication process.

The archivists, librarians, and assistants at many libraries and archives provided crucial aid in collecting historical materials (see also the section Archival Sources and Library Collections). We are grateful for their professionalism and have benefitted from their knowledge in finding people, sources, and contextual information. As they are so many, we cannot mention them here by name yet would like to acknowledge the institutions to which we are extremely grateful for the help we received: the Mackie Family Collection in the History of Neuroscience and Taylor Family Digital Library at the University of Calgary; University Library of the University of Alberta; Provincial Archives of Alberta; Provincial Archives of Manitoba; Zweigbibliothek fuer Medizingeschichte of the Humboldt University of Berlin; the Medizinische Zentralbibliothek and the Library of the Humboldt University; the Staatsbibliothek Preussischer Kulturbesitz; the Deutsches Bundesarchiv in Koblenz, Germany; the Aussenarchiv of the Max Planck Institute for Psychiatry; the Archives of the Max Planck Society in Berlin; the Library of the Max Planck Institute for Brain Research in Frankfurt am Main; the German National Library in Frankfurt am Main; the Archives of the Institute for the History of Medicine and Medical Museum at the University of Zurich; Library and Archives Canada in Ottawa; the Rockefeller Foundation Archives in Sleepy Hollow, NY; and the Library of Congress and National Archives and Records Administration in Washington, DC.

We also thank Athabasca University Press in Edmonton for encouraging this project and for making this volume on the history of eugenics and its intricate connections with the history of psychiatry and neurology possible. In particular, we wish to include Megan Hall, Pamela Holway, Alison Jacques, Connor Houlihan, Marvin Harder, and Sergiy Kozakov along with two anonymous reviewers who commented thoroughly on our earlier manuscript.

Finally, we wish to extend special thanks to our colleagues in the University of Calgary’s History of Neuroscience Interest Group, who gave us frequent and highly constructive feedback during the planning and writing phases of this book. We would also like to thank the Awards to Scholarly Publications Program of the Canadian Federation for the Humanities and Social Sciences for their support.

Frank W. Stahnisch and Erna Kurbegović

PROLOGUE Eugenics and Its Study

Robert A. Wilson

As the current volume attests, contemporary academic and public interest in the history of eugenics and its contemporary significance continues to grow. The volume’s focus on the role of psychiatry in the eugenics movement in Canada and internationally and the relationship between eugenics and psychiatry more generally allows a multidirectional start to be made on raising and addressing difficult questions that have remained unasked. The Living Archives on Eugenics in Western Canada project is pleased to have been able to offer support both for the workshop at which many of the papers here were first presented and for the publication of this book.

My comments are organized around three chief thematic tasks. First, I will provide some idea of the trajectory of the scholarship on eugenics over the past thirty-five years that set the context for the contributions to the current volume. Second, I will articulate a view of the relationships between eugenics and disability, on the one hand, and eugenics past and eugenics present, on the other. This should make it clear that eugenics and eugenic thinking are of more than historical interest. And third, I will make some remarks more directly relevant to the book’s specific focus on the connections between eugenics and psychiatry—connections that have been underexplored in the literature to date, to which this collection makes a significant contribution. The second of these themes is the focus of the admirable commentaries by Marc Workman (chapter 9) and by Gregor Wolbring (chapter 10), while the editors’ introduction and their concluding chapter both articulate a detailed view on the third of these themes. My own general views on eugenics have been developed in a number of publications in the past few years.¹

FROM ARCHIVES TO ACTIVISM

Between the appearance of historian Daniel Kevles’s In the Name of Eugenics, with its focus on the relationship between biological science and eugenics, and legal scholar Paul Lombardo’s Three Generations, No Imbeciles, on the famous Buck v. Bell case, interest spread steadily among scholars in articulating the broader relevance of the history of eugenics for a cluster of contemporary issues.² This cluster ranged from issues of reproductive autonomy to science and scientism, biological (particularly genetic) determinism, and disability and human variation. Since 2010, the contemporary resonances of eugenics have spiked, not only in concert with ongoing concerns about emerging biotechnologies (such as CRISPR), but also as there has been further reflection on broader social policies, such as forced child removal and immigration restriction, as means of achieving eugenic ends.

Accordingly, the ways in which eugenics has been taken up by scholars have diversified during this time and the resulting scholarship has increasingly connected with issues of ongoing significance for people marginalized in our societies by eugenic ideas, practices, and policies. For example, recent years have seen the publication of a major handbook on the history of eugenics, several journals that have dedicated special issues to eugenics, books exploring eugenics in North America in more detail, as well as those focused particularly on eugenics in Alberta, and the appearance of eugenic survivor testimony and memoirs.³ The present volume continues and extends this trend into the domain of psychiatry, though the task of integrating this extension with emerging work within the Mad Pride movement headed by psychiatric survivors remains one for future scholarship.⁴

Recognition of the need for public engagement around eugenics can be understood against two dissonant social contexts that are especially poignant in North America. First, in the early 2000s, official apologies were made by the governments of four of the thirty-one American states to have passed eugenic sterilization laws: Virginia, Oregon, and North Carolina, in 2002, and California, in 2003. These apologies followed in the wake of over eight hundred settled legal actions in Alberta, Canada, brought by sterilization survivors against the Government of Alberta for wrongful confinement and sterilization under the province’s Sexual Sterilization Act (1928–72), as well as revelations of the relative recency of eugenic sterilization in the Scandinavian countries.⁵ Second, in the past ten years it has been revealed that sexual sterilization continues to be practised in several disparate circumstances: for example, on women and girls with intellectual disabilities in Australia, and on women in the California prison system.⁶ While the settlements and apologies were intended to make it clear that eugenics was a matter of a regrettable past, that view is undermined by ongoing sterilization of just the sorts of people who were the target of past eugenics policies and laws. The dissonance here, in turn, raises questions about the forms that eugenic policy takes beyond sterilization, and the manifestations of “newgenic” thought and practice that exist now, well beyond the explicit, self-conscious eugenics era of the past.

UNDERSTANDING DISABILITY AND NEWGENICS

Disability has never been far beneath the surface in the trading zone between eugenics past and newgenics present.⁷ Perceived and ascribed disabilities of body and mind were one of the core traits that provided the basis for institutionalization and sterilization on eugenic grounds for the first seventy-five years of the twentieth century. This is so even though, as Douglas Wahlsten shows in chapter 2, the basis for policies of sexual segregation and sterilization reflected ignorance and confusion about the basics of genetics and the nature of inheritance of what elsewhere I call “eugenic traits.”⁸ Since that time, the eugenic preoccupation with the character of future generations has seeped into what have become everyday practices in the realm of reproductive choice. As Marsha Saxton and Adrienne Asch have forcefully argued, the use of prenatal screening technologies to facilitate the selective abortion of fetuses with features that signify disabling traits—the paradigm here being trisomy 21 in a fetus indicating Down Syndrome in the child—expresses a negative view of such disabilities sufficient to warrant terminating an otherwise wanted pregnancy.⁹ The eliminative structure of what disability theorist Rosemary Garland-Thomson has called eugenic logic persists in contemporary practices governing reproductive choice, social inclusion, and democratic participation and their relationship to disability.¹⁰

The assumption that it would be better if disability simply did not exist, which underlies eugenic logic, runs deep in contemporary social thought and practice, deep enough to pass as common sense. That those who would make the same assumption about dark-skinned people would be critiqued as harbouring racism serves as a marker of how distinctively disability is presently conceptualized as something negative: misfortunate, regrettable, limiting, disease-like, in need of elimination. This tie between eugenics and contemporary disability studies, however, also suggests (less depressingly) that eugenics and reflection on its history can also play a more positive role in disability politics. Survivor testimony of what it was like to be housed in the training schools for the feeble-minded and subjected to dehumanization beyond strictly eugenic policies constitutes a major source of knowledge about eugenics in Alberta. Revelations of the lackadaisical application of intelligence tests, of the use of those deemed to be “morons” to care for so-called “low-grade” children, and of the effects of extensive psychotropic experimentation by the medical superintendent at the Provincial Training School for Mental Defectives (PTS), Dr. Leonard J. Le Vann (1915–87), are just three examples.¹¹

As we move to articulate a more complex and complete collective memory of the explicitly eugenic era, I suspect that such survivor knowledge will increasingly reinforce and support the view that the disability activism slogan “nothing about us without us” has epistemic as well as political resonance.¹² Together with the standpoint of those surviving newgenics, this insider witnessing of eugenics opens up a role for oral history in reflecting on the question, What sorts of people should there be? Like other neutral-sounding questions, surface appearances here mask the fact that this one sits very differently with those on either side of eugenic logic.

EUGENICS AND PSYCHIATRY

The most prominent cluster of traits that featured as the basis for eugenic sterilization policies in North American and Europe were mental or psychological, falling into two traditional categories: the first—including so-called mental deficiency, mental defectiveness, feeble-mindedness, idiocy, and imbecility—concerned people with or deemed to have subnormal levels of intelligence, typically from birth and often ascribed from early in childhood; the second was the paradigmatic concern of psychiatry and psychiatrists: insanity, lunacy, psychosis, madness.¹³ Even though psychologists—the non-medical competitor to psychiatrists—were in effect the gatekeepers to feeble-mindedness through their development and adoption of intelligence testing and their special connection to childhood research and education, psychiatrists played an active role in the administration and enforcement of eugenic policies, especially in Europe, as documented in a number of the contributions to the current volume.¹⁴

Psychologists used intelligence quotient (IQ) tests as their major diagnostic technological weapon in the eugenic “war against the weak,” and their role in the eugenic past has a long history of having been well discussed by scholars.¹⁵ The contribution of psychiatrists, by contrast, is lesser known and is sometimes thought to be more contingently related to the profession of psychiatry and more idiosyncratic. Again, the present volume challenges this view and constitutes the beginnings of a more systematic consideration of psychiatry, alongside psychology and genetics, as forming one of the many disciplinary branches in the eugenic tree. Together with neurologists, psychiatrists are clinicians of the brain and of the presumed departures from its normal function that lead to failures in the nervous system and psychiatric symptoms.¹⁶ German psychiatrist Emil Kraepelin’s (1856–1926) views of nervous degeneration and the psychiatric genetics of Ernst Ruedin (1874–1952)—both discussed in several of the chapters herein—and, more generally, hereditary views of psychiatric traits represent major ways in which psychiatry influenced the trajectory of eugenics.¹⁷ The scientific authority that psychiatry inherited from its medical standing, however, gave the discipline a much broader role in diagnosis, treatment, and recommendation than it would otherwise have had.

In Canada, perhaps as elsewhere, what could pass for scientific authority was sometimes surprising. Dr. John MacEachran (1877–1971), chair of the Alberta Eugenics Board for most of its forty-three-year history—and the subject of chapter 1, by Henderikus J. Stam and Ashley Barlow—occupied that role not only by virtue of his position as the long-standing provost of the University of Alberta (1911–45), but also as the founding chair of what was to become its Department of Philosophy, Psychology, and Education. MacEachran’s scientific authority rested at least in part in his being perceived as a psychologist, despite the fact that his two doctoral dissertations were both squarely within the discipline of philosophy. Moreover, MacEachran never, so far as I can determine, published a single paper in psychology in his long career and life. Likewise, Dr. Le Vann, medical superintendent of the PTS from 1949 until 1974, passed himself off as a psychiatrist when he in fact had no such accreditation in Canada, as was revealed in the 1995 lawsuit that eugenics survivor Leilani Muir brought against the province of Alberta for wrongful confinement and sterilization.¹⁸ Le Vann’s authority as a putative psychiatrist likely made it easier for him to engage in psychotropic drug experimentation on children at the PTS and may even have been partially responsible for his initial appointment as the medical superintendent there.

What this says about the strength of eugenic ideology, about the seriousness of confining and sterilizing those deemed feeble-minded, and about the tangled relationships between eugenics, institutionalization, and clinical sciences, including psychiatry, will be informed by the kind of work that the present volume undertakes as well as that in the field of philosophical psychiatry.¹⁹

PSYCHIATRY
AND THE
LEGACIES
OF EUGENICS

FOREWORD

ACKNOWLEDGMENTS

PROLOGUE Eugenics and Its Study

FROM ARCHIVES TO ACTIVISM

UNDERSTANDING DISABILITY AND NEWGENICS

EUGENICS AND PSYCHIATRY

LIST OF FIGURES AND TABLES

FIGURES

List of Tables

PSYCHIATRY AND THE LEGACIES OF EUGENICS

FOREWORD

ACKNOWLEDGMENTS

PROLOGUE Eugenics and Its Study

FROM ARCHIVES TO ACTIVISM

UNDERSTANDING DISABILITY AND NEWGENICS

EUGENICS AND PSYCHIATRY

LIST OF FIGURES AND TABLES

FIGURES

List of Tables

PSYCHIATRY
AND THE
LEGACIES
OF EUGENICS