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The Origin And Nature Of Our Institutional Models
Failure of Preventive Marriage Laws. In order to understand how institutions for the retarded in the United States developed as they did, we must understand the failure of alternative provisions.
During the indictment period, the only hope seen was in the prevention of procreation of individuals likely to produce retardates. Three methods suggested themselves: forbidding the mating of retardates by law; preventing procreation, of those retardates who might mate, by sterilization; and preventing both mating and procreation, by means of segregation.
Outlawing of procreation was attempted early in the alarmist period. In about 1895, House Bill 681, containing the following provision, was passed in Connecticut:
"Every man who shall carnally know any female under the age of forty-five years who is epileptic, imbecile, feeble-minded, or a pauper, shall be imprisoned in the State prison not less than three years. Every man who is epileptic who shall carnally know any female under the age of forty-five years, and every female under the age of forty-five years who shall consent to be carnally known by any man who is epileptic, imbecile, or feeble-minded, shall be imprisoned in the State prison not less than three years" (Beedy, 1895, p. 468). Similar bills were soon passed, and some of these bills are still on the books today. A national marriage law to prohibit marriage to the feeble-minded and insane was proposed as early as 1897 by Wells (1897), and was widely supported. In 1899, what is now the American Association on Mental Deficiency appointed a committee to explore cooperation with the National Conference on Charities and Correction, the Prison Congress, the Medico-Psychological Society, and other bodies that might be interested in supporting restrictive marriage laws (J. Psycho-Asthenics. 1899, 3, pp. 194-195). By 1900, Wilmarth (1902, p. 156) had this to say: "There are only two remedies for the abatement of this evil in the class of which we speak to-day. The seclusion of feeble-minded and epileptic adults, especially females between the ages of fifteen and forty-five who are liable to become willing subjects to man's rascality, and the passing of such laws as shall prevent the marriage of defectives, or the living together as man and wife of any one with a defective person."
The ineffectiveness of marriage laws was soon recognized: "Restrictive marriage laws are no doubt advisable, but . . . unavailing because the unfit reproduce their kind regardless of marriage laws" (Murdoch, 1913, pp. 36-37). Alas, sex, even less than alcohol later on, was not easily outlawed. However, sterilization suggested itself as a reasonable alternative.
Failure of Preventive Sterilization. Sterilization, or as it was also called, asexualization and unsexing, was apparently first advocated to a significant degree in the mid-1890's. Like virtually all administrative measures which the nondeviant design to manage the deviant, sterilization was often rationalized as being to the retardate's advantage. Barr (1902) called for "... invoking the aid of surgical interference to secure . . . greater liberty, therefore, greater happiness to the individual" (p. 5).
In 1902, Nicholson (p. 495) ended the discussion of papers on the "feeble-minded and epileptic" at the Detroit National Conference on Charities and Correction by stating that "the only way to get rid of such imbeciles is to stop raising them." A more direct tact was taken by Perry (1903, p. 254): "... It would now be well to prepare our several states to call to our assistance the surgeon's knife to prevent the entailing of this curse upon innocent numbers of yet unborn children." Barr asked: "... Knowing the certain transmission of such taint, how can one fail to appreciate the advantage of prevention over penalty, or to recognize as the most beneficient instrument of law the surgeon's knife preventing increase. And why not? We guard against all epidemics, are quick to quarantine small-pox, and we exclude the Chinese; but we take no steps to eliminate this evil from the body social" (1902, p. 163).
It was soon recognized that sterilization, in order to reduce the number of retardates to an appreciable extent, had to be compulsory, and such laws were passed throughout the nation and generally upheld by the courts. (5) However, it was also found that sterilization laws were only slightly more enforceable than mating laws; that not all retardates were reached by the laws; and that sterilization would not prevent as many cases of retardation as had been thought: "Compulsory surgical sterilization of all defectives is proposed as a radical method for preventing the hereditary transmission of feeble-mindedness. At least six states have passed laws authorizing or requiring this operation. In no state, however, has this remedy been applied on a large scale. There are many objections to this plan. The friends of the patients are not willing to have the operation performed. The normal 'carriers' of defect would not be affected. The presence of these sterile people in the community, with unimpaired sexual desire and capacity would be direct encouragement of vice and a prolific source of venereal disease. Sterilization would not be a safe and effective substitute for permanent segregation and control" (Fernald, 1915, pp. 95-96).
(5) An apparently widely held view was stated by Taylor (1898), who reasoned that if procreation was rendered impossible by surgery, there would be no further value in preserving the sexual instinct of the retardate. Since much harm was seen to result in the cultivation or even retention of this instinct, Taylor recommended that it would be just as well "... to remove the organs which the sufferers are unfit to exercise normally, and for which they are the worse in the unnatural cultivation or use" (p. 81). Thus, for males, castration was widely preferred over vasectomy (Cave, 1911; Van Wagenen, 1914). In one stroke, it not only accomplished sterilization; it also eliminated "sexual debaucheries" (Cave) and masturbation (Van Wagenen), and perhaps even improved "the singing voice" (Barr, 1905) and diminished epileptic seizures (Barr, 1904). Sometimes, castration was performed "... after exhausting every other means ..." as a "... cure for masturbation," even without a perceived need for sterilization (Reports from States, 1895, p. 348). By 1914, sterilization was used not only for eugenic but also for penal reasons, sometimes in addition to a prison sentence. The courts upheld this measure as constituting neither cruel nor unusual punishment for certain crimes (Van Wagenen). In cases there vasectomy was performed, retardates did "not require an anesthetic since all that is required is to cut the vas defrens" (Risley, 1905, p. 97)