White Coat Underground

I’m actually rather surprised that the movement to castrate autistic kids isn’t more in the news. Parents of autistic kids are very good at advocacy, so where are they on this one? On the other hand, the abuse of the mentally and cognitively disabled is so ingrained in our society, that perhaps these parents can’t even see it.

The idea of castrating undesirables is not new. An American eugenics movement arose in the early part of the 20th century, leading to eugenics legislation, such as the Johnson Immigration Act of 1924. To give you an idea of some of the thinking that went into this legislation:

Thank God we have in America perhaps the largest percentage of any country in the world of the pure, unadulterated Anglo-Saxon stock; certainly the greatest of any nation in the Nordic breed. It is for the preservation of that splendid stock that has characterized us that I would make this not an asylum for the oppressed of all countries, but a country to assimilate and perfect that splendid type of manhood that has made America the foremost Nation in her progress and in her power, and yet the youngest of all the nations.

—Senator Ellison DuRant Smith (SC)

The Strangeloveian prose may sound quirky to the modern ear, but this thinking was common, and led to real world horror. For this (and for political reasons), Jews were left to die in Europe, and Americans of “inferior breeding” were imprisoned and sterilized.

A little knowledge can be a dangerous thing. Just as Creationists understand just enough evolutionary theory to get it spectacularly wrong, American eugenicists knew just enough (and the average American next to nothing) about the heritability of traits to make it conform to their ideologies, regardless of the accuracy of their interpretations. The infamous Supreme Court case of Buck v. Bell in 1927, which upheld a Virginia law requiring the sterilization of the mentally retarded gave us the famous quote from Justice Oliver Wendell Holmes, “Three generations of imbeciles are enough.” No one was going to question the heritability of “imbecility”; it was a convenient truth, and it was going to stay that way. And lest you think that Holmes was simply hurling invective, “imbecile” was a technical term: it referred to people with an IQ of 26-50, and lay between”moron” (IQ of 51-70) and “idiot” (IQ of 0-25). The term “mongolian idiot” was the official nomenclature for Trisomy 21 (Down’s syndrome) because of the cognitive disability and eye shape characteristic of these people.

So Holmes was using the language of science to perpetrate an inhumane and unscientific practice that fit the ideology of the times (and lest you think this is a distant historical relic, the Virginia law wasn’t repealed until 1974). Of course, sterilization was too useful a tool of social control to limit it to “imbeciles”; In Angela Davis’s book, Women, Race, and Class, Davis documents that between 1964 and 1981 about 65 percent of South Carolina sterilizations were performed on African Americans.

The history of forced sterilization in the U.S. may not be well-remembered, but it is long and dark. If we are to protect some of our most vulnerable, we must change our ahistorical thinking. And, yes, chemical castration, as is being practiced on autistic children, is not the same as actual sterilization. In some ways, it’s worse. It interferes with normal growth and development, perhaps adding life-long psychological and physical disabilities to the cognitive and social problems that already exist. It does, however, share at least one fundamental characteristic with forced sterilization: it is a crime against humanity.

Comments

#1 Sam C
May 24, 2009

Has it occurred to you that people in 50 years time might be sneering at the misguided views of people of our time in the same way that we sneer at the views from 50 years ago that we find disgusting, disquieting or abhorrent?

That’s not to defend any of the inhumane views and treatments of the past that you describe here. But it is as well to realise that we too might have views that won’t look too good in the mirror of history. We are a product of our time just as they were of theirs.
#2 Denice Walter
May 24, 2009

And the illustrative quote by (the well-named) *duRant* Smith sounds as anachronistic as any from the Social Darwinists(Spencer, Sumner,others)of a hundred years ago.Coincidentally, I spent yesterday walking around the fabled “Lower East Side”(NYC)among the “Millenials”(20-somethings)who don’t seem to care much for ethnic labels as they search out clothing bargains and *au courant* cafes.On Orchard St., there is actually a “tenement museum” celebrating immigration and ethnic diversity.Things change.Well, for *most* of us, anyway.
#3 Colin
May 24, 2009

Sam,

The ultimate definitions of inhumanity don’t really change – what has changed is the perception of *when* certain cruelties are ‘allowed’. If anything, the consideration of how we may be looked back upon should make us strive to always do everything as ethically as possible. I don’t think we can look around at industrialised society today and identify anything as perniciously evil as slavery because we, as a society, have spent the last few hundred years fighting for human rights. Equality is a difficult goal to acheive and it takes time (here at the University of Cambridge the last male-only college accepted their first women undergraduates in 1988), and we still have work to do on the gender equality front, but the simple fact that we sneer at the despicable views of despicable people doesn’t mean we shouldn’t uphold human rights and ethics principles. If people look back at us in 50 years time with our crazy talk about ‘not castrating disabled people’ and ‘not torturing prisoners of war’ in a bad light, then shame on them.

Incidentally, PalMD, another nice comparison is insulin shock therapy. Insulin shock therapy was used as a ‘treatment’ for schizophrenia between the 1930s and 1970s (administering insulin to induce a coma). It appears to have little effect and is apparently very traumatic (information all taken very quickly from Wikipedia: I must say I don’t know very much about the nuances of this therapy). The difference being that it was endorsed by the scientists (although my high school course in phsycology left me a little doubtful as to the competence and/or rigor of early 19th century psychologists).
#4 Dianne
May 24, 2009

Has it occurred to you that people in 50 years time might be sneering at the misguided views of people of our time in the same way that we sneer at the views from 50 years ago that we find disgusting, disquieting or abhorrent?

I certainly hope so. Among other things, I’m hoping people sneer at the unenlightened fools who opposed marriage rights for some people simply based on their sexual orientation and the moral zombies who defended waterboarding. But there’s probably something else going on that is going to horrify future generations that I don’t even notice as well.
#5 Patience
May 25, 2009

Has it occurred to you that people in 50 years time might be sneering at the misguided views of people of our time in the same way that we sneer at the views from 50 years ago that we find disgusting, disquieting or abhorrent?

I should certainly hope that this applies to chemically castrating children who have done nothing wrong but be born neurologically different than the norm.
#6 megan
May 25, 2009

Maybe people should have a right to know the chances of passing on something debilitating to take steps if they choose to procreate to prevent it from affecting their progeny. People genetically select and test IVF embryos all the time. Why is autism given a no touch but women with breast cancer look to prevent it from occurring as their offspring get older and that’s okay. If one can mitigate the environmental and hereditary chances then they should be given that help and option but not forced or government mandated. Most people wouldn’t choose to burden themselves, family and society by willingly selecting to have physical and mental genetic restraints by birth and circumstances. The fact society provides altruistic means for those individual to not become failed selections that die off from not being able to compete/survive shouldn’t then foster ignoring cures and prevention solutions.
#7 hedberg
May 25, 2009

Is there a shortage of commas in the world? That would explain their parsimonious use, I suppose.

Here are some from my private stash; use as you wish:

,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
#8 The Blind Watchmaker
May 27, 2009

The Geier’s horrid practice stems (like most pseudosciences)from a single false premise. They still think that ethyl mercury is causing autism. This has been proven wrong, but they still cling to it as truth.

Their subsequent thought process stems from this single false premise and their denialism of the truth.

From this premise they speculate that testosterone binds the mercury which makes it more chemically available. Boys have higher testosterone, therefore (according to them), they have more autism. By shutting down the testosterone with Lupron, they will lower the bioavailability of the mercury. (If this doesn’t cause enough damage, they will then attempt to kill the child with chelation).

Now, even if the premise were true, this hypothesis will still be preposterous as pointed out by Orac.

Now, even if the Lupron hypothesis was true, the end results would be unthinkable (a kid with a screwed up sexual development).

So, we have a major false premise, followed by a preposterous hypothesis with an unthinkable result.

No wonder they are so popular!
#9 Dr Benway
May 28, 2009

The notion of chemical castration doesn’t strike me as horrifying or cruel. If Lupron would allow a violent, non-verbal boy a chance at a more normal life, it might be a reasonable therapy.

But that’s a big “if.”

What really bothers me is this: an experimental therapy is being used on a population unable to provide consent and outside of the structure of a registered clinical trial. Patients will bear the risk of this unproven therapy while we learn nothing useful for future patients.

When patients can’t make their own decisions, experimental therapies outside of a registered trial are not ethical. We must minimize experimentation with this population. We can’t do that without appropriate oversight and data collection every time some unproven treatment is used.