Similarly the hereditarily insane and epileptic can best be cared for through life-long segregation—a course which society is likely to adopt readily, because of a general dread of having insane and epileptic persons at liberty in the community. There are undoubtedly cases where the relatives of the affected individual can and should assume responsibility for his care. No insane or epileptic person whose condition is probably of a hereditary character should be allowed to leave an institution unless it is absolutely certain that he or she will not become a parent: if sterilization is the only means to assure this, then it should be used. In many cases it has been found that the individual and his relatives welcome such a step.
The habitual criminals, the chronic alcoholics, and the other defectives whom we have mentioned as being undesirable parents, will in most cases need to be given institutional care throughout life, in their own interest as well as that of society. This is already being done with many of them, and the extension of the treatment involves no new principle nor special difficulty.
It should be borne in mind that, from a eugenic point of view, the essential element in segregation is not so much isolation from society, but separation of the two sexes. Properly operated, segregation increases the happiness of the individuals segregated, as well as working to the advantage of the body politic. In most cases the only objection to it is the expense, and this, as we have shown, need not be an insuperable difficulty. For these reasons, we believe that segregation is the best way in which to restrict the reproduction of those whose offspring could hardly fail to be undesirable, and that sterilization should be looked upon only as an adjunct, to be used in special cases where it may seem advantageous to allow an individual full liberty, or partial liberty, and yet where he or she can not be trusted to avoid reproduction.
Having reached this point in the discussion of restrictive eugenics, it may be profitable to consider the so-called "eugenic laws" which have been before the public in many states during recent years. They are one of the first manifestations of an awakening public conscience on the subject of eugenics; they show that the public, or part of it, feels the necessity of action; they equally show that the principles which should guide restrictive eugenics are not properly understood by most of those who have interested themselves in the legislative side of the program.
Twelve states now have laws on their statute books (but usually not in force) providing for the sterilization of certain classes of individuals. Similar laws have been passed in a number of other states, but were vetoed by the governors; while in many others bills have been introduced but not passed. We shall review only the bills which are actually on the statute books in 1916, and shall not attempt to detail all the provisions of them, but shall consider only the means by which they propose to attain a eugenic end.
The state of Indiana allows the sterilization of all inmates of state institutions, deemed by a commission of three surgeons to be unimprovable physically or mentally, and unfit for procreation. The object is purely eugenic. After a few hundred operations had been performed in Jeffersonville reformatory, the law aroused the hostility of Governor Thomas R. Marshall, who succeeded in preventing its enforcement; since 1913 we believe it has not been in effect. It is defectively drawn in some ways, particularly because it includes those who will be kept in custody for life, and who are therefore not proper objects of sterilization.
The Washington law applies to habitual criminals and sex offenders; it is a punitive measure which may be ordered by the court passing sentence on the offender, but has never been put in force. Sterilization is not a suitable method of punishment, and its value as a eugenic instrument is jeopardized by the interjection of the punitive motive.
California applied her law to all inmates (not voluntary) of state hospitals for the insane and the state home for the feeble-minded, and all recidivists in the state prisons. The motive is partly eugenic, partly therapeutic, partly punitive. It is reported[88] that 635 operations have been performed under this law, which is administered by the state commission for the insane, the resident physician of any state prison, and the medical superintendent of any state institution for "fools and idiots." For several years California had the distinction of being the only state where sterilization was actually being performed in accordance with the law. The California measure applies to those serving life sentences—an unnecessary application. Although falling short of an ideal measure in some other particulars, it seems on the whole to be satisfactorily administered.
Connecticut's law provides that all inmates of state prisons and of the state hospitals at Middletown and Norwich may be sterilized if such action is recommended by a board of three surgeons, on eugenic or therapeutic grounds. It has been applied to a few insane persons (21, up to September, 1916).
Nevada has a purely punitive sterilization law applying to habitual criminals and sex offenders. The courts, which are authorized to apply it, have never done so.